Tuesday, January 10, 2023

Gut microbiota

 Gut microbiota

Introduction

Gut microbiota are the microorganisms that are found living in the digestive tracts of humans. Alternative terms include gut flora and gut microbiome. The gastro intestinal metagenome is the aggregate of all the genomes of gut microbiota. In the human, the gut is the main location of human microbiota

The gut microbiota has broad impacts, including effects on colonization, resistance to pathogens, maintaining the intestinal epithelium, metabolizing dietary and pharmaceutical compounds, controlling immune function, and even behavior through the gut-brain axis.

The relationship between some gut flora and humans is not merely commensal, a non-harmful coexistence but rather a mutualistic relationship.Some human gut microorganisms benefit the host by fermenting dietary fiber into short-chain fatty acids (SCFAs), such as acetic acid and butyric acid, which are then absorbed by the host. Intestinal bacteria also play a role in synthesizing vitamin B and vitamin K as well as metabolizing bile acidssterols, and xenobiotics. The systemic importance of the SCFAs and other compounds they produce are like hormones and the gut flora itself appears to function like an endocrine organ, and dysregulation of the gut flora has been correlated with a host of inflammatory and autoimmune conditions.

Composition

The microbial composition of the gut microbiota varies across regions of the digestive tract. The colon contains the highest microbial density recorded in any habitat on Earth, representing between 300 and 1000 different species. However, 99% of gut bacteria come from about 30 or 40 species. Bacteria also make up to 60% of the dry mass of feces

Over 99% of the bacteria in the gut are anaerobes, but in the cecumaerobic bacteria reach high densities. It is estimated that the human gut microbiota have around a hundred times as many genes as there are in the human genome.

In humans, the gut microbiota has the largest numbers of bacteria and the greatest number of species compared to other areas of the body. In humans, the gut flora is established at one to two years after birth, by which time the intestinal epithelium and the intestinal mucosal barrier that it secretes have co-developed in a way that is tolerant to, and even supportive of, the gut flora and that also provides a barrier to pathogenic organisms.

The composition of human gut microbiota changes over time, when the diet changes, and as overall health changes. The microbial composition of the gut microbiota varies across the digestive tract. In the stomach and small intestine, relatively few species of bacteria are generally present. The colon, in contrast, contains the highest microbial density recorded in any habitat on Earth with up to 1012 cells per gram of intestinal content. 

These bacteria represent between 300 and 1000 different species. However, 99% of the bacteria come from about 30 or 40 species. As a consequence of their abundance in the intestine, bacteria also make up to 60% of the dry mass of fecesFungiprotistsarchaea, and viruses are also present in the gut flora, but less is known about their activities.

Over 99% of the bacteria in the gut are anaerobes, but in the cecumaerobic bacteria reach high densities. It is estimated that these gut flora have around a hundred times as many genes in total as there are in the human genome.

Many species in the gut have not been studied outside of their hosts because most cannot be cultured. While there are a small number of core species of microbes shared by most individuals, populations of microbes can vary widely among different individuals. Within an individual, microbe populations stay fairly constant over time, even though some alterations may occur with changes in lifestyle, diet and age. 

Types

Bacteria

The four dominant bacterial phyla in the human gut are- 

·        Bacillota 

·        Bacteroidota 

·        Actinomycetota 

·        Pseudomonadota.

Most bacteria belong to the following genera

·        Bacteroides 

·        Clostridium 

·        Faecalibacterium

·        Eubacterium 

·        Ruminococcus 

·        Peptococcus 

·        Peptostreptococcus

·        Bifidobacterium. 

Other genera, such as Escherichia and Lactobacillus, are present to a lesser extent. 

Species from the genus Bacteroides alone constitute about 30% of all bacteria in the gut, suggesting that this genus is especially important in the functioning of the host.

