Gut Microbiome Article

Gut microbiome article:dr laskery
The word microbiome is defined as the collection of microbes or microorganisms

that inhabit an environment, creating a sort of mini-ecosystem. Our human
microbiome is made up of communities of symbiotic, commensal and pathogenic
bacteria (along with fungi and viruses) all of which call our bodies home. These
Stress
9/2/16 drdweber@panaxea.com
128 Chronic psychological stress is associated with a greater risk of depression,
cardiovascular disease (CVD), diabetes, autoimmune diseases, upper respiratory
infections (URIs), and poorer wound healing
Stress induces increased permeability of the gut allowing bacteria and bacterial
antigens to cross the epithelial barrier and activate a mucosal immune response,
which in turn alters the composition of the microbiome and leads to enhanced HPA
drive. Patients with irritable bowel syndrome and major depression indicate
that in these syndromes alteration of the HPA may be induced by increased gut
permeability. In the case of irritable bowel syndrome the increased permeability can
respond to probiotic therapy (2012 doi: 10.1016/j.psyneuen
Inflammation
130 Depression and inflammation fuel one another. Inflammation plays a key
role in depressions pathogenesis for a subset of depressed individuals.
Stressors and pathogens can lead to exaggerated or prolonged inflammatory
responses. The resulting sickness behaviours (e.g., pain, disturbed sleep),
depressive symptoms, and negative health behaviors (e.g., poor diet, a sedentary
lifestyle) may act as mediating pathways that lead to further, unrestrained
inflammation and depression
Much of the inflammation and systemic dysfunction observed among patients with
autoimmune, inflammatory and psychological diseases can now be traced to
components of the microbiome, and to the genetic pathways that pathogens within
the microbiome dysregulate in order to survivMicrobiome composition is often
altered in patients with chronic inflammatory conditions. This dysbiosis, or microbial
imbalance, has been associated with a growing number of chronic diagnoses
including Crohns disease, ulcerative colitis (Morgan et al., 2012), irritable bowel
syndrome (Franceschi et al., 2009), psoriasis, both type 1 (Giongo et al., 2010) and
type 2 diabetes (Larsen et al., 2010), and cardiovascular diseaseeMicrobiome &
Stress
135 Prolonged stress triggers unfavorable shifts in bacterial composition and
diversity. Populations of beneficial microbes die off, while colonies having adverse
affects in large numbers flourish. In dysbiosis, it's easy for health to degrade, as the
bacteria are no longer capable of supporting our optimal immune function.
Additionally, stress can impact the structure and function of the intestine itself. Over
time, it can slow down gut motility, leading to constipation, digestive disorders,
toxic build-up and SIBO (Kellman R, 2016). Microbiota & Mood
communities exist in unique, complementary blends, and inhabit everything from
our skin and genitals, to our mouths and eyes, and of course our intestines.
For every one human gene we have, there are 100 associated genes within our
microbiome. More than 100 trillion microorganisms live in our gut, mouth, skin and
other mucosal surfaces of our bodiesonly 10% of the cells in our body are human!
These microbes have numerous beneficial functions relevant to supporting life
such as digesting food, preventing disease-causing pathogens from invading the
body, and synthesising essential nutrients and vitamin
Stress
Inflammation
Stress
97 percent of women and 68 percent of men report experiencing cravings for
certain foods (Weingarten & Elston, 1991). Cravings are thought to be a
combination of social, cultural, psychological, and physiological factors and are a
major barrier to weight loss and optimal health for many individuals (2013, doi:
10.5681/hpp.2013.002). A recent body of evidence suggests that gut microbes
might play a significant role in influencing cravings. s.
97 percent of women and 68 percent of men report experiencing cravings for
certain foods (Weingarten & Elston, 1991). Cravings are thought to be a
combination of social, cultural, psychological, and physiological factors and are a
Stress
Inflammation
Stress
major barrier to weight loss and optimal health for many individuals (2013, doi:
10.5681/hpp.2013.002). A recent body of evidence suggests that gut microbes
might play a significant role in influencing cravings.
These interactions are also widespread in microbial communities, where
microbes can exchange or compete for nutrients, signalling molecules, or immune
evasion mechanisms(Marx CJ, 2009). Several previous studies have identified
individual microbial interactions that are essential for community stability in the
healthy commensal microbiota (Sansonetti PJ, 2004; Arumugam et al., 2011) and
Stress
Inflammation
Stress
many are further implicated in dysbioses and overgrowth of pathogens linked to
disease
Diet-induced changes to gut-associated microbial communities are now suspected
of contributing to growing epidemics of chronic illness in the developed world,
including obesity (Ley, et al., 2006) and
inflammatory bowel disease (Devkota, et al., 2012). Diet-induced obesity (DIO)
produced a bloom in Obesity & Microbiota
drdweber@panaxea.com
Stress
Inflammation
Stress
155 Societal changes, including use of antibiotics and increasing consumption
of food additives have provoked microbiota aggression and consequently, may be
contributing factors to the increased incidence of obesity and its associated
diseases. Humanity is facing an epidemic of metabolic syndrome, a group of
interrelated metabolic disorders including obesity, insulin resistance,
hyperglyacemia, hyperlipidemia, and hepatic steatosis (Nathan C, 2008). a single
uncultured clade within Microbiome & Cancer
Stress
Inflammation
Stress
174 Both germ-free mice and mice treated with a heavy dose of antibiotics
responded poorly to a variety of cancer therapies. The most logical link between the
microbiome and cancer is the immune system. Resident microbes can either dial up
inflammation or tamp it down, and can modulate immune cells vigilance for
invaders (Yandaell, 2016). Oral administration of Bifidobacterium alone
improved tumour control to the same degree as programmed cell death protein 1
ligand 1 (PD-L1)specific antibody therapy, and combination treatment nearly
abolished tumour outgrowth (DOI:10.1126/science.aac4255).
