Therapeutic bubble tea: Preventing the formation of uremic toxins with hydrogel immobilized microbes

项目摘要 每年超过10万美国人开始透析时，他们的肾脏失去了能力， 血液中的毒素半数人会在五年内死亡这些高死亡率部分是因为 由于透析在去除蛋白质结合的尿毒症毒素（PBUT）方面无效， 硫酸吲哚酚和硫酸对甲酚，否则它们会被健康的肾脏清除。 在此，我们提出了一种非侵入性的可摄入的珍珠奶茶，以降低血液中的 PBUT和改善终末期肾病（ESKD）患者的结局。 与试图通过透析从血液中去除毒素的传统治疗相反， 这项研究提供了一种完全不同的方法，它可以防止毒素的形成， 起源PBUT是肠道微生物代谢的副产物;吲哚和对甲酚来源于肠道微生物代谢。 肠中的氨基酸发酵，两种溶质在肝脏中被磺化， PBUT硫酸吲哚酚和硫酸对甲酚。我们提出了一种新的微生物丰富的泡沫茶 这将扩大肠道降解尿毒症毒素（UT）前体（吲哚和 对甲酚），从而防止它们在肝脏中磺化成毒性形式。气泡成分 将被设计成在胃中保持紧密，从而保护水凝胶截留 微生物从低pH值，然后膨胀在中性pH值在小肠和结肠， UT扩散到水凝胶中，其中UT降解微生物将使它们失活。 最后，泡泡茶将被完整地排出体外，而不会改变天然的肠道微生物组。这 概念建立在微生物富集水凝胶在生物工程中的成功应用之上 以及环境工程，用于药物输送和废水处理。 我们将首先通过富集新的吲哚和对甲酚降解微生物来开发珍珠奶茶 从环境中，为微生物设计第二种专门的水凝胶载体，以及 最后在控制良好的生物反应器单元中复制它们的肠道之旅。基板 曲线，pH梯度和去除率将通过实验测量和数学计算 模拟以可视化细菌的空间定位并确定UT随时间的降解。 将这些水凝胶加入到配制的泡沫茶饮料中可以改善慢性病患者的生活。 肾脏疾病和ESKD患者通过减轻尿毒症症状的负担， 并发症

Project summary Each year over 100,000 Americans begin dialysis when their kidneys lose the capacity to remove toxins from the blood and half of them die within five years. These high mortality rates are in part due to the ineffectiveness of dialysis at removing protein-bound uremic toxins (PBUTs) such as indoxyl sulfate and p-cresol sulfate, which would otherwise be removed by healthy kidneys. Herein, we propose a non-invasive ingestible bubble tea to reduce the blood concentration of PBUTs and improve the outcomes of patients with end stage kidney disease (ESKD). In contrast to conventional treatments, which attempt to remove toxins from the blood by dialysis, this research offers a radically different approach, which prevents the formation of toxins at their origin. PBUTs are byproducts of gut microbial metabolism; indole and p-cresol originate in the gut from fermentation of amino acids and both solutes are sulfonated in the liver to form the PBUTs indoxyl sulfate and p-cresol sulfate. We propose a novel microbe enriched bubble tea which will expand the capacity of the gut to degrade the uremic toxin (UT) precursors (indole and p-cresol) and thereby prevent their sulfonation to toxic forms in the liver. The bubble components will be engineered to remain tight in the stomach, hence protecting the hydrogel entrapped microbes from low pH, and then swell at neutral pH in the small intestine and colon, allowing UTs to diffuse into the hydrogel where the UT degrading microorganisms will deactivate them. Finally, the bubble tea will be excreted intact without altering the natural gut microbiome. This concept builds on the successful applications of microbe enriched hydrogels in bioengineering and environmental engineering for drug delivery and wastewater treatment. We will develop the bubble tea by first enriching novel indole and p-cresol degrading microbes from the environment, second engineering specialized hydrogel carriers for the microbes, and finally replicating their trip through the gut in well controlled bioreactor units. The substrate profiles, pH gradients, and removal rates will be experimentally measured and mathematically simulated to visualize spatial localization of bacteria and to determine UT degradation over time. Delivering these hydrogels in a formulated bubble tea drink could improve the lives of chronic kidney disease and ESKD patients by reducing the burden from uremic symptoms and complications.