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Gut microbiota manipulation may emerge as new option for noncommunicable diseases

Jackey Suen
30 Jul 2018
Gut microbiota manipulation, achieved with foecal microbiota transplantation (FMT) or dietary intervention, may help address noncommunicable diseases (NCDs).

“Gut microbiota contributes to maturation of the immune system, colonization resistance to pathogens, and development of normal colonic structure,” explained Dr Sunny Wong of the Institute of Digestive Disease, Chinese University of Hong Kong. “Dysbiosis of the gut microbiota is observed in digestive diseases such as colorectal cancer, inflammatory bowel disease and Clostridium difficile infection, as well as metabolic diseases such as cardiovascular diseases and diabetes.”

FMT restores colonic microbial ecology by introducing gut flora obtained from faeces of healthy individuals. It is approved by the US FDA and the UK National Institute for Health and Care Excellence for the treatment of recurrent C. difficile infection.

“The procedure for the preparation and administration of FMT is simple. Around 50–300 g of faeces are first collected from a healthy donor and then dissolved in 50–100 mL of normal saline. After blending, the faecal materials are filtered through a metal strainer. The filtrate can then be administered to patients through several approaches, including oesophageal-gastro-duodenoscopy and colonoscopy,” explained Wong.

“The efficacy of FMT in the treatment of irritable bowel syndrome, obesity, diabetes, and treatment-naïve C. difficile infection will be evaluated in several ongoing studies,” he added.

There is also a growing body of evidence on the role of gut microbiota in the pathogenesis of NCDs.

“For example, trimethylamine N-oxide [TMAO], a hepatic oxidation product of the gut microbial metabolite trimethylamine, is a potential promoter of atherosclerosis and cardiometabolic disease,” said Dr Jagmeet Madan of the SNDT Women’s University, Mumbai, India. “In patients with acute coronary syndrome, circulating TMAO level predicts the presence of vulnerable coronary plaque, plaque rupture, and long-term risks of incident cardiovascular events.” [Circ Res 2017;120:1183-1196; J Clin Invest 2014;124:4204-4211]

“Diets rich in fat and/or carbohydrate are found to increase Gram-positive bacteria and reduce Gram-negative bacteria in the gut, leading to intestinal hyperpermeability and increased endotoxin levels,” she explained. “This in turn promotes nuclear factor-κB activation and proinflammatory response, which contributes to the development of various NCDs, such as cardiovascular diseases and type 2 diabetes.”

In a clinical trial, dietary intervention with a diet based on whole grains, traditional Chinese medicinal foods and prebiotics was associated with enhanced intestinal barrier integrity, reduced circulating antigen load, and amelioration of inflammatory and metabolic phenotypes. [FEMS Microbiol Ecol 2014;87:357-367]

“Future research should focus on addressing NCDs via gut microbiota manipulation using a food-based approach,” suggested Madan. “One possible way to start with is to identify active components from Asian traditional foods.”

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Most Read Articles
30 Aug 2020
Diabetes bears an increased hazard of developing kidney cancer among postmenopausal women, but this association is only limited to those without obesity, a study has shown.
11 Jul 2020
Individuals who eat large amounts of vegetables and fruits, wheat, nuts, and dairy products are better protected against insulin resistance, diabetes mellitus, and excessive abdominal fat as compared with those who consume lots of fast foods, alcoholic beverages, and desserts—a dietary pattern described to promote metabolic abnormalities and disorders, as reported in a study.
22 Aug 2020
A weakened correlation between fructosamine and glycated haemoglobin (HbA1c) levels may be indicative of obesity in type 2 diabetes patients, reports a new study.
29 Aug 2020
Sodium-glucose co-transporters (SGLT) 2 and 1/2 inhibitors help improve glycaemic control in patients with type 1 diabetes (T1D), reports a new meta-analysis.