9/2/16
Stress
Inflammation
Stress
Cancer & the Microbiome
175 Gut bacteria can dial up inflammation locally in the colon, as well as in other
parts of the body, leading to the release of reactive oxygen species, which damage
cells and DNA, and of growth factors that spur tumour
growth and blood vessel formation. Some gut
bacteria (e.g., Bifidobacterium) appear
to activate dendritic cells, which present cancer-cell
Stress
Inflammation
Stress
antigens to T cells that in turn kill the cancer
cellsthe Mollicutes class of the Firmicutes, which was diminished by Microbiota &
Immunity
The microbiota plays a fundamental role on the induction, training, and function
of the host immune system. In return, the immune system has largely evolved as a
means to maintain the symbiotic relationship of the host with these highly diverse
and evolving microbes. When operating optimally, this immune system-
microbiota alliance allows the induction of protective responses to pathogens and
the maintenance of regulatory pathways involved in the maintenance of tolerance
Stress
Inflammation
Stress
to innocuous antigens (2014, Dsubsequent dietary manipulations that limited
weight gain (Turnbaugh, et al., 2008). The immune system plays a vital role in
keeping the body healthy by providing a fine balance between the elimination of
invading pathogens and the maintenance of tolerance to healthy self-tissue.
However, in the case of patients with autoimmune disorders, the mechanism to
maintain selftolerance fails and the result is that the immune system mistakenly
attacks and destroys healthy self-tissue. Given the intimate interplay between
gut microbiota and the host immune system, it is not surprising that some members
of the gut microbiota have been linked to autoimmune diseases. Increasing
Bacteroides Antibiotic treatments, vaccinations and hygiene practices all can alter
Stress
Inflammation
Stress
gut microbiota composition. Antibiotic use was associated with the reduction of
Bacteroides and Bifidobacterium and the outgrowth of Campylobacter,
Streptococcus, Leuconostoc or yeasts such as Candida albicans in the intestinal
microbial communities. Changes in microbial communities in early life due to
certain practices such as C-section might increase ones risk in developing asthma,
allergy and autoimmune disease in the later childhood diminishes Firmicutes
(Watson & Preedy, 2010). The human microbiome may have a role in auto-immune
diseases like diabetes, rheumatoid arthritis, muscular dystrophy, multiple sclerosis,
fibromyalgia, and perhaps some cancers (2009, doi:10.1038/nm.2015. PMC
3034219). Toll-like receptors (TLRs) in the intestines are a type of PRR (pattern
Stress
Inflammation
Stress
recognition receptor) used by host cells to help repair damage and recognise
dangers to the host. This could be important in immune tolerance and autoimmune
diseasesAutoimmunity and allergies are caused by a damaged immune system, and
repairing the damage cures the diseases. Damage to the immune system typically
represents a break in the continual development of immune cells in the lining of the
intestines. Immune cell development in the gut is dependent on bacteria, the gut
flora. In humans, extensive antibiotic treatment produces defective immune
systems that are either overly aggressive, i.e. autoimmune, or susceptible to
infection and cancer.
Stress
Inflammation
Stress
9/2/16
CNS
212 Alterations in the balance of the gut microbiome due to a combination of
environmental and genetic factors can now be associated with detrimental or
protective effects in experimental autoimmune diseases. These gut
microbiome alterations can unbalance the gastrointestinal immune responses and
influence distal effector sites leading to CNS disease including both demyelination
Stress
Inflammation
Stress
and affective disorders (2014, doi: 10.1016/ j.febslet.201The gut microbiome has
been described for its role in shaping the immune system early in life and early data
suggest associations between T1D (type 1 diabetes) risk and alterations in gut
microbial communities (2016, doi: 10.1007/s11892-016-0753-3). Environmental
factors during critical developmental windows - gestation, birth, weaning and
puberty may contribute to T1D risk. For example mode of delivery (vaginal or C-
section) and exposure to antibiotics (pre- or post-natally) are two factors that
modulate the maternal and/or offspring microbiome and can impact T1D
development (2016, doi: 10.1016/j.jaut.2016.02.004).
Stress
Inflammation
Stress
9/2/16
The initial colonisation of the human gut microbiota begins in utero (Aagaard et
al., 2014) and is strongly influenced by microbial exposures at birth (Dominguez-
Bello et al., 2010). Events in early microbiome development may have a role in
promoting susceptibility to or protection from disease later in life (Cho et al., 2012
and Cox et al., 2014), and it may also be true for type
1 diabetes (Brown et al., 2011, Giongo
Stress
Inflammation
Stress
et al., 2011 and de Goffau et al., 2013). Kostic et al., (2015) identified
aspects of infant gut microbiome development that are unique
to the T1D state (doi:10.1016 Allergies
229 Maternal diet during pregnancy might be one of the factors that influences
fetal immune responses associated with childhood allergy. Sausenthaler, et al.,
(2007) suggests that the intake of allergenic foods and foods rich in n6
polyunsaturated fatty acids during pregnancy may increase and foods rich in n3
Stress
Inflammation
Stress
polyunsaturated fatty acids may decrease the risk of allergic diseases in the
offspring.
