Zhou Shengnan, Yan Yinyin, Chu Rui, Chen Na, Wang Li, Zhang Hongxia, Wang Yan, Wang Mengting, Na Li, Ren Hongyan, Chen Menghua, Li Philip Kam-Tao, Tian Na
Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China.
The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shanxi, China.
Sci Rep. 2024 Dec 28;14(1):31413. doi: 10.1038/s41598-024-83056-5.
The gut microbiota alterations interact with the pathogenesis and progression of chronic kidney disease (CKD). Probiotics have received wide attention as a potential management in CKD. We investigated the effects of Lactobacillus paracasei N1115 (LP N1115) on intestinal microbiota and related short-chain fatty acids (SCFAs) in end stage kidney disease patients on peritoneal dialysis (PD) in a single-center, prospective, randomized, double-blind, placebo-controlled study. The patients were randomly allocated into two groups. The intervention group (n = 38, PR group) was given the probiotics (two bags) containing fructooligosaccharide (FOS) (additive amount > 80%), maltosaccharin, and LP N1115 (additive amount > 3 × 10 CFU/bag) every day whereas the control group (n = 19, PL group) received placebo (two bags) containing only pregelatinized starch and lactose, both for 12 weeks. In addition to collecting fecal samples for 16S rRNA gene high-throughput sequencing and SCFAs analysis, gastrointestinal (GI) symptoms were also assessed at baseline and after the intervention. Probiotics administration caused significant changes in the composition of gut microbiota, as indicated by increased abundance of beneficial bacteria (Firmicutes), decreased Bacteroidetes, and opportunistic pathogens (Fusobacterium, Bilophila) (p < 0.05). However, there was no significant difference in intestinal microbial diversity. SCFAs levels increased in PR group although the change was not statistically significant between the two groups (P > 0.05). In addition, probiotics administration could effectively reduce GI symptoms, particularly in dyspepsia and constipation (p < 0.05). Together, the results suggest that probiotics administration caused significant changes in the composition of gut microbiota and also could effectively reduce GI symptoms, particularly in dyspepsia and constipation in PD patients. Trial registration: This study was registered with the Chinese Clinical Trial Registry (Trial registration number: ChiCTR-INR-17011718; Date of the first registration: 21/06/2017).
肠道微生物群的改变与慢性肾脏病（CKD）的发病机制及进展相互作用。益生菌作为CKD的一种潜在治疗方法受到了广泛关注。在一项单中心、前瞻性、随机、双盲、安慰剂对照研究中，我们调查了副干酪乳杆菌N1115（LP N1115）对终末期肾病腹膜透析（PD）患者肠道微生物群及相关短链脂肪酸（SCFAs）的影响。患者被随机分为两组。干预组（n = 38，PR组）每天服用含有低聚果糖（FOS）（添加量>80%）、麦芽糊精和LP N1115（添加量>3×10⁹CFU/袋）的益生菌（两袋），而对照组（n = 19，PL组）服用仅含预胶化淀粉和乳糖的安慰剂（两袋），两组均持续12周。除了收集粪便样本进行16S rRNA基因高通量测序和SCFAs分析外，还在基线和干预后评估胃肠道（GI）症状。服用益生菌导致肠道微生物群组成发生显著变化，表现为有益菌（厚壁菌门）丰度增加、拟杆菌门减少以及机会致病菌（梭杆菌属、嗜胆菌属）减少（p < 0.05）。然而，肠道微生物多样性无显著差异。PR组SCFAs水平升高，尽管两组间变化无统计学意义（P > 0.05）。此外，服用益生菌可有效减轻GI症状，尤其是消化不良和便秘（p < 0.05）。总之，结果表明服用益生菌导致肠道微生物群组成发生显著变化，并且还可有效减轻GI症状，尤其是PD患者的消化不良和便秘。试验注册：本研究已在中国临床试验注册中心注册（试验注册号：ChiCTR-INR-17011718；首次注册日期：2017年6月21日）。
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