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Abstract: SA-PO099

Dysbiosis of Gut Microbiota in Children with Relapsing Idiopathic Nephrotic Syndrome

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders


  • Suruda, Chikushi, Department of Pediatrics, Kansai Medical University, Osaka, Japan
  • Kimata, Takahisa, Kansai Medical University, Hirakata-shi, Japan
  • Yamanouchi, Sohsaku, Kansai Medical University, Hirakata-shi, Japan
  • Tsuji, Shoji, Kansai Medical University, Hirakata-shi, Japan
  • Kaneko, Kazunari, Kansai Medical University, Hirakata-shi, Japan

Background and Aims: Although the etiology of idiopathic nephrotic syndrome (INS) remains unknown, it is suggested that an abnormality in regulatory T cells (Treg), which have a central role in the suppression of inflammatory and allergic responses is involved. We also reported that the Treg is suppressed in number at the onset or relapse of INS in childhood (Pediatr Int., 2017). It was recently reported that Clostridium species, particularly clusters IV and XIVa of the genus Clostridium composing gut microbiota enhance the frequency of Treg in the colon. Taken together, we wonder whether a dysbiosis of gut microbiota leads to insufficient induction of Treg resulting in the relapse of INS. This study was conducted to clarify the dysbiosis in patients with INS and its association with their relapse.


Subjects and Methods: We collected naturally excreted feces (at onset of INS) from eight INS patients who relapsed (group R; median age: 3.0 years, 5 males and 3 females), four INS patients who did not relapse (group NR; median age: 4.3 years, 2 males and 2 females), and seven healthy children (group C; median age: 3.7 years, 4 males and 3 females). We conducted metagenome analysis using bacterial DNA that was extracted from the feces, The composition of colonizing bacteria was assessed by 16S ribosomal RNA gene sequencing of fecal samples using the Ion 16S Metagenomics Kit and the Ion Torrent Personal Genome Machine platform and compared the proportion of Clostridium species, clusters IV and XIVa of gut microbiota among 3 groups. Kruskal-Wallis test was used for statistical analysis.


The proportion of Clostridium species ,clusters IV and XIVa was significantly lower in the group R (median 0.8%) than those in the group C (14.3%) (P = 0.002, respectively). In contrast, there was no significant difference in the proportion between the group NR(11.4%) and group C (P = 0.83).


Discussion and Conclusion: Gut dysbiosis characterized by the lower proportion of clusters IV and XIVa of the genus Clostridium might be contributed to relapse of INS.