The gastrointestinal microbiota and multi-strain probiotic therapy: In children and adolescent obesity

Abstract

Childhood obesity is a predisposing factor for chronic diseases both in the adolescent years and into adulthood. Current research efforts have focused on host and environmental factors that may affect energy balance. This has lead to a plausible, biological postulation that an obese microbiota profile may exist and may demonstrate increased energy yielding behaviour by such bacteria. Consequently, the gastrointestinal tract (GIT) microbiota is gaining significant research interest in relation to obesity in an attempt to better understand the aetiology of obesity and potentially new methods of treatment. It is now well known that the microbiota that colonise the GIT perform a number of functions that include regulating the normal development and function of the mucosal barriers; assisting with maturation of immunological tissues, which in turn promotes immunological tolerance to antigens from foods, the environment, or potentially pathogenic organisms; chemical communication and influence of target tissues such as the liver, brain, muscle, adipose tissue, heart and GIT; preventing propagation of pathogenic microorganisms as well as controlling nutrient uptake and metabolism. Here we develop a hypothesis that multi-strain probiotics may provide a potential therapeutic role when supplemented conjointly with lifestyle interventions for obese children/adolescents. The administration of multi–strain probiotics in conjunction with lifestyle measures may rescue the GIT obese microbiome phenotype and encourage the re-establishment of a microbiome towards one that resembles that of lean individuals.

Introduction

In humans, following birth, bacteria colonise all body mucosal and extra-mucosal tissue sites that include the GIT, mouth, hair, nose, ears, vagina, lungs and skin, thereby giving rise to site-specific unique microbiota communities.[1] The human metagenome has been reported to consist of Homo sapiens genes and the genes that are present in the microbes that colonise and inhabit the human body.[2] Hence, the bacterial cohort in addition to contributing cues that allow for the maturation of immune tissues and function to provide immunological tolerance, also encode for metabolic capacity that in conjunction with the human host work to provide metabolites and energy balance.[3] Many of these metabolic activities still remain to be elucidated. This review considers the links between GIT dysbiosis and obesity and the metabolic sequalae that may ensue as well as the potential adjuvant role that probiotics may have in rescuing an obese-prone phenotype in adolescence.