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Gut-Derived Metabolites and Their Role in Immune Dysfunction in Chronic Kidney Disease
Open AccessReview

Chronic Kidney Disease-Associated Immune Dysfunctions: Impact of Protein-Bound Uremic Retention Solutes on Immune Cells

by Maxime Espi 1,2, Laetitia Koppe 3,4,5, Denis Fouque 3,4,5 and Olivier Thaunat 1,2,6,*
1
Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69000 Lyon, France
2
CIRI, INSERM U1111, Université Claude Bernard Lyon I, CNRS UMR5308, Ecole Normale Supérieure de Lyon, 69000 Lyon, France
3
Département de Néphrologie-Dialyse-Nutrition, Centre Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France
4
CarMeN, INSERM U1060, INRA 1397, 69310 Pierre-Bénite, France
5
Lyon-Sud Medical Faculty, Université de Lyon, 69000 Lyon, France
6
Lyon-Est Medical Faculty, Université de Lyon, 69000 Lyon, France
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(5), 300; https://doi.org/10.3390/toxins12050300
Received: 27 March 2020 / Revised: 28 April 2020 / Accepted: 30 April 2020 / Published: 6 May 2020
(This article belongs to the Special Issue Immune Dysfunction in Uremia)
Regardless of the primary disease responsible for kidney failure, patients suffering from chronic kidney disease (CKD) have in common multiple impairments of both the innate and adaptive immune systems, the pathophysiology of which has long remained enigmatic. CKD-associated immune dysfunction includes chronic low-grade activation of monocytes and neutrophils, which induces endothelial damage and increases cardiovascular risk. Although innate immune effectors are activated during CKD, their anti-bacterial capacity is impaired, leading to increased susceptibility to extracellular bacterial infections. Finally, CKD patients are also characterized by profound alterations of cellular and humoral adaptive immune responses, which account for an increased risk for malignancies and viral infections. This review summarizes the recent emerging data that link the pathophysiology of CKD-associated immune dysfunctions with the accumulation of microbiota-derived metabolites, including indoxyl sulfate and p-cresyl sulfate, the two best characterized protein-bound uremic retention solutes. View Full-Text
Keywords: chronic kidney disease; uremic toxins; immune system chronic kidney disease; uremic toxins; immune system
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Espi, M.; Koppe, L.; Fouque, D.; Thaunat, O. Chronic Kidney Disease-Associated Immune Dysfunctions: Impact of Protein-Bound Uremic Retention Solutes on Immune Cells. Toxins 2020, 12, 300.

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