Gut microbiota profiles and fecal beta‐glucuronidase activity in kidney transplant recipients with and without post‐transplant diarrhea

  title={Gut microbiota profiles and fecal beta‐glucuronidase activity in kidney transplant recipients with and without post‐transplant diarrhea},
  author={Lisa T. Zhang and Lars F Westblade and Fatima Iqbal and Michael R. Taylor and Alice Chung and Michael J. Satlin and Matthew Magruder and Emmanuel Edusei and Shady Albakry and Brittany Botticelli and Amy E. Robertson and Tricia Alston and Darshana M. Dadhania and Michelle Lubetzky and Simon A. Hirota and Steven C. Greenway and John Richard Lee},
  journal={Clinical Transplantation},
Post‐transplant diarrhea is a common complication after solid organ transplantation and is frequently attributed to the widely prescribed immunosuppressant mycophenolate mofetil (MMF). Given recent work identifying the relationship between MMF toxicity and gut bacterial β‐glucuronidase activity, we evaluated the relationship between gut microbiota composition, fecal β‐glucuronidase activity, and post‐transplant diarrhea. We recruited 97 kidney transplant recipients and profiled the gut… 

Fecal β-glucuronidase activity differs between hematopoietic cell and kidney transplantation and a possible mechanism for disparate dose requirements

Microbially mediated β-glucuronidase activity may be a critical determinant in the amount of mycophenolate entering the systemic circulation and an important factor to consider for precision dosing of MMF.

New insights into the microbiome in kidney transplantation

The microbiota has important implications for immunosuppressive medications and immunological outcomes in kidney transplant recipients and the role of the urine microbiota in the development of immunological and infectious complications is described.

The Microbiota and Kidney Transplantation: Influence on the Graft

An improved understanding of the function and composition of the indigenous microbiota may help in finding further solutions to stabilise the microbiota after kidney transplantation.

Temporal shifts in safety and efficacy profile of mycophenolate mofetil 2 g versus 3 g daily early after heart transplantation

Evaluated the safety and efficacy of MMF 1.5 g every 12 h (q12) versus 1 g q12 [low‐dose, LD] and explored the association between neutropenia and GUS to explore the impact of gut bacteria β‐d‐glucuronidases on MMF bioavailability.

Synthesis, Biological Evaluation, and In Silico Studies of Novel Coumarin-Based 4H,5H-pyrano[3,2-c]chromenes as Potent β-Glucuronidase and Carbonic Anhydrase Inhibitors

Among the stream of synthesized compounds, 12e and 12i were the most potent inhibitors of β-glucuronidase, while 12h, 12i, and 12j showed greater potency against hCA II.



Gut microbiota dysbiosis and diarrhea in kidney transplant recipients

  • J. LeeMatthew Magruder M. Suthanthiran
  • Medicine, Biology
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2019
It is suggested that posttransplant diarrhea is not associated with common infectious diarrheal pathogens but with a gut dysbiosis, and PICRUSt (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) to predict metagenomic functions is found that diarrheale fecal specimens had a lower abundance of metabolic genes.

Gut Microbial Community Structure and Complications After Kidney Transplantation: A Pilot Study

This pilot study identified significant alterations in the gut microbiota after kidney transplantation and distinct microbiota structures were observed in allograft recipients with posttransplant diarrhea, AR, and Enterococcus UTI.

Characteristics and Dysbiosis of the Gut Microbiome in Renal Transplant Recipients

It is shown that renal transplant recipients (RTRs) suffer from dysbiosis, a disruption in the balance of the gut microbiome, and Proton-pump inhibitors, mycophenolate mofetil, and estimated glomerular filtration rate (eGFR) are significant determinants of the Gut microbiome of RTRs.

Gut uropathogen abundance is a risk factor for development of bacteriuria and urinary tract infection

The results support a gut microbiota–UTI axis, suggesting that modulating the gut microbiota may be a potential novel strategy to prevent UTIs and show that uropathogenic gut abundance might represent a risk factor for development of bacteriuria and UTI.

An intact microbiota is required for the gastrointestinal toxicity of the immunosuppressant mycophenolate mofetil.

  • K. FlanniganMichael R. Taylor S. Hirota
  • Medicine, Biology
    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
  • 2018

Diagnosis and management of diarrhea in solid‐organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

These guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of diarrhea in the pre‐ and

Association of Fecal Microbial Diversity and Taxonomy with Selected Enzymatic Functions

Observed associations with microbial alpha and beta diversity and taxonomy suggest that these enzymatic functions are performed by particular taxa and that diversity indices may serve as surrogates of bacterial functions.

Impact of Norovirus/Sapovirus-Related Diarrhea in Renal Transplant Recipients Hospitalized for Diarrhea

This study indicates that NoV/SaV infection causes posttransplant chronic diarrhea potentially complicated by severe kidney graft impairment and is associated with a greater weight loss at the time of admission, a 8.7-fold longer duration of symptoms and a more frequent need for mycophenolic acid dosage reduction.

Microbiome alterations following solid-organ transplantation: consequences, solutions, and prevention

This work is licensed to and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( 3.0/).

Baseline graft status is a critical predictor of kidney graft failure after diarrhoea.

  • A. DevresseL. Morin J. Zuber
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2019
This study shows that pre-existing conditions (re-transplantation, chronic graft dysfunction and late occurrence) determine the primary functional long-term consequences of post-trans transplant diarrhoea.