An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients.
An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients.
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创新的合成型配方可降低自由血清硫酸硫酸盐，小肠的渗透性，并在IIIB-IV期CKD患者的随机试验试验中减轻胃肠道症状。
DOI：
10.3390/toxins13050334
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发表时间：
2021-05-05
期刊：
影响因子：
4.2
通讯作者：
Gesualdo L
中科院分区：
文献类型：
--
作者：
Cosola C;Rocchetti MT;di Bari I;Acquaviva PM;Maranzano V;Corciulo S;Di Ciaula A;Di Palo DM;La Forgia FM;Fontana S;De Angelis M;Portincasa P;Gesualdo L
肠道微生物群的蛋白质分解失调已被认为是慢性肾脏疾病（CKD）的典型特征，也是其进展的危险因素。肠源性尿毒症毒素（UT）如硫酸吲哚酚（IS）和硫酸对甲苯酯（PCS）的血液蓄积、肠通透性和便秘是伴随CKD进展并触发慢性炎症的典型特征。为了验证创新合生素制剂NATUREN G®在调节循环UT水平、肠道通透性和胃肠道症状方面的疗效，我们在IIIb-IV期CKD患者和健康对照中开展了一项随机、单盲、安慰剂对照的初步试验。与安慰剂治疗组相比，合生元两个月的给药仅在CKD组中导致游离IS减少。其他UT没有显著变化，尽管观察到不同的时间趋势（安慰剂组增加，合生素组减少）。此外，补充后，小肠通透性降低，腹痛和便秘症状改善，仅在CKD组中观察到。获得的结果表明NATUREN G®在CKD中的作用具有特异性，并证明了在更广泛的研究人群中进一步验证的合理性。
Proteolytic dysbiosis of the gut microbiota has been recognized as both a typical feature of chronic kidney disease (CKD) and a risk factor for its progression. Blood accumulation of gut-derived uremic toxins (UTs) like indoxyl sulfate (IS) and p-cresyl sulfate (PCS), intestinal permeability and constipation are typical features accompanying CKD progression and triggering chronic inflammation. In order to verify the efficacy of the innovative synbiotic formulation NATUREN G® in modulating the levels of circulating UTs, intestinal permeability and gastrointestinal symptoms, we set up a randomized, single-blind, placebo-controlled, pilot trial in stage IIIb-IV CKD patients and in healthy controls. Two-month administration of the synbiotic resulted in a decrease of free IS, as compared with the placebo-treated arm, only in the CKD group. The other UTs did not significantly change, although different trends in time (increase in the placebo arm and decrease in the synbiotic arm) were observed. Moreover, after supplementation, reduction of small intestinal permeability and amelioration of abdominal pain and constipation syndromes were observed only in the CKD group. The obtained results suggest the specificity of action of NATUREN G® in CKD and justify further validation in a wider study population.
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