AUTHOR=Wang I-Kuan , Yen Tzung-Hai , Hsieh Pei-Shan , Ho Hsieh-Hsun , Kuo Yi-Wei , Huang Yen-Yu , Kuo Yu-Lun , Li Chi-Yuan , Lin Hung-Chih , Wang Jiu-Yao 

TITLE=Effect of a Probiotic Combination in an Experimental Mouse Model and Clinical Patients With Chronic Kidney Disease: A Pilot Study

JOURNAL=Frontiers in Nutrition

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.661794

DOI=10.3389/fnut.2021.661794

ISSN=2296-861X

ABSTRACT=<p>The aim of the present study was to evaluate whether probiotic administration could slow declining renal function. C57BL/6 mice (6–8 weeks of age, male) were fed a diet supplemented with adenine to induce chronic kidney disease (CKD). The experimental groups were additionally supplemented with 10<sup>9</sup> colony-forming units (CFU)/day (high-dose) and 10<sup>7</sup> CFU/day (low-dose) probiotics containing <italic>Lactobacillus acidophilus</italic> (TYCA06), <italic>Bifidobacterium longum</italic> subspecies <italic>infantis</italic> (BLI-02), and <italic>B. bifidum</italic> (VDD088). Renal function and histology were examined. Patients with stage 3–5 CKD and not on dialysis were recruited from July 2017 to January 2019. Two capsules of probiotics containing 2.5 × 10<sup>9</sup> CFU with the same composition were administered twice daily for 6 months. The decline in the estimated glomerular filtration rate (eGFR) was measured before and after the intervention. In addition, changes in the serum endotoxin and cytokine levels, gastrointestinal symptom scores, and the stool microbiota were measured. Probiotics could attenuate renal fibrosis and improve renal function in CKD mice. Thirty-eight patients completed the 6-month study. The mean baseline eGFR was 30.16 ± 16.52 ml/min/1.73 m<sup>2</sup>. The rate of decline in the eGFR was significantly slower, from −0.54 (−0.18, −0.91) to 0.00 (0.48, −0.36) ml/min/1.73 m<sup>2</sup>/month (<italic>P</italic> = 0.001) after 6 months of treatment. The serum levels of TNF-α, IL-6, IL-18, and endotoxin were significantly decreased after probiotic administration. Borborygmus and flatulence scores, as well as stool formation improved significantly. The abundance of <italic>B. bifidum</italic> and <italic>B. breve</italic> in the stool microbiota increased significantly. In conclusion, a combination of probiotics might attenuate renal function deterioration in CKD mice and human patients.</p>