Functional changes of the gastric bypass microbiota reactivate thermogenic adipose tissue and systemic glucose control via intestinal FXR-TGR5 crosstalk in diet-induced obesity
Julia Münzker,
Nadine Haase,
Andreas Till,
Robert Sucher,
Sven-Bastiaan Haange,
Linda Nemetschke,
Thorsten Gnad,
Elisabeth Jäger,
Jiesi Chen,
Sjaak J. Riede,
Rima Chakaroun,
Lucas Massier,
Peter Kovacs,
Mario Ost,
Ulrike Rolle-Kampczyk,
Nico Jehmlich,
Juliane Weiner,
John T. Heiker,
Nora Klöting,
Gudrun Seeger,
Markus Morawski,
Verena Keitel,
Alexander Pfeifer,
Martin von Bergen,
Joerg Heeren,
Ute Krügel,
Wiebke K. Fenske
Affiliations
Julia Münzker
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Nadine Haase
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Andreas Till
Department of Internal Medicine I, Division of Endocrinology, Diabetes and Metabolism, University Medical Center Bonn
Robert Sucher
Department of Visceral-, Transplant-, Thoracic- and Vascular Surgery, University of Leipzig
Sven-Bastiaan Haange
Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research Leipzig–UFZ
Linda Nemetschke
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Thorsten Gnad
Institute of Pharmacology and Toxicology, University Hospital, University of Bonn
Elisabeth Jäger
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Jiesi Chen
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Sjaak J. Riede
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Rima Chakaroun
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Lucas Massier
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Peter Kovacs
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
Mario Ost
Department of Neuropathology, University of Leipzig
Ulrike Rolle-Kampczyk
Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research Leipzig–UFZ
Nico Jehmlich
Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research Leipzig–UFZ
Juliane Weiner
Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig
John T. Heiker
Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig
Nora Klöting
Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig
Gudrun Seeger
Paul Flechsig Institute of Brain Research, Faculty of Medicine, University of Leipzig
Markus Morawski
Paul Flechsig Institute of Brain Research, Faculty of Medicine, University of Leipzig
Verena Keitel
Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University
Alexander Pfeifer
Institute of Pharmacology and Toxicology, University Hospital, University of Bonn
Martin von Bergen
Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research Leipzig–UFZ
Joerg Heeren
Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf
Ute Krügel
Rudolf Boehm Institute of Pharmacology and Toxicology, University of Leipzig
Wiebke K. Fenske
Department of Internal Medicine I, Division of Endocrinology, Diabetes and Metabolism, University Medical Center Bonn
Abstract Background Bariatric surgery remains the most effective therapy for adiposity reduction and remission of type 2 diabetes. Although different bariatric procedures associate with pronounced shifts in the gut microbiota, their functional role in the regulation of energetic and metabolic benefits achieved with the surgery are not clear. Methods To evaluate the causal as well as the inherent therapeutic character of the surgery-altered gut microbiome in improved energy and metabolic control in diet-induced obesity, an antibiotic cocktail was used to eliminate the gut microbiota in diet-induced obese rats after gastric bypass surgery, and gastric bypass-shaped gut microbiota was transplanted into obese littermates. Thorough metabolic profiling was combined with omics technologies on samples collected from cecum and plasma to identify adaptions in gut microbiota-host signaling, which control improved energy balance and metabolic profile after surgery. Results In this study, we first demonstrate that depletion of the gut microbiota largely reversed the beneficial effects of gastric bypass surgery on negative energy balance and improved glucolipid metabolism. Further, we show that the gastric bypass-shaped gut microbiota reduces adiposity in diet-induced obese recipients by re-activating energy expenditure from metabolic active brown adipose tissue. These beneficial effects were linked to improved glucose homeostasis, lipid control, and improved fatty liver disease. Mechanistically, these effects were triggered by modulation of taurine metabolism by the gastric bypass gut microbiota, fostering an increased abundance of intestinal and circulating taurine-conjugated bile acid species. In turn, these bile acids activated gut-restricted FXR and systemic TGR5 signaling to stimulate adaptive thermogenesis. Conclusion Our results establish the role of the gut microbiome in the weight loss and metabolic success of gastric bypass surgery. We here identify a signaling cascade that entails altered bile acid receptor signaling resulting from a collective, hitherto undescribed change in the metabolic activity of a cluster of bacteria, thereby readjusting energy imbalance and metabolic disease in the obese host. These findings strengthen the rationale for microbiota-targeted strategies to improve and refine current therapies of obesity and metabolic syndrome. Video Abstract Graphical abstract Bariatric Surgery (i.e. RYGB) or the repeated fecal microbiota transfer (FMT) from RYGB donors into DIO (diet-induced obesity) animals induces shifts in the intestinal microbiome, an effect that can be impaired by oral application of antibiotics (ABx). Our current study shows that RYGB-dependent alterations in the intestinal microbiome result in an increase in the luminal and systemic pool of Taurine-conjugated Bile acids (TCBAs) by various cellular mechanisms acting in the intestine and the liver. TCBAs induce signaling via two different receptors, farnesoid X receptor (FXR, specifically in the intestines) and the G-protein-coupled bile acid receptor TGR5 (systemically), finally resulting in metabolic improvement and advanced weight management. BSH, bile salt hydrolase; BAT brown adipose tissue.