Allergies
230 Changes in the immune function of the respiratory tract are linked to the
immunomodulatory activity of the gut microbiota via the concept of a "common
mucosal response". The gut microbiota shapes systemic immunity, thus affecting
the lung mucosa. Alternatively, changes in the gut microbiota may reflect
Stress
Inflammation
Stress
alterations in the oropharyngeal microbiota, which may in turn directly affect the
lung microbiota and host immune responses via microaspirationAsthma
231 Asthma and atopic syndrome, classically associated with hyper-activation
of the T helper 2 (Th2) arm of adaptive immunity, are among the most common
chronic illnesses worldwide. Emerging evidence relates atopy and asthma to the
composition and function of the human microbiome. Evidence to date suggests
that the airway and/or gut microbiome may represent fertile targets for prevention
Stress
Inflammation
Stress
or management of allergic asthma and other diseases in which adaptive immune
dysfunction is a prominent feature (2015, doi: 10.1016/j.chom.2015.04.007). Note:
atopic dermatitis, allergic rhinitis and asthmaAgeing
244 A myriad of clinical changes, including a basal proinflammatory state
(inflamm-ageing), directly interface with the microbiota of older adults and enhance
susceptibility to disease accompany ageing. Studies in older adults
demonstrate that the gut microbiota correlates with diet, location of residence (e.g.,
Stress
Inflammation
Stress
community dwelling, long-term care settings), and basal level of inflammation.
Links exist between the microbiota and a variety of clinical problems plague older
adults, including physical frailty, C. difficile colitis, vulvovaginal atrophy, colorectal
carcinoma, and atherosclerotic diseaseThe human immune
system is likely influenced by the gut
microbiota, and their interaction plausibly
contributes to the process of inflamm-
ageing. On going studies suggest that diet is
associated with both the gut microbiota and
systemic inflammation with an impact on functional status of older adults.
Stress
Inflammation
Stress
Manipulating the intestinal microbiota and microbiome may be beneficial for
maintaining health and treating disease, particularly among older adults. Ageing
246 The microbiota may modulate ageing-related changes in innate immunity,
sarcopaenia, and cognitive function, all of which are elements of frailty. Both cell
culture-dependent and -independent studies show that the gut microbiota of older
people differs from that of younger adults. There is no chronological threshold
Stress
Inflammation
Stress
or age at which the composition of the microbiota suddenly alters; rather, changes
occur gradually with timeAgeing
247 Culture-based studies have indicated that the gut microbiota of older
people was different from that of younger adults, but the detailed findings were
contradictory. Small-scale studies had also shown that the microbiota composition
could be altered by dietary intervention or supplementation. Major separations
in the microbiota correlated with selected clinical measurements. It should thus be
Stress
Inflammation
Stress
possible to programme the microbiota to enrich bacterial species and activities that
promote healthier ageing (2014, doi: 10.1017/S0029665114000597). Summary
248 The prebiotic effect has been shown to associate with modulation of
biomarkers and activity(ies) of the immune system. Confirming the studies in
adults, it has been demonstrated that, in infant nutrition, the prebiotic effect
includes a significant change of gut microbiota composition, especially an increase
of faecal concentrations of bifidobacteria. This concomitantly improves stool
Stress
Inflammation
Stress
quality (pH, SCFA, frequency and consistency), reduces the risk of gastroenteritis
and infections, improves general well-being and reduces the incidence of allergic
symptoms such as atopic eczema.
Summary
249 Recent data, both from experimental models and from human studies,
support the beneficial effects of particular food products with prebiotic properties on
energy homeostasis, satiety regulation and body weight gain. Together, with
Stress
Inflammation
Stress
data in obese animals and patients, these studies support the hypothesis that gut
microbiota composition (especially the number of bifidobacteria) may contribute to
modulate metabolic processes associated with syndrome X, especially obesity and
diabetes type 2THE SYMPHONY THAT WE CREATE WITH OUR LITTLE FRIENDS AND
HOW MUCH THEY CONTRIBUTE TO THE HARMONY (OR NOT)
The gut microbiota and some probiotics can regulate immune functions, protecting
the host form infections and chronic inflammation. In contrast, dysbiosis and
endotoxaemia may be inflammatory factors responsible for developing insulin
resistance and body weight gain. The gut microbiota as a whole improves the
Stress
Inflammation
Stress
host's ability to extract and store energy from the diet leading to body weight gain,
while specific commensal microbes seem to exert beneficial effects on bile salt,
lipoprotein, and cholesterol metabolism (Sanz et al.,
Microbiologists have known for some time that different diets create different gut
flora. In a 2014 study in Nature, it was indicated that these changes can happen
incredibly fast in the human gutwithin three or four days of a big shift in what one
eats. David, et al., (2014) found that the bacteria that lives in peoples guts is
surprisingly responsive to change in diet, potentially facilitating the diversity of
human dietary lifestylesAccording to UMCG researcher Alexandra Zhernakova 60
Stress
Inflammation
Stress
dietary factors can influence the diversity. What these mean exactly is still hard to
say," she says. "But there is a good correlation between diversity and health:
greater diversity is betterBeyond diet, at least 19 different kinds of medicine --
some of which are widely used -have an impact on microbiome diversity. An earlier
study by Groningen researchers has shown that antacids decrease this diversity,
while antibiotics and the diabetes drug metformin also have an effect (2016, DOI:
10.1126/science.aad3503). The gut microbiota, in addition to their ability to
process dietary derived material, are also capable of performing a range of
biotransformations on xenobiotics, such as drugs and their metabolites, in ways that
can affect absorption and bioavailability
Stress
Inflammation
Stress
Individual genera of bacteria have been shown to have preferences. For example,
Bacteroidetes has been shown to have a preference for particular fats; Prevotella
grows best on a carbohydrate source; Bifidobacteria are able to outcompete others
in the presence of dietary fibre (2011, doi: 10.1126/science.1208344). Other
microbes are specialists and can only grow on a single nutrient source. Some
microbes, such as Akkermansia muciniphila, do not depend on dietary substrates at
all and instead thrive on the carbohydrate of the mucus layer secreted by host gut
epithelial cells
Stress
Inflammation
Stress
Given that microbes coevolved with us and constantly depend on the incoming
dietary substrates that we provide for their own sustenance, its really no surprise
that they are able to preferentially shape our eating preferences to improve their
