Probiotics as Complementary Treatment for Metabolic Disorders

Abstract

Over the past decade, growing evidence has established the gut microbiota as one of the most important determinants of metabolic disorders such as obesity and type 2 diabetes. Indeed, obesogenic diet can drastically alter bacterial populations (i.e., dysbiosis) leading to activation of pro-inflammatory mechanisms and metabolic endotoxemia, therefore promoting insulin resistance and cardiometabolic disorders. To counteract these deleterious effects, probiotic strains have been developed with the aim of reshaping the microbiome to improve gut health. In this review, we focus on benefits of widely used probiotics describing their potential mechanisms of action, especially their ability to decrease metabolic endotoxemia by restoring the disrupted intestinal mucosal barrier. We also discuss the perspective of using new bacterial strains such as butyrate-producing bacteria and the mucolytic Akkermansia muciniphila, as well as the use of prebiotics to enhance the functionality of probiotics. Finally, this review introduces the notion of genetically engineered bacterial strains specifically developed to deliver anti-inflammatory molecules to the gut.

Metabiotics: The Functional Metabolic Signatures of Probiotics: Current State-of-Art and Future Research Priorities—Metabiotics: Probiotics Effector Molecules

“…They are acting as positive modulator for the treatment of antibiotic-associated diarrhea, crohn's disease, ulcerative colitis, obesity and cholesterol reduction. These molecules have been successfully applied for the therapeutic intervention of treatment of various inflammatory disorders and also help in alleviation of insulin resistance and obesity [27]. Though the exact mechanism of their action is yet to be fully elucidated but their capability of modifying the epigenome will drive the more comprehensive understanding of their health promoting attributes.…”

Targeting the gastrointestinal tract to treat type 2 diabetes

“…Direct chronic treatment in diet-induced obese mice with alive, but not heat-killed A. muciniphila reversed weight and fat mass gain, as well as insulin resistance (Everard et al 2013). Further, chronic treatment with dietary phenols from grapes, or cranberry extract, improved glucose tolerance and insulin sensitivity which was hypothesized to be due to A. muciniphila abundance (Anhe et al 2015, Roopchand et al 2015. Although A. muciniphila remains to be tested in humans, this is one example in an ever-expanding list of potential probiotics that could help lower glucose levels in type 2 diabetes (Le Barz et al 2015, Stenman et al 2015a.…”

“…Further, chronic treatment with dietary phenols from grapes, or cranberry extract, improved glucose tolerance and insulin sensitivity which was hypothesized to be due to A. muciniphila abundance (Anhe et al 2015, Roopchand et al 2015. Although A. muciniphila remains to be tested in humans, this is one example in an ever-expanding list of potential probiotics that could help lower glucose levels in type 2 diabetes (Le Barz et al 2015, Stenman et al 2015a. It is interesting to note that metformin treatment has been shown to alter the gut microbiota, with chronic treatment resulting in A. muciniphila abundance, as well as changes in bile acid levels, suggesting a gut microbiota-mediated role for metformin treatment (Lien et al 2014, Napolitano et al 2014, Shin et al 2014.…”

Novel perspectives on therapeutic modulation of the gut microbiota

“…In this context, certain bacteria could be used as probiotics with targeted pathways to restore health in metabolic disorders. Intestinal bacteria such as Akkermansia muciniphila, several Lactobacillus strains and probiotic formulations as VSL#3 have been proposed as modulators of metabolism [Le Barz et al 2015], but more research is needed to understand what subsets will benefit from these strains and the short-and long-term benefits, as well as cost-benefit of such supplementation.…”