Research: Challenges in Nutrition - Role of the gut microbiome in chronic diseases: a narrative review

[Meleber]

Abstract

"The gut microbiome, i.e., the community of bacteria and other microorganisms living in the human gut, has been implicated both directly and indirectly (mediating the effects of diet) on human health [1, 2]. The associations between gut microbiome composition and disease status have been widely reported, while recent studies have demonstrated a role for the gut microbiome in influencing remote organs, mucosal, and immune function [3, 4]. Considerable effort is currently focused on understanding the natural history of microbiome development in humans in the context of health outcomes, in parallel with improving our knowledge of microbiome–host molecular interactions. These efforts ultimately aim to develop effective approaches to rehabilitate perturbed human microbial ecosystems as a means to restore health and prevent disease. This review details the role of the gut microbiome in chronic diseases (Fig. 1) and ways it can be modulated for the management or prevention of chronic conditions.

Differences in gut microbiome composition and function have been associated with a variety of chronic diseases ranging from gastrointestinal inflammatory and metabolic conditions to neurological, cardiovascular, and respiratory illnesses.

The aim of this narrative review is to describe the associations between gut microbiome composition and various types of chronic diseases and to discuss the links to habitual diet and dietary components (Table 1)."

"Key messages

Gut microbiome composition is significantly different in healthy individuals compared to affected individuals with a broad range of chronic diseases. Lower microbiome diversity appears to be a common theme across many of the diseases

Auto-immune diseases, in common with cardiometabolic diseases and irritable bowel syndrome (IBS), show low abundances of SCFA producing bacteria such as Bifidobacterium sp, Faecalibacterium sp, Roseburia sp,orCoprococcus eutactus

High abundances of pathogenic bacteria (such as E. coli, S. aureus, and C. difficile) are common in some of these diseases

SCFAs but also other microbial metabolites are involved in the health effects of gut microbiome composition and microbial metabolites can be better predictors of health outcomes than microbiome diversity

Gut microbiome composition is modifiable by various therapeutic strategies. Dietary interventions can result in robust changes in both gut microbiome composition and function and in the corresponding health effects"

Source

nature.com/articles/s41430-...

[Meleber]

I can relate to the information in the article. Not been breastfed, repetitive courses of penicillin as from my very early childhood because of asthmatic bronchitis and a mother with a dysfunctional gut has most probably led to chronic fatigue, anemia, generalised anxiety disorder & major depressive disorder and many other physical/neurological symptoms including a functional gastrointestinal disorder. As mentioned in an earlier post, I didn't get the best start on this world 🙁 . Fortunately I was born in the Netherlands so it could have been worse. 🙂

[Meleber in reply to Meleber]

forgot to mention the genes I inherited

[Meleber in reply to Meleber]

it's just (too) complicated. How did it start, what is the root cause, if there is one (1). I now think, with my current knowledge, that there are many factors that contributed to my health problems but still hope on some relieve and that is why I now opt for chronic cyclic use of (a low dosage) antibiotics. I will discuss this option with a consultant in the second week of December.

I can't repair my genes and also cannot undo some of the other early life events that hadn't a positive effect on the development of my microbiome but hopefully am able to increase my quality of life a little bit.

[EOLHPC in reply to Meleber]

yes, we’ll said: that’s pretty much the way I look at my version of all this…& I tend to imagine myself as a Venn diagram of overlapping underlying causes & manifestations …same goes for my reactions to all the meds I’m on

[EOLHPC in reply to Meleber]

many thanks for all your posts about this. Am 69 and been living with infant onset hypermobile Ehlers Danlos + lupus & it’s usual AID secondaries (Sjogrens, vasculitis etc) + antibody deficiency disease (a type of Primary Immunodeficiency Disease) all my life, so feeling as if I relate to your story.