Fungi

Fungal genera that have been detected in the gut include 

·        Candida

·        Saccharomyces 

·        Aspergillus 

·        Penicillium

·        Rhodotorula 

·        Trametes

·        Pleospora 

·        Sclerotinia 

·        Bullera

·        Galactomyces

Rhodotorula is most frequently found in individuals with inflammatory bowel disease while Candida is most frequently found in individuals with hepatitis B cirrhosis and chronic hepatitis B.

Archaea

Archaea constitute another large class of gut flora which are important in the metabolism of the bacterial products of fermentation.

Enterotype

An enterotype is a classification of living organisms based on its bacteriological  ecosystem in the human gut microbiome not dictated by age, gender, body weight, or national divisions. There are indications that long-term diet influences enterotype. Three human enterotypes have been proposed.

·        Type 1 is characterized by high levels of Bacteroides

·        Type 2 has few Bacteroides but Prevotella are common

·        Type 3 has high levels of Ruminococcus

Stomach

Due to the high acidity of the stomach, most microorganisms cannot survive there. The main bacterial inhabitants of the stomach include Streptococcus, Staphylococcus, Lactobacillus and Peptostreptococcus. Helicobacter pylori is a  gram-negative spiral bacterium that establishes on gastric mucosa causing chronic gastritis, and peptic ulcer disease, and is a carcinogen for gastric cancer.

Intestines

The small intestine contains a trace amount of microorganisms due to the proximity and influence of the stomach. Gram-positive cocci and rod-shaped bacteria are the predominant microorganisms found in the small intestine. However, in the distal portion of the small intestine alkaline conditions support gram-negative bacteria of the Enterobacteriaceae

The bacterial flora of the small intestine helps in a wide range of intestinal functions. The bacterial flora provides regulatory signals that enable the development and utility of the gut. Overgrowth of bacteria in the small intestine can lead to intestinal failure. In addition the large intestine contains the largest bacterial ecosystem in the human body. 

About 99% of the large intestine and feces flora are made up of obligate anaerobes such as Bacteroides and Bifidobacterium. Factors that disrupt the microorganism population of the large intestine include antibiotics, stress, and parasites.

Bacteria make up most of the flora in the colon and 60% of the dry mass of feces. This fact makes feces an ideal source of gut flora for any tests and experiments by extracting the nucleic acid from fecal specimens, and bacterial 16S rRNA gene sequences are generated with bacterial primers. This form of testing is also often preferable to more invasive techniques, such as biopsies.

Five phyla dominate the intestinal microbiota: 

·        Bacteroidota 

·        Bacillota 

·        Actinomycetota 

·        Pseudomonadota 

·        Verrucomicrobiota

Bacteroidota and Bacillota constitute 90% of the composition. Somewhere between 300 and 1000 different species live in the gut, with most estimates at about 500. However, it is probable that 99% of the bacteria come from about 30 or 40 species, with Faecalibacterium prausnitzii (phylum firmicutes) being the most common species in healthy adults.

Relation with humans

The relationship between gut flora and humans is not merely commensal (a non-harmful coexistence), but rather is a mutualisticsymbiotic relationship. Though people can survive with no gut flora the microorganisms perform a host of useful functions, such as fermenting unused energy substrates, training the immune system via end products of metabolism like propionate and acetate, preventing growth of harmful species, regulating the development of the gut, producing vitamins for the host (such as biotin and vitamin K), and producing hormones to direct the host to store fats. 

Extensive modification and imbalances of the gut microbiota and its microbiome or gene collection are associated with obesity. However, in certain conditions, some species are thought to be capable of causing disease by causing infection or increasing cancer risk for the host.

Factors affecting Gut Biome

Age

It has been demonstrated that there are common patterns of microbiome composition evolution during life. In general, the diversity of microbiota composition of fecal samples is significantly higher in adults than in children, although interpersonal differences are higher in children than in adults. Much of the maturation of microbiota into an adult-like configuration happens during the three first years of life.

