Over-feeding the gut microbiome: A scoping review on health implications and therapeutic perspectives

Abstract

The human gut microbiome has gained increasing attention over the past two decades. Several findings have shown that this complex and dynamic microbial ecosystem can contribute to the maintenance of host health or, when subject to imbalances, to the pathogenesis of various enteric and non-enteric diseases. This scoping review summarizes the current knowledge on how the gut microbiota and microbially-derived compounds affect host metabolism, especially in the context of obesity and related disorders. Examples of microbiome-based targeted intervention strategies that aim to restore and maintain an eubiotic layout are then discussed. Adjuvant therapeutic interventions to alleviate obesity and associated comorbidities are traditionally based on diet modulation and the supplementation of prebiotics, probiotics and synbiotics. However, these approaches have shown only moderate ability to induce sustained changes in the gut microbial ecosystem, making the development of innovative and tailored microbiome-based intervention strategies of utmost importance in clinical practice. In this regard, the administration of next-generation probiotics and engineered microbiomes has shown promising results, together with more radical intervention strategies based on the replacement of the dysbiotic ecosystem by means of fecal microbiota transplantation from healthy donors or with the introduction of synthetic communities specifically designed to achieve the desired therapeutic outcome. Finally, we provide a perspective for future translational investigations through the implementation of bioinformatics approaches, including machine and deep learning, to predict health risks and therapeutic outcomes.

Keywords: Gut microbiome; Microbial metabolites; Obesity; Next-generation probiotics; Fecal microbiota transplantation; Deep learning

Core Tip: The gut microbiome (GM) has gained increasing attention in recent years due to its key role in contributing to host health, potentially serving as a target for personalized precision medicine. This review summarizes the current evidence for the involvement of the GM in the regulation of various pathophysiological aspects, particularly in obesity and related comorbidities. The influence of diet and the molecules produced by commensal microorganisms is discussed, together with traditional and innovative microbiome-based strategies in the prevention and treatment of obesity, up to the development of machine and deep learning bioinformatics tools for the prediction of health risks and therapeutic outcomes.