own chances of survival
Metabolites
19 When microbes metabolise dietary substrates, they produce by-products
called metabolites. Microbial metabolites include many neuroactive agents (2013,
doi: 10.1371/ journal.ppat.1003726) that are small enough to penetrate the
Stress
Inflammation
Stress
selectively permeable blood-brain barrier. Studies on chocolate cravings have
found that even when eating identical diets, people who are chocolate desiring
have different microbial breakdown products in their urine than people who are
chocolate indifferent
Synbiotics
20 The synergistic combinations of pro- and prebiotics are called synbiotics.
The synbiotic concept was first introduced as mixtures of probiotics and
Stress
Inflammation
Stress
prebiotics that beneficially affect the host by improving the survival and
implantation of live microbial dietary supplements in the gastrointestinal tract, by
selectively stimulating the growth and/or by activating the metabolism of one or a
limited number of healthpromoting bacteria, thus improving host welfare
Summary
21 Arguably, diet is a convenient medium for manipulating the gut microbiota
composition. The investigation of the resilience of the gut microbiota and its ability
Stress
Inflammation
Stress
to change in response to dietary interventions is expected to facilitate the design of
effective nutritional therapies. Thus, a new avenue of research in the field of
nutrition will target the use of dietary components to treat/prevent gut dysbiosis,
thus leading to new prophylactic approaches for gut related disorders (e.g. obesity)
and diseases. However, our understanding of the intricate relationships between gut
microbiota, host and diet is at its infancy. In addition, the huge genetic variability
that exists between subjects and small cohorts used in the metagenomic studies
performed so far does not allow a precise reconstruction of the relationship between
gut microbiota composition and diet. Large-scale studies with greater statistical
Stress
Inflammation
Stress
power will be required to reveal the delicate contributions of diet and other
environmental factors on the gut microbiota composition of a given individual.
Several themes have emerged from population- level analyses. These analyses
suggest that a healthy gut microbiome is one that provides an abundance of
metabolic pathways, has a diversity and evenness of microbial groups (lots of
different bacteria with no single group overpowering another), and demonstrates
the ability to resist harm and return to a healthy state after insult (2012, doi:
10.1038/nature1123
Stress
Inflammation
Stress
24 Several themes have emerged from population- level analyses. These
analyses suggest that a healthy gut microbiome is one that provides an abundance
of metabolic pathways, has a diversity and evenness of microbial groups (lots of
different bacteria with no single group overpowering another), and demonstrates
the ability to resist harm and return to a healthy state after insult (2012, doi:
10.1038/nature11234). Indeed, at least one study has shown the microbiome
of healthy adults is relatively stable over a five-year period (2013, doi:
10.1126/science.1237439).
Stress
Inflammation
Stress
Probiotic Therapy
25 There is evidence suggesting that probiotic therapy is effective at returning a
dysregulated microbiome to a healthy one. Increased microbial diversity
appears to be a central feature of a healthy
microbiome, and supplementation with certain
lactic acid bacteria such as that used in the
Stress
Inflammation
Stress
current study may increase levels of
diversity.
Antibiotics can be likened to a four-edged sword against bacteria. The first two
edges of the antibiotic sword were identified immediately after their discovery and
deployment in that they not only benefit an individual in treating their infection but
also benefit the community in preventing the spread of that infectious agent.
The third edge was already recognized by Alexander Fleming in 1945 in his Nobel
acceptance speech, which warned about the cost to the community of antibiotic
resistance that would inevitably evolve and be selected for during clinical practice.
Stress
Inflammation
Stress
The fourth edge of the antibiotic sword remained unappreciated until recently,
i.e., the cost that an antibiotic exerts on an individuals own health via the collateral
damage of the drug on bacteria that normally live on or in healthy humans: our
microbiota. Our relationship with these symbiotic bacteria is especially
important during the early years of life, when the adult microbiome has not yet
formed. Many activities of modern life, including our obsession with getting rid of
germs, deprive us of the microbial diversity that seems to promote long-term
health. Low microbial diversity has been associated with several autoimmune
disorders, for example, including inflammatory bowel disease and type 1 diabetes,
which occurs when the body targets certain cells in the pancreas that produce the
Stress
Inflammation
Stress
insulin hormone. Among probiotics, those containing bifidobacteria should
receive special attention in trials to prevent relapse of colonic Crohn's disease
2002, Bamba et al. demonstrated a potential role of germinated barley foodstuff
(GBF) in inducing remission in patients with mild to moderate active ulcerative
colitis. The same result was confirmed by a study conducted by Kanauchi et al
(2002). The delicate symbiotic relationship between the gut microbiota and the
host appears to be lost in Crohns disease (CD) and ulcerative colitis (UC). In this
perspective, several studies have been conducted to assess the role of prebiotics
and probiotics in gut microbiota modulation in inflammatory bowel disease (IBD)
Stress
Inflammation
Stress
Abundant data have incriminated intestinal bacteria in the initiation and
amplification stages of inflammatory bowel diseases (IBD). One theory has
suggested a breakdown in the balance between putative species of protective
versus harmful intestinal bacteriathis concept has been termed dysbiosis
(doi:10.1136/gut.53.1.1). Gut dysbiosis can lead to physiological changes in the
intestinal environment, disrupting the functions of the gut microbiota, autoimmune,
allergic, metabolic and alcoholic liver diseases, irritable bowel syndrome, colorectal
cancer, and bacterial infections have all been linked to dysbiosisDysbiosis & IBD
Stress
Inflammation
Stress
33 Dysbiosis is an important immunologic pathogenic process in IBD. Changes
of intestinal microbiota through genetics and environment may contribute to
defective host immune response. Unfortunately, it is not clear whether dysbiosis
contributes to the development of IBD or is instead a consequence of the disease.
