STRUCTURAL AND FUNCTIONAL INTESTINAL BARRIER ABNORMALITIES AND CHRONIC KIDNEY DISEASE. LITERATURE REVIEW. PART II
https://doi.org/10.36485/1561-6274-2022-26-2-46-64
Abstract
The last few decades have been marked by significant progress in the investigation of the intestinal microbial-tissue complex and its role in the pathogenesis of a wide range of diseases. The presence of intestinal barrier dysfunction has also been confirmed in various nephropathies. Patients with chronic kidney disease (CKD) are characterized by specific alterations of the qualitative and quantitative composition of the gut microbiota. These changes contribute to an increase in the fermentation of food proteins into uremic toxins, such as p-cresyl sulfate, indoxyl sulfate and trimethylaminoxide, disorders of immune tolerance mechanisms of the mucous membrane, disorganization of intestinal epithelium tight junctions, which inevitably leads to an increase of transepithelial permeability. Translocation of bacteria and microbial metabolism products from the intestinal lumen into the systemic circulation is responsible for systemic inflammation, which is currently considered as one of the leading causes of the CKD progression and related complications. However, the exact mechanisms of gut-kidney interaction remain poorly understood. The second part of the review gives a detailed description of the structural and functional disorders of the intestinal muco-epithelial barrier identified in various nephropathies. The mechanisms of uremia-induced intestinal epithelial disruption are discussed, as well as the current therapeutic strategies that may attenuate consequences of intestinal barrier dysfunction in patients with CKD.
About the Authors
M. O. Pyatchenkov
Military Medical Academy S.M. Kirov
Russian Federation
Russian Federation
Mikhail O. Pyatchenkov, PhD, Department of nephrology and blood purification
194044, St. Petersburg
Phone: +7 (812) 5424314
A. S. Rumyantsev
Saint Petersburg State University; Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Alexandr Sh.Rumyantsev, MD, PhD, DMedSci. Department of Faculty Therapy, Saint Petersburg State University; Department of Propaedeutics of Internal Diseases, Pavlov First Saint Petersburg State Medical University
199106, St. Petersburg
Phone: +7 (812) 3260326
E. V. Sherbakov
Military Medical Academy S.M. Kirov
Russian Federation
Russian Federation
Evgeniy V.Scherbakov, Department of nephrology and blood purification
194044, St. Petersburg
Phone: +7 (812) 5424314
A. G. Markov
Saint Petersburg State University
Russian Federation
Russian Federation
Alexander G. Markov, D.Sc., professor, Department of General
Physiology
199034, St. Petersburg, Universitetskaj nab. 7-9
Phone: +7 (812) 3289589
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For citations:
Pyatchenkov M.O., Rumyantsev A.S., Sherbakov E.V., Markov A.G. STRUCTURAL AND FUNCTIONAL INTESTINAL BARRIER ABNORMALITIES AND CHRONIC KIDNEY DISEASE. LITERATURE REVIEW. PART II. Nephrology (Saint-Petersburg). 2022;26(2):46-64. (In Russ.) https://doi.org/10.36485/1561-6274-2022-26-2-46-64
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