Rôle des probiotique dans le dysfonctionnement rénal

Abstract

Chronic kidney disease constitutes a major global public health problem, with calcium oxalate urolithiasis representing one of its most common causes. Given the limitations of conventional therapies and dietary restriction regimens, the gut-kidney axis and the role of probiotics—particularly lactic acid bacteria of the genus Lactobacillus—are attracting growing scientific interest as a complementary preventive approach. This work aims to evaluate, both in vitro and in silico, the ability of two lactic strains, SS (Lactobacillus fermentum) and SL (Lactobacillus plantarum), to degrade potassium oxalate and real kidney stones, as well as the inhibitory potential of lactic acid against pathogenic urease. After confirming strain purity by Gram staining, oxalate-degrading activity was investigated using the well diffusion method on MRS agar supplemented with potassium oxalate (0.1% and 0.5%), permanganometric titration in liquid medium, and gravimetric monitoring of calcium oxalate kidney stones. A molecular docking study (AutoDock Vina) also assessed the binding affinity of L-lactic acid against Proteus mirabilis urease. The study was complemented by an in silico pharmacokinetic and toxicological analysis. The results show that both strains degrade potassium oxalate on solid medium (clear zones ranging from 6.9 to 29.3 mm depending on the strain and concentration) and in liquid medium (degradation rates of 19.5% for SS and 10.3% for SL). Gravimetric monitoring reveals more pronounced stone degradation by strain SL (1.90–2.69%) than by strain SS (0.55%). The in silico study confirms a favorable affinity of lactic acid for urease (ΔG = -4.6 kcal/mol), with good compliance with Lipinski's rules and satisfactory predicted intestinal absorption, despite class III toxicity at high doses. These converging results suggest genuine potential for strains SS and SL as probiotic candidates in the prevention of renal lithiasis, paving the way for further in vivo studies.