Zhi Wenqiang, Li Aizhong, Wang Qian, Yuan Xiaoli, Qing Jianbo, Zhang Caixiang, Wang Yuxin, Li Yafeng
The Nephrology Department of Shanxi Provincial People's Hospital, Shanxi Medical University, Taiyuan, 030001, China.
Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China.
Sci Rep. 2024 Oct 2;14(1):22935. doi: 10.1038/s41598-024-74171-4.
To assess the safety and efficacy of fecal microbiota transplantation (FMT) as an adjunctive therapeutic intervention for IgA nephropathy (IgAN). Fifteen patients with IgA nephropathy were recruited based on inclusion and exclusion criteria and underwent FMT using enteric microbial capsules. Clinical indicators, intestinal microbiota and metabolomic profiles, as well as changes in serum immune cells and cytokines, were monitored before and after FMT. No severe adverse reactions were observed in the subjects. After FMT, there was a reduction in the 24-h urinary protein quantification in subjects. The relative abundances of Phocaeicola_vulgatus, Bacteroides_uniformis, Prevotella_copri, Phocaeicola_dorei, Bacteroides_ovatus, Bacteroides_xylanisolvens, Parabacteroides _distasonis, Bifidobacterium_pseudocatenulatum, Bacteroides_sp._HF-162, and Bifidobacterium_longum changed after FMT. In terms of intestinal metabolites, the levels of acylcarnitine18:0 (ACar.18:0), cotinine, N-arachidonoyl-L-serine, phosphatidylcholine (PC. (18:3e/22:6)), serotonin, and fumagillin showed significant changes. Flow cytometry analysis showed the absolute count of plasma B cells decreased in subjects, and this change correlated with alterations in the intestinal microbiota and metabolites. This study preliminarily evaluates the safety and efficacy of FMT in patients with IgAN. No significant adverse reactions were observed, and the administration of FMT alongside ACEI/ARB therapy was effective in reducing urinary protein levels in patients with IgAN, a process that may be associated with B-cell immunity.
评估粪便微生物群移植(FMT)作为IgA肾病(IgAN)辅助治疗干预措施的安全性和有效性。根据纳入和排除标准招募了15例IgA肾病患者,并使用肠溶微生物胶囊进行FMT。在FMT前后监测临床指标、肠道微生物群和代谢组学谱,以及血清免疫细胞和细胞因子的变化。受试者未观察到严重不良反应。FMT后,受试者24小时尿蛋白定量降低。FMT后,普通拟杆菌、均匀拟杆菌、粪普雷沃菌、多雷拟杆菌、卵形拟杆菌、木聚糖解拟杆菌、狄氏副拟杆菌、假链状双歧杆菌、HF-162拟杆菌属和长双歧杆菌的相对丰度发生了变化。在肠道代谢物方面,酰基肉碱18:0(ACar.18:0)、可替宁、N-花生四烯酰-L-丝氨酸、磷脂酰胆碱(PC.(18:3e/22:6))、血清素和烟曲霉素水平出现显著变化。流式细胞术分析显示受试者血浆B细胞绝对计数减少,且这种变化与肠道微生物群和代谢物的改变相关。本研究初步评估了FMT对IgAN患者的安全性和有效性。未观察到明显不良反应,在ACEI/ARB治疗的基础上进行FMT可有效降低IgAN患者的尿蛋白水平,这一过程可能与B细胞免疫有关。