Zusammenfassung
Das Darmmikrobiom des Menschen ist dank des rapiden Fortschritts der Genanalytik und Bioinformatik in den letzten Jahren für unterschiedlichste forschende Fachdisziplinen weiter zugänglich geworden. In großen Metaanalysen von Stuhlproben und Anamnesen und über Tierexperimente mit keimfreien Mäusen werden Zusammenhänge zwischen unterschiedlichen Pathologien und der Darmbesiedlung hergestellt. Neben immunologischen und neuropsychologischen Erkrankungen stehen metabolische Erkrankungen im Vordergrund, wie Insulinresistenz und Adipositas. Dabei scheint Übergewicht mit Verschiebungen des Mikrobioms assoziiert, die Charakterisierung eines „übergewichtigen Mikrobioms“ ist bisher noch nicht gelungen. Neben der Ernährung wird auch der Einfluss von Geburtsmodus, frühkindlicher Ernährung und Antibiotikatherapien neu diskutiert. Tierexperimente zeigen, dass steril aufwachsende Mäuse trotz hochkalorischer Ernährung kein Gewicht zunehmen, jedoch nach einer Stuhltransplantation Übergewicht entwickeln. Die Inzidenz von Insulinresistenz in dieser Gruppe ist dabei von der Fütterung der Spendermäuse abhängig. In ersten klinischen Studien gelang es zum Teil, diese Ergebnisse auf den Menschen zu übertragen. Wegen der geringen Gesamtzahl von Studien und dem noch immer sehr begrenzten Wissen über konkrete Eigenschaften und Zusammensetzung der Mikrobiota ist jedoch vorerst nicht mit klinischer Anwendung von Mikrobiomtherapien zu rechnen.
Abstract
Due to the rapid progress of genetic and bioinformatic analysis techniques, the human gut microbiome has increasingly become the subject of research for a growing variety of medical fields. Large meta-analyses of stool samples in various diseases as well as germ-free animal models are used to assess possible associations between the gut microbiome and various pathogenic findings. In addition to associations with immunologic and neuropsychological disorders, one of the main areas of research has been metabolic diseases such as insulin resistance and obesity. In this context, it has been shown that obesity may be associated with a shift in the gut microbiome. However, a distinct characterization of an “obese microbiome” has not yet been established. In addition to nutrition and the mode of birth, early childhood nutrition and antibiotic therapies are suggested to play an influential role on the gut microbiome. Animal models have been used to demonstrate that germ-free mice, which do not gain extra weight despite a high calorie intake, develop obesity after a fecal transfer. In these mice, the incidence of insulin resistance depends on the nutrition of the fecal donor mice. Preliminary data in humans seem to confirm these findings. However, due to the still only limited data and knowledge on the specific alterations and pathogenic role of the human microbiome composition in relation to various diseases, a general clinical use of a specific microbiome therapy is currently not established.
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F. Bertram und D. Menge geben an, dass kein Interessenkonflikt besteht. V. Andresen weist auf folgende Beziehungen hin: Vorträge und/oder Beratungstätigkeiten für folgende Firmen: Allergan, Almirall, AstraZeneca, Boehringer Ingelheim, Falk, KyowaKirin, Nordmark, Schwabe, Shire, Yakult.
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Dieser Beitrag wurde bereits publiziert in: Gynäkologe 2017 · 50:111–119. DOI 10.1007/s00129-016-4022-y
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Bertram, F., Menge, D. & Andresen, V. Die Bedeutung des Mikrobioms für die Adipositas. Diabetologe 13, 260–267 (2017). https://doi.org/10.1007/s11428-017-0229-3
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DOI: https://doi.org/10.1007/s11428-017-0229-3