Does the Microbiome Affect the Outcome of Renal Transplantation?
Does the Microbiome Affect the Outcome of Renal Transplantation?
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DOI：
10.3389/fcimb.2020.558644
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发表时间：
2020
影响因子：
5.7
通讯作者：
McBain AJ
中科院分区：
文献类型：
--
作者：
Campbell PM;Humphreys GJ;Summers AM;Konkel JE;Knight CG;Augustine T;McBain AJ
人类微生物组在健康和疾病中的作用日益明显。新出现的证据表明，微生物组受到实体器官移植的影响。肾移植是终末期肾脏疾病（ESRD）的金标准治疗，即慢性肾脏疾病（CKD）的晚期。ESRD和移植如何影响微生物组，反之亦然的问题包括微生物组如何受到尿素和肌酐等毒素浓度增加（在ESRD中升高）的影响，移植后肾功能的恢复是否会改变微生物组的组成，以及终身服用免疫抑制药物对微生物组的影响。在ESRD和治疗性免疫抑制中已经报道了微生物组组成和活性的变化，但对移植结果的影响尚不清楚。在这里，我们考虑了目前的证据，即移植后肾功能的改变和免疫抑制会影响肾移植患者的口腔、肠道和尿液微生物群。讨论了这些微生物组的变化可能导致疾病、全身性炎症或器官本身的排斥反应，以及肾功能恢复可能重新建立益生菌的可能性。
The role of the human microbiome in health and disease is becoming increasingly apparent. Emerging evidence suggests that the microbiome is affected by solid organ transplantation. Kidney transplantation is the gold standard treatment for End-Stage Renal Disease (ESRD), the advanced stage of Chronic Kidney Disease (CKD). The question of how ESRD and transplantation affect the microbiome and vice versa includes how the microbiome is affected by increased concentrations of toxins such as urea and creatinine (which are elevated in ESRD), whether restoration of renal function following transplantation alters the composition of the microbiome, and the impact of lifelong administration of immunosuppressive drugs on the microbiome. Changes in microbiome composition and activity have been reported in ESRD and in therapeutic immunosuppression, but the effect on the outcome of transplantation is not well-understood. Here, we consider the current evidence that changes in kidney function and immunosuppression following transplantation influence the oral, gut, and urinary microbiomes in kidney transplant patients. The potential for changes in these microbiomes to lead to disease, systemic inflammation, or rejection of the organ itself is discussed, along with the possibility that restoration of kidney function might re-establish orthobiosis.