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samedi 17 mars 2018

MICROBIOME AND TYPE 1 AND 2 DIABETES


Microbial modulation of diabetes  (type 2)
Short-chain fatty acids (SCFAs) are produced by various human gut microbes. SCFAs act as an energy source to the colonic epithelium and are also sensed by host signaling pathways that modulate appetite and inflammation. Deficiency of gut SCFAs is associated with type 2 diabetes. Zhao et al. found that adopting a high-fiber diet promoted the growth of SCFA-producing organisms in diabetic humans. The high-fiber diet induced changes in the entire gut microbe community and correlated with elevated levels of glucagon-like peptide-1, a decline in acetylated hemoglobin levels, and improved blood-glucose regulation.

REPORT

Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes

Science 09 Mar 2018:
Vol. 359, Issue 6380, pp. 1151-1156
DOI: 10.1126/science.aao5774

Ann Med. 2017 Feb; 49(1):11-22. doi: 10.1080/07853890.2016.1222449. Epub 2016 Nov 29.

Is there a role for gut micro biota in type 1 diabetes pathogenesis?

Author information

Abstract

Type 1 diabetes mellitus (T1D) is an autoimmune disease characterized by insufficient insulin production due to the destruction of insulin secreting β-cells in the Langerhans islets. A variety of factors, including chemicals, viruses, commensal bacteria and diet have been proposed to contribute to the risk of developing the disorder. In the last years, gut micro biota has been proposed as a main factor in T1D pathogenesis. Several alterations of gut microbiota composition were described both in animal model and in humans. The decrease of Firmicutes/Bacteroides ratio was the most frequent pattern described, in particular, in human studies. Furthermore, Bacteroides, Clostridium cluster XIVa, Lactobacillus, Bifidobacterium, and Prevotella relative abundances were different in healthy and affected subjects. Dysbiosis would seem to increase intestinal permeability and thus promote the development of a pro-inflammatory niche that stimulates β-cell autoimmunity in predisposed subjects. Preliminary studies on animal models were realized to investigate the role of gut microbiota modulation as therapy or prevention approach in predisposed animals: promising and stimulating results have been reported. Key message Dietary antigens and microbiota-derived products might act as triggers of T1D by causing a pro-inflammatory and metabolic dysfunctional environment.

I remember my colleagues laughing at me in 2005 when I expressed my opinion that Diabetes 1 and 2 are inflammatory manifestations and that many of the measurements such as Cholesterol were just inflammatory markers. Microbiome understanding was just surfacing at that time.
Now they are not laughing, both Type 1 and Type 2 Diabetes in susceptible people have been associated with Microbiome changes in diversity and that treatment may include methods of increasing the diversity.

This is the advantage of doing Clinical Work exclusively among a single cultural racial group such as American Indians in my case. Your desire to alleviate some of their suffering would lead you to think in innovative fashion about the origins of metabolic diseases among this group.