Mob raum mob thiab plab dysbiosis: Kev piav qhia piav qhia tsom mus rau Pathphysiology thiab Kev Kho Mob

Abstract:Mob raum mob (AKI)thiabplab dysbiosiscuam tshuam ib leeg bidirectionally. AKI induces microbiota hloov pauv hauv plab hnyuv (GI), thaum lub plab dysbiosis kuj ua rau AKI hnyav dua. Kev sib cuam tshuam ntawm AKI thiab plab dysbiosis tseem tsis tau paub meej tab sis tsim nyog rau kev tshawb nrhiav ntxiv. Kev tshuaj xyuas tam sim no tsom rau ntawm pathophysiology ntawm qhov kev sib tshuam bidirectional thiabAKI kev kho mobhauv lub hauv paus no. Ob leegmacrophagesthiabneutrophilsntawm lub cev tiv thaiv kab mob thiab T pab hom 17 cell los ntawm covadaptive tiv thaiv kab mobyog cov neeg tseem ceeb ntawm AKI-induced plab dysbiosis. Hloov pauv, dysbiosis-vim kev tsim tawm ntau dhau ntawm plab-derived uremic toxins thiab tsim tsis txaus ntawm cov saw luv fatty acids yog lub ntsiab tseem ceeb ua rau AKI tsis zoo. Ntau qhov kev kho tshiab tau npaj los txhawm rau txhawm rau AKI kev nce qib los ntawm kev hloov kho GI microbiome thiab rhuav tshem lub voj voog phem no. Cov ntaub ntawv txhawb nqa cov txiaj ntsig ntawm kev kho mob probiotic hauv AKI cov neeg mob, thaum cov txiaj ntsig ntawm postbiotics feem ntau txwv rau cov tsiaj. Prebiotics thiab synbiotics feem ntau tham hauvcov neeg mob raum mobdua liAKI cov neeg mob. Cov nyhuv ntawm kev kho adsorbent zoo li pheej hmoo, tab sis xav tau kev tshawb fawb ntxiv ua ntej kev kho mob tuaj yeem siv rau cov neeg mob. Kev kho lub cev tiv thaiv kab mob thiab qee cov tshuaj repurposed xws li allopurinol yog qhov kev cia siab ntawm kev kho mob yav tom ntej thiab tsim nyog ntxiv kev sib tham thiab kev soj ntsuam.

Ntsiab lus:mob raum raug mob; dysbiosis; kev tiv thaiv; prebiotics;probiotics; luv-chain fatty acids; synbiotics

HERBAL FORMULATION FOR KIDNEY DISEASE

1. Taw qhia

Mob raum raug mob (AKI) yog ib qho chaw kho mob uas cuam tshuam txog li 1% ntawm cov pej xeem, 2-7% ntawm kev mus pw hauv tsev kho mob, thiab 13-78% ntawm cov neeg mob hnyav [1-4]. Nws muaj feem cuam tshuam nrog ntau yam kev mob nkeeg thiab kev pheej hmoo ntawm kev tuag uas nce ntxiv nrog rau kev ua kom hnyav thiab ntev ntawm AKI [5,6]. Txawm hais tias kev txhim kho cov tshuaj, AKI-kev cuam tshuam kev mob thiab kev tuag tseem nyob siab [7]. Ib qho kev piav qhia txog qhov tshwm sim tsis txaus ntseeg yog cov kab mob sib kis ntawm lub raum thiab cov kab mob ntxiv rau lub raum thaum AKI [8]. Cov kev tshawb fawb uas twb muaj lawm tau qhia txog kev sib tham ntawm lub raum thiab ntau yam kab mob hauv nruab nrog cev / kab ke xws li lub plawv, lub hlwb, lub cev tsis muaj zog, lub ntsws, plab, thiab pob txha. Cov kab mob hauv nruab nrog cev no ua rau muaj ntau qhov tshwm sim nyob deb ntawm lub cev tom qab AKI, suav nrog cov xwm txheej hauv lub plawv, lub plab zom mov (GI) los ntshav, xwm txheej mob stroke, malignancy, thiab txawm pob txha tawg [9].

