肠道微环境与糖尿病肾病

Intestinal microenvironment and diabetic kidney disease

肠道微环境作为一种复杂的微生态系统,在肥胖、高脂血症、糖尿病、高血压、慢性肾脏病、溃疡性结肠炎等多种疾病中发挥重要作用.饮食、药物、疾病均影响肠上皮细胞和人体微生物组的结构、功能,直接或间接调节机体代谢及免疫系统,造成全身炎症水平升高,加重基础疾病.肾脏是糖尿病微血管损伤的重要器官,但目前尚无针对肠道微环境预防、治疗、逆转糖尿病肾脏病的创新性策略.本文聚焦肠道微环境对糖代谢和免疫功能的影响、糖尿病对肠道微环境的影响以及干预肠道微环境对糖尿病肾病的意义,旨在以人体微生物组作为靶点,为个体化治疗延缓糖尿病肾病进展提供思路.

As a complex microecosystem,intestinal microenvironment plays an important role in a large group of diseases,such as obesity,hyperlipidemia,diabetes,hypertension,chronic kidney disease,and ulcerative colitis.Diet,drugs and diseases all affect the composition and function of intestinal epithelial cells and human microbiome,and regulate body metabolism and immune system both directly or indirectly,resulting in aggravation of systemic inflammation and basic diseases.Kidney is the most important organ of microvascular damage in diabetes.However,there remains an unmet need for innovative therapeutic strategies targeting at gut microenviroment to prevent,treat and reverse diabetic kidney disease.This review will focus on the influence of intestinal microenvironment on glucose metabolism and immunological function of host,summarize effect of diabetes on intestinal microenvironment and discuss current preclinical and clinical evidence of manipulating gut microenvironment to treat diabetes kidney disease,in order to provide ideas targeting at human microbiome for slowing progression of diabetic kidney disease by individualized treatment.