Frontiers in Immunology (Jun 2021)
Immunological Impact of a Gluten-Free Dairy-Free Diet in Children With Kidney Disease: A Feasibility Study
- María José Pérez-Sáez,
- María José Pérez-Sáez,
- Audrey Uffing,
- Juliette Leon,
- Naoka Murakami,
- Andreia Watanabe,
- Thiago J. Borges,
- Thiago J. Borges,
- Venkata S. Sabbisetti,
- Pamela Cureton,
- Victoria Kenyon,
- Leigh Keating,
- Karen Yee,
- Carla Aline Fernandes Satiro,
- Gloria Serena,
- Friedhelm Hildebrandt,
- Cristian V. Riella,
- Towia A. Libermann,
- Minxian Wang,
- Julio Pascual,
- Joseph V. Bonventre,
- Paolo Cravedi,
- Alessio Fasano,
- Leonardo V. Riella,
- Leonardo V. Riella,
- Leonardo V. Riella
Affiliations
- María José Pérez-Sáez
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- María José Pérez-Sáez
- Servicio de Nefrología, Hospital del Mar, Barcelona, Spain
- Audrey Uffing
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Juliette Leon
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Naoka Murakami
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Andreia Watanabe
- Department of Pediatrics, Pediatric Nephrology Unit, Instituto da Criança, Hospital das Clínicas - University of São Paulo Medical School (USP), São Paulo, Brazil
- Thiago J. Borges
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Thiago J. Borges
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
- Venkata S. Sabbisetti
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Pamela Cureton
- Center for Celiac Research and Treatment, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, United States
- Victoria Kenyon
- Center for Celiac Research and Treatment, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, United States
- Leigh Keating
- Experimental Therapeutics/Interventional Trials Center, Boston Children’s Hospital, Boston, MA, United States
- Karen Yee
- Center for Clinical Investigation, Brigham & Women’s Hospital, Boston, MA, United States
- Carla Aline Fernandes Satiro
- Division of Nutrition, Instituto da Criança, Hospital das Clínicas - University of Sao Paulo Medical School, Sao Paulo, Brazil
- Gloria Serena
- Center for Celiac Research and Treatment, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, United States
- Friedhelm Hildebrandt
- Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Cristian V. Riella
- 0Renal Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- Towia A. Libermann
- 1Beth Israel Deaconess Medical Center Genomics, Proteomics, Bioinformatics and Systems Biology Center, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- Minxian Wang
- 2Medical and Population Genetics Program, Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Julio Pascual
- Servicio de Nefrología, Hospital del Mar, Barcelona, Spain
- Joseph V. Bonventre
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Paolo Cravedi
- 3Renal Division, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Alessio Fasano
- Center for Celiac Research and Treatment, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, United States
- Leonardo V. Riella
- Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Leonardo V. Riella
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
- Leonardo V. Riella
- 4Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- DOI
- https://doi.org/10.3389/fimmu.2021.624821
- Journal volume & issue
-
Vol. 12
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 WES 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.
Keywords
