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World J Gastroenterol. Jan 21, 2017; 23(3): 406-413
Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.406
Potential role of the gut microbiota in synthetic torpor and therapeutic hypothermia
Claudia Sisa, Silvia Turroni, Roberto Amici, Patrizia Brigidi, Marco Candela, Matteo Cerri
Claudia Sisa, Roberto Amici, Matteo Cerri, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
Silvia Turroni, Patrizia Brigidi, Marco Candela, Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
Author contributions: Sisa C, Candela M and Cerri M wrote the paper; Turroni S, Amici R and Brigidi P revised and edited the draft; all authors read and approved the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marco Candela, PhD, Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy. marco.candela@unibo.it
Telephone: +39-51-2099727 Fax: +39-51-2099734
Received: August 27, 2016
Peer-review started: August 31, 2016
First decision: November 9, 2016
Revised: November 18, 2016
Accepted: December 16, 2016
Article in press: December 19, 2016
Published online: January 21, 2017
Processing time: 140 Days and 8.8 Hours
Abstract

Therapeutic hypothermia is today used in several clinical settings, among them the gut related diseases that are influenced by ischemia/reperfusion injury. This perspective paved the way to the study of hibernation physiology, in natural hibernators, highlighting an unexpected importance of the gut microbial ecosystem in hibernation and torpor. In natural hibernators, intestinal microbes adaptively reorganize their structural configuration during torpor, and maintain a mutualistic configuration regardless of long periods of fasting and cold temperatures. This allows the gut microbiome to provide the host with metabolites, which are essential to keep the host immunological and metabolic homeostasis during hibernation. The emerging role of the gut microbiota in the hibernation process suggests the importance of maintaining a mutualistic gut microbiota configuration in the application of therapeutic hypothermia as well as in the development of new strategy such as the use of synthetic torpor in humans. The possible utilization of tailored probiotics to mold the gut ecosystem during therapeutic hypothermia can also be taken into consideration as new therapeutic strategy.

Keywords: Therapeutic hypothermia; Gut microbiota; Hibernation; Dysbiosis; Synthetic torpor

Core tip: Therapeutic hypothermia is currently limited by several factors, including the patient compensatory response. Recently, the possibility to induce synthetic torpor in non-hibernators has opened new scenarios, but a deep understanding of torpor and hibernation physiology is required. One particular aspect to consider is the gut microbiota (GM). In hibernators, the GM undergoes seasonal shifts, as a physiological response to the body temperature drop, and is considered playing a central role in regulating physiology, specifically influencing the immune system. Since the GM changes induced by synthetic torpor have never been described in non-hibernators, possible risks and reasonable interventions are suggested.