Changes in Oral and Gut Microbiota and Incidence and Severity of Patient-Reported Symptoms in Pre- and Post-Kidney Transplant Patients

肾移植前后患者口腔和肠道微生物群的变化以及患者报告症状的发生率和严重程度

• 批准号: 10024086
• 负责人: Mark Lockwood
• 金额: $ 16.19万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-25 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10024086
• 关键词: 16S ribosomal RNA sequencing; Address; Affect; Age; Antibiotics; Antiviral Agents; Anxiety; Awareness; Bacteria; Birth; Cesarean section; Cessation of life; Chemicals; Chronic Kidney Failure; Communication; Communities; Complete Blood Count; Confounding Factors (Epidemiology); Creatinine; Data; Development; Dietary History; Dietary Intervention; Disease; Education; Ethnic Origin; Etiology; Exposure to; Family; Fatigue; Feces; Gastrointestinal tract structure; Gender; Gene Components; Genes; Glomerular Filtration Rate; Goals; Graft Rejection; Health; Human; Immunologics; Immunosuppression; Immunosuppressive Agents; Incidence; Income; Individual; Infection; Inflammatory; Intervention; Kidney Diseases; Kidney Transplantation; Life Style Modification; Link; Living Donors; Longitudinal Studies; Measurement; Measures; Mental Depression; Metabolic; Methods; Mission; Monitor; National Institute of Nursing Research; Nature; Neurotransmitters; Nurses; Nutritional status; Operative Surgical Procedures; Oral; Oral cavity; Organism; Outcome; Outcome Measure; Participant; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Phenotype; Process; Production; Prospective cohort study; Proteobacteria; Quality of life; Questionnaires; Race; Regimen; Renal function; Reporting; Research; Resolution; Sampling; Sampling Studies; Schedule; Severities; Shotguns; Sleep; Sleep Disorders; Sleep disturbances; Sputum; Structure; Symptoms; System; Tacrolimus; Taxonomy; Time; Transplant Recipients; Transplantation; Transplantation Surgery; Vagina; anxiety symptoms; beta diversity; cytokine; delayed graft function; design; diet and exercise; disabling symptom; experience; fecal microbiota; gut microbiome; gut microbiota; gut-brain axis; health related quality of life; improved; innovation; medication compliance; medication nonadherence; metagenomic sequencing; microbial community; microbiome; microbiome alteration; microbiome sequencing; microbiota; multidisciplinary; novel; novel strategies; oral microbial community; oral microbiome; personalized medicine; post-transplant; probiotic supplementation; prospective; reduce symptoms; restoration; symptom cluster; symptom science

Abstract This novel prospective cohort study will explore the relationship between kidney transplantation (antibiotics, antivirals, and immunosuppressants), changes in the composition and functional gene content of the microbiome, and the incidence and severity of patient reported symptoms before and after patients receive a kidney transplant from a live donor. We have selected living donor recipients to reduce the chance of missing samples, as these are scheduled surgeries. Thirty-nine subjects will provide stool and sputum samples for shot gun metagenomic sequencing of the microbiome before transplant, during the first week after transplant prior to discharge, and at 3 months after the transplant. Demographic (age, gender, race/ethnicity, income, education) and disease specific data (HT/WT/BMI, creatinine, estimated glomerular filtration rate, basic metabolic panel, complete blood count), and medication adherence data (electronic medication adherence monitoring and tacrolimus trough levels) will be collected. Potential confounding variables will include: historical use of antibiotics, concomitant medications, mode of delivery (vaginal vs. caesarian birth), and nutritional status (Diet History Questionnaire III). Incidence and severity of symptoms of fatigue, sleep dysfunction, and anxiety/depression–like symptoms will be measured using the Patient Reported Outcome Measurement Systems (PROMIS) 57 v2.1. Health related quality of life will be assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF v1.3). This research will support the mission of the National Institute of Nursing Research (NINR) to promote and improve the health and quality of life of individuals, families, and communities. The proposed study will contribute to the NINR mission by: 1) Exploring the mechanisms underlying incidence and severity of symptoms after kidney transplantation with the goal of developing personalized treatments, including pre-probiotics supplementation, lifestyle modification, and dietary interventions that address these mechanisms through symptom science research; 2) Helping individuals with chronic kidney disease/kidney transplant recipients better understand and manage these conditions by engaging individuals as active participants in managing their own health through awareness of modifiable factors that alter the microbiome; and 3) Promoting the development of innovative, multidisciplinary, nurse-led teams to advance research on microbiome and health after kidney transplantation.

抽象的 这项新型的前瞻性队列研究将探索肾移植之间的关系（抗生素，， 抗病毒药和免疫抑制剂）的组成和功能基因含量的变化 微生物组，患者报告之前和之后的患者的事件和严重程度 来自活捐赠者的肾脏移植。我们选择了活着的捐助者，以减少失踪的机会 样本，因为这些是计划的手术。三十九个受试者将提供粪便和痰液样品进行射击 移植前的枪支微生物组的枪支宏基因组测序，在移植之前的第一周 出院，在移植后3个月。人口统计学（年龄，性别，种族/种族，收入， 教育和疾病特定数据（HT/WT/BMI，肌酐，估计的肾小球过滤率，基本 代谢面板，全血数）和药物依从性数据（电子药物依从性 将收集监测和他克莫司麻烦水平）。潜在的混杂变量将包括：历史 使用抗生素，伴随药物，分娩方式（阴道与凯撒出生）和营养 状态（饮食史问卷III）。疲劳症状的发病率和严重程度，睡眠功能障碍和 动画/抑郁症状符号将使用患者报告的结果测量来测量 系统（Promis）57 v2.1。与健康相关的生活质量将使用肾脏疾病质量进行评估 生命缩写形式（KDQOL-SF V1.3）。这项研究将支持美国国家护理研究所的任务 研究（NINR）旨在促进和改善个人，家庭和 社区。拟议的研究将通过以下方式为NINR任务做出贡献：1）探索机制 肾脏移植后的潜在事件和症状的严重程度 个性化治疗方法，包括补充前病，改变生活方式和饮食 通过症状科学研究来解决这些机制的干预措施； 2）帮助个人 慢性肾脏疾病/肾脏移植接受者通过 通过认识可修改的人，让个人成为积极参与者来管理自己的健康 改变微生物组的因素； 3）促进创新，多学科，护士领导的发展 在肾脏移植后提高有关微生物组和健康研究的团队。