Large scale GWAS to multi-omics studies in the last decades postulates T2D is a phenotypically complex metabolic disease that affected 11% global population with the age adjusted mortality rate 18.5 per million.
Recent studies on gut microbiome (GM) postulates its potential regulatory role on host metabolism through intestinal glucose absorption as well as energy balance. Proportional rise of Gammaproteobacteria on which the species from Escherichia/Shigella identified as key biomarker for dysbiosis of T2D GM which is also coined as proinflammatory catalyst. In the present study, we documented the same; additionally we found an association with the severity of Diabetic Nephropathy (DN) by using it as a model of T2D microvascular complication. Earlier studies (13), including ourselves, established strong positive correlation between retarded eGFR and expression of inflammasome complex among T2D patients. In the present study we probably first-time tried to explain the correlation of concomitant multidirectional dysregulation like transcriptional alteration and GM dysbiosis for the severity of DN. Studies including present data identified a wide range complex cellular network that includes a) alteration of blood flow and endothelial permeability b) chronic inflammation and c) metabolic endotoxemia for the severity of same.
Landmark clinical trials established a clear relationship between Pre/Syn and Probiotic usage and metabolite control atleast for the clinical variables like lipid profile, creatinine as well as glucose control among T2D. GM modification and metabolite repairment is postulated but yet to establish the mechanism. Our team tried to explain the GM modification and its impact on transcriptome to reduce the host inflammation through long term probiotic usage among T2D. The double blind RCT is found effective on metabolic control among the treatment arm (Specific Probiotic usage) and found less aggravate for eGFR retardation to placebo among T2D patients. The clinical trial indicating that low dosage long term adherence of certain probiotic may be beneficial for Diabetic Kidney disease.