Das menschliche „Gewebs“-Mikrobiom im metabolischen Syndrom: der „Leaky Gut“ Hypothese auf der Spur

Zusammenfassung

Durch die Veränderung der intestinalen Permeabilität können Faktoren wie das Mikrobiom, Ernährung oder Medikamentengabe Einfluss auf die Entwicklung von Parametern des metabolischen Syndroms nehmen. Dabei kommt es zu Veränderungen im parazellulären Raum, durch die ein Influx von bakteriellen Bestandteilen möglich wird. Adipositas und Diabetes sind zudem mit erhöhten Endotoxinspiegeln in der von Endotoxin, z. B. über den TLR4 Rezeptor bekannt sind, ist der genaue Beitrag zu Merkmalen des metabolischen Syndroms noch unklar. Klar ist aber, dass Entzündung und Insulinresistenz erhöht werden können. Auch die Frage nach einem „Gewebs“-Mikrobiom im metabolischen Syndrom kann aufgrund der Datenlage noch nicht eindeutig beantwortet werden, denn obwohl erste Daten bakterielle DNA im Fettgewebe zeigen, gibt es auch gegensätzliche Arbeiten. Ein „Leaky Gut“ ist ein mögliches Merkmal des metabolischen Syndroms, welches zu den beobachteten Phänotypen beiträgt und, u. a. durch die erhöhte Entzündung in einem negativen Feedbackloop die intestinale Permeabilität weiter erhöhen kann.

Abstract

By altering the intestinal permeability factors like the microbiome, diet or medications can impact and shape attributes of the metabolic syndrome. Through changes in the paracellular space an influx of bacterial components becomes possible. Additionally, obesity and diabetes are associated with increased endotoxin levels in the circulation and even bacterial DNA was detected. Although some mechanisms and consequences of endotoxin actions are known (e. g. via TLR4 receptor), the exact contribution to features of the metabolic syndrome are unclear. However, it is evident that inflammation and insulin resistance can be increased. The question about a human tissue microbiome in metabolic syndrome can, due to limited data, not be answered yet. Even though first results show bacterial DNA in adipose tissue, there are also opposing studies. A “leaky gut” is a possible feature of the metabolic syndrome which contributes to its phenotype and can so, e. g. by elevated inflammation, further increase the intestinal permeability in a vicious cycle.

Schlüsselwörter

Intestinale Permeabilität - Endotoxin - Bakteriämie - Fettgewebe

Key words

Intestinal permeability - endotoxin - bacteremia - adipose tissue

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