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Gut Microbial Dysbiosis in the Pathogenesis of Gastrointestinal Dysmotility and Metabolic Disorders

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KOREAN SOC NEUROGASTROENTEROLOGY & MOTILITY
DOI: 10.5056/jnm20149

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Diabetes mellitus; Fecal microbiota transplantation; Gastrointestinal microbiome; Irritable bowel syndrome; Metabolic diseases

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The gut microbiota, the largest and most complex population of microorganisms in the human body, plays vital roles in regulating host immunity, procuring energy from food, and preventing the colonization of pathogens. Dysbiosis in the gut microbiota is increasingly recognized as a core pathophysiology in gastrointestinal motility and metabolic disorders, although the causal relationship is still largely unexplored. Research is ongoing to understand the communication between gut microbes and host physiology, with potential therapeutic avenues currently limited to antibiotics, fecal microbiota transplantation, probiotics, and dietary interventions.
Of all microorganisms in the human body, the largest and most complex population resides in the gastrointestinal (GI) tract. The gut microbiota continuously adapts to the host environment and serves multiple critical functions for their hosts, including regulating host immunity, procuring energy from food, and preventing the colonization of pathogens. Mounting evidence has suggested gut microbial imbalance (dysbiosis) as a core pathophysiology in the development of GI motility and metabolic disorders, such as irritable bowel syndrome and diabetes. Current research has focused on discovering associations between these disorders and gut microbial dysbiosis; however, whether these associations are a consequence or cause is still mostly unexplored. State-of-the-art studies have investigated how gut microbes communicate with our body systems through microbiota-derived metabolites and how they are able to modulate host physiology. There is now mounting evidence that alterations in the composition of small intestinal microbes have an association with GI dysmotility and metabolic disorders. Although treatment options for gut microbial dysbiosis are currently limited, antibiotics, fecal microbiota transplantation, probiotics, and dietary interventions are currently the best options. However, treatment with broad-spectrum antibiotics has been viewed with skepticism due to the risk of developing antibiotic resistant bacteria. Studies are warranted to elucidate the cellular and molecular pathways underlying gut microbiota-host crosstalk and for the development of a powerful platform for future therapeutic approaches. Here, we review recent literature on gut microbial alterations and/or interactions involved in the pathophysiology of GI dysmotility and metabolic disorders.

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