The main factors that improve gut microbiota composition

Abstract

The aim is to observe and compare the main factors that can improve gut microbiota composition. Materials and methods. The literature study research was performed in PubMed and Google Scholar electronic databases. We assessed more than 300 studies, data from 65 of which were included in this review. They are presented in three tables: nonpharmacological influence on gut microbiota composition, drugs impact on gut microbiota, and medicines prescribed for gut microbiota correction. Results. On the one hand, non-pharmacological methods of gut microbiota improvement are the safest and the most traditional: healthy diet and physical activity, good sleep, avoiding stress and bad habits, but they are the most difficult for patients’ fulfillment and doctors’ observation. All listed are the components of a healthy way of life and should be followed by everybody. The most prescribed drugs have a significant influence on gut microbiota composition, so physicians should consider their effects in prescriptions. They are antibiotics, steroids and non-steroids, proton pump inhibitors, laxatives, antidepressants, etc. On the other hand, despite the diversity of available medicines (prebiotics, probiotics, paraprobiotics, postbiotics, synbiotics, and antibiotics) that can be used for gut microbiota improvement, all of them are under investigation and need further evaluation. The trendiest medicines for today are paraprobiotics and postbiotics. Paraprobiotics are represented by heat / ultraviolet / sonication Lactobacillus spp., Bifidobacterium spp., and Saccharomyces strains. Postbiotics are performed by short-chain fatty acids, secreted biosurfactants, secreted proteins, organic acids, amino acids, bacteriocins, vitamins, and peptides. Most of the data on their pharmacodynamics is based on animal studies or experimental research, so they need further investigations. Fecal gut microbiota transplantation is also an up-to-date method for multiple disease correction but is approved only for the treatment of recurrent and refractory infections caused by Clostridium difficile. Conclusions. Gut microbiota composition improvement methods are an up-to-date topic for practical medicine because gut microbiota changes are closely linked with host health status. Gut microbiota violations lead to metabolic, cardiovascular, neurological, inflammatory disorders, etc. Nowadays the healthy way of life is the best gut microbiota composition improvement method, but prebiotics, probiotics, paraprobiotics, postbiotics, synbiotics, antibiotics supplementation, and fecal microbiota transplantation also take place and have their indisputable advantages in special cases. Unfortunately, most pharmacological methods of gut microbiota modulation have a weak evidence base. Therefore, this question needs further research in appropriate patient groups with long-term monitoring.

Keywords

• probiotics
• prebiotics
• synbiotics
• gastrointestinal microbiome
• metabolomics
• coronary artery disease