Despite the importance of microbiota, pharmaceutical antibiotics are not
effective in the treatment of IBD and in fact, create a worsening condition.
Gluten & Dysbiosis
Stress
Inflammation
Stress
42 Gluten sensitivity is a result of dysbiosis not a genetic disorder. Dysbiosis
(also called dysbacteriosis) refers to a condition with microbial imbalances on or
within the body. Dysbiosis is most prominent in the digestive tract or on the
skin, but can also occur on any exposed surface or mucous membrane such as the
vagina, lungs, mouth, nose, sinuses, ears, nails, or eyes. It has been associated with
different illnesses, like inflammatory bowel disease and chronic fatigue syndrome
(Dysbiosis is a state in which the microbiota becomes altered as a consequence of
an alteration in the composition of the microbiota, a change in bacterial metabolic
Stress
Inflammation
Stress
activity, and/or a shift in local distribution of communities. Many factors can alter
the gastrointestinal ecosystem, including antibiotics, psychological and physical
stresses, radiation, altered peristalsis, and dietary changes (Prakash et al., 2011).
The close relationships between gut microbiota, health, and disease, has led to
great interest in using probiotics, or prebiotics to positively modulate the gut
microbiota to prevent or treat diseases. Disturbance of intestinal microflora
(dysbiosis) is putatively a key element in the environmental component causing
inflammatory bowel disease. Prebiotics are among the dietary components
used in an attempt to counteract dysbiosis. Such predominantly carbohydrate
dietary components exert effects on the luminal environment by physicochemical
Stress
Inflammation
Stress
changes through pH alteration, by production of short chain fatty acids and by
selectively promoting putatively health-beneficial bacteria (Szilagyi A.,
Diet plays a key role in IBD pathogenesis, and there is a growing appreciation that
the interaction between diet and microbes in a susceptible person contributes
significantly to the onset of disease (DOI: 10.1002/mnfr.201600129).
Crohns disease (CD), a major form of human inflammatory bowel disease, is
characterised by primary immunodeficiencies. The nuclear receptor peroxisome
proliferatoractivated receptor gamma (PPAR) is essential for intestinal homeostasis
in response to both dietary- and microbiota-derived signals.
Stress
Inflammation
Stress
A causative role of bacteria in Crohn's disease (CD) has been surmised for a
long time. Only in recent years however has there been a large body of evidence
from genetic and bacteriological studies indicating that the intestinal flora is the
essential factor in driving the Crohn's inflammatory process (doi:
10.1136/gut.2005.085381). Probiotics alter the function of the mucosal immune
system to make it more anti-inflammatory and less proinflammatory; specifically,
probiotics can stimulate dendritic cells to make them slightly less responsive and
slightly less reactive to bacteria within the lumen (
SIBO & Microbiome
Stress
Inflammation
Stress
57 Small intestinal bacterial overgrowth syndrome (SIBO) is defined as an
increase in the number and/or alteration in the type of bacteria in the upper
gastrointestinal tract. Symptoms related to SIBO are bloating, diarrhoea,
malabsorption, weight loss and malnutrition. The duodenum and proximal
jejunum normally contain small numbers of bacteria, usually lactobacilli and
enterococci aerobes, while the large intestine contains vast quantities of anaerobes.
SIBO is often misdiagnosed and generally under-diagnosed. Nevertheless, SIBO
Stress
Inflammation
Stress
can cause severe malabsorption, serious malnutrition and deficiency syndromes
(doi: 10.3748/wjg.v16.i24.2978).
SIBO & Microbiome
9/2/16 drdweber@panaxea.comPrebiotics and probiotics exert various beneficial
effects in SIBO and the macro-organism, they strengthen the barrier function of the
gut, inhibit several pathogens, modify the inflammatory response of the bowel, and
they also reduce visceral hypersensitivity (Preidis & Versalovic, 2009). They are
also more effective in influencing the clinical symptoms of irritable bowel syndrome
Stress
Inflammation
Stress
and SIBO compared to a placebo (Barbara et al., 2008). A study by Kim et al.,
(2012) found that of those patients with IBS, 37.5% were positive for small intestine
bacterial overgrowth (SIBO), compared to the less than 10% without IBS.
SIBO & Microbiome
59 Curcumin might reduce the damage done by SIBO and promote the
regeneration and repair of the intestinal epithelium and the protection mechanism
may be the NFB signalling pathway being inhibited by curcumin (Chang et al.,
Stress
Inflammation
Stress
2008). A study by Chen et ., (2009) shows that Ganoderma can protect the
small intestine from the SIBO induced damage.
SIBO & Microbiome
60 Administration of da huang (Emodin) orally can decrease the enteric mucosa
structure and permeability change after ischemia/reperfusion (I/R) injury. Rhubarb
protects the gut by inducing more expressed HSP70 heat shock protein in the
intestine and help to protect cells from stress. Salvianolate from dan shen is
Stress
Inflammation
Stress
helpful for reducing endotoxin level, ameliorating injury and enhancing immune
function of intestinal mucosa and improving the barrier function (Yang et al., 2010).
