Tangon Narongsak, Kumfu Sirinart, Chattipakorn Nipon, Chattipakorn Siriporn C
Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Microbiol Res. 2025 Mar;292:128005. doi: 10.1016/j.micres.2024.128005. Epub 2024 Dec 8.
Immunoglobulin A nephropathy (IgAN) is the most prevalent form of primary glomerulonephritis globally, yet its pathogenesis remains incompletely understood. While much research has focused on the gut microbiome in the development of the disease, emerging evidence suggests that the oropharyngeal microbiota may also be a potential contributor. Studies have revealed significant alterations in oropharyngeal microbial diversity and specific bacterial taxa in IgAN patients, correlating with disease severity and progression. This review aims to comprehensively summarize and discuss the key findings from in vitro, in vivo, and clinical studies into the oropharyngeal bacteria and microbiome alterations in IgAN. Clinical studies have identified associations between certain oropharyngeal bacteria, particularly CnmStreptococcus mutans, Campylobacter rectus, and Porphyromonas gingivalis with IgAN patients and severe clinical outcomes with. In vitro and in vivo studies further establish a causal relationship between IgAN and oropharyngeal bacteria such as Streptococcus and Haemophilus. Microbiome analyses demonstrate dysbiotic patterns in IgAN patients and identify new potential bacterial genera that have yet to be explored experimentally but may potentially contribute to the disease's pathogenesis. Additionally, the use of these bacterial genera as diagnostic and prognostic biomarkers of IgAN has achieved promising performance. Overall, the evidence highlights the strong connection between oropharyngeal bacteria and IgAN through both causal and non-causal associations. Further investigation into these newly identified bacterial genera and integration of multi-omics data are necessary to uncover mechanisms, validate their role in IgAN, and potentially develop novel diagnostic and therapeutic approaches.
免疫球蛋白A肾病（IgAN）是全球原发性肾小球肾炎最常见的形式，但其发病机制仍未完全明确。虽然许多研究聚焦于肠道微生物群在该疾病发生发展中的作用，但新出现的证据表明，口咽微生物群也可能是一个潜在因素。研究显示，IgAN患者的口咽微生物多样性和特定细菌类群有显著改变，且与疾病严重程度和进展相关。本综述旨在全面总结和讨论体外、体内及临床研究中关于IgAN患者口咽细菌及微生物群改变的关键发现。临床研究已确定某些口咽细菌，特别是变形链球菌（CnmStreptococcus mutans）、直肠弯曲菌（Campylobacter rectus）和牙龈卟啉单胞菌（Porphyromonas gingivalis）与IgAN患者及严重临床结局之间存在关联。体外和体内研究进一步证实了IgAN与链球菌和嗜血杆菌等口咽细菌之间的因果关系。微生物群分析显示IgAN患者存在生态失调模式，并识别出尚未进行实验探索但可能对疾病发病机制有潜在影响的新的潜在细菌属。此外，将这些细菌属用作IgAN的诊断和预后生物标志物已取得了良好效果。总体而言，证据表明口咽细菌与IgAN之间通过因果和非因果关联存在紧密联系。进一步研究这些新发现的细菌属并整合多组学数据，对于揭示发病机制、验证它们在IgAN中的作用以及开发新的诊断和治疗方法很有必要。
