Diversity and composition changes of intestinal fungi in patients with chronic kidney disease

XIE Huichao; XIAO Weidong; HAN Ben; SUN Lihua; CHEN Yihui

doi:10.16016/j.2097-0927.202404133

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Diversity and composition changes of intestinal fungi in patients with chronic kidney disease

Clinical Medicine | 更新时间：2025-01-23

- Diversity and composition changes of intestinal fungi in patients with chronic kidney disease
- Journal of Army Medical University Vol. 47, Issue 2, Pages: 168-176(2025)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第二附属医院普通外科，重庆
  2.陆军军医大学（第三军医大学）第二附属医院营养科，重庆
- 作者简介：
  
  CHEN Yihui， E-mail： doctor_cyh@163.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202404133
  CLC： R333.3;R379;R692
- Published：30 January 2025，
  
  Received：28 April 2024，
  
  Revised：18 September 2024，
- 稿件说明：
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XIE HUICHAO, XIAO WEIDONG, HAN BEN, et al. Diversity and composition changes of intestinal fungi in patients with chronic kidney disease. [J]. Journal of army medical university, 2025, 47(2): 168-176.
DOI：

XIE HUICHAO, XIAO WEIDONG, HAN BEN, et al. Diversity and composition changes of intestinal fungi in patients with chronic kidney disease. [J]. Journal of army medical university, 2025, 47(2): 168-176. DOI： 10.16016/j.2097-0927.202404133.

摘要

目的

研究慢性肾脏病（chronic kidney disease， CKD）患者和健康对照者肠道真菌多样性和组成的差异。

方法

收集在陆军军医大学第二附属医院肾内科就诊的8名CKD患者；并招募与其年龄、性别相匹配的5名健康对照者。采集CKD患者（

=8）和健康对照者（

=5）的新鲜粪便样本，利用ITS DNA测序技术确定肠道真菌组成，进而利用生物信息学手段比较2组间真菌菌群多样性、结构和功能的特征差异。

结果

CKD组和健康对照组在年龄、性别构成和BMI等方面均无统计学差异。2组肠道真菌的Alpha多样性评估结果表明，Simpson指数和Shannon指数存在统计学差异（

0.01），Beta多样性存在统计学差异（

0.01）。CKD患者中

Candida

（假丝酵母属）相对丰度显著增加（

0.01），而

Cladosporium

（枝孢霉属）和

Penicillium

（青霉属）相对丰度显著下降（

0.05）。线性判别分析（LEfSe）表明，CKD患者个体中

Candida

显著富集，而

Cladosporium

和

Penicillium

的存在量则明显少于健康对照组。

结论

CKD患者的肠道真菌组成与健康人群不同，呈现特定的变化。肠道真菌菌群失调可能促进CKD的进展。调节肠道真菌、恢复肠道微生物稳态可能成为CKD治疗的一种新策略。

Abstract

Objective‍　‍To analyze the diversity and composition changes of gut fungal communities between patients with chronic kidney disease （CKD） and healthy controls. Methods‍　‍A total of 8 CKD patients admitted in Department of Nephrology of our hospital， and another 5 age- and gender-matched healthy individuals were recruited in this study. Fresh fecal samples were collected from the CKD patients and healthy controls. ITS DNA sequencing was employed to determine the composition of intestinal fungi， and then bioinformatics analysis was applied to compare the differences in fungal community diversity， structure， and function between the 2 groups. Results‍　‍There were no statistical differences between the 2 groups in terms of age， gender composition， BMI， and so forth. The results of Alpha diversity assessment showed statistical differences were observed in Simpson index and Shannon index in the intestinal fungi between the 2 groups （

0.01）. So was in the Beta diversity between them （

0.01）. The relative abundance of

Candida

was increased significantly （

0.01）， while those of

Cladosporium

and

Penicillium

were decreased in the CKD group （

0.05）. LEfSe analysis revealed that

Candida

was significantly enriched in CKD patients， whereas

Cladosporium

and

Penicillium

were significantly lower in abundance when compared to the healthy control group. Conclusion‍　‍The composition of intestinal fungi in CKD patients is different from that in healthy individuals， exhibiting characteristic changes. Dysfunction of gut fungal flora may promote the progression of CKD. Regulating gut fungi and restoring gut microbiota homeostasis may become a new strategy for CKD treatment.

关键词

慢性肾脏病肠道真菌ITS DNA肠道微生物稳态

Keywords

chronic kidney diseasefungiITS DNAgut microbiota homeostasis

references

WANG Y N， MA S X， CHEN Y Y， et al. Chronic kidney disease： Biomarker diagnosis to therapeutic targets［J］. Clin Chim Acta， 2019， 499： 54-63. DOI： 10.1016/j.cca. 2019.08.030http://dx.doi.org/10.1016/j.cca.2019.08.030.

