Investigation of the relationship between gut microbiota and transplant immunity in Japanese living-donor kidney transplant recipients

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K18124
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56030:Urology-related
• Research Institution: Nara Medical University
• Principal Investigator: Hori Shunta 奈良県立医科大学, 医学部, 助教 (30623681)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 腎移植 / 腸内細菌叢 / 上皮間葉転換 / サルコペニア

Outline of Final Research Achievements

Long-term oral administration of immunosuppressive drugs is required for renal transplantation, which may adversely affect renal function and muscle mass. In this study, we investigated between these mechanism and the intestinal flora. It was suggested that calcineurin inhibitors caused renal dysfunction through the mechanism of epithelial-mesenchymal transition. A marked decrease in muscle mass was also confirmed with prednisolone and calcineurin inhibitors. Furthermore, it has been confirmed that the characteristic intestinal flora is composed by oral administration of various immunosuppressive agents, and the relationship between renal function and muscle mass is under investigation.

Free Research Field

腎移植

Academic Significance and Societal Importance of the Research Achievements

免疫抑制剤の改良により腎移植の短期成績は大きく向上した。今後の課題として長期の成績向上があげられるが、今回の検討から免疫抑制剤の長期内服により腎機能障害や筋障害が生じることが再確認できた。腸内細菌叢は免疫機構や薬物の吸収・代謝に大きく関与していることが指摘されており、今回の調査で判明した特徴的な腸内細菌叢の構築と腎機能障害や筋障害の関連が示せれば、今までにない新たなアプローチ（腸内環境を整える治療）で腎移植の長期成績向上に貢献できる。