Obesity
62 Obesity, particularly in infants, is becoming a significant public health
problem that has reached epidemic status worldwide. Obese children have an
increased risk of developing obesity-related diseases, such as metabolic syndromes
and diabetes, as well as increased risk of premature death and adverse health
Stress
Inflammation
Stress
outcomes later in life. Maternal obesity and weight gain influence microbiota
composition and activity during pregnancy and lactation. They affect microbial
diversity in the gut and breast milk. Such microbial changes may be transferred
to the offspring during delivery and also during lactation (Garcia-Mantrana &
Collado, 2016)
Colorectal Cancer Colitis
Stress
Inflammation
Stress
69 Intestinal microbiota influences the progression of colitisassociated
colorectal cancer. With diet being a key determinant of the gut microbial ecology,
dietary interventions are an attractive avenue of intervention. Curcumin has
been demonstrated to have antiinflammatory, antioxidative, and antiproliferative
properties. Curcumin reduced or eliminated colonic tumour burden with limited
effects on mucosal immune responses. The beneficial effect of curcumin on
tumourigenesis was associated with the maintenance of a more diverse colonic
microbial ecolog
Microbiome & Psychophysical Diseases
Stress
Inflammation
Stress
Microbiota influence brain chemistry and consequently behaviour. We know that
Clostridium difficile, the nasty gut hospital-based gut infection that kills 14,000
people each year in the U.S., is associated with depression and dementia. Two
antidepressants, mirtazapine (Remeron) and fluoxetine (Prozac), are linked to a
nearly 50 per cent increased risk for Clostridium difficile infection
Dysregulated gut-brain axis has been adopted as a suitable model for irritable
bowel syndrome. The gut microbiome may play an important role in the onset and
Stress
Inflammation
Stress
exacerbation of symptoms of IBS and it has been demonstrated that manipulation
of the microbiota can influence the key symptoms (2014 doi:
10.3748/wjg.v20.i39.14105). Patients with IBS may experience comorbid
anxiety and depression. Irritable bowel syndrome is common, with a prevalence
estimated between 3% and 28.
significant amount of clinical and research data suggest the importance of the
brain-gut interaction in IBS. There is a high prevalence of psychiatric disorders in
patients with IBS. The published literature indicates that fewer than half of
individuals with IBS seek treatment for it. Of those who do, 50% to 90% have
Stress
Inflammation
Stress
psychiatric disorders, including panic disorder, generalised anxiety disorder, social
phobia, pos The signals along the GB axis can
originate in the gut, the brain or both, with the
objective of maintaining normal gut function
and appropriate behaviour. The gastrointestinal tract
has long been known to be sensitive to stress and
stress mediators, including catecholamines, but the
notion that stress, and stress mediators, can influence the composition and function
of the gut microbiota is a relatively new concept (ttraumatic stress disorder, and
major depression (
Stress
Inflammation
Stress
Stress
75 Findings by De Palma, et al., (2014) suggest that stress, whether acute or
chronic, modulates the gut environment to select a dysbiotic microbiota, which in
turn can induce anxiety and depression; however, the exact pathways and
mediators of this effect are yet to be elucidated. Commensal bacteria might
modulate brain biochemistry and behaviour through the production of specific
metabolites (Barrett et al. 2012; Hsiao et al. 2013). It has been shown previously
Stress
Inflammation
Stress
that commensal bacteria can modulate behaviour through the vagus nerve (Bravo
et al. 2011), affecting neurotransmitter metabolism (2014, doi:
10.1113/jphysiol.2014.273995)
IBS
The microbiota is a factor in the pathogenesis of IBS. Clinical
observations, such as the recognition of the de novo development of IBS following
enteric infections, as well as descriptions of changes in colonic bacterial populations
in IBS. Alterations in gut barrier function, occurring in response, or in parallel, to
Stress
Inflammation
Stress
changes in the microbiota, have also been widely described and can be seen to play
a pivotal role in generating and sustaining host immune responses both within and
beyond the gut
IBS
Psychiatric and extraintestinal functional disorder (EIFD) comorbidities are
common in functional gastrointestinal disorders (FGID), decrease health-related
quality of life (HRQOL) and are associated with greater GI symptom burdens; these
Stress
Inflammation
Stress
factors were stronger predictors of HRQOL than GI symptoms in FGID patients.
Abuse experiences common among IBS sufferers are associated with reports of
greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of
abuse; this relationship may be partially mediated by concomitant mood
disturbances (2016 doi: 10.1111/nmo.12848.).
79
Microbiome & IBS
Stress
Inflammation
Stress
80 There are alterations of gut microbiota in IBS patients and it implies that
alterations of gut microbiota might be involved in the pathogenesis of IBS (doi:
10.1111/jgh.13471). As compared to healthy controls, the standardised mean
difference (SMD) of Bifidobacteria, Lactobacillus, Escherichia Coli and Enterobacter
in Chinese IBS patients were -1.42, -0.91, 0.83 and 0.57 respectively. But the SMDs
of Bacteroides and Enterococcus were found no significant differences in Chinese
patients. However, the SMDs of Bifidobacteria and Bacteroides in IBS patients from
Stress
Inflammation
Stress
other regions were -0.76 and 1.17 while the SMDs of Lactobacillus, Escherichia Coli,
Enterobacter and Enterococcus were found no significant differences.
IBS & Prebiotics
84 People with IBS often have anxiety and/or depression which has been found
to directly correlate with dysbiosis and decreased gut microbial diversity (2015 doi:
10.2147/ NDT.S61997). A study found that a prebiotic mixture benefited
anxiety in irritable bowel syndrome (IBS) sufferers (2009 DOI: 10.1111/j.1365-
Stress
Inflammation
Stress
2036.2008.03911.x). Daily treatment with the prebiotic mixture for 4 weeks
reduced anxiety scores and had a significant positive impact on quality of life.
Psychobiotic Microbiome
Evidence is emerging of benefits in alleviating symptoms of depression and in
chronic fatigue syndrome. Such benefits may be related to the antiinflammatory
actions of certain psychobiotics and a capacity to reduce hypothalamic-pituitary-
adrenal axis activity (Dinan, Stanton & Cryan, 2013). Most physical and mental
diseases have inflammation as their root cause. The vast majority of our immune
Stress
Inflammation
Stress
system, about 70% of it, is located in the gut microbiome. The phrase
'psychobiotics' is used to describe an emerging class of probiotics of relevance to
psychiatry (Dinan et al., doi: 10.1016/j.biopsych.2013.05.001). Such "mind-
altering" probiotics may act via their ability to produce various biologically active
compounds, such as peptides and mediators normally associated with mammalian
neurotransmission.
