2021 Fiscal Year Final Research Report

Changes of microbiome in patients with chronic kidney disease and new therapeutic strategy by their improvement

Research Project

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Project/Area Number	19K08700
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 53040:Nephrology-related
Research Institution	Nagoya University
Principal Investigator	Kato Sawako 名古屋大学, 医学系研究科, 特任講師 (80625757)
Co-Investigator(Kenkyū-buntansha)	石本卓嗣愛知医科大学, 医学部, 准教授 (00534835) 丸山彰一名古屋大学, 医学系研究科, 教授 (10362253) 小杉智規名古屋大学, 医学系研究科, 准教授 (90584681)
Project Period (FY)	2019-04-01 – 2022-03-31
Keywords	腸内細菌叢 / 慢性腎不全 / 細胞老化 / コホート研究 / 炎症 / カルシウム
Outline of Final Research Achievements	We analyzed bacterial DNA fragments in the circulating leukocytes collected from the patients who had just started dialysis therapy and one year after dialysis initiation. The bacterial strains in the circulating leukocytes at the start of dialysis differed greatly according to the primary disease of renal failure (diabetes mellitus, polycystic kidney, nephrosclerosis, chronic nephritis). There was no difference in bacterial strains between diabetic and non-diabetic, or patients with and without a history of cardiovascular disease.Next, we compared the bacterial genera among patients at the start dialysis, those one year after the start of dialysis therapy and healthy subjects. We found the difference in key bacterial genera involved with induction of inflammation between dialysis patients and healthy subjects. In addition, there was a correlation between the increase in serum calcium levels at the start of dialysis and the growth of Bacillus bacteria.
Free Research Field	腎臓内科学
Academic Significance and Societal Importance of the Research Achievements	慢性腎臓病患者は、末期には人工透析療法など高負荷の治療を必要とし、心臓病や脳卒中などの血管合併症の罹患率も高い。そのため、慢性腎臓病の進行を抑制と、合併症の予防は社会的にも重要な問題である。今回、循環白血球内に取り込まれた細菌由来のDNA断片を解析したところ、末期腎不全患者の細菌叢は健常人と異なることを見いだした。炎症に関与している可能性のある細菌叢群の比率と血清カルシウム上昇に関与する可能性のある菌の増殖が認められた。慢性腎臓病患者の管理において、腸内細菌叢の変調が炎症の惹起や動脈石灰化に関与している可能性が示唆され、あらたな治療戦略の開発につながるものと思われた。