Interactions Between Gut Microbiota, Host, and Herbal Medicines: A Review of New Insights Into the Pathogenesis and Treatment of Type 2 Diabetes

Abstract

Herbal medicines (HMs) are a major subset of complementary and alternative medicine. They have been employed for the efficient clinical management of type 2 diabetes mellitus (T2DM) for centuries. However, the related underlying mechanisms still remain to be elucidated. It has been found out that microbiota is implicated in the pathogenesis and treatment of T2DM. An interplay between gut microbiota and host occurs mainly at the gastrointestinal mucosal barrier. The host movements influence the composition and abundance of gut microbiota, whereas gut microbiota in turn modulate the metabolic and immunological activities of the host. Intestinal dysbiosis, endotoxin-induced metabolic inflammation, immune response disorder, bacterial components and metabolites, and decreased production of short-chain fatty acids are considered significant pathogenic mechanisms underlying T2DM. The interaction between gut microbiota and HMs during T2DM treatment has been investigated in human, animal, and in vitro studies. HMs regulate the composition of beneficial and harmful bacteria and decrease the inflammation caused by gut microbiota. Furthermore, the metabolism of gut microbiota modulates HM biotransformation. In this review, we have summarized such research findings, with the aim to improve our understanding of the pathogenesis and potential therapeutic mechanisms of HMs in T2DM and to provide new insights into specific targeted HM-based therapies and drug discovery.

Traditional Chinese Medicine Alleviates Ulcerative Colitis via Modulating Gut Microbiota

“…For example, many TCMs contain polyphenols, but the polyphenols show less than 10% absorption and about 90–95% of the polyphenols accumulate in colon [ 36 ]. Growing evidence demonstrates orally administrated TCM is affected by enzymes of gut microbiota [ 37 , 38 ]. Nitroreductase and azoreductase are two major reductases in gut bacteria.…”

“…Multiple studies showed lower relative abundance of SCFA-producing bacteria, for instance, Faecalibacterium , Clostridium clusters IV and XIVb, Roseburia , Odoribacter , and Leuconostocaceae in UC patients [ 56 , 57 ]. TCM has been found to adjust the gut flora structure and metabolic profiles [ 37 , 58 , 59 ]. It is reported that SCFAs exert their effects through activating G-protein-coupled receptors (GPCRs) and inhibiting histone deacetylases (HDACs) [ 60 – 62 ].…”

Characterization of B-cell Receptor Heavy Chain Complementarity-determining Region 3 Repertoire Based on the Differences of Symbiotic Microorganisms in the Gut of Mice

“…Dysregulation of intestinal mucosal immune system can progressively lead to autoimmune disease and in ammation-driven carcinogenesis [1]. The gut microbiota has been shown to play critical roles in maintaining intestinal mucosal immune system homeostasis [2][3][4]. The intestinal mucosal immune system includes three different mucosal lymphoid structures: the epithelia, Peyer's patches and the lamina propria [5].…”

Potential of an Enzyme Mixture of Glucose Oxidase, Glucosyl Transferase, and Fructosyl Transferase as an Antidiabetic Medicine

“…Additional and/or alternative agents (sulfonylureas, thiazolidinediones, α-glucosidase inhibitors, dipeptidyl peptidase-4 inhibitors, and sodium-dependent glucose transporter 2) and injectable medications (insulin and glucagon-like peptide-1) may be considered, as the disease progresses [7]. Complementary and alternative medications may include other therapeutic approaches, although the underlying mechanisms remain to be elucidated [8].…”

“…Oligosaccharides in the alimentary tract modulate gut microbiota composition [13]. The microbiota is implicated in T2D pathogenesis and treatment [8]. Transglucosidase decreases postprandial blood glucose levels in individuals with IGT and T2D [14,15].…”