NABER T， PUROHIT S. Chronic kidney disease： role of diet for a reduction in the severity of the disease［J］. Nutrients， 2021， 13（9）： 3277. DOI： 10.3390/nu13093277http://dx.doi.org/10.3390/nu13093277.

CIGARRAN GULDRIS S， GONZÁLEZ PARRA E， CASES AMENÓS A. Gut microbiota in chronic kidney disease［J］. Nefrologia， 2017， 37（1）： 9-19. DOI： 10.1016/j.nefro. 2016.05.008http://dx.doi.org/10.1016/j.nefro.2016.05.008.

HOBBY G P， KARADUTA O， DUSIO G F， et al. Chronic kidney disease and the gut microbiome［J］. Am J Physiol Renal Physiol， 2019， 316（6）： F1211-F1217. DOI： 10.1152/ajprenal.00298.2018http://dx.doi.org/10.1152/ajprenal.00298.2018.

RYSZ J， FRANCZYK B， ŁAWIŃSKI J， et al. The impact of CKD on uremic toxins and gut microbiota［J］. Toxins， 2021， 13（4）： 252. DOI： 10.3390/toxins13040252http://dx.doi.org/10.3390/toxins13040252.

SABATINO A， REGOLISTI G， COSOLA C， et al. Intestinal microbiota in type 2 diabetes and chronic kidney disease［J］. Curr Diab Rep， 2017， 17（3）： 16. DOI： 10.1007/s11892-017-0841-zhttp://dx.doi.org/10.1007/s11892-017-0841-z.

CHUNG S， BARNES J L， ASTROTH K S. Gastrointestinal microbiota in patients with chronic kidney disease： a systematic review［J］. Adv Nutr， 2019， 10（5）： 888-901. DOI： 10.1093/advances/nmz028http://dx.doi.org/10.1093/advances/nmz028.

LI X V， LEONARDI I， ILIEV I D. Gut mycobiota in immunity and inflammatory disease［J］. Immunity， 2019， 50（6）： 1365-1379. DOI： 10.1016/j.immuni.2019.05.023http://dx.doi.org/10.1016/j.immuni.2019.05.023.

LIMON J J， SKALSKI J H， UNDERHILL D M. Commensal fungi in health and disease［J］. Cell Host Microbe， 2017， 22（2）： 156-165. DOI： 10.1016/j.chom.2017.07.002http://dx.doi.org/10.1016/j.chom.2017.07.002.

SOKOL H， LEDUCQ V， ASCHARD H， et al. Fungal microbiota dysbiosis in IBD［J］. Gut， 2017， 66（6）： 1039-1048. DOI： 10.1136/gutjnl-2015-310746http://dx.doi.org/10.1136/gutjnl-2015-310746.

ILIEV I D， FUNARI V A， TAYLOR K D， et al. Interactions between commensal fungi and the C-type lectin receptor Dectin-1 influence colitis［J］. Science， 2012， 336（6086）： 1314-1317. DOI： 10.1126/science.1221789http://dx.doi.org/10.1126/science.1221789.

VARDAKAS K Z， MICHALOPOULOS A， KIRIAKIDOU K G， et al. Candidaemia： incidence， risk factors， characteristics and outcomes in immunocompetent critically ill patients［J］. Clin Microbiol Infect， 2009， 15（3）： 289-292. DOI： 10.1111/j.1469-0691.2008.02653.xhttp://dx.doi.org/10.1111/j.1469-0691.2008.02653.x.

FAKHIM H， VAEZI A， DANNAOUI E， et al. Comparative virulence of Candida auris with Candida haemulonii， Candida glabrata and Candida albicans in a murine model［J］. Mycoses， 2018， 61（6）： 377-382. DOI： 10.1111/myc.12754http://dx.doi.org/10.1111/myc.12754.

STEVENS L A， LI S Y， WANG C C， et al. Prevalence of CKD and comorbid illness in elderly patients in the United States： results from the kidney early evaluation program （KEEP）［J］. Am J Kidney Dis， 2010， 55（3 Suppl 2）： S23-S33. DOI： 10.1053/j.ajkd.2009.09.035http://dx.doi.org/10.1053/j.ajkd.2009.09.035.

RUIZ-ORTEGA M， RAYEGO-MATEOS S， LAMAS S， et al. Targeting the progression of chronic kidney disease［J］. Nat Rev Nephrol， 2020， 16（5）： 269-288. DOI： 10.1038/s41581-019-0248-yhttp://dx.doi.org/10.1038/s41581-019-0248-y.

BÁBÍČKOVÁ J， KLINKHAMMER B M， BUHL E M， et al. Regardless of etiology， progressive renal disease causes ultrastructural and functional alterations of peritubular capillaries［J］. Kidney Int， 2017， 91（1）： 70-85. DOI： 10.1016/j.kint.2016.07.038http://dx.doi.org/10.1016/j.kint.2016.07.038.

