Xu Penghao, Zhang Mengjie, Cui Shiyan, Wang Lingling, Li Yanni, Li Yuchen, Jiang Chen
Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Ren Fail. 2025 Dec;47(1):2542532. doi: 10.1080/0886022X.2025.2542532. Epub 2025 Aug 7.
Gut microbiome disorders and intestinal barrier damage were found in peritonitis. However, the relationship between the gut microbiome and peritoneal dialysis-associated peritonitis (PDAP) remains unknown. This study aimed to investigate the role of the gut microbiome in PDAP and explore its correlation with intra-abdominal inflammation.
We used a two-fold strategy to investigate the causal relationship between the gut microbiome and PDAP. First, a Mendelian randomization (MR) study was conducted using summarized statistics from genome-wide association studies (GWAS) of the gut microbiome and peritonitis. Additionally, a case-control study with 24 patients from the peritoneal dialysis (PD) and PDAP groups were conducted to validate the role of candidate bacteria in peritonitis, using 16S rRNA sequencing to capture their gut microbiomes.
We screened four protective and one risky bacteria for peritonitis using MR analysis. The results of MR analysis were validated in the case-control study. We observed a shift in the co-occurrence pattern from the PD group to the PDAP group, suggesting potential destabilization of the gut bacterial network in the PDAP group. Furthermore, analysis of 17 protective and three risky bacteria revealed differential bacteria through LefSe and random forest analyses. Among these, we observed a significant negative correlation between , , , and and interleukin-6 levels.
Gut microbiome dysbiosis in peritoneal dialysis patients is a significant contributing factor to PDAP, with alterations in microbial abundance showing a strong correlation with the severity of intraperitoneal inflammation.
腹膜炎患者存在肠道微生物群紊乱和肠屏障损伤。然而，肠道微生物群与腹膜透析相关腹膜炎（PDAP）之间的关系尚不清楚。本研究旨在探讨肠道微生物群在PDAP中的作用，并探讨其与腹腔内炎症的相关性。
我们采用双重策略研究肠道微生物群与PDAP之间的因果关系。首先，利用肠道微生物群和腹膜炎的全基因组关联研究（GWAS）的汇总统计数据进行孟德尔随机化（MR）研究。此外，对24例腹膜透析（PD）组和PDAP组患者进行病例对照研究，以验证候选细菌在腹膜炎中的作用，采用16S rRNA测序捕获其肠道微生物群。
我们通过MR分析筛选出4种对腹膜炎有保护作用的细菌和1种有风险的细菌。MR分析结果在病例对照研究中得到验证。我们观察到从PD组到PDAP组共现模式的转变，提示PDAP组肠道细菌网络可能不稳定。此外，对17种保护菌和3种风险菌的分析通过LefSe和随机森林分析揭示了差异菌。其中，我们观察到[具体细菌名称1]、[具体细菌名称2]、[具体细菌名称3]、[具体细菌名称4]与白细胞介素-6水平之间存在显著负相关。
腹膜透析患者肠道微生物群失调是PDAP的一个重要促成因素，微生物丰度的改变与腹腔内炎症的严重程度密切相关。
