Effects of chronic exercise on gut microbiota and intestinal barrier in human with type 2 diabetes

Abstract

BacKGrOUNd: intestinal dysbiosis has been proposed as a possible contributor of the development of type 2 diabetes (T2d). indeed, commensal fungi and opportunistic bacteria stimulate the local immune system, altering intestinal permeability with consequent leaky gut, which in turn activates systemic inflammation responsible for insulin resistance. It is also well known that chronic exercise improves glucose control and diabetes-induced damage. The aim of this study was to evaluate the role of chronic exercise on gut flora composition and leaky gut in T2D stable patients. MeTHOdS: Thirty clinically stable patients with T2d were studied before and after a six months program of endurance, resistance and flexibility training. Metabolic and anthropometric evaluations were carried out. Gut flora and intestinal permeability were measured in stools by selective agar culture medium and molecular biology measurements of zonulin, which is the protein that modulates enterocyte tight junctions. RESULTS: Diabetes causes significant intestinal mycetes overgrowth, increased intestinal permeability and systemic low-grade inflammation. However, exercise improved glycemia, functional and anthropometric variables. Moreover, chronic exercise reduced intestinal mycetes overgrowth, leaky gut, and systemic inflammation. Interestingly, these variables are closely correlated. cONcLUSiONS: exercise controls diabetes by also modifying intestinal microbiota composition and gut barrier function. This data shows an additional mechanism of chronic exercise and suggests that improving gut flora could be an important step in tailored therapies of T2d.

Faecalibacterium prausnitzii‐derived microbial anti‐inflammatory molecule regulates intestinal integrity in diabetes mellitus mice via modulating tight junction protein expression

“…DM and its complications have become important global health issues. Previous studies have shown that DM patients and animal models suffer impaired intestinal barrier structure and function . Malfunction of the intestinal barrier promotes the absorption of pathogens and toxins from the lumen, which induces intestinal inflammation and hyperglycemia deterioration .…”

The role of physical exercise in the treatment of IBS

“…Little is known about the effect of training programs on gut permeability neither in healthy subject nor patients with diseases associated with increased permeability. Recently, it was reported that gut permeability (measured as fecal zonulin) decreased in elderly diabetic patients after 6 months of endurance and resistance training program (moderate intensity) 41 ; interestingly, decrease in fecal zonulin correlated with plasma CRP, suggesting a parallel reduction of the systemic inflammatory state and gut permeability. No information exists in IBS patients.…”

The Interplay between Immune System and Microbiota in Diabetes

“…Furthermore, increased production of butyrate, a marker of gut health, and increased abundance of butyrate-producing species were found in individuals with greater levels of aerobic fitness [38]. Another study showed that in T2D patients, a six-month endurance, resistance, and flexibility training program decreased intestinal mycetes overgrowth, gut permeability, and systemic inflammation, resulting in improved glycemia and functional and anthropometric variables [39].…”