The Promising Role of Microbiome Therapy on Biomarkers of Inflammation and Oxidative Stress in Type 2 Diabetes: A Systematic and Narrative Review

Abstract

BackgroundOne in 10 adults suffer from type 2 diabetes (T2D). The role of the gut microbiome, its homeostasis, and dysbiosis has been investigated with success in the pathogenesis as well as treatment of T2D. There is an increasing volume of literature reporting interventions of pro-, pre-, and synbiotics on T2D patients.MethodsStudies investigating the effect of pro-, pre-, and synbiotics on biomarkers of inflammation and oxidative stress in T2D populations were extracted from databases such as PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to January 2022.ResultsFrom an initial screening of 5,984 hits, 47 clinical studies were included. Both statistically significant and non-significant results have been compiled, analyzed, and discussed. We have found various promising pro-, pre-, and synbiotic formulations. Of these, multistrain/multispecies probiotics are found to be more effective than monostrain interventions. Additionally, our findings show resistant dextrin to be the most promising prebiotic, followed closely by inulin and oligosaccharides. Finally, we report that synbiotics have shown excellent effect on markers of oxidative stress and antioxidant enzymes. We further discuss the role of metabolites in the resulting effects in biomarkers and ultimately pathogenesis of T2D, bring attention toward the ability of such nutraceuticals to have significant role in COVID-19 therapy, and finally discuss few ongoing clinical trials and prospects.ConclusionCurrent literature of pro-, pre- and synbiotic administration for T2D therapy is promising and shows many significant results with respect to most markers of inflammation and oxidative stress.

The Emerging Role of the Aging Process and Exercise Training on the Crosstalk between Gut Microbiota and Telomere Length

“…The gut ecosystem of healthy adults demonstrates strong adaptations to potential stressors, such as pharmacological treatments, acute illness, and lifestyle changes (acute or chronic) [11]. However, each type of stressor is capable of generating a signature in the microbial composition regarding the balance between symbiotic and pathobiont microorganisms [12]. Cross-sectional studies of fecal samples from subjects in different age groups indicate age-related changes in GM competition and diversity, supporting longitudinal studies [13].…”

“…However, these studies only support the thesis that the composition of GM may reflect each individual's aging process. However, it has not yet been described to what extent the microbiota is a biomarker of aging [12]. Therefore, the fine line between host health and environmental influences still needs to be understood due to the fact that when considering that GM contributes to the triggering of geriatric giants, such as frailty, sarcopenia, and cognitive impairment [17,27,28].…”

“…Furthermore, several pieces of evidence support that the exacerbated reactive oxygen species (ROS) and pro-inflammatory cytokines production lead to greater cell and/or DNA damage, increasing cell division rate and, thus, inducing a greater telomere shortening. In addition, recent research has shown that many GM species could be related to increased oxidative stress and chronic inflammation [8,[10][11][12]. Therefore, it is plausible to infer that telomere shortening may be associated with GM dysbiosis through redox imbalance and exacerbated inflammatory signaling pathways.…”

Can probiotic, prebiotic, and synbiotic supplementation modulate the gut-liver axis in type 2 diabetes? A narrative and systematic review of clinical trials

“…Furthermore, it has been suggested that the translocation and ratio alterations of the intestinal microbiome in diabetic and obese patients may lead to the metabolism of otherwise insoluble and indigestible carbohydrates, significantly raising energy harvesting and adiposity in the liver ( 20 ). Dysbiosis is also involved in chronic inflammation and oxidative stress ( 21 ). This is partly due to the production and release of endotoxins, including lipopolysaