Journal of Shanghai Jiao Tong University (Medical Science) ›› 2023, Vol. 43 ›› Issue (8): 1044-1048.doi: 10.3969/j.issn.1674-8115.2023.08.013

• Review • Previous Articles    

Research progress in the role of gut microbiota in the pathogenesis and treatment of IgA nephropathy

LI Junru(), OUYANG Yan, XIE Jingyuan()   

  1. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-05-03 Accepted:2023-07-25 Online:2023-08-28 Published:2023-08-28
  • Contact: XIE Jingyuan;
  • Supported by:
    National Natural Science Foundation of China—Key International (Regional) Joint Research Program(82120108007);National Natural Science Foundation of China(82270739);Shanghai 2021 "Science and Technology Innovation Action Plan" Outstanding Academic Leaders Program(21XD1402000);Science and Technology Innovation Action Plan of Shanghai Science and Technology Committee(22140904000);Shanghai Municipal Key Clinical Specialty(shslczdzk02502);Shanghai Shenkang Hospital Development Center "Three-year Action Plan for Promoting Clinical Skills and Clinical Innovation in Municipal Hospitals"(SHDC2020CR6017);Key Project of Medical Engineering Cross Research Fund for "Star of Jiao Tong University" of Shanghai Jiao Tong University(YG2019ZDA18);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20152207)


As the most common form of glomerulonephritis worldwide, IgA nephropathy (IgAN) is characterized by the diffuse deposition of immune complexes formed by glycosylation-deficient IgA1 (Gd-IgA1) and its specific antibodies (Gd-IgA1-IgG) in the glomerular mesangium. Although the mechanisms of Gd-IgA1 production are still unknown, there is accumulating evidence that Gd-IgA1-producing plasma cells are primarily derived from gut-associated lymphoid tissue, giving rise to the "gut-kidney axis" theory. Further research has discovered that gut microbiota may be involved in IgAN development and progression, and that several interventions to regulate gut microbiota, such as probiotics, fecal microbiota transplantation, and intestinal immunity modulation, may be used in the treatment of IgAN. In patients with IgAN, targeted-release formulation-budesonide has been shown to reduce urinary protein levels and delay kidney progression. Gut microbiota has promising potential as a preventive, diagnostic and therapeutic target for IgAN, and further research is needed.

Key words: IgA nephropathy, intestinal microbiota, gut-kidney axis, intestinal mucosal immunity, therapeutics

CLC Number: