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2 mei 2024: Bron: The American Journal of Gastroenterology, April 22, 2024

Uit een vergelijkende studie met volwassenen met een normaal gewicht (N = 105), overgewicht (N = 67) en obesitas (N = 42)  blijkt de darmflora - microbioom van de dunne darm (duodenale) statistisch significant veranderd bij de personen met overgewicht en obesitas vergeleken met die bij mensen met een normaal gewicht. 

Bij een BMI tussen de 18,5 en de 25 is sprake van een gezond gewicht. Bij een BMI tussen de 25 en de 30 heeft men overgewicht. En een BMI van 30 of hoger betekent dat men obesitas heeft. Wanneer de BMI 40 of hoger is dan spreken we van morbide obesitas, ofwel ziekelijk overgewicht.

Deze studie onder leiding van prof. dr. Gabrielle Leita leverde een overtuigend en statistisch significant bewijs dat het microbioom - darmflora van de dunne darm sterk verschilt tussen personen met een normaal gewicht, overgewicht of obesitas.

De inhoud van het lumen - vaatholtes van de dunne darm werd verzameld via oesofagogastroduodenoscopie en 16S-rRNA en shotgun-metagenomische sequencing werden uitgevoerd. Plasma-inflammatoire markers en plasmalipiden werden gemeten om correlaties met veranderingen in het microbioom vast te stellen. Veranderingen in de samenstelling en het functionele potentieel van het microbioom in de dunne darm werden gecategoriseerd op basis van verschillen tussen normaal gewicht, overgewicht of obesitasstatus en als escalatie (geassocieerd met een verandering in relatieve overvloed van normaal gewicht naar overgewicht en obesitas) of de-escalatiekenmerken (geassocieerd met een verandering in overgewicht versus normaal gewicht, maar niet tussen normaal gewicht en obesitas).

Veranderingen in Lactobacillus gasseri en verminderde L-reuteri werden geassocieerd met obesitasL acidophilus, L hominis en Bifidobacterium dentium werden geïdentificeerd als de-escalatiekenmerken.

Specifieke Lactobacillus-soorten werden in verband gebracht met dyslipidemie.

Zie deze grafiek:

Abstract

Volgens de onderzoekers vestigen deze bevindingen de aandacht op de noodzaak om het dunnedarmmicrobioom in menselijke populaties verder te karakteriseren en, nog belangrijker, om te beginnen te begrijpen hoe dunnedarmspecifieke microben, zoals de hier geïdentificeerde, interageren met de gastheer om fysiologische en belangrijke gastheerprocessen te veranderen, zoals de opname van voedingsstoffen en de entero-endocriene productie, die plaatsvinden in de dunne darm.

Het volledige studierapport is gratis in te zien. Klik op de titel van het abstract:

Characterization of the Small Bowel Microbiome Reveals Different Profiles in Human Subjects Who Are Overweight or Have Obesity

Leite, Gabriela PhD1Barlow, Gillian M. PhD1Rashid, Mohamad MBChB1Hosseini, Ava MPH1Cohrs, Daniel MD1; Parodi, Gonzalo BS1; Morales, Walter BS1Weitsman, Stacy MS1Rezaie, Ali MD1,2Pimentel, Mark MD, FACG1,2Mathur, Ruchi MD1,3

Author Information
The American Journal of Gastroenterology ():10.14309/ajg.0000000000002790, April 22, 2024. | DOI: 10.14309/ajg.0000000000002790


Abstract

INTRODUCTION: 

Gut microbiome changes are linked to obesity, but findings are based on stool data. In this article, we analyzed the duodenal microbiome and serum biomarkers in subjects with normal weight, overweight, and obesity.

METHODS: 

Duodenal aspirates and serum samples were obtained from subjects undergoing standard-of-care esophagogastroduodenoscopy without colon preparation. Aspirate DNAs were analyzed by 16S rRNA and shotgun sequencing. Predicted microbial metabolic functions and serum levels of metabolic and inflammatory biomarkers were also assessed.

RESULTS: 

Subjects with normal weight (N = 105), overweight (N = 67), and obesity (N = 42) were identified. Overweight-specific duodenal microbial features include lower relative abundance (RA) of Bifidobacterium species and Escherichia coli strain K-12 and higher Lactobacillus intestinalisL. johnsonii, and Prevotella loescheii RA. Obesity-specific features include higher Lactobacillus gasseri RA and lower L. reuteri (subspecies rodentium), Alloprevotella rava, and Leptotrichia spp RA. Escalation features (progressive changes from normal weight through obesity) include decreasing Bacteroides pyogenesStaphylococcus hominis, and unknown Faecalibacterium species RA, increasing RA of unknown Lactobacillus and Mycobacterium species, and decreasing microbial potential for biogenic amines metabolism. De-escalation features (direction of change altered in normal to overweight and overweight to obesity) include Lactobacillus acidophilusL. hominisL. iners, and Bifidobacterium dentium. An unknown Lactobacillus species is associated with type IIa dyslipidemia and overweight, whereas Alloprevotella rava is associated with type IIb and IV dyslipidemias.

DISCUSSION: 

Direct analysis of the duodenal microbiome has identified key genera associated with overweight and obesity, including some previously identified in stool, e.g., Bifidobacterium and Lactobacillus. Specific species and strains exhibit differing associations with overweight and obesity, including escalation and de-escalation features that may represent targets for future study and therapeutics.

CONFLICTS OF INTEREST

Guarantor of the article: Ruchi Mathur, MD.

Specific author contributions: R.M. and M.P.: conceptualization. A.H. and M.R.: resources. G.L., G.B., G.P., S.W., and W.M.: investigation. G.L., A.R., and M.P.: formal analysis. G.B., M.P., and R.M.: project administration. G.L., G.B., D.C., and R.M.: writing—original draft. G.L., G.B., A.R., M.P., and R.M.: writing—review and editing.

Financial support: This study was supported in part by funds from The Monica Lester Charitable Trust, and The Elias, Genevieve, and Georgianna Charitable Trust.

Potential competing interests: None to report.

Study Highlights

WHAT IS KNOWN

  • ✓ Stool studies indicate that gut microbial populations are altered in overweight and obesity.
  • ✓ Stool studies have linked alterations in AkkermansiaBifidobacteria, and Lactobacillus species to obesity.
  • ✓ The composition of the small bowel microbiome is significantly different from that of stool.
  • ✓ The roles of small bowel microbes in overweight and obesity are poorly understood.

WHAT IS NEW HERE

  • ✓ The small bowel (duodenal) microbiome is significantly altered in subjects with overweight and obesity vs normal weight.
  • ✓ Specific microbial alterations are overweight-specific or obesity-specific; others are escalation or de-escalation features.
  • ✓ Bifidobacterium dentium is a de-escalation feature, consistent with known anti-obesity effects.
  • ✓ Changes in Lactobacillus gasseri and decreased L. reuteri are obesity-specific, but L. acidophilus and L. hominis are de-escalation features.
  • ✓ Specific Lactobacillus species are linked to type IIa dyslipidemia, and Alloprevotella rava is linked to type IIb and IV dyslipidemias.

ACKNOWLEDGEMENTS

The authors thank the REIMAGINE Study Group for their assistance in obtaining samples. The REIMAGINE Study Group includes Christopher Almario MD, FACG, Benjamin Basseri MD, Yin Chan MD, Bianca Chang MD, Derek Cheng MD, Pedram Enayati MD, Srinivas Gaddam MD, Laith Jamil MD, FACG, Quin Liu MD, Simon Lo MD, Marc Makhani MD, Deena Midani MD, Mazen Noureddin MD, FACG, Kenneth Park MD, Shirley Paski MD, Nipaporn Pichetshote MD, Shervin Rabizadeh MD, Soraya Ross MD, Omid Shaye MD, Rabindra Watson MD, Ali Rezaie MD, and Mark Pimentel MD, FACG. The authors also thank Maria Jesus Villanueva-Milan, PhD, and Maritza Sanchez for assisting with sample processing and analysis. Finally, we thank Frank Lee, the Monica Lester Charitable Trust, and the Elias, Genevieve, and Georgianna Charitable Trust for their generous support of the MAST program.

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Keywords:

small intestinal microbiome; obesity; overweight; BifidobacteriumLactobacillus; biogenic amines metabolism; dyslipidemias

Supplemental Digital Content

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology


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