Etiology of minimal change nephrotic syndrome focusing on the gut microbiota affecting gut immunity.

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K08287
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52050:Embryonic medicine and pediatrics-related
• Research Institution: Kansai Medical University
• Principal Investigator: TSUJI Shoji 関西医科大学, 医学部, 准教授 (00360256)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 微小変化型ネフローゼ症候群 / puromycin / 8-OHｄG / 酸化ストレス

Outline of Final Research Achievements

This study was designed to prove the hypothesis that abnormalities in the gut microbiota play an important role in the etiology of first onset or relapse of MCNS. Initially, we expected that the urinary protein level would be higher than that of the control rats. The results showed that, on the contrary, the urinary protein levels were lower. We hypothesized that the administration of the four antimicrobial agents decreased urinary protein in PAN rats as a result of sterilization of gut bacteria associated with oxidative stress. Therefore, we measured urinary 8-OHdG, a marker of oxidative stress, and found that 8-OHdG was significantly decreased before and after administration of the four antimicrobial agents.

Free Research Field

小児科学

Academic Significance and Societal Importance of the Research Achievements

小児ネフローゼ症候群の第一選択薬は副腎皮質ステロイド薬である。副腎皮質ステロイド薬の投与により約90%が寛解となる。しかし、約60～70%が再発をきたし、再び副腎皮質ステロイド薬の投与を必要とする。副腎皮質ステロイド薬の副作用は多岐にわたるが、特に小児で問題となる低身長は治療終了後も改善しない。そのため、副腎皮質ステロイド薬の総投与量をできる限り減少することを目的として様々な治療法が考案されている。今回の報告者らの結果により抗菌薬投与がネフローゼの一つの治療法として確立すれば副腎皮質ステロイド薬の総投与量減少が期待され社会的貢献は大きいと考える。