Postbiotics and Kidney Disease

Abstract

Chronic kidney disease (CKD) is projected to become the fifth global cause of death by 2040 as a result of key shortcomings in the current methods available to diagnose and treat kidney diseases. In this regard, the novel holobiont concept, used to describe an individual host and its microbial community, may pave the way towards a better understanding of kidney disease pathogenesis and progression. Microbiota-modulating or -derived interventions include probiotics, prebiotics, synbiotics and postbiotics. As of 2019, the concept of postbiotics was updated by the International Scientific Association of Probiotics and Prebiotics (ISAPP) to refer to preparations of inanimate microorganisms and/or their components that confer a health benefit to the host. By explicitly excluding purified metabolites without a cellular biomass, any literature making use of such term is potentially rendered obsolete. We now review the revised concept of postbiotics concerning their potential clinical applications and research in kidney disease, by discussing in detail several formulations that are undergoing preclinical development such as GABA-salt for diet-induced hypertension and kidney injury, sonicated Lactobacillus paracasei in high fat diet-induced kidney injury, GABA-salt, lacto-GABA-salt and postbiotic-GABA-salt in acute kidney injury, and O. formigenes lysates for hyperoxaluria. Furthermore, we provide a roadmap for postbiotics research in kidney disease to expedite clinical translation.

Puerariae Lobatae Radix Alleviates High Salt Diet Induced Chronic Kidney Disease by Repairing Intestinal Epithelial Barrier and Down-Regulating Fibrotic Signaling

“…It is well known that excessive salt intake is associated with hypertension, which closely links cardiovascular disease and CKD. Therefore, how to relieve the potential risk about kidney injury brought by high salt has arisen the attention [30,31]. Previous review advocated non-pharmacological strategies such as dietary and lifestyle modulation as well as kidney disease-specific pharmacological interventions to achieve kidney function preservation [32].…”

The ameliorating effect of limosilactobacillus fermentum and its supernatant postbiotic on cisplatin-induced chronic kidney disease in an animal model

“…In a review study, Favero et al acknowledged that the therapeutic strategy of postbiotics was still defined as targeting downstream signaling pathways of the gastrointestinal microbiome. They proposed a roadmap for the clinical application of postbiotics for kidney disease [ 66 ]. It is worth noting that postbiotics have potent therapeutic effects on cisplatin-induced CKD caused by other factors.…”

Renal Health Improvement in Diabetes through Microbiome Modulation of the Gut–Kidney Axis with Biotics: A Systematic and Narrative Review of Randomized Controlled Trials

“…FMT from healthy donors has been shown to improve podocyte-involved glomerular injury in experimental studies with diabetic rats, in a process mediated by restoration of the AMPKα activity [ 94 ]. Lastly, postbiotics, or functional metabolites of bacteria such as the SCFAs acetate, propionate, and butyrate, are emerging with promising therapeutic effects against high blood pressure, hyperglycemia, hyperlipidemia, and even for the prevention and treatment of DN and other kidney diseases [ 29 , 137 , 138 , 139 ].…”