Li Xiao-Jun, Shan Qi-Yuan, Wu Xin, Miao Hua, Zhao Ying-Yong
School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, No. 548 Binwen Road, Hangzhou, 310053, Zhejiang, China.
State Key Laboratory of Kidney Diseases, First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
Cell Mol Life Sci. 2024 Dec 5;81(1):480. doi: 10.1007/s00018-024-05532-5.
Gut microbiota is a complex and dynamic system that plays critical roles in human health and various disease. Progressive chronic kidney disease (CKD) suggests that patients irreversibly progress to end-stage kidney disease and need renal replacement treatments, including dialysis and transplantation. Ample evidence indicates that local oxidative stress and inflammation play pivotal roles in the pathogenesis and progression of CKD and dysbiosis of gut microbiota. CKD is always accompanied by intestinal inflammation and oxidative stress, which lead to rapid systemic translocation of bacterial-derived uraemic toxins, including indoxyl sulphate, phenyl sulphate and indole-3-acetic acid, and the consequent development and aggravation of renal fibrosis. Although inflammation and oxidative stress have been extensively discussed, there is a paucity of reports on the effects of gut microbiota on renal fibrosis and gut microbiota mediation of oxidative stress and inflammation. This review provides an overview of gut microbiota on inflammation and oxidative stress in renal fibrosis, briefly discusses regulation of the gut flora using microecological preparations and natural products, such as resveratrol, curcumin and emodin as treatments for CKD, and provides a clear pathophysiological rationale for the design of promising therapeutic strategies.
肠道微生物群是一个复杂的动态系统，在人类健康和各种疾病中发挥着关键作用。进行性慢性肾脏病（CKD）意味着患者会不可逆转地进展至终末期肾病，需要进行肾脏替代治疗，包括透析和移植。大量证据表明，局部氧化应激和炎症在CKD的发病机制和进展以及肠道微生物群失调中起关键作用。CKD常伴有肠道炎症和氧化应激，这会导致细菌源性尿毒症毒素（包括硫酸吲哚酚、硫酸苯酯和吲哚 - 3 - 乙酸）迅速发生全身转运，进而导致肾纤维化的发展和加重。尽管炎症和氧化应激已被广泛讨论，但关于肠道微生物群对肾纤维化的影响以及肠道微生物群对氧化应激和炎症的介导作用的报道却很少。这篇综述概述了肠道微生物群在肾纤维化中的炎症和氧化应激方面的作用，简要讨论了使用微生态制剂和天然产物（如白藜芦醇、姜黄素和大黄素）调节肠道菌群作为CKD的治疗方法，并为设计有前景的治疗策略提供了明确的病理生理学依据。
