Article 180803

LETTER TO THE EDITOR
AL-ANBAR MEDICAL JOURNAL

Anb. Med. J. 19(2): 163–164, 2023
Probiotics and Gut Microbiota: A New Horizon in Pediatric Chronic Kidney Disease
Mustafa Ali Kassim Kassim,1 Alexandru Cosmin Pantazi,2, ∗ and Mustafa Hussein Naser Naser1
1
Faculty of Medicine, ”Ovidius” University of Constanta, 900470 Constanta, Romania
2
Department of Pediatrics, Faculty of Medicine, ”Ovidius” University, 900470 Constanta, Romania
(Received : 30 July 2023; Accepted : 29 August 2023; First published online: 10 October 2023)
DOI: 10.33091/amj.2023.142221.1301 c 2023, Al-Anbar Medical Journal
ear Editor, with interest, we read Nori et al. re- Recent work discussed modulating GM via probiotics in
D view entitled ”Probiotics in Women and Pediatrics

Health: A Narrative Review” published in Al-
Anbar Medical Journal volume 19, issue 1, 2023
[1]. The review discussed the role of probiotics in pediatric
health, including gastrointestinal, respiratory, psychological,
children with idiopathic nephrotic syndrome (INs). Probi-
otics’ beneficial effect was confirmed by reducing the relaps-
ing time and frequency [6]. Yamaguchi et al.’s result confirms
the same beneficial effect and discusses an increased growth
of beneficial GM and T-Regulatory cells (T-reg) in the blood
and neurological diseases. as an underlying mechanism for the immunomodulatory role
We believe that the role of gut microbiota (GM) and modu- of probiotics [7]. Qiu et al.’s results declare a disturbed GM
lating them by probiotics in pediatric chronic kidney diseases composition among newly diagnosed INs children, suggesting
(CKD) is worth mentioning. GM application in CKD can GM’s role in INs pathogenesis. Furthermore, the authors con-
yield encouraging outcomes as summarized in Figure 1. Such firm increased levels of beneficial GM following treatment as
endeavors would furnish valuable insights into novel probi- well as an increase in the proportion of T-reg [8].
otic strains and their potential benefits for renal disease in Another study noticed increased growth of beneficial GM
pediatrics [2]. following 4-weeks of therapy with steroids (a common drug
Examining GM in pediatric CKD is an emerging field of used in inducing remission) among cases with idiopathic
research. Alterations in GM composition and function have nephrotic syndrome [9]. Children with steroid-resistant
been linked to various pediatric diseases through the produc- nephrotic syndrome (SRNS) showed improved GM profiling
tion of metabolites, regulation of immune responses, and mod- following dietary modification (gluten- and dairy-free-Diet)
ulation of inflammation [3, 4]. for 4 weeks. The authors proposed that this diet had anti-
Identifying a specific GM signature or marker may indi- inflammatory and immunomodulatory effects as the T-reg
cate the presence or progression of CKD, thus allowing timely cells showed a 4-fold increase [7]. The modulation of T-reg
interventions to prevent disease progression [2]. Further- and TH-17 equilibrium plays a crucial role in the develop-
more, different GM profiles may respond differently to medi- ment of renal inflammation. Consequently, probiotic admin-
cations or dietary treatments, allowing for customised treat- istration may yield advantageous outcomes by influencing the
ment strategies based on an individual’s unique GM; in addi- kidney-gut axis through immune regulatory mechanisms [2].
tion, GM alteration may be a non-invasive method to evaluate Furthermore, apart from the association between GM and pe-
treatment efficiency and disease progression [5]. Neverthe- diatric renal diseases, there is also a correlation between the
less, it is crucial to acknowledge that investigations into the urine microbiome and conditions such as urinary tract infec-
diagnostic utilization of GM in pediatric PKD are currently tions, vesicoureteral reflux, and neurogenic bladder. Never-
nascent. theless, the impact of GM on these diseases remains poorly
understood [10].
In conclusion, GM and its modulation through probiotics
present a promising frontier in pediatric CKD research. This
∗ Corresponding author: E-mail: pantazi.cosmin@365. innovative approach could potentially lead to the development
univ-ovidius.ro of novel, personalized treatment strategies and non-invasive
This is an open-access article under the CC BY 4.0 license diagnostic tools, thereby enhancing patient outcomes.
163
http://doi.org/10.33091/amj.2023.142221.1301
Mustafa Ali Kassim Kassimet al. Anb. Med. J. 19(2), 2023
Figure 1. The main diagnostic and therapeutic roles of the gut microbiota in children with chronic kidney disease.
ETHICAL DECLARATIONS Availability of Data and Material

None.
Acknoweldgements
Competing Interests
None.
The authors declare that there is no conflict of interest.
Funding
Ethics Approval and Consent to Participate No funding.
None. Authors’ Contributions

Kassim MAK, Pantazi ACP, and Naser MHNN were
equally responsible for the conception and literature review.
Consent for Publication
(MAKK) wrote and drafted the manuscript. All authors have
None. read and agreed on the final version of the manuscript.
REFERENCES
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Health; A Narrative Review. Al-Anbar Medical Journal, biotics for children with idiopathic nephrotic syndrome.
19(1):10–16, 2023. Nutrients, 13(2):365, 2021.
[2] You-Lin Tain and Chien-Ning Hsu. Role of the Gut [8] Qiu Tingting, Yi Xin, Xu Lulu, Wang Lifeng, Hu Xihui,
Microbiota in Children with Kidney Disease. Children, and Li Xiaozhong. The correlation between gut micro-
10(2):269, 2023. biota dysbiosis and primary nephrotic syndrome in chil-
[3] Haichao Wang et al. Perturbed gut microbiome and fe- dren. Acta Medica Mediterranea, 36(2):971–976, 2020.
cal and serum metabolomes are associated with chronic [9] Yulin Kang et al. Compositional alterations of gut micro-
kidney disease severity. Microbiome, 11(1):3, 2023. biota in children with primary nephrotic syndrome after
[4] Alexandru Cosmin Pantazi et al. Relationship between initial therapy. BMC nephrology, 20(1):1–9, 2019.
Gut Microbiota and Allergies in Children: A Literature [10] Dijana Vitko et al. Urinary tract infections in children
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LETTER TO THE EDITOR

AL-ANBAR MEDICAL JOURNAL

DOI: 10.33091/amj.2023.142221.1301 c 2023, Al-Anbar Medical Journal

D view entitled ”Probiotics in Women and Pediatrics

ETHICAL DECLARATIONS Availability of Data and Material

None. Authors’ Contributions

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