Probiotics, prebiotics and synbiotics for chronic kidney disease: protocol for a systematic review and meta-analysis

Pei, Ming; Wei, Lidong; Hu, Shouci; Yang, Bo; Si, Jinhua; Yang, Hongtao; Zhai, Jing

doi:10.1136/bmjopen-2017-020863

Cited by 16 publications

(14 citation statements)

References 28 publications

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“…SCFA contribute to the health of the gut (microbiome and mucosa) and the overall health of the host. They have been shown to exert anti-inflammatory, anti-oxidative, anti-diabetic, anti-cancer and antibacterial effects [ 20 , 21 ]. A dysbiotic gut microbiome and lower levels of SCFA contribute to various diseases such as inflammatory bowel disease [ 5 , 22 , 23 ], rheumatoid arthritis and multiple sclerosis [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Supplementation of Short-Chain Fatty Acid, Sodium Propionate, in Patients on Maintenance Hemodialysis: Beneficial Effects on Inflammatory Parameters and Gut-Derived Uremic Toxins, A Pilot Study (PLAN Study)

Marzocco

Fazeli

Micco

et al. 2018

JCM

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Background: In end-stage renal disease (ESRD), gut-derived uremic toxins play a crucial role in the systemic inflammation and oxidative stress promoting the excess morbidity and mortality. The biochemical derangement is in part a consequence of an insufficient generation of short-chain fatty acids (SCFA) due to the dysbiosis of the gut and an insufficient consumption of the fermentable complex carbohydrates. Aim of the study: The primary end-point was to evaluate the potential efficacy of SCFA (specifically, sodium propionate (SP)) for patients on maintenance hemodialysis (MHD) on systemic inflammation. Secondary end-points included potential attenuation of oxidative stress markers, insulin resistance and production of gut-derived uremic toxins indoxyl sulfate and p-cresol sulfate, as well as health status after SP supplementation. Study design: We performed a single-center non-randomized pilot study in 20 MHD patients. They received the food additive SP with a daily intake of 2 × 500 mg in the form of capsules for 12 weeks. Pre-dialysis blood samples were taken at the beginning, after six weeks and at the end of the administration period, as well as four weeks after withdrawal of the treatment. Results: The subjects revealed a significant decline of inflammatory parameters C-reactive protein (−46%), interleukin IL-2 (−27%) and IL-17 (−15%). The inflammatory parameters IL-6 and IFN-gamma showed a mild non-significant reduction and the anti-inflammatory cytokine IL-10 increased significantly (+71%). While the concentration of bacterial endotoxins and TNF-α remained unchanged, the gut-derived uremic toxins, indoxyl sulfate (−30%) and p-cresyl sulfate (−50%), revealed a significant decline. The SP supplementation reduced the parameters of oxidative stress malondialdehyde (−32%) and glutathione peroxidase activity (−28%). The serum insulin levels dropped by 30% and the HOMA-index by 32%. The reduction of inflammatory parameters was associated with a lowering of ferritin and a significant increase in transferrin saturation (TSAT). Four weeks after the end of the treatment phase, all improved parameters deteriorated again. Evaluation of the psycho-physical performance with the short form 36 (SF-36) questionnaire showed an enhancement in the self-reported physical functioning, general health, vitality and mental health. The SP supplementation was well tolerated and without important side effects. No patient had left the study due to intolerance to the medication. The SP supplementation in MHD patients reduced pro-inflammatory parameters and oxidative stress and improved insulin resistance and iron metabolism. Furthermore, SP effectively lowered the important gut-derived uremic toxins indoxyl and p-cresol sulfate. These improvements were associated with a better quality of life. Further controlled studies are required in a larger cohort to evaluate the clinical outcome.

