Front. Immunol. 12:624821. doi: 10.3389/fimmu.2021.624821
Authors:
Maria Jose Perez-Saez1,2†, Audrey Uffing1†, Juliette Leon1, Naoka Murakami1, Andreia Watanabe3, Thiago J. Borges1,4, Venkata S. Sabbisetti1, Pamela Cureton5, Victoria Kenyon5, Leigh Keating6, Karen Yee7, Carla Aline Fernandes Satiro8, Gloria Serena5, Friedhelm Hildebrandt9, Cristian V. Riella 10, Towia A. Libermann11, Minxian Wang12, Julio Pascual2, Joseph V. Bonventre1, Paolo Cravedil13, Alessio Fasano5‡ and Leonardo V. Riella 1,4,14*‡
Abstract:
Kidney disease affects 10% of the world population and is associated with increased mortality. Steroid-resistant nephrotic syndrome (SRNS) is a leading cause of end-stage kidney disease in children, often failing standard immunosuppression. Here, we report the results of a prospective study to investigate the immunological impact and safety of a gluten-free and dairy-free (GF/DF) diet in children with SRNS. The study was organized as a four-week summer camp implementing a strict GF/DF diet with prospective collection of blood, urine and stool in addition to whole exome sequencing of DNA of participants. Using flow cytometry, proteomic assays and microbiome metagenomics, we show that GF/DF diet had a major anti-inflammatory effect in all participants both at the protein and cellular level with 4-fold increase in T regulatory/T helper 17 cells ratio and the promotion of a favorable regulatory gut microbiota. Overall, GF/DF can have a significant anti-inflammatory effect in children with SRNS and further trials are warranted to investigate this potential dietary intervention in children with SRNS.