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Modulation der intestinalen Mikrobiota durch Ernährungsinterventionen

Modulation of the intestinal microbiota by nutritional interventions

  • Schwerpunkt: Mikrobiom
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Zusammenfassung

Der Mensch lebt mit Milliarden kommensaler Mikroorganismen in Symbiose. Die sogenannte Mikrobiota besiedelt die verschiedenen Grenzflächen, so etwa die Haut, Urogenital- und Gastrointestinaltrakt. Kommensale Bakterien verdrängen besonders im Darm potenziell pathogene Keime, sind an der Synthese von Vitaminen beteiligt und sorgen für die Fermentation von Ballaststoffen. Ein Ungleichgewicht in der bakteriellen Zusammensetzung der intestinalen Mikrobiota ist mit zahlreichen Erkrankungen assoziiert, z. B. mit chronisch-entzündlichen Darmerkrankungen, kolorektalem Karzinom und Fettleberhepatitis. Zudem mehren sich die Anhaltspunkte, dass auch Verschiebungen innerhalb der intestinalen Mikrobiota pathophysiologisch relevant sind. Daher könnte die spezifische Beeinflussung der intestinalen Mikrobiota eine erfolgsversprechende Strategie in der begleitenden Therapie oben genannter Erkrankungen sein. Die intestinale Mikrobiota wird maßgeblich durch Mikro- und Makronährstoffe sowie durch sekundäre Pflanzeninhaltsstoffe in unserer Nahrung beeinflusst. Auch synthetisch hergestellte Nahrungsbestandteile wie Emulgatoren und Süßstoffe können die Diversität der Mikrobiota modulieren. Aufgrund der individuellen Unterschiede in der Zusammensetzung der intestinalen Mikrobiota und der mangelnden Spezifität ist das therapeutische Potenzial von Ernährungsinterventionen zur Beeinflussung der Mikrobiota bei Erkrankungen des Gastrointestinaltrakts noch stark limitiert. Die Kombination neuer technischer Analyseverfahren unter Einbeziehung selbstlernender Algorithmen wird sehr wahrscheinlich schon bald die aktuell bestehenden Limitationen überbrücken und eine personalisierte, hochspezifische und damit therapeutisch wirksame Modulation der Mikrobiota erlauben.

Abstract

Humans live in symbiosis with billions of commensal bacteria. The so-called microbiota live on different biological interfaces such as the skin, the urogenital tract and the gastrointestinal tract. Commensal bacteria replace potentially pathogenic microbes, synthesize vitamins and ferment dietary fibre. An imbalance in the bacterial composition of the intestinal microbiota has been associated with various diseases including gut-associated disorders such as inflammatory bowel diseases, colorectal cancer and nonalcoholic fatty liver disease. Furthermore, a shift in the microbiota composition appears to be of pathophysiological relevance which renders the specific modulation of the intestinal microbiota a promising approach in the treatment of the above mentioned diseases. Our intestinal microbiota composition is mainly modulated by dietary macro- and micronutrients but also by secondary plant compounds and synthetic food additives such as emulsifiers and artificial sweeteners. Nutritional interventions with the purpose to modulate the intestinal microbiota show only limited therapeutic potential in the treatment of gut-associated disorders, which may be due to individual differences in the intestinal microbiota composition and a lack of specificity. A combination of newly established technical analytic approaches involving a machine-learning algorithm may bridge the currently existing limitations by providing a personalized, highly-specific and consequently therapeutically effective microbiota modulation.

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Authors and Affiliations

  1. Institut für Ernährungsmedizin, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    S. Derer, C. Sina &  A. E. Wagner

  2. Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Lübeck, Deutschland

    H. Lehnert & C. Sina

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  1. S. Derer
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  2. H. Lehnert
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  3. C. Sina
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  4. A. E. Wagner
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Correspondence to A. E. Wagner.

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Interessenkonflikt

S. Derer, H. Lehnert, C. Sina und A.E. Wagner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H. Lehnert, Lübeck

J. Mössner, Leipzig

B. Salzberger, Regensburg

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Derer, S., Lehnert, H., Sina, C. et al. Modulation der intestinalen Mikrobiota durch Ernährungsinterventionen. Internist 58, 435–440 (2017). https://doi.org/10.1007/s00108-017-0217-0

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  • DOI: https://doi.org/10.1007/s00108-017-0217-0

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