Belgium
Belgium (België | Belgique | Belgien)
Human stool metabolome differs upon 24 hour blood pressure levels and blood pressure dipping status: a prospective longitudinal study
Belgium brought football from the elites to the working class. That effort started the nation down a road in which football supplanted rugby as the favorite pastime.
Like many European football nations, Belgium has enjoyed its golden era of the sport. In 1980 the Belgian squad reached the FIFA World Cup finals after an unbeaten record in Group Play, only to narrow suffer defeat at the hands of the Germans. Since then, the Belgian football team has had respectable showings on the world and European stages. There is no doubt that the team is yearning for a title and one that should grab your attention.
Their respectable and eye-grabbing FIFA World Cup performances aren't the only thing about which you should know. The Belgians present bold research in this year's NephroWorldCup as the team studies the interaction between the human microbiome and hypertension (Video 1).
Carousel 1: The gut microbiome and kidney disease | Courtesy of Drs. Sibel Gockay Bek and Annabel Biruete (zoom in for details)
Video 1: The Human Microbiome
The theory that the gut microbiome has an effect on kidney disease is not new (Carousel 1). For example, evidence suggests gut microbes increase indoxyl sulfate and p-cresol sulfate, which may decrease kidney survival, or that an increase in proteobacteria increase allograft rejection (Carousel 1).
Carousel 2: Blood pressure classification by the European Society of Hypertension (zoom in for details)
The authors propose that the gut microbiome can effect events upstream from kidney disease, such as hypertension. The way they studied this theory was by looking at the dip in blood pressure that is associated with circadian variation.
Twenty-six (26) participants underwent 24-hour home blood pressure (BP) monitoring, they were subdivided into:
dippers (night-to-day SBP ratio ≤ 0.9) versus non-dippers, and
normotensives versus hypertensives using European Society of Hypertension guidelines (Carousel 2).
Stool samples were analyzed using metabolomics and a particular interest was paid to short-chain fatty acids (SCFA) produced by the gut micobiota.
The authors found a significant correlation between stool metabolome and BP readings in both sexes (R-squared = 0.72 and R-squared = 0.79, respectively | entire cohort was R-squared = 0.45). Being a non-dipper was associated with higher amounts of important SCFA:
fecal acetate,
propionate and
butyrate.
These specific SCFAs were higher in hypertensive participants (Figure 1).
Figure 3: Metabolome analysis in hypertension and dipping status
The fact that dipping-status in blood pressure is associated to the gut microbiota is a novel observation. Indeed this correlation implies that the gut microbiota can alter the circadian control of blood pressure, though how it does so is up for debate. an alteration of the circadian control of diurnal BP, how the gut microbiota does this is still up for debate.
The microbiome continues to amaze. As more research enters this space, we learn more about this intricate multicellular system. The implications in human health appear to be far reaching. The Belgian team felt confident that this research is strong enough to keep people thinking!
It's only logical that more research will come testing the similar and novel hypotheses. Those future studies may test interventional approaches (i.e., stool transplant) to treat hypertension or kidney disease. Is the gut microbiome a therapeutic "target"? How much more do we need to understand before being making conclusions? As it stands, is there enough information in the current body of scientific knowledge to being excited ? If so, then go ahead and cast your vote for Belgium to become the champion of the NephroWorldCup.