Yes, my team of NHS tertiary care immunology, rheumatology & gastroenterology & dermatology & cornea team consultants have me on combined therapy treatment plans that help a lot, but my life has been & still is a 24/7/12 challenge eg, am in my 5th year of segueing into Chronic Intestinal Failure + Chronic Intestinal Pseudo Obstruction.

My consultants all say that being conscientious about lifestyle/self help techniques from my very earliest years has prolonged my life & increased it’s quality. They also think all this very early onset immune dysfunction & connective tissue disorder is probably partly down to 5 months’ daily in utero exposure to the internationally notorious endocrine disrupting very first synthetic oestrogen Diethylstilbestrol (DES) combined with my genetic predispositions (hypermobility syndrome + a more severe form of either EDS or marfan + a mast cell activation disorder) are what tipped me over into all these rare comorbidities. Maybe you know that the Netherlands also has a significant community of DES offspring. I was exposed in the USA , & moved to th3 U.K. at 21, The NHS is one country that didn’t prescribe DES much (although the UK justice system did use DES to punish gay male victims of the justice system, eg Alan Turing):

rarediseases.org/gard-rare-...

researchgate.net/profile/Na...

diethylstilbestrol.co.uk/ch...

[userotc]

We currently live in a world where healthcare is generally administered by medics using drugs to try to reduce symptoms. There is little or no knowledge/training and intent in managing their root causes eg the gut. At least here in the UK, this will worsen as the firefighting continues and resources reduce.The only viable solution is via Nutritional Therapists who are focused and qualified in treating personalised, root causes. They should be a major part of mainstream healthcare. But patients shouldn't compromise their health by waiting for that and must see them privately.

[xjrs in reply to userotc]

I'm sorry, but I have a different view about nutritional therapists. I have much experience of them, and they made my health far worse to the point of me become a shadow of myself. When I complained to the last one, that I had become very ill and lots loads of weight because of her treatments, she abandoned me and wouldn't answer my emails. Totally unprofessional. I know some people say there are some good ones, but, unfortunately, they don't go through the rigger of training that medical professionals do and some of the courses that turn them into nutritional therapists have very little in the way of prerequisites e.g., you just need maths and English and that's it. If a doctor had that little basis in background education, there would be litigation everywhere. They are also completely unregulated, usually based on limited studies that haven't undergone clinical trials, so they make up their own treatments and each has a different view. Some of them are under the 'functional medicine' umbrella - again that training is not based on passed clinical trials and just theories from its founders based on limited and not rigoursly tested research. They are not recognised by the NHS in the UK and rightly so. I agree that professional medical training should include a more holistic approach than just drugs. This has started with things like social prescribing for depression, but we still have a long way to go.

[userotc in reply to xjrs]

Sorry youve had a bad experience but it is unlikely to be worse than mine following an NHS prescription drug with adverse health effects still continuing almost 7y later. So anyone can get good or bad healthcare whether doctors or naturopaths. For both, its important to check qualifications and experience etc but sadly few/none do for GPs.

Interesting that you state it is "not recognised by the NHS in the UK" when numerous GPs eg Dr Sarah Jarvis and others made famous during covid, seek to advise on nutritional health despite NO relevant qualifications!.

I hope your experience with NHS GPs is better than mine/others.

[userotc in reply to xjrs]

I should add for you or others reading this, you should ensure that a nutritional therapist is approved as well as qualified. BANT is the main body bant.org.uk/

[xjrs in reply to userotc]

Both the nutritional therapists who I used, who totally messed me up, and showed a complete lack of professionalism were BANT qualified.

[userotc]

As I said, good and bad in all professions as we should all know.I presume the GP that messed me up (thanks for the lack of sympathy btw! ☹️ ) was "approved" just by being a GP. In the highly unlikely event I'd consider another, I'd first check them out eg via site "I want great care" plus very extensive research.

But at least your naturopaths can be challenged legally if they were found wanting. My dad tried to do this via solicitors for the GP but discovered they are bullet-proof.

PS. BANT is not a qualification but a standard.