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Abstract: SA-PO1065

Effect of Probiotic Supplementation on Regulatory T Cells and Inflammatory Monocytes in Patients Undergoing Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Choi, Eunho, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Yang, Jihyun, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Park, Myeong soo, BIFIDO Co., Ltd., Hongchun gun, Korea (the Republic of)
  • Oh, Sewon, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Kim, Myung-Gyu, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Jo, Sang-Kyung, Korea University Anam Hospital, Seoul, Korea (the Republic of)

Emerging evidence suggests that intestinal dysbiosis might contribute to systemic inflammation and cardiovascular diseases in dialysis patients. This study investigated the effects of probiotics supplementation on various inflammatory parameters in hemodialysis (HD) patients.


This study included 22 patients undergoing maintenance HD (IRB No. 2018AN0346). Patients received probiotics twice daily for 3 months (Zigunduk Bifidus Premium from BIFIDO Co, total 10 billion CFU of Bifidobacterium bifidum BGN4, Bifidobacterium longum BORI, Lactobacillus acidophilus AD031, and Enterococcus facium BH06). The percentages of CD14+CD16+ proinflammatory monocytes and CD4+CD25+ regulatory T cells (Treg) were determined by flow cytometry. Serum levels of calprotectin and zonulin (novel biomarkers of intestinal inflammation), and cytokine response to lipopolysaccharide (LPS) challenge, as well as various clinical parameters were compared before and after probiotics supplementation.


The percentage of Treg showed a significant increase after 3 months of probiotic supplementation compared with baseline levels (8.6% vs. 3.5%, p<0.001), and the event count of CD14+CD16+ proinflammatory monocytes decreased significantly over baseline counts (194 vs. 310 cell numbers, p<0.05). LPS stimulation-induced interleukin (IL)-10 and IL-6 levels increased significantly (1159 vs. 517 pg/mL, and 37431 vs. 27663 pg/mL, respectively, p<0.05). Serum levels of calprotectin but not zonulin significantly decreased after probiotic supplementation.


These preliminary data suggest that probiotic supplementation may modulate systemic inflammation via expansion of Treg, suppression of proinflammatory monocytes, as well as reduction of gut inflammation in patients undergoing HD. Thus, targeting intestinal dysbiosis might be a new therapeutic strategy.

Figure 1 (a) CD4+CD25+ Treg percentage (b) Actual event count of CD14+CD16+ proinflammatory monocyte subset * p<0.05, *** p<0.001