LEAF IRINA A， DUFFIELD JEREMY S. What can target kidney fibrosis？［J］. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc， 2017， 32（S1）： i89-i97.

LI F X， WANG M H， WANG J P， et al. Alterations to the gut microbiota and their correlation with inflammatory factors in chronic kidney disease［J］. Front Cell Infect Microbiol， 2019， 9： 206. DOI： 10.3389/fcimb.2019.00206http://dx.doi.org/10.3389/fcimb.2019.00206.

CHEHOUD C， ALBENBERG L G， JUDGE C， et al. Fungal signature in the gut microbiota of pediatric patients with inflammatory bowel disease［J］. Inflamm Bowel Dis， 2015， 21（8）： 1948-1956. DOI： 10.1097/MIB.000000000000 0454http://dx.doi.org/10.1097/MIB.0000000000000454.

WANG T T， FAN C G， YAO A R， et al. The adaptor protein CARD9 protects against colon cancer by restricting mycobiota-mediated expansion of myeloid-derived suppressor cells［J］. Immunity， 2018， 49（3）： 504-514.e4. DOI： 10.1016/j.immuni.2018.08.018http://dx.doi.org/10.1016/j.immuni.2018.08.018.

BARCIK W， BOUTIN R C T， SOKOLOWSKA M， et al. The role of lung and gut microbiota in the pathology of asthma［J］. Immunity， 2020， 52（2）： 241-255. DOI： 10.1016/j.immuni.2020.01.007http://dx.doi.org/10.1016/j.immuni.2020.01.007.

KROHN S， ZELLER K， BÖHM S， et al. Molecular quantification and differentiation of Candida species in biological specimens of patients with liver cirrhosis［J］. PLoS One， 2018， 13（6）： e0197319. DOI： 10.1371/journal.pone.0197319http://dx.doi.org/10.1371/journal.pone.0197319.

KOWALEWSKA B， ZORENA K， SZMIGIERO-KAWKO M， et al. Higher diversity in fungal species discriminates children with type 1 diabetes mellitus from healthy control［J］. Patient Prefer Adherence， 2016， 10： 591-599. DOI： 10.2147/PPA.S97852http://dx.doi.org/10.2147/PPA.S97852.

ZHANG X， PAN L Y， ZHANG Z， et al. Analysis of gut mycobiota in first-episode， drug-naïve Chinese patients with schizophrenia： a pilot study［J］. Behav Brain Res， 2020， 379： 112374. DOI： 10.1016/j.bbr.2019.112374http://dx.doi.org/10.1016/j.bbr.2019.112374.

DANIEL H M， LACHANCE M A， KURTZMAN C P. On the reclassification of species assigned to Candida and other anamorphic ascomycetous yeast Genera based on phylogenetic circumscription［J］. Antonie Van Leeuwenhoek， 2014， 106（1）： 67-84. DOI： 10.1007/s10482-014-0170-zhttp://dx.doi.org/10.1007/s10482-014-0170-z.

LUISA GIL M， MURCIANO C， YÁÑEZ A， et al. Role of Toll-like receptors in systemic Candida albicans infections［J］. Front Biosci （Landmark Ed）， 2016， 21（2）： 278-302. DOI： 10.2741/4388http://dx.doi.org/10.2741/4388.

LEONARDI I， LI X， SEMON A， et al. CX3CR1+ mononuclear phagocytes control immunity to intestinal fungi［J］. Science， 2018， 359（6372）： 232-236. DOI： 10.1126/science.aao1503http://dx.doi.org/10.1126/science.aao1503.

LAMBOOIJ J M， HOOGENKAMP M A， BRANDT B W， et al. Fungal mitochondrial oxygen consumption induces the growth of strict anaerobic bacteria［J］. Fungal Genet Biol， 2017， 109： 1-6. DOI： 10.1016/j.fgb.2017.10.001http://dx.doi.org/10.1016/j.fgb.2017.10.001.

MASON K L， ERB DOWNWARD J R， FALKOWSKI N R， et al. Interplay between the gastric bacterial microbiota and Candida albicans during postantibiotic recolonization and gastritis［J］. Infect Immun， 2012， 80（1）： 150-158. DOI： 10.1128/IAI.05162-11http://dx.doi.org/10.1128/IAI.05162-11.

YANG T， RICHARDS E M， PEPINE C J， et al. The gut microbiota and the brain-gut-kidney axis in hypertension and chronic kidney disease［J］. Nat Rev Nephrol， 2018， 14（7）： 442-456. DOI： 10.1038/s41581-018-0018-2http://dx.doi.org/10.1038/s41581-018-0018-2.

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