Acute Kidney Injury and Gut Dysbiosis: A Narrative Review Focus on Pathophysiology and Treatment.
Acute Kidney Injury and Gut Dysbiosis: A Narrative Review Focus on Pathophysiology and Treatment.
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急性肾脏损伤和肠道营养不良：叙述性综述着重于病理生理学和治疗。
DOI：
10.3390/ijms23073658
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发表时间：
2022-03-26
影响因子：
5.6
通讯作者：
Shiao CC
中科院分区：
文献类型：
--
作者：
Chou YT;Kan WC;Shiao CC
急性肾损伤（AKI）与肠道生态失调是相互影响的。AKI诱导胃肠道（GI）系统的微生物群改变，而肠道生态失调也会加重AKI。AKI与肠道生态失调之间的相互作用尚不清楚，但值得进一步研究。目前的综述主要集中在这种双向相互作用的病理生理和AKI的治疗基础上。先天免疫的巨噬细胞和中性粒细胞以及适应性免疫的T辅助型17细胞都是aki诱导的肠道生态失调的关键参与者。相反，生态失调引起的肠道源性尿毒症毒素过量产生和短链脂肪酸生成不足是AKI恶化的主要因素。人们提出了许多新的治疗方法，通过改革胃肠道微生物群和打破这种恶性循环来阻止AKI的进展。数据支持益生菌治疗AKI患者的益处，而后益生菌的结果主要局限于动物。益生元和合成抗生素主要是在慢性肾病患者而不是AKI患者中讨论的。吸附剂治疗的效果似乎很有希望，但在将其应用于患者之前还需要进行更多的研究。免疫疗法和别嘌呤醇等药物是未来治疗的前景，值得进一步探讨和研究。
Acute kidney injury (AKI) and gut dysbiosis affect each other bidirectionally. AKI induces microbiota alteration in the gastrointestinal (GI) system, while gut dysbiosis also aggravates AKI. The interplay between AKI and gut dysbiosis is not yet well clarified but worthy of further investigation. The current review focuses on the pathophysiology of this bidirectional interplay and AKI treatment in this base. Both macrophages and neutrophils of the innate immunity and the T helper type 17 cell from the adaptive immunity are the critical players of AKI-induced gut dysbiosis. Conversely, dysbiosis-induced overproduction of gut-derived uremic toxins and insufficient generation of short-chain fatty acids are the main factors deteriorating AKI. Many novel treatments are proposed to deter AKI progression by reforming the GI microbiome and breaking this vicious cycle. Data support the benefits of probiotic treatment in AKI patients, while the results of postbiotics are mainly limited to animals. Prebiotics and synbiotics are primarily discussed in chronic kidney disease patients rather than AKI patients. The effect of adsorbent treatment seems promising, but more studies are required before the treatment can be applied to patients. Immune therapy and some repurposed drugs such as allopurinol are prospects of future treatments and are worth more discussion and survey.
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影响因子：
28.2
作者：
Donohoe DR;Holley D;Collins LB;Montgomery SA;Whitmore AC;Hillhouse A;Curry KP;Renner SW;Greenwalt A;Ryan EP;Godfrey V;Heise MT;Threadgill DS;Han A;Swenberg JA;Threadgill DW;Bultman SJ
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Bultman SJ
影响因子：
4.6
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Braga TT;Forni MF;Correa-Costa M;Ramos RN;Barbuto JA;Branco P;Castoldi A;Hiyane MI;Davanso MR;Latz E;Franklin BS;Kowaltowski AJ;Camara NO
通讯作者：
Camara NO
DOI：
10.1126/science.1198469
发表时间：
2011-01-21
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Atarashi K;Tanoue T;Shima T;Imaoka A;Kuwahara T;Momose Y;Cheng G;Yamasaki S;Saito T;Ohba Y;Taniguchi T;Takeda K;Hori S;Ivanov II;Umesaki Y;Itoh K;Honda K
通讯作者：
Honda K
影响因子：
6
作者：
Andrade-Silva, Magaiver;Cenedeze, Marcos Antonio;de Almeida, Danilo Candido
通讯作者：
de Almeida, Danilo Candido
影响因子：
7.1
作者：
Bliss, DZ;Stein, TP;Settle, RG
通讯作者：
Settle, RG