The Vital Role of the Gut Microbiota

The gut microbiota and human host have a symbiotic relationship that helps promote health and prevent disease.4,7 Gut microbiota are key regulators of physiologic, metabolic, and immune-related processes that are required in maintaining homeostasis.3,15,16

Compelling evidence also suggests that gut microbiota can influence the activity of other organ systems, including the CNS.3,17

  • Metabolism
  • First Line of Defense
  • Gut-Brain Connection

Metabolism

  • Intestinal bacteria are involved in3,15-17:
    • Synthesis of essential vitamins and amino acids
    • Absorption of nutrients
    • Digestion of otherwise indigestible carbohydrates, dietary fibers, proteins, and complex polysaccharides
  • Gut microbiota also produce short-chain fatty acids, such as acetic, propionic, and butyric acids, which serve as an energy source to the host intestinal epithelium and stimulate secretion of intestinal peptides involved in glucose metabolism and food intake3,15-17

First Line of Defense

  • Gut microbiota are the body's first line of defense against GI pathogens and toxins.3,14 A healthy gut microbiome works with the immune system to protect the host by3,18:
    • Producing antimicrobial compounds (eg, bacteriocin)
    • Outcompeting pathogens for nutrients
    • Selectively preventing bacteria from adhering to the intestinal wall
  • Gut microbiota also influence GI immune system development and help regulate immune response and inflammation in the GI tract3,18

Gut-Brain Connection

  • A bidirectional exchange between gut microbiota and the CNS has been observed in animal studies.19,20 These systems communicate through the vagus nerve, the hypothalamic pituitary adrenal axis, and the production of neurotransmitters and their precursors3
  • Although the bidirectional communication between the CNS and gut microbiota has yet to be validated in humans, ongoing research has the potential to influence clinical specialties beyond gastroenterology19-21
AN EXTRAORDINARY BALANCE
CNS = central nervous system
GI = gastrointestinal
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References

  1. Lloyd-Price J, Abu-Ali G, Huttenhower C. The healthy human microbiome. Genome Med. 2016;8(1):51.
  2. Ursell LK, Metcalf JL, Parfrey LW, Knight R. Defining the human microbiome. Nutr Rev. 2012;70(suppl 1):S38-S44.
  3. Sidhu M, van der Poorten D. The gut microbiome. Aust Fam Physician. 2017;46(4):206-211.
  4. Ringel Y. The gut microbiome in irritable bowel syndrome and other functional bowel disorders. Gastroenterol Clin North Am. 2017;46(1):91-101.
  5. Quigley EM. Gut bacteria in health and disease. Gastroenterol Hepatol (N Y). 2013;9(9):560-569.
  6. Raskov H, Burcharth J, Pommergaard HC, Rosenberg J. Irritable bowel syndrome, the microbiota and the gut-brain axis. Gut Microbes. 2016;7(5):365-383.
  7. Passos MDCF, Moraes-Filho JP. Intestinal microbiota in digestive diseases. Arq Gastroenterol. 2017;54(3):255-262.
  8. Distrutti E, Monaldi L, Ricci P, Fiorucci S. Gut microbiota role in irritable bowel syndrome: new therapeutic strategies. World J Gastroenterol. 2016;22(7):2219-2241.
  9. Flint HJ, Scott KP, Louis P, Duncan SH. The role of the gut microbiota in nutrition and health. Nat Rev Gastroenterol Hepatol. 2012;9(10):577-589.
  10. Gorkiewicz G, Moschen A. Gut microbiome: a new player in gastrointestinal disease. Virchows Arch. 2018;472:159-172.
  11. Dong TS, Gupta A. Influence of early life, diet, and the environment on the microbiome. Clin Gastroenterol Hepatol. 2019;17(2):231-242.
  12. Cresci GA, Bawden E. Gut microbiome: what we do and don’t know. Nutr Clin Pract. 2015;30(6):734-746.
  13. Shin A, Preidis GA, Shulman R, Kashyap PC. The gut microbiome in adult and pediatric functional gastrointestinal disorders. Clin Gastroenterol Hepatol. 2019;17(2):256-274.
  14. Carding S, Verbeke K, Vipond DT, Corfe BM, Owen LJ. Dysbiosis of the gut microbiota in disease. Microb Ecol Health Dis. 2015;26:26191.
  15. Wang B, Yao M, Lv L, Ling Z, Li L. The human microbiota in health and disease. Engineering. 2017;3:71-82.
  16. Jandhyala SM, Talukdar R, Subramanyam C, Vuyyuru H, Sasikala M, Reddy DN. Role of the normal gut microbiota. World J Gastroenterol. 2015;21(29):8787-8803.
  17. Cani PD. Human gut microbiome: hopes, threats and promises. Gut. 2018;67(9):1716-1725.
  18. Ghoshal UC, Shukla R, Ghoshal U, Gwee KA, Ng SC, Quigley EM. The gut microbiota and irritable bowel syndrome: friend or foe? Int J Inflam. 2012;2012:151085.
  19. Kennedy PJ, Cryan JF, Dinan TG, Clarke G. Irritable bowel syndrome: a microbiome-gut-brain axis disorder? World J Gastroenterol. 2014;20(39):14105-14125.
  20. Tillisch K. The effects of gut microbiota on CNS functions in humans. Gut Microbes. 2014;5(3):404-410.
  21. Brett BE, de Weerth C. The microbiota-gut-brain axis: a promising avenue to foster healthy development outcomes. Dev Psychobiol. 2019;61(5):772-782.
  22. Forbes JD, Van Domselaar G, Bernstein CN. The gut microbiota in immune-mediated inflammatory diseases. Front Microbiol. 2016;7:1081.
  23. Lee KN, Lee OY. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome. World J Gastroenterol. 2014;20(27):8886-8897.
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