Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2022; 13(3): 150-160
Published online Mar 15, 2022. doi: 10.4239/wjd.v13.i3.150
Efficacy of probiotics on the modulation of gut microbiota in the treatment of diabetic nephropathy
Nozomi Nagase, Yuka Ikeda, Ai Tsuji, Yasuko Kitagishi, Satoru Matsuda
Nozomi Nagase, Yuka Ikeda, Ai Tsuji, Yasuko Kitagishi, Satoru Matsuda, Department of Food Science and Nutrition, Nara Women's University, Nara 630-8506, Japan
Author contributions: Each author has participated sufficiently in the work of drafting the article and/or revising the article for important rational content; all authors give final approval of the version to be submitted.
Conflict-of-interest statement: The authors declare that they have no competing financial interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Satoru Matsuda, MD, PhD, Professor, Department of Food Science and Nutrition, Nara Women's University, Kita-Uoya Nishimachi, Nara 630-8506, Japan. smatsuda@cc.nara-wu.ac.jp
Received: March 5, 2021
Peer-review started: March 5, 2021
First decision: May 3, 2021
Revised: May 21, 2021
Accepted: February 11, 2022
Article in press: February 11, 2022
Published online: March 15, 2022
Abstract

Diabetic nephropathy (DN) is a major cause of end-stage renal disease, and therapeutic options for preventing its progression are insufficient. The number of patients with DN has been increasing in Asian countries because of westernization of dietary lifestyle, which may be associated with the following changes in gut microbiota. Alterations in the gut microbiota composition can lead to an imbalanced gastrointestinal environment that promotes abnormal production of metabolites and/or inflammatory status. Functional microenvironments of the gut could be changed in the different stages of DN. In particular, altered levels of short chain fatty acids, D-amino acids, and reactive oxygen species biosynthesis in the gut have been shown to be relevant to the pathogenesis of the DN. So far, evidence suggests that the gut microbiota may play a key role in determining networks in the development of DN. Interventions directing the gut microbiota deserve further investigation as a new protective therapy in DN. In this review, we discuss the potential roles of the gut microbiota and future perspectives in the protection and/or treatment of kidneys.

Keywords: Diabetic nephropathy, Short chain fatty acids, Superoxide dismutase, Reactive oxygen species, D-amino acids, Gut microbiota, Diabetes mellitus, Renal disease

Core tip: Evolving evidence suggests that the gut microbiota may play a key role in the development of diabetic nephropathy (DN). Interventions aimed at the gut microbiota deserve further investigation as a novel protective therapy in DN. We review the potential roles of the gut microbiota in the protection of kidneys and in the development of DN.