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It has become clear that oxidants are elevated, and antioxidants are decreased, at onset of idiopathic nephrotic syndrome (INS). It was suggested that overexpression of podocyte CD80 induced by abnormalities of Tregs was involved in the pathogenesis of INS. Subsequently, it became clear that quantitative or qualitative reduction of Tregs has a profound impact on the development of INS. To address why Tregs are decreased at onset of INS, it was hypothesized that a decrease in Tregs may be associated with dysbiosis. Given the critical role of butyrate\u2010producing bacteria in the differentiation of Tregs, the gut microbiota was analyzed with a particular focus on the abundance of butyrate\u2010producing bacteria, and it was found that pediatric patients with INS had low levels of butyrate in their stool and a low percentage of butyrate\u2010producing bacteria. Interestingly, it was recently reported that gut dysbiosis increases oxidative stress in the intestinal tract. Taken together, we currently hypothesize that gut dysbiosis is associated with a predisposition to INS because of immunological abnormalities characterized by abnormal Tregs with increased oxidative stress.<\/jats:p>","DOI":"10.1111\/ped.14679","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:44:36Z","timestamp":1614818676000},"page":"1011-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The long and winding road to the etiology of idiopathic nephrotic syndrome in children: Focusing on abnormalities in the gut microbiota"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3607-8355","authenticated-orcid":false,"given":"Shoji","family":"Tsuji","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kansai Medical University Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8215-0832","authenticated-orcid":false,"given":"Kazunari","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kansai Medical University Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.16"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14184-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz185"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(81)80760-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V85769"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)91880-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biocel.2006.07.001"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2014.0324"},{"key":"e_1_2_9_10_1","first-page":"165","article-title":"Oxidative stress status in children with nephrotic syndrome","volume":"39","author":"Rajbala A","year":"1997","journal-title":"Panminerva Med."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2002.00016.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1696-6"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3195-2"},{"key":"e_1_2_9_14_1","first-page":"90","article-title":"Oxidative stress markers in initial therapy and remission of nephrotic syndrome and serum malondialdehyde level predictor from routine laboratory test","volume":"18","author":"Habriel Ruslie R","year":"2021","journal-title":"Med. 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