HERBAL FORMULATION FOR KIDNEY DISEASE

Cov kab mob GI thiab ib puag ncig mesenteric lymphatics suav nrog lub cev qhov chaw nqus dej loj tshaj plaws. Nws nthuav tawm cov as-ham thiab txawv teb chaws antigens, microbes, thiab cov khoom tsim teeb meem. Multilayered mechanisms los ntawm cov neeg kho tshuab epithelial nruj hlws ris mus rau lub plab flora thiab lub cev tiv thaiv kab mob equip peb lub cev nrog ib tug tiv thaiv barrier tiv thaiv intrusion [10]. Thaum ntxov xyoo 2000s, cov kev tshawb fawb tau kos cov kev sib txuas ntawm GI ib puag ncig thiab ntau yam kab mob hauv lub cev tsis ua haujlwm (MODS) thiab tau hais tias lub plab ua haujlwm ua lub cev muaj zog ntawm lub cev tsis ua haujlwm [11]. Lawv kuj tau taw qhia tias kev cuam tshuam ntawm plab hnyuv epithelium barrier ua rau cov kab mob thiab cov khoom microbial to, pib, thiab exacerbating txoj kev loj hlob ntawm MODS.

HERBAL FORMULATION FOR KIDNEY DISEASE

Hauv xyoo tas los no, cov pov thawj tau pib qhia tias lub raum thiab GI ib puag ncig tau hla txoj hauv kev. Kev sib cuam tshuam ntawm plab microbiota thiab lub raum tau ua rau muaj kev tshawb fawb tshiab thiab kev sib tham ntau hauv pathophysiology thiab kev kho mob. Txawm li cas los xij, cov kev tshawb fawb soj ntsuam kev sib raug zoo ntawm lub plab microbiota hloov pauv, hu ua dysbiosis, thiab kab mob hauv lub raum feem ntau yog tackled nyob rau hauv mob raum kab mob (CKD) [12,13], qhov kev tshawb fawb tsawg muaj txog kev koom tes ntawm AKI thiab plab dysbiosis ( Table 1) [14–17]. Cov kev tshawb fawb soj ntsuam no pom tau tias plab microbiota plays nephroprotective lossis neu uropathogenic luag hauj lwm hauv AKI [15,16]. Clinically, AKI induces plab dysbiosis uas suav nrog kev cuam tshuam ntawm Escherichia coli, Bacteroidetes, Bifidobacterium, Salmonella, Lactobacillus, Clostridium, Ruminococcus, Rothia, Staphylococcus, Enterobacter, Faecalibacterium, thiab Lachnospiraceae, thiab lwm yam. AKI-induced plab dysbiosis hloov cov metabolism ntawm ntau cov saw luv fatty acids (SCFAs), cov amino acids xws li D-serine, thiab qee cov tshuaj lom neeg xws li acylcarnitines [15-17]. Lub plab dysbiosis kuj ua rau mob plab hnyuv thiab ua rau plab hnyuv. Txhua yam uas tau hais los saum no ua lub luag haujlwm tseem ceeb hauv kev txiav txim siab AKI txoj kev loj hlob thiab qhov hnyav. Hais lus luv luv, kev sib cuam tshuam ntawm ob lub raum thiab lub plab dysbiosis txhais tau hais tias ib qho cuam tshuam thiab ua rau lwm tus, piav qhia qhov nyuaj thiab nrawm ntawm cov txheej txheem.

Table 1. Kev tshawb fawb soj ntsuam kev koom tes ntawm AKI thiab plab dysbiosis

Txawm li cas los xij, cov txheej txheem pathophysiological ntawm AKI thiab plab dysbiosis tsis to taub meej thiab tsim nyog ntawm kev tshuaj xyuas thiab kho tshiab. Txhawm rau txhim kho kev paub thiab ua kom pom kev sib cuam tshuam ntawm AKI thiab plab dysbiosis hauv zej zog kev kho mob, peb muab cov lus tshuaj xyuas tom qab kev tshawb fawb dav dav ntawm PubMed siv cov ntsiab lus "plab" "dysbiosis" " raum " "AKI" "pathophysiology" thiab " kev kho mob". Kev tshuaj xyuas cov lus piav qhia tsom mus rau cov kab mob pathophysiology ntawm qhov kev sib cuam tshuam thiab muaj peev xwm kho AKI. Txawm hais tias feem ntau cov tswv yim xav tau yog ua raws li cov qauv tsiaj, cov pov thawj uas twb muaj lawm no pab cov kws kho mob thiab cov kws tshawb fawb nkag siab txog cov kab mob hauv qab, uas yog qhov tseem ceeb rau cov kev xav tshiab los txhim kho cov kev mob tshwm sim ntawm AKI cov neeg mob.

HERBAL FORMULATION FOR KIDNEY DISEASE