ObjectivePatients with renal failure suffer from symptoms caused by uraemic toxins, possibly of gut microbial origin, as deduced from studies in animals. The aim of the study is to characterise relationships between the intestinal microbiome composition, uraemic toxins and renal failure symptoms in human end-stage renal disease (ESRD).DesignCharacterisation of gut microbiome, serum and faecal metabolome and human phenotypes in a cohort of 223 patients with ESRD and 69 healthy controls. Multidimensional data integration to reveal links between these datasets and the use of chronic kidney disease (CKD) rodent models to test the effects of intestinal microbiome on toxin accumulation and disease severity.ResultsA group of microbial species enriched in ESRD correlates tightly to patient clinical variables and encode functions involved in toxin and secondary bile acids synthesis; the relative abundance of the microbial functions correlates with the serum or faecal concentrations of these metabolites. Microbiota from patients transplanted to renal injured germ-free mice or antibiotic-treated rats induce higher production of serum uraemic toxins and aggravated renal fibrosis and oxidative stress more than microbiota from controls. Two of the species, Eggerthella lenta and Fusobacterium nucleatum, increase uraemic toxins production and promote renal disease development in a CKD rat model. A probiotic Bifidobacterium animalis decreases abundance of these species, reduces levels of toxins and the severity of the disease in rats.ConclusionAberrant gut microbiota in patients with ESRD sculpts a detrimental metabolome aggravating clinical outcomes, suggesting that the gut microbiota will be a promising target for diminishing uraemic toxicity in those patients.Trial registration numberThis study was registered at ClinicalTrials.gov (NCT03010696).
Mite antigen has been suggested to play important roles in the onset and/or development of atopic dermatitis, and mite antigen-induced dermatitis models appear beneficial for the basic study of atopic dermatitis. In the present study therefore, we attempted to establish an allergic dermatitis model in mice using Dermatophagoides farinae crude extract as an antigen. Mite antigen solution at a concentration of 1 or 10 mg/ml was painted 5 times repeatedly at an interval of 7 d onto the ear of NC/Nga or BALB/c mice with or without simultaneous tape-stripping. Apparent biphasic ear swelling was observed after the 4th and 5th antigen applications in both strains of mice treated with 10 mg/ml of antigen solution. Thickening of the epidermis, fibrosis of the dermis, and the accumulation of inflammatory cells were also observed after the 5th application. The inflammatory changes were more evident in NC/Nga mice than in BALB/c mice and potentiated by tape-stripping. The ear swelling was accompanied by increased serum IgE, increased expression of interleukin-4 mRNA and decreased expression of interferon-g g mRNA in cervical lymph nodes and ears. These results indicate that ear swelling caused by repeated mite antigen application with simultaneous tape-stripping has a Th2-dominant background and that the inflammatory responses are expressed more potently in NC/Nga mice than in BALB/c mice. The dermatitis caused by mite antigen in NC/Nga mice appears to be a useful model for the basic study of atopic dermatitis.
We have established an allergic dermatitis model in NC/Nga mice by repeated local exposure of mite antigen for analyzing atopic dermatitis. We examined how four Kampo medicines, Juzen-taiho-to, Hochu-ekki-to, Shofu-san and Oren-gedoku-to, on the dermatitis model to obtain basic information on their usefulness for treating atopic dermatitis. Mite antigen (Dermatophagoides farinaecrude extract) solution at a concentration of 10 mg/ml was painted on the ear of NC/Nga mice after tape stripping. The procedure was repeated five times, at 7 day intervals. An apparent biphasic ear swelling was caused after the fourth and fifth antigen exposures with elevated serum IgE levels and accumulation of inflammatory cells. In the cervical lymph nodes and ear lobes, the five procedures of antigen exposure induced interleukin-4 mRNA expression but reduced interferon-γ mRNA expression. Oral administration of all four Kampo medicines inhibited the formation of ear swelling and inflammatory cell accumulation. Juzen-taiho-to and Hochu-ekki-to apparently prevented the elevation of serum IgE level. Furthermore, the four Kampo medicines showed a tendency to prevent not only the increase in interleukin-4 mRNA expression but also the decrease in interferon-γ mRNA expression. The present results indicate that Juzen-taiho-to, Hochu-ekki-to, Shofu-san and Oren-gedoku-to may correct the Th1/Th2 balance skewed to Th2, and this activity helps inhibit dermatitis in NC/Nga mice. The ability of the Kampo medicines to correct the Th1/Th2 balance seems to underlie their effectiveness in treating of atopic dermatitis.
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