慢性肾脏病5期患者的肠道菌群变化

Changes of intestinal microbiota in patients with chronic kidney disease 5

目的通过16S rDNA测序技术探究慢性肾脏病5期(CKD5)患者与健康人体内肠道菌群构成的差异。方法研究入组健康对照组69例、慢性肾脏病5期非透析(CKD5-NHD)组24例、慢性肾脏病5期透析(CKD5-HD)组29例。通过16s rDNA测序技术研究CDK5组(CKD5-NHD组和CKD5-HD组)与健康对照组肠道菌群构成的差异,以LDA>2.0表示两组间生物群落存在显著差异。基于测序结果,应用宏基因组数据统计分析(STAMP)软件映射到京都基因与基因组百科全书(KEGG)和蛋白质直系同源簇(COG)数据库,研究CKD5患者肠道微生物群可能具有的功能。结果健康对照组中,拟杆菌门(Bacteroidetes)、γ-变形菌纲(Gammaproteobacteria)、肠杆菌科(Enterobacteriaceae)等占优势;在CKD-HD组中,肠球菌科(Enterococcaceae)、真细菌属(Eubacterium)、红杆菌科(Rhodobacteraceae)等丰度较高;而在CKD-NHD组中,放线菌门(Actinobacteria)、双歧杆菌属(Bifidobacterium)、红蝽菌目(Coriobacteriales)等为主要优势菌群。通过肠道微生物群功能预测发现,CKD5患者肠道失调的微生物群在脂质代谢、碳水化合物代谢、蛋白质及氨基酸代谢方面有着更活跃的表现。结论与健康人相比,CKD5患者肠道菌群发生显著变化。CKD5患者的紊乱肠道菌群能够影响机体物质代谢,并通过影响机体多种代谢及信号传导通路增加罹患并发症风险。

Objective To explore the differences of gut microbiota composition between chronic kidney disease 5 (CKD5) patients and healthy people. Methods The individuals were divided into the healthy control group (n=69), CKD5-none hemodialysis (NHD) group (n=24) and CKD5-hemodialysis (HD) group (n=29). 16S rRNA gene sequencing technology was used to analyze differences of the gut microbiota composition among the three groups. LDA>2.0 indicated significant differences in the biome between two groups. Based on the sequencing results, the function of intestinal microflora in CKD5 patients was studied by means of STAMP software mapping to KEGG and COG database.Results In the healthy control group, Bacteroidetes, Gammaproteobacteria, and Enterobacteriaceae were dominant.Enterococcaceae, Eubacterium, Rhodobacteraceae were high in CKD5-HD group, while Actinobacteria, Bifidobacterium ,Coriobacteriales were dominant in the CKD5-NHD group. In the CKD5 patients, glycerolipid, carbohydrate, protein and amino acid metabolism activity was increased. Conclusion Significant differences were found in the composition and function of the gut microbiota between the CKD5 patients and healthy individuals. Imbalance of the gut microbiota in CKD5 patients may increased the risk of complications by influencing a variety of metabolic and signaling pathways.