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The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease

Diabetic kidney disease (DKD) is a progressive disorder, which is increasing globally in prevalence due to the increased incidence of obesity and diabetes mellitus. Despite optimal clinical management, a significant number of patients with diabetes develop DKD. Hence, hitherto unrecognized factors a...

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Autores principales: Zaky, Amgad, Glastras, Sarah J., Wong, May Y. W., Pollock, Carol A., Saad, Sonia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431784/
https://www.ncbi.nlm.nih.gov/pubmed/34502562
http://dx.doi.org/10.3390/ijms22179641
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author Zaky, Amgad
Glastras, Sarah J.
Wong, May Y. W.
Pollock, Carol A.
Saad, Sonia
author_facet Zaky, Amgad
Glastras, Sarah J.
Wong, May Y. W.
Pollock, Carol A.
Saad, Sonia
author_sort Zaky, Amgad
collection PubMed
description Diabetic kidney disease (DKD) is a progressive disorder, which is increasing globally in prevalence due to the increased incidence of obesity and diabetes mellitus. Despite optimal clinical management, a significant number of patients with diabetes develop DKD. Hence, hitherto unrecognized factors are likely to be involved in the initiation and progression of DKD. An extensive number of studies have demonstrated the role of microbiota in health and disease. Dysregulation in the microbiota resulting in a deficiency of short chain fatty acids (SCFAs) such as propionate, acetate, and butyrate, by-products of healthy gut microbiota metabolism, have been demonstrated in obesity, type 1 and type 2 diabetes. However, it is not clear to date whether such changes in the microbiota are causative or merely associated with the diseases. It is also not clear which microbiota have protective effects on humans. Few studies have investigated the centrality of reduced SCFA in DKD development and progression or the potential therapeutic effects of supplemental SCFAs on insulin resistance, inflammation, and metabolic changes. SCFA receptors are expressed in the kidneys, and emerging data have demonstrated that intestinal dysbiosis activates the renal renin-angiotensin system, which contributes to the development of DKD. In this review, we will summarize the complex relationship between the gut microbiota and the kidney, examine the evidence for the role of gut dysbiosis in diabetes and obesity-related kidney disease, and explore the mechanisms involved. In addition, we will describe the role of potential therapies that modulate the gut microbiota to prevent or reduce kidney disease progression.
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spelling pubmed-84317842021-09-11 The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease Zaky, Amgad Glastras, Sarah J. Wong, May Y. W. Pollock, Carol A. Saad, Sonia Int J Mol Sci Review Diabetic kidney disease (DKD) is a progressive disorder, which is increasing globally in prevalence due to the increased incidence of obesity and diabetes mellitus. Despite optimal clinical management, a significant number of patients with diabetes develop DKD. Hence, hitherto unrecognized factors are likely to be involved in the initiation and progression of DKD. An extensive number of studies have demonstrated the role of microbiota in health and disease. Dysregulation in the microbiota resulting in a deficiency of short chain fatty acids (SCFAs) such as propionate, acetate, and butyrate, by-products of healthy gut microbiota metabolism, have been demonstrated in obesity, type 1 and type 2 diabetes. However, it is not clear to date whether such changes in the microbiota are causative or merely associated with the diseases. It is also not clear which microbiota have protective effects on humans. Few studies have investigated the centrality of reduced SCFA in DKD development and progression or the potential therapeutic effects of supplemental SCFAs on insulin resistance, inflammation, and metabolic changes. SCFA receptors are expressed in the kidneys, and emerging data have demonstrated that intestinal dysbiosis activates the renal renin-angiotensin system, which contributes to the development of DKD. In this review, we will summarize the complex relationship between the gut microbiota and the kidney, examine the evidence for the role of gut dysbiosis in diabetes and obesity-related kidney disease, and explore the mechanisms involved. In addition, we will describe the role of potential therapies that modulate the gut microbiota to prevent or reduce kidney disease progression. MDPI 2021-09-06 /pmc/articles/PMC8431784/ /pubmed/34502562 http://dx.doi.org/10.3390/ijms22179641 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Zaky, Amgad
Glastras, Sarah J.
Wong, May Y. W.
Pollock, Carol A.
Saad, Sonia
The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease
title The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease
title_full The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease
title_fullStr The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease
title_full_unstemmed The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease
title_short The Role of the Gut Microbiome in Diabetes and Obesity-Related Kidney Disease
title_sort role of the gut microbiome in diabetes and obesity-related kidney disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431784/
https://www.ncbi.nlm.nih.gov/pubmed/34502562
http://dx.doi.org/10.3390/ijms22179641
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