As the microbiome composition changes, so does the composition of bacterial proteins produced in the gut. In adult microbiomes, a high prevalence of enzymes involved in fermentation, methanogenesis and the metabolism of arginine, glutamate, aspartate and lysine have been found. In contrast, in infant microbiomes the dominant enzymes are involved in cysteine metabolism and fermentation pathways.

Geography

Gut microbiome composition depends on the geographic origin of populations. Variations in a trade-off of Prevotella, the representation of the urease gene, and the representation of genes encoding glutamate synthase/degradation or other enzymes involved in amino acids degradation or vitamin biosynthesis show significant differences between populations from different origins.

Also sharing numerous common environmental exposures in a family is a strong determinant of individual microbiome composition. This effect has no genetic influence and it is consistently observed in culturally different populations.

Nutrition

Malnourished children have less mature and less diverse gut microbiota than healthy children, and changes in the microbiome associated with nutrient scarcity can in turn be a pathophysiological cause of malnutrition. 

Malnourished children also typically have more potentially pathogenic gut flora, and more yeast in their mouths and throats. Altering diet may lead to changes in gut microbiota composition and diversity.

Ethnicity

Twelve microbe families are found varied in abundance based on the race or ethnicity of the individual. Individuals of the same race or ethnicity have more similar microbiomes than individuals of different racial backgrounds.

Socioeconomic status

Studies have demonstrated a link between an individual's socioeconomic status (SES) and their gut microbiota.

Functions

(1) Direct defense against pathogens

(2) Fortification of host defense by its role in developing and maintaining the intestinal epithelium and inducing antibody production there

(3)  Metabolizing otherwise indigestible compounds in food

(4) Its role in the gut-brain axis is also proved

(5) Fermenting unused energy substrates

(6) Training the immune system via end products of metabolism like  propionate and acetate,

(7) Preventing growth of harmful species,

(8) Producing vitamins for the host (such as biotin and vitamin K)

(9) Producing hormones to direct the host to store fats

Direct inhibition of pathogens

The gut flora community plays a direct role in defending against pathogens by fully colonizing the space, making use of all available nutrients, and by secreting compounds that kill or inhibit unwelcome organisms that would compete for nutrients with it, these compounds are known as cytokines. Different strains of gut bacteria cause the production of different cytokines.

Cytokines are chemical compounds produced by our immune system for initiating the inflammatory response against infections. Disruption of the gut flora allows competing organisms like Clostridium difficile to become established that otherwise are kept in abeyance.

Enteric protection and immune system

In humans, a gut flora similar to an adult's is formed within one to two years of birth. As the gut flora gets established, the lining of the intestines, the intestinal epithelium and the intestinal mucosal barrier that it secretes, develop as well, in a way that is tolerant to, and even supportive of, commensal microorganisms and also provides a barrier to pathogenic ones. Specifically, goblet cells that produce the mucosa proliferate, and the mucosa layer thickens, providing an outside mucosal layer in which friendly microorganisms can anchor and feed, and an inner layer that even these organisms cannot penetrate. 

Additionally, the development of gut-associated lymphoid tissue (GALT), which forms part of the intestinal epithelium and which detects and reacts to pathogens, appears and develops during the time that the gut flora develops and established. The GALT that develops is tolerant to gut flora species, but not to other microorganisms. GALT also normally becomes tolerant to food to which the infant is exposed, as well as digestive products of food, and gut flora's metabolites (molecules formed from metabolism) produced from food.

The human immune system creates cytokines that can drive the immune system to produce inflammation in order to protect itself, and that can tamp down the immune response to maintain homeostasis and allow healing after insult or injury. 

Different bacterial species that appear in gut flora have been shown to be able to drive the immune system to create cytokines selectively; Bacteroides fragilis and some Clostridia species appear to drive an anti-inflammatory response, while some segmented filamentous bacteria drive the production of inflammatory cytokines. Gut flora can also regulate the production of antibodies by the immune system.

