The human body hosts an enormous diversity of microorganisms that have recently been identified as having crucial roles in health. Researchers have now begun to unravel the relationships between perturbations in the microbiome and several disease states. In a recent e-publication ahead-of-print by the journal Transplantation, John R. Lee, MD, an Instructor of Medicine in the Division of Nephrology and Hypertension and a KL2 Scholar in the Weill Cornell CTSC, and his colleagues describe an exciting pilot study that identified significant alterations in gut microbiota following kidney transplantation.
Lee et al. analyzed the bacterial composition of serial stool samples from 26 kidney transplant patients using a technology called 16S rRNA deep sequencing and have reported several novel findings. From pre-transplantation to post-transplantation, the fecal abundance of Proteobacteria increases. Proteobacteria are comprised of a group of gram-negative bacteria, many of which are known to cause diseases in humans (e.g. Klebisella and Pseudomonas), which has interesting implications for kidney transplant recipients who encounter a high rate of post-transplant bacterial infections. Lee et al. also reported that transplant recipients who developed diarrhea had less microbial diversity and had lower abundance of Bacteroides, Ruminococcus, Coprococcus, and Dorea than recipients who did not develop diarrhea. These data suggest that diarrhea may be associated with a lack of beneficial bacteria, which may lead to novel approaches for treating post-transplant diarrhea. Lee et al. also investigated transplant recipients who developed acute rejection and reported a distinct microbial profile associated with acute rejection, which may provide a fundamentally new understanding of transplant rejection.
“All these pilot findings suggest the importance of studying the gut microbiota after kidney transplantation,” Dr. Lee observed. “In the future, we hope to eventually be able to modulate the gut microbiota to favor the outcomes we want.”
Dr. Lee discovered an enthusiasm for translational research as a resident at NewYork Presbyterian Hospital–Weill Cornell Medical Center. That passion has been nurtured in the laboratory of Manikkam Suthanthiran, MD, a pioneer in the development of noninvasive urinary biomarkers for evaluating acute rejection in kidney transplantation, and in the laboratory of Eric Pamer, MD, a pioneer in characterizing the gut microbiota in allogeneic stem cell transplant recipients.
The support of great mentors such as Dr. Suthanthiran and Dr. Pamer and the satisfaction of taking care of kidney transplant recipients were two factors that drew Dr. Lee to his specialty in Nephrology and his research career as a physician scientist. “(Kidney transplant) patients need close follow up, which allows you to build close relationships with them,” Dr. Lee noted. “There is tremendous satisfaction in watching patients improve following transplantation. We know that there is a definite improvement in the quality of life compared with dialysis.”
Learning how to design and conduct a research study can be an enormous challenge for an early-career investigator. Dr. Lee credits the support of the KL2 grant and the CTSC’s Clinical and Translational Education Program (CTEP) in making his research possible. “The CTSC has a wonderful program for clinical investigation,” he said. “I’m enormously thankful for the Master’s program (in Clinical and Translational Investigation) because it has given me a solid foundation in research.”
To read Lee et al.’s study, click here.
To learn more about translational research training and education through CTEP, visit our website.