Fecal microbiota characteristics of Chinese patients with primary IgA nephropathy: a cross-sectional study

Abstract

Background: Growing evidence has shown that the gut-renal connection and gut microbiota dysbiosis play a critical role in immunoglobulin A nephropathy (IgAN). However, the fecal microbiome profile in Chinese patients with IgAN remains unknown. A cross-sectional study was designed for the first time to investigate the fecal microbiota compositions in patients with primary IgAN in China and to evaluate the relationship between the fecal microbiome and IgAN clinical presentation. Methods: Fecal samples were collected from 17 IgAN patients and 18 age-, sex-, and body mass index-matched healthy controls, and bacterial DNA was extracted for 16S ribosomal RNA gene sequencing targeting the V3-V4 region. Results: Fecal samples from the IgAN patients and healthy controls showed differences in gut microbiota community richness and compositions. Compared to the healthy controls, IgAN patients at the phylum level had an increased abundance of Fusobacteria, but a decreased abundance of Synergistetes. The significantly increased genera in the IgAN group were Escherichia-Shigella, Hungatella, and Eggerthella, all of which possess pathogenic potential. Furthermore, the genus Escherichia-Shigella was negatively associated with the estimated glomerular filtration rate (eGFR) but was positively associated with the urinary albumin-to-creatinine ratio (uACR). However, the genus rectale_group was present in the IgAN group with a low abundance and was negatively associated with the uACR. Functional analysis disclosed that infection-related pathways were enriched in the IgAN group. Conclusions: We demonstrate that gut microbiota dysbiosis occurs in patients with IgAN, and that changes in gut bacterial populations are closely related to IgAN clinical features, suggesting that certain specific gut microbiota may be a potential therapeutic target for IgAN.

Specific alterations in gut microbiota in patients with chronic kidney disease: an updated systematic review

“…Twelve (12/25) studies analyzed the relatively distinct taxa at the phylum level ( Table S6 ), of which two studies (2/10) focused on ESRD [ 24 , 25 ]. Six (6/10) and three (3/10) studies demonstrated that Proteobacteria [ 24 , 25 , 27–29 , 33 ] and Fusobacteria [ 18 , 27 , 34 ] were more abundant, while two (2/10) studies [ 18 , 29 ] showed that the abundance of Synergistetes in patients with CKD was less than that in controls. The abundance of Firmicutes , Bacteroidetes , and Actinobacteria in patients with CKD was inconsistent when compared to controls.…”

“…Of 12 studies, 10 studies were conducted in China, and two (2/10) studies focused on ESRD. Five (5/8), two (2/8), and two (2/8) studies demonstrated that Proteobacteria [ 20 , 27–29 , 33 ], Fusobacteria [ 18 , 27 ], and Bacteroidetes [ 17 , 33 ] were more abundant, while four (4/8) and two (2/8) studies revealed that Firmicutes [ 17 , 27 , 28 , 33 ] and Synergistetes [ 18 , 29 ] were less abundant in Chinese CKD patients compared with healthy controls, respectively. However, the two studies conducted in the US [ 34 ] and Italy [ 19 ] did not identify any taxa with the same alteration in CKD patients.…”

“…Fourteen (14/25) studies documented the relatively distinct taxa at the family level ( Table S9 ), of which five studies [ 21 , 23–25 , 28 ] focused on ESRD. Five (5/9) and two (2/9) studies showed that Enterococcaceae [ 18 , 19 , 27 , 28 , 33 ] and Fusobacteriaceae [ 17 , 27 ] were more abundant in patients with CKD than in healthy controls, respectively. Four (4/9) studies showed that Prevotellaceae [ 19 , 20 , 28 , 33 ] and Lachnospiraceae [ 27 , 28 , 32 , 33 ] were less abundant in patients with CKD than in healthy controls, respectively.…”

“…Four (4/9) studies showed that Prevotellaceae [ 19 , 20 , 28 , 33 ] and Lachnospiraceae [ 27 , 28 , 32 , 33 ] were less abundant in patients with CKD than in healthy controls, respectively. Two (2/9) studies showed Synergistaceae [ 18 , 30 ] and Lactobacillaceae [ 19 , 30 ] were less abundant in patients with CKD than in healthy controls, respectively. Two (2/5) studies found that Enterococcaceae [ 21 , 25 ], Streptococcaceae [ 23 , 25 ], and Desulfovibrionaceae [ 22 , 24 ] were more abundant in patients with ESRD than in controls.…”

Perspectives on how mucosal immune responses, infections and gut microbiome shape IgA nephropathy and future therapies

“…In supporting this, studies showed that the microbial characteristics among patients with IgAN and healthy controls were different. More specifically, higher percentages of the Ruminococcaceae , Lachnospiraceae , Eubacteriaceae, Streptococcaeae, Escherichia-Shigella , Hungatella , or Eggerthella genera/species could be observed in patients with IgAN 27 , 28 . Moreover, patients with IgAN presented significantly higher intestinal permeability, which was related to increased proteinuria, microhematuria, and serum levels of IgA when compared with healthy controls 14 .…”