The Immunomodulatory Effect of the Gut Microbiota in Kidney Disease

Abstract

The human gut microbiota is a complex cluster composed of 100 trillion microorganisms, which holds a symbiotic relationship with the host under normal circumstances. Intestinal flora can facilitate the treatment of human metabolic dysfunctions and interact with the intestinal tract, which could influence intestinal tolerance, immunity, and sensitivity to inflammation. In recent years, significant interests have evolved on the association of intestinal microbiota and kidney diseases within the academic circle. Abnormal changes in intestinal microbiota, known as dysbiosis, can affect the integrity of the intestinal barrier, resulting in the bacterial translocation, production, and accumulation of dysbiotic gut-derived metabolites, such as urea, indoxyl sulfate (IS), and p-cresyl sulfate (PCS). These processes lead to the abnormal activation of immune cells; overproduction of antibodies, immune complexes, and inflammatory factors; and inflammatory cell infiltration that can directly or indirectly cause damage to the renal parenchyma. The aim of this review is to summarize the role of intestinal flora in the development and progression of several renal diseases, such as lupus nephritis, chronic kidney disease, diabetic nephropathy, and renal ischemia-reperfusion injury. Further research on these mechanisms should provide insights into the therapeutic potential of regulating intestinal flora and intervening related molecular targets for the abovementioned nephropathy.

Versatile Triad Alliance: Bile Acid, Taurine and Microbiota

“…However, it also reduces the injurious effect of several kidney diseases, including diabetic nephropathy, glomerulonephritis, chronic renal failure, and acute kidney injury [ 424 , 425 , 426 , 427 ]. Similarly, intestinal flora has been reported to prevent the development and progression of several renal diseases, such as lupus nephritis, chronic kidney disease, diabetic nephropathy, and renal ischemia–reperfusion injury [ 428 ]. Similarly, both taurine and gut bacteria play a role in cardiovascular diseases [ 429 , 430 ], neurological [ 51 , 53 , 54 , 55 , 56 , 57 , 58 , 60 , 61 , 62 , 63 , 64 , 431 ] and multiple other disorders.…”

Faecal Microbiota Transplantation and Chronic Kidney Disease

“…Gut microbiota dysbiosis contributes to the impaired gut barrier, excessive production of uremic toxins, and translocation of the gut microbiome, leading to the abnormal activation of the immune cells [62]. The active immune cells, such as neutrophils, macrophages, dendritic cells, and lymphocytes, then infiltrate kidneys and promote the pro-or antiinflammatory reactions [60].…”

Integrating the Synergy of the Gut Microbiome into Regenerative Medicine: Relevance to Neurological Disorders

“…Gut dysbiosis affecting the integrity of the intestinal barrier may lead to bacterial translocation, production, and accumulation of dysbiotic gut-derived metabolites, such as urea, indoxyl sulfate, and p-cresyl sulfate, which cause abnormal activation of immune cells, overproduction of antibodies, immune complexes, and inflammatory factors that may directly or indirectly cause damage to the renal parenchyma [ 38 ]. Administration of the probiotic L. casei has been shown to reduce kidney inflammation by restoring the SCFA-producing gut microbiome and nicotinamide metabolism [ 39 ]. Regulating the gut microbiome has been shown to lower blood pressure, ameliorate kidney disease, and prevent complications in patients with chronic kidney disease.…”

“…Studies have shown the correlation between intestinal flora and diabetes. Restoring the gut microbiota is considered to be an effective strategy in preventing and treating diabetes and diabetic nephropathy [ 39 ]. Administration of antibiotics has been shown to protect against renal ischemia-reperfusion injury by reducing the maturation status of the bone marrow monocytes and F4/80 + renal resident macrophages [ 39 ].…”