An interdisciplinary research team led by the University of Illinois at Chicago's School of Nursing has received a $3 million grant from the National Institutes of Health to study the relationship between the gut microbiome and pain and other distressing symptoms experienced by some kidney transplant patients.
The five-year study builds on a pilot study that linked changes in the gut microbiome to disabling pain, a symptom experienced by nearly half of kidney transplant patients.
“The goal of a kidney transplant is to enable people to return to work, participate in community activities and spend quality time with their families,” he explained. Mark Lockwood“However, some transplant recipients continue to experience symptoms such as pain, fatigue, sleep problems, depression and anxiety that can negatively impact their quality of life,” said Matthews, an associate professor in the School of Nursing who led the study.
There are many reasons why the gut microbiome changes after kidney transplantation, Lockwood says. It could be due to dietary changes: Kidney patients undergoing dialysis generally have a very restricted diet, but after transplantation they are able to expand their food choices. Or it could be related to the immunosuppressant drugs that transplant patients must take for the rest of their lives. After transplantation, it comes with a lot of stress for many patients, who feel a great responsibility to look after their transplanted kidney. Through their study, the team hopes to understand more about the processes at work.
For the new study, the team will enroll 120 patients undergoing kidney transplants who will provide samples to assess their gut microbiome before surgery and monthly for six months after. Participants will also complete questionnaires to determine the severity of their symptoms, their stress levels, and the impact of kidney disease on their quality of life. Because it is well known that nutrition influences the gut microbiome, the research team will also conduct detailed dietary assessments before surgery and again three and six months after surgery.
For logistical reasons, the study is only enrolling patients receiving living donor kidney transplants because those surgeries are scheduled in advance, but Lockwood says he would eventually like to include non-living donor kidney transplant patients, who may experience a greater symptom burden due to longer dialysis periods.
The goal is to gain a better understanding of the mechanisms that cause symptoms that affect a person's quality of life. The gut microbiome is a particularly promising area of research because previous studies have shown it to be highly sensitive to changes in diet, physical activity and stress, Lockwood explained.
“Gut bacteria play important roles in health and disease,” Lockwood said. “Understanding how the nutrition, stress and medications needed to maintain a transplanted kidney affect gut bacterial composition and function may help us create personalized treatment plans that reduce symptom burden and improve quality of life.”
The grant was provided by the National Institute of Diabetes and Digestive and Kidney Diseases. Other researchers on the study were Dr. Mario Spaggiari and Beatriz Peñalver Bernabe In the Faculty of Medicine, Ardis Durenbos and Chan Park In the Faculty of Nursing, Lisa Tushing Humphreys University of Applied Health Sciences, and Stephen Green From Rush University.