Psychobiotics
Stress
Inflammation
Stress
90 Neurochemical containing/producing probiotic bacteria may be viewed as
delivery vehicles for neuroactive compounds and as such, probiotic bacteria may
possibly have the potential as a therapeutic strategy in the prevention and/or
treatment of certain neurological and neurophysiological conditions (2014, doi:
10.1007/978-1-4939-0897-4_10).
Ingestion of specific probiotics, namely "psychobiotics", produces psychotropic

effects on behavior and affects the hypothalamic-pituitary-adrenal axis and
Stress
Inflammation
Stress
neurochemicals in the brain. Liu et al., (2016) examined the psychotropic effects of
a potential psychobiotic bacterium, Lactobacillus plantarum (Lp). Behavioural
tests revealed that chronic ingestion of Lp increased the locomotor and significantly
reduced the anxiety-like behaviours, and the depression-like behaviours were
reduced. It also reduced ELS-induced elevation of serum corticosterone under both
basal and stressed states.
Psychobiotics
Stress
Inflammation
Stress
92 In addition, Lp reduced inflammatory cytokine levels and increased anti-
inflammatory cytokine level in the serum. Furthermore, the dopamine level in the
prefrontal cortex (PFC) were significantly increased. This demonstrates the
psychotropic properties and has great potential for improving stress-related
symptoms (2016, doi: 10.1016/j.brainres.2015.11.018).
Psychobiotics
Stress
Inflammation
Stress
93 Therefore, altered microbiota have been linked to neuropsychological
disorders including depression and autism spectrum disorder, metabolic disorders
such as obesity, and gastrointestinal disorders including inflammatory bowel
disease and irritable bowel syndrome (2015, doi: 10.2147/NDT.S61997).
Fortunately, studies have also indicated that gut microbiota may be modulated with
the use of probiotics, antibiotics, and faecal microbiota transplants as a prospect for
therapy in microbiota-associated diseases. It is clear that the gut microbiota can be
a key regulator of mood, cognition, pain, and obesity (2015, doi:
10.1016/bs.aambs.2015.02.001).
Stress
Inflammation
Stress
Microbiome & Psyche
Some micro-organisms living in the guts are psychoactive. That is, they deliver
neuroactive substances such as gamma-aminobutyric acid (GABA) and serotonin
that influence the brain via the gut-brain axis. Microbes that actively secrete GABA
in the gut have been identified by researchers. Chief among them are strains of
Lactobacillus and Bifidobacterium. Alterations in the microbial composition of
the gastrointestinal tract (dysbiosis) are believed to contribute to inflammatory and
functionSerotonin
Stress
Inflammation
Stress
95 According to Dr Amy Myers good bacteria that keeps yeast levels in check
are out of balance, either from taking a round of antibiotics, drinking too much
alcohol, eating a diet high in refined carbohydrates, or long term birth control pill
use then the yeast become too numerous. She claims that the yeast then coats
the lining of your intestinal tract, and suppresses the bodys ability to make or
secrete serotonin. al bowel disorders and psychiatric comorbidities (Bercik, et al.,
2011).
Stress
Inflammation
Stress
9Psychobiotics
98 Dinan, et al., (2013) define a psychobiotic as a live organism that, when
ingested in adequate amounts, produces a health benefit in patients suffering from
psychiatric illness. As a class of probiotic, these bacteria are capable of producing
and delivering neuroactive substances such as gamma-aminobutyric acid and
serotonin, which act on the brain-gut axis. The benefits may be related to the
Stress
Inflammation
Stress
anti-inflammatory actions of certain psychobiotics and a capacity to reduce
hypothalamic-pituitary-adrenal axis activity.(doi: 10.1016/ j.biopsych.2013.05.001).
Psychobiotics
99 Psychobiotics appear to act on the brain is by exerting effects on the bodys
stress response system, which involves the brain and the adrenal glands 2014 doi:
10.1111/nmo. 12295. ). The HPA axis becomes dysfunctional in the context of
chronic stress or illness. When HPA-axis dysfunction occurs, the production and
Stress
Inflammation
Stress
rhythmic timing of cortisol and other stress-related hormones becomes disrupted.
This is believed to play a central role in causing mood disorders and cognitive
problems (006 doi:10.1383/psyt. 2006.5.5.166).
Psychobiotics
100 There is a distinct perturbation of the composition of gut microbiota in
animal models of depression and chronic stress. This has direct implications for the
development of psychobiotic-based therapeutic strategies for psychiatric disorders.
Stress
Inflammation
Stress
Moreover, given that affective co-morbidities, such as major depression and
anxiety states, are common in patients presenting with irritable bowel syndrome
(IBS), it may have implications for functional bowel disorders also (2013 doi:
10.1111/nmo.12198).
Psychobiotics
101 Microbes produce neurotransmitters. More than 50 percent of your bodys
dopamine and 90 percent of your bodys serotonin are produced in your gut, along
Stress
Inflammation
Stress
with about 30 other neurotransmitters (Eisenhofer, et al., 1997; Kim & Camilleri,
2000). These molecules are critical for signalling between cells of the nervous
system. Dopamine in the striatum and serotonin in the hypothalamus have both
been shown to be involved in the regulation of eating behaviour (2016, doi:
10.1017/S0033291716000222).
