Gut Microbiota and Membranous Nephropathy: Novel Molecular Mechanisms and Natural Product Therapeutic Strategies
Xiaohui Zhao, Ziyi Liu, Chongming Wu
Abstract
Membranous nephropathy (MN), a clinically significant chronic kidney disease (CKD) variant comprising primary and secondary forms, adversely affecting both individual patients and societal healthcare resources. Currently, both conservative treatment regimens for low-risk patients and immunosuppressive therapies for moderate-to-high-risk patients in clinical settings are confronted with the dual challenges of suboptimal efficacy and pronounced side effects. This clinical dilemma underscores the pressing need for innovative therapeutic strategies that can optimize treatment outcomes while minimizing adverse reactions. The deepening research into the gut–kidney axis has revealed that gut microbiota plays a critical role in the progression of MN. Emerging microbiota-targeted therapeutic strategies, particularly probiotic supplementation, fecal microbiota transplantation (FMT), standardized traditional Chinese medicine (TCM) formulations, and precision prebiotic administration, are increasingly recognized as promising interventions in MN management. Leveraging the advantages of TCM and adopting an integrated approach of traditional Chinese and Western medicine for MN intervention hold promising research and application prospects. This article reviews recent advances in the gut-kidney axis in MN, explores new diagnostic biomarkers and therapeutic interventions targeting gut microbiota modulation, and provides a novel perspective for MN treatment rooted in the integration of traditional Chinese and Western medicine.