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Section: Introductionmentioning

confidence: 99%

Supplementation of Short-Chain Fatty Acid, Sodium Propionate, in Patients on Maintenance Hemodialysis: Beneficial Effects on Inflammatory Parameters and Gut-Derived Uremic Toxins, A Pilot Study (PLAN Study)

Marzocco

Fazeli

Micco

et al. 2018

JCM

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“…This meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines for Protocols (PRISMA-P). [ 20 , 21 ]…”

Section: Methodsmentioning

confidence: 99%

Effect of probiotics, prebiotics and synbiotics for chronic bronchitis or chronic obstructive pulmonary disease

Pei¹,

Wang³

et al. 2020

Medicine

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Background: Probiotics, prebiotics and synbiotics have been widely used in the treatment of respiratory diseases, but their clinical efficacy for treating chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) has not been well studied. Methods: The following electronic databases will be searched for eligible randomized controlled trials: the Cochrane Library, EMBASE, MEDLINE, PubMed, Scopus, the Web of Science, the China National Knowledge Infrastructure, the Wanfang database, and the China Science and Technology Journal database (VIP Information Network). We will search these electronic databases weekly and extract relevant data from their inception dates until September 30, 2020. Risk of publication bias will be evaluated by the Cochrane Handbook for Systematic Reviews of Interventions. Data synthesis will be conducted using Review Manager (RevMan) version 5.3 software. Sensitivity and quality of evidence analyses will be conducted. Results: This systematic review and meta-analysis will provide a high-quality synthesis from existing evidence for estimating the efficacy and safety of probiotics, prebiotics and synbiotics in the treatment of CB or COPD. Conclusion: This systematic review and meta-analysis will provide reliable and accurate evidence to guide the use of probiotics, prebiotics and synbiotics in the treatment of CB or COPD. Registration OSF registration number: DOI 10.17605/OSF.IO/SP35M.

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“…Conversely, selective targeting of gut-microbiota-dependent TMAO generation has been reported to protect CKD progression in a murine model of CKD [ 79 ]. Although the uses of prebiotics, probiotics, postbiotics, and synbiotics have shown potential positive effects against uremic toxin generation, their evidence is still limited for the treatment and prevention of human CKD [ 80 , 81 , 82 ].…”

Section: Gut Microbiota and Kidney Diseasementioning

confidence: 99%

“…Recently, researchers have increasingly turned their attention on gut microbiota and its derived metabolites as a potential target for therapeutics [ 81 , 82 , 93 , 94 ]. In clinical practice, the most generally used gut microbiota-targeted therapies are probiotics and prebiotics.…”

Section: Gut Microbiota-targeted Therapymentioning

confidence: 99%

Chronic Kidney Disease and Gut Microbiota: What Is Their Connection in Early Life?

Hsu

Tain

2022

IJMS

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The gut–kidney interaction implicating chronic kidney disease (CKD) has been the focus of increasing interest in recent years. Gut microbiota-targeted therapies could prevent CKD and its comorbidities. Considering that CKD can originate in early life, its treatment and prevention should start in childhood or even earlier in fetal life. Therefore, a better understanding of how the early-life gut microbiome impacts CKD in later life and how to develop ideal early interventions are unmet needs to reduce CKD. The purpose of the current review is to summarize (1) the current evidence on the gut microbiota dysbiosis implicated in pediatric CKD; (2) current knowledge supporting the impact of the gut–kidney axis in CKD, including inflammation, immune response, alterations of microbiota compositions, short-chain fatty acids, and uremic toxins; and (3) an overview of the studies documenting early gut microbiota-targeted interventions in animal models of CKD of developmental origins. Treatment options include prebiotics, probiotics, postbiotics, etc. To accelerate the transition of gut microbiota-based therapies for early prevention of CKD, an extended comprehension of gut microbiota dysbiosis implicated in renal programming is needed, as well as a greater focus on pediatric CKD for further clinical translation.

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Probiotics, prebiotics and synbiotics for chronic kidney disease: protocol for a systematic review and meta-analysis

Cited by 16 publications

References 28 publications

Supplementation of Short-Chain Fatty Acid, Sodium Propionate, in Patients on Maintenance Hemodialysis: Beneficial Effects on Inflammatory Parameters and Gut-Derived Uremic Toxins, A Pilot Study (PLAN Study)

Supplementation of Short-Chain Fatty Acid, Sodium Propionate, in Patients on Maintenance Hemodialysis: Beneficial Effects on Inflammatory Parameters and Gut-Derived Uremic Toxins, A Pilot Study (PLAN Study)

Effect of probiotics, prebiotics and synbiotics for chronic bronchitis or chronic obstructive pulmonary disease

Chronic Kidney Disease and Gut Microbiota: What Is Their Connection in Early Life?

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