nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное общество10.28996/2618-9801-2024-3-283-302nid-709Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESМикробиота кишечника и заболевания почек. Обзор литературыGut microbiota and kidney diseases. Literature reviewhttps://orcid.org/0000-0002-1047-0378ШутовЕ. В.ShutovE. V.

Шутов Евгений Викторович – доктор медицинских наук, руководитель межокружного нефрологического центра

125284, Москва, 2-й Боткинский проезд, д. 5 

125284, Москва, 2-ой Боткинский проезд, д. 5, корпус 11 

5, 2nd Botkinsky drive, 125284, Moscow 

5, 2nd Botkin passage, building 11, Moscow, 125284 

Shutov_e_v@mail.ruhttps://orcid.org/0000-0002-4556-6740БольшаковС. А.BolshakovS. A.

Большаков Степан Алексеевич – младший научный сотрудник, врач-терапевт 

125284, Москва, 2-й Боткинский проезд, д. 5

5, 2nd Botkinsky drive, 125284, Moscow 

my@stepan-bolshakov.ruhttps://orcid.org/0009-0002-8610-3950МакароваТ. А.MakarovaT. A.

Макарова Татьяна Александровна – врач-нефролог  

125284, Москва, 2-й Боткинский проезд, д. 5

5, 2nd Botkinsky drive, 125284, Moscow 

tmakarova24@icloud.comhttps://orcid.org/0009-0001-0960-1844ФедосееваИ. А.FedoseevaI. A.

Федосеева Ирина Анатольевна – врач-нефролог 

125284, Москва, 2-й Боткинский проезд, д. 5

5, 2nd Botkinsky drive, 125284, Moscow 

fedosseeva-irina@mail.ruhttps://orcid.org/0000-0002-7628-8851ТеплюкД. А.TeplyukD. A.

Теплюк Дарья Андреевна – врач-гастроэнтеролог 

125284, Москва, 2-й Боткинский проезд, д. 5

119991, Москва, ул. Трубецкая, д. 8, стр. 2

5, 2nd Botkinsky drive, 125284, Moscow 

8, building 2, Trubetskaya str., Moscow, 119991 

teplyouk@gmail.ruhttps://orcid.org/0000-0001-5031-9798ПавловЧ. С.PavlovC. S.

Павлов Чавдар Савович – доктор медицинских наук, заведующий кафедрой терапии 

125284, Москва, 2-й Боткинский проезд, д. 5

119991, Москва, ул. Трубецкая, д. 8, стр. 2

5, 2nd Botkinsky drive, 125284, Moscow 

8, building 2, Trubetskaya str., Moscow, 119991 

chpavlov@mail.ruСороколетовС. М.SorokoletovS. M.

Сороколетов Сергей Михайлович – доктор медицинских наук, заместитель главного врача по терапевтической помощи 

125284, Москва, 2-й Боткинский проезд, д. 5

5, 2nd Botkinsky drive, 125284, Moscow 

sorokoletov-sm@mail.ruГБУЗ “Московский многопрофильный научно-клинический центр Боткинская больница” ДЗМ ; Кафедра нефрологии и гемодиализа ФГБОУ ДПО РМАНПО Минздрава РоссииРоссияBotkin Hospital ; Chair of Nephrology and Hemodialysis of Russian Medical Academy of Continuous Professional EducationRussian FederationГБУЗ “Московский многопрофильный научно-клинический центр Боткинская больница” ДЗМРоссияBotkin HospitalRussian FederationГБУЗ “Московский многопрофильный научно-клинический центр Боткинская больница” ДЗМ ; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова»РоссияBotkin Hospital ; Sechenov First Moscow State Medical UniversityRussian Federation202420092024263283302Copyright © Шутов Е.В., Большаков С.А., Макарова Т.А., Федосеева И.А., Теплюк Д.А., Павлов Ч.С., Сороколетов С.М., 20242024Шутов Е.В., Большаков С.А., Макарова Т.А., Федосеева И.А., Теплюк Д.А., Павлов Ч.С., Сороколетов С.М.Shutov E.V., Bolshakov S.A., Makarova T.A., Fedoseeva I.A., Teplyuk D.A., Pavlov C.S., Sorokoletov S.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/709

Технологические достижения последних лет привели к значительному росту понимания роли микробных сообществ, населяющих организм человека. Микробиота кишечника представляет собой одну из самых разнообразных микробиот организма человека и включает более 35 000 видов бактерий с 10 миллионами генов. По этой причине многие авторы называют микробиоту кишечника дополнительным органом. Микроорганизмы, населяющие кишечник, представляют собой динамическую экосистему, состав которой тем не менее относительно постоянен у каждого человека, но в то же время существенно зависит от экзо- и эндогенных факторов. Коллективно они функционируют как «второй геном», оказывая глубокое влияние на метаболические пути хозяина, управляя сложным гомеостатическим равновесием организма. Исследования механизмов, лежащих в основе взаимодействия «микроб–хозяин» как в здоровом состоянии, так и в ходе заболевания, являются предметом научного интереса во всем мире. Микробиота кишечника заметно изменяется при ХБП, а накопленные данные подтверждают теорию о том, что дисбиоз в значительной степени способствует прогрессированию почечной недостаточности. Уремические токсины кишечного происхождения, снижение синтеза короткоцепочечных жирных кислот, изменение pH кишечной среды, нарушение кишечного барьера и, как следствие, нарастание системного воспаления – неполный перечень патологических процессов, происходящих при непосредственном участии кишечной микробиоты. Описанные изменения у пациентов с заболеваниями почек требуют дальнейшего изучения их взаимосвязи с патогенезом, механизмами прогрессирования заболевания. Используемые для изучения состава микробиома: метагеномный и метатранскриптомный анализы, дополненные анализом белков, метаболитов и иммунома, а также механистическими экспериментами в модельных системах значительно улучшили нашу способность понимать структуру и функции микробиома, существенно расширяя наши знания о микробных сообществах и их влиянии на метаболизм. Целью множества исследований в настоящее время является рассмотрение этой двунаправленной связи между представителями микробиоты и хозяином и потенциальных вмешательств, которые могут помочь в восстановлении мутуалистических отношений.

Recent technological advances have significantly enhanced our understanding of the role microbial communities play in the human body. The gut microbiota, one of the most diverse microbiomes, consists of over 35,000 bacterial species and 10 million genes, leading researchers to consider it as an additional organ. This whiles relatively stable within each individual highly influenced by exogenous and endogenous factors. Collectively, the gut microbiota functions as a "second genome", profoundly impacting the host’s metabolic pathways and regulating the body’s complex homeostatic balance.

Research into the "microbe–host" interaction, both in health and disease, has garnered worldwide scientific. In chronic kidney disease (CKD), the gut microbiota undergoes significant changes, and growing evidences suggests that dysbiosis plays a crucial role in the progression of renal failure. Key pathological process, such as the production of gut-derived uremic toxins, decreased synthesis of short–chain fatty acids, altered intestinal pH, compromised intestinal barrier function, and heightened systemic inflammation, are all linked the intestinal microbiota. However, relationship between these changes and the pathogenesis and progression of kidney disease requires further investigation. Advances in microbiome research, including metagenomic and metatranscriptomic analyses, alongside proteomic, metabolomics, and immunomic studies, have greatly expanded our understanding of microbiomal community structure and functions. These technologies, coupled with mechanistic experiments in model systems, have deepened our knowledge of how the microbiome influences metabolism. Current research aims to explore the bidirectional relationship between the microbiota and the host, identifying potential interventions that could help restore a mutualistic relationship.

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The authors declare that there are no conflicts of interest present.