Affective Disorders
Stress
Inflammation
Stress
103 An increasing number of studies are showing connections between the gut
microbiota, and stress, depression, and anxiety (2009, doi:
10.1016/j.biopsych.2008.06.026; 2014, doi:10.1038/ncomms8735). Poor
mental health has long been associated with an increased likelihood to eat
unhealthy foods (Oliver, Wardle & Gibson, 2000). In 2004, a seminal experiment
showed that germ-free mice raised in sterile conditions with no gut microbes had an
exaggerated hypothalamicpituitary adrenal (HPA) axis response to stress (2014,
doi: 10.1523/ JNEUROSCI.3299-14.2014
Behaviour & Microbe Population
Stress
Inflammation
Stress
104 A less diverse microbial population has fewer distinct microbial species and
therefore likely has a few species with large population sizes. Researchers have
hypothesised that species with large population sizes are able to use fewer
resources for outcompeting other microbial species, leaving more resources
available for manipulating the behaviour of the host (2014,doi:
10.1002/bies.201400071).
Stress
Inflammation
Stress
Food Cravings
105 Interestingly, obese individuals tend to have lower microbial diversity than
individuals of a healthy weight (2009, doi: 10.1038/nature07540; 2013, doi:10.1038/
nature12506 31). This may partially explain why people who are overweight
tend to have more difficulty with food cravings. In other words, microbes could be a
major barrier to weight loss.
crobiome & Psyche
Stress
Inflammation
Stress
A number of microbes can produce other neurotransmitters, such as
norepinephrine, serotonin, and dopamine. Bifidobacterium infantis, taken as an
probotic, alters serotonin levels just like Prozac but without the undesirable side
effects (Davidson, 2014). B. infantis has been clinically demonstrated to be very
good at reducing the symptoms caused by chronic immune activation in the gut,
autoimmune diseases, and excessive cortisol release. Along with some other
probiotic bacteria, it is a good choice for people with leaky gut, IBS, IBD, coeliac
disease, and Crohns disease (Nootriment, 2015)
Stress
Inflammation
Stress
108
Prebiotic Mix
109 Prebiotics are foods that selectively feed certain beneficial microbes over
others. Prebiotics have been shown to increase BDNF (2013
Alzheimer's Disease
Stress
Inflammation
Stress
114 Periodontitis and Alzheimer disease (AD) are associated with systemic
inflammation. Research by Noble et al., (2014) studied serum IgG to periodontal
microbiota as possible predictors of incident AD. Serum IgG levels to common
periodontal microbiota are associated with risk for developing incident AD (2014,
doi: 10.1371/journal.pone.0114959). Curcumin prevents tissue damage during
various chronic inflammatory diseases including periodontitis and may reduce the
risks of systemic diseases associated with this local disorder (2013, doi:
10.1155/2013/329740).
Stress
Inflammation
Stress
Alzheimer's Disease
115 Curcumin been used in various types of treatments for dementia and
traumatic brain injury. Curcumin also has a potential role in the prevention and
treatment of Alzheimer's disease (AD). Curcumin as an antioxidant, anti-
inflammatory and lipophilic action improves the cognitive functions in patients with
AD. Oxidative stress, free radicals, beta amyloid, cerebral deregulation caused
Stress
Inflammation
Stress
by bio-metal toxicity and abnormal inflammatory reactions contribute to the key
event in AD pathology (2008, doi: 10.4103/0972-2327.40220)
Alzheimer's
Anxiety
In 2013, microbiology researchers published research results that linked a
specific variety of probiotic bacteria with anxious behaviours in mice. The mice were
Stress
Inflammation
Stress
known to have alterations in their gut microbiota and GI barrier defects (dysbiosis)
and also exhibited anxious, obsessive behaviours (such as obsessively burying
marbles). When they were given oral doses of one of two strains of the
bacterium Bacteroides fragilis, both their GI problems and maladaptive behaviours
improved. (Hsiao et al, 2013; Smith, 2015)
118CNS & Microbiome
Stress
Inflammation
Stress
120 The emerging links between our gut microbiome and the central nervous
system (CNS) are regarded as a paradigm shift in neuroscience with possible
implications for not only understanding the pathophysiology of stress-related
psychiatric disorders, but also their treatment. Deficits in intestinal permeability
may underpin the chronic low-grade inflammation observed in disorders such as
depression and the gut microbiome plays a critical role in regulating intestinal
permeability (doi: 10.3389/fncel. 2015.00392).
CNS & Microbiome
Stress
Inflammation
Stress
Accumulating data now indicate that the gut microbiota also communicates
with the CNS possibly through neural, endocrine and immune pathways and
thereby influences brain function and behaviour. Studies in germ-free animals
and in animals exposed to pathogenic bacterial infections, probiotic bacteria or
antibiotic drugs suggest a role for the gut microbiota in the regulation of anxiety,
mood, cognition and pain (doi: 10.1038/nrn3346).
9 The vagus nerves path, showing the organs it connects between the brain at its
top end and the intestines at its bottom end. The communication highway allows
Stress
Inflammation
Stress
the brain, lungs, heart, spleen, liver, kidneys, pancreas, stomach, and intestines to
talk to one another.
A dysfunction in the gut-brain axis has been elucidated by a multitude of studies
linked to neuropsychological, metabolic, and gastrointestinal disorders. For
instance, altered microbiota has been linked to neuropsychological disorders
including depression and autism spectrum disorder, metabolic disorders such as
obesity, and gastrointestinal disorders including inflammatory bowel disease and
irritable bowel syndrome
Stress
Inflammation
Stress

Gut Microbiome Article

Încărcat de

Informații document

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Gut Microbiome Article

Încărcat de

Drepturi de autor:

Formate disponibile

Gut microbiome article:dr laskery

The word microbiome is defined as the collection of microbes or microorganisms

Ingestion of specific probiotics, namely "psychobiotics", produces psychotropic

S-ar putea să vă placă și