Linking gut microbiota to cardiovascular disease and hypertension: Lessons from chronic kidney disease

Meijers, Björn; Jouret, François; Evenepoel, Pieter

doi:10.1016/j.phrs.2018.04.023

Cited by 39 publications

(30 citation statements)

References 95 publications

(121 reference statements)

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“…Gut microbiota-derived metabolites TMAO, TMA, and DMA from dietary methylamines have recently gained much attention due to their high association with CV risk [8][9][10]29,30]. In the present study, our results are consistent with previous reported data in CKD adults [31,32], showing that TMAO is increased in CKD with a weak inverse correlation (r = −0.283) between plasma TMAO level and eGFR.…”

Section: Discussionsupporting

confidence: 92%

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Association of Trimethylamine, Trimethylamine N-oxide, and Dimethylamine with Cardiovascular Risk in Children with Chronic Kidney Disease

Hsu

Chang-Chien

Lin

et al. 2020

JCM

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Chronic kidney disease (CKD) is associated with high risk for cardiovascular disease (CVD). Gut microbiota-dependent metabolites trimethylamine (TMA), trimethylamine N-oxide (TMAO), and dimethylamine (DMA) have been linked to CKD and CVD. We examined whether these methylamines are correlated with cardiovascular risk in CKD children. A total of 115 children and adolescents with CKD stage G1–G4 were enrolled in this cross-sectional study. Children with CKD stage G2–G4 had higher plasma levels of DMA, TMA, and TMAO, but lower urinary levels of DMA and TMAO than those with CKD stage G1. Up to 53% of CKD children and adolescents had blood pressure (BP) abnormalities on 24-h ambulatory BP monitoring (ABPM). Plasma TMA and DMA levels inversely associated with high BP load as well as estimated glomerular filtration rate (eGFR). Additionally, CKD children with an abnormal ABPM profile had decreased abundance of phylum Cyanobacteria, genera Subdoligranulum, Faecalibacterium, Ruminococcus, and Akkermansia. TMA and DMA are superior to TMAO when related to high BP load and other CV risk factors in children and adolescents with early-stage CKD. Our findings highlight that gut microbiota-dependent methylamines are related to BP abnormalities and CV risk in pediatric CKD. Further studies should determine whether these microbial markers can identify children at risk for CKD progression.

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Section: Discussionsupporting

confidence: 92%

“…Gut microbiome has been identified as a source of pathogenic mediators in CKD [7]. Certain gut microbiota-derived metabolites have been shown to correlate with CVD in patients with CKD [8,9]. Among them, trimethylamine N-oxide (TMAO) has attracted increasing notoriety recently as a causative factor in various CVD.…”

Section: Introductionmentioning

confidence: 99%

Association of Trimethylamine, Trimethylamine N-oxide, and Dimethylamine with Cardiovascular Risk in Children with Chronic Kidney Disease

Hsu

Chang-Chien

Lin

et al. 2020

JCM

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“…In the absence of carbohydrates, α-amino nitrogen can produce potentially toxic end products mainly through fermentation. It has been reported that the αamino nitrogen fermentation pattern is the key player in gut ecosystem disorders in CKD patients [66], which may contribute to IgAN.…”

Section: Discussionmentioning

confidence: 99%

Fecal microbiota characteristics of Chinese patients with primary IgA nephropathy: a cross-sectional study

Xie

et al. 2020

BMC Nephrol

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Background: Growing evidence has shown that the gut-renal connection and gut microbiota dysbiosis play a critical role in immunoglobulin A nephropathy (IgAN). However, the fecal microbiome profile in Chinese patients with IgAN remains unknown. A cross-sectional study was designed for the first time to investigate the fecal microbiota compositions in patients with primary IgAN in China and to evaluate the relationship between the fecal microbiome and IgAN clinical presentation. Methods: Fecal samples were collected from 17 IgAN patients and 18 age-, sex-, and body mass index-matched healthy controls, and bacterial DNA was extracted for 16S ribosomal RNA gene sequencing targeting the V3-V4 region. Results: Fecal samples from the IgAN patients and healthy controls showed differences in gut microbiota community richness and compositions. Compared to the healthy controls, IgAN patients at the phylum level had an increased abundance of Fusobacteria, but a decreased abundance of Synergistetes. The significantly increased genera in the IgAN group were Escherichia-Shigella, Hungatella, and Eggerthella, all of which possess pathogenic potential. Furthermore, the genus Escherichia-Shigella was negatively associated with the estimated glomerular filtration rate (eGFR) but was positively associated with the urinary albumin-to-creatinine ratio (uACR). However, the genus rectale_group was present in the IgAN group with a low abundance and was negatively associated with the uACR. Functional analysis disclosed that infection-related pathways were enriched in the IgAN group. Conclusions: We demonstrate that gut microbiota dysbiosis occurs in patients with IgAN, and that changes in gut bacterial populations are closely related to IgAN clinical features, suggesting that certain specific gut microbiota may be a potential therapeutic target for IgAN.

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“…As a consequence of diet restrictions and prolonged colonic transit, the microbiota activity moves towards a proteolytic fermentation pattern. This metabolic shift represents the explanation of significant prevalence in bacterial types processing urease, uricase, and indole and p-cresol forming enzymes [ 55 ]. Microbial diversity is significantly damaged in CKD patients, with a decreased number of beneficial bacteria that generate SCFAs and an increase in bacteria that produce uremic toxins (indoxyl sulfate, p-cresyl sulfate, and TMAO) [ 52 ].…”

Section: An Underestimated Source Of Smouldering Inflammation—gut mentioning

confidence: 99%

Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome

Mihai

Codrici

Popescu

et al. 2018

Journal of Immunology Research

374

254

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Persistent, low-grade inflammation is now considered a hallmark feature of chronic kidney disease (CKD), being involved in the development of all-cause mortality of these patients. Although substantial improvements have been made in clinical care, CKD remains a major public health burden, affecting 10–15% of the population, and its prevalence is constantly growing. Due to its insidious nature, CKD is rarely diagnosed in early stages, and once developed, its progression is unfortunately irreversible. There are many factors that contribute to the setting of the inflammatory status in CKD, including increased production of proinflammatory cytokines, oxidative stress and acidosis, chronic and recurrent infections, altered metabolism of adipose tissue, and last but not least, gut microbiota dysbiosis, an underestimated source of microinflammation. In this scenario, a huge step forward was made by the increasing progression of omics approaches, specially designed for identification of biomarkers useful for early diagnostic and follow-up. Recent omics advances could provide novel insights in deciphering the disease pathophysiology; thus, identification of circulating biomarker panels using state-of-the-art proteomic technologies could improve CKD early diagnosis, monitoring, and prognostics. This review aims to summarize the recent knowledge regarding the relationship between inflammation and CKD, highlighting the current proteomic approaches, as well as the inflammasomes and gut microbiota dysbiosis involvement in the setting of CKD, culminating with the troubling bidirectional connection between CKD and renal malignancy, raised on the background of an inflammatory condition.

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Linking gut microbiota to cardiovascular disease and hypertension: Lessons from chronic kidney disease

Cited by 39 publications

References 95 publications

Association of Trimethylamine, Trimethylamine N-oxide, and Dimethylamine with Cardiovascular Risk in Children with Chronic Kidney Disease

Association of Trimethylamine, Trimethylamine N-oxide, and Dimethylamine with Cardiovascular Risk in Children with Chronic Kidney Disease

Fecal microbiota characteristics of Chinese patients with primary IgA nephropathy: a cross-sectional study

Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome

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