One function of this regulation is to cause B cells to class switch to IgA. In most cases B cells need activation from T helper cells to induce class switching; however, in another pathway, gut flora cause NF-kB signaling by intestinal epithelial cells which results in further signaling molecules being secreted. These signaling molecules interact with B cells to induce class switching to IgA. IgA is an important type of antibody that is used in mucosal environments like the gut.

It has been shown that IgA can help diversify the gut community and helps in getting rid of bacteria that cause inflammatory responses. Ultimately, IgA maintains a healthy environment between the host and gut bacteria. These cytokines and antibodies can have effects outside the gut, in the lungs and other tissues.

The immune system can also be altered due to the gut bacteria's ability to produce metabolites that can affect cells in the immune system. For example short-chain fatty acids (SCFA) can be produced by some gut bacteria through fermentation. SCFAs stimulate a rapid increase in the production of innate immune cells like neutrophilsbasophils and eosinophils. These cells are part of the innate immune system that tries to limit the spread of infection.

Metabolism

Without gut flora, the human body would be unable to utilize some of the undigested carbohydrates it consumes, because some types of gut flora have  enzymes that human cells lack for breaking down certain polysaccharides. Carbohydrates that humans cannot digest without bacterial help include certain starchesfiberoligosaccharides, and sugars that the body failed to digest and absorb like lactose in the case of lactose intolerance and sugar alcohols, mucus produced by the gut, and proteins.

Bacteria turn carbohydrates they ferment into short-chain fatty acids by a form of fermentation called saccharolytic fermentation. Products include acetic acidpropionic acid and butyric acid. These materials can be used by host cells, providing a major source of energy and nutrients. 

Gases which are involved in signaling and may cause flatulence and organic acids, such as lactic acid, are also produced by fermentation. Acetic acid is used by muscle, propionic acid facilitates liver production of ATP, and butyric acid provides energy to gut cells.

Gut flora also synthesize vitamins like biotin and folate, and facilitate absorption of dietary minerals, including magnesium, calcium, and iron.

Methanobrevibacter smithii is a member of domain Archaea, and is the most abundant methane producing archaeal species in the human microbiota.

Gut microbiota also serve as a source of Vitamins K and B12 that are not produced by the body or produced in little amount.

Pharmacomicrobiomics

The human metagenome i.e., the genetic composition of an individual and all microorganisms that reside on or within the individual's body varies considerably between individuals. Since the total number of microbial and viral cells in the human body (over 100 trillion) greatly outnumber Homo sapiens cells (tens of trillions) there is considerable potential for interactions between drugs and an individual's microbiome, including

·        drugs altering the composition of the human microbiome 

·        drug metabolism by microbial enzymes modifying the drug's  pharmacokinetic profile

·        microbial drug metabolism affecting a drug's clinical efficacy and  toxicity   profile

Apart from carbohydrates, gut microbiota can also metabolize other  xenobiotics  such as drugs, phytochemicals, and food toxicants. More than 30 drugs have been shown to be metabolized by gut microbiota. The microbial metabolism of drugs can sometimes inactivate the drug.

Probiotics, prebiotics, synbiotics, and pharmabiotics

Probiotics are microorganisms that are believed to provide health benefits when consumed.

Prebiotics- These are typically non-digestible, fiber compounds that pass undigested through the upper part of the gastrointestinal tract and stimulate the growth or activity of advantageous gut flora by acting as substrate for them.

Synbiotics- It refers to food ingredients or dietary supplements combining probiotics and prebiotics in a form of synergism.

Pharmabiotics- The term is used in various ways, to mean: 

a. pharmaceutical formulations (standardized manufacturing that can obtain regulatory approval as a drug) of probiotics, prebiotics, or synbiotics 

b. probiotics that have been genetically engineered or otherwise optimized for best performance (shelf life, survival in the digestive tract, etc.)

c. the natural products of gut flora metabolism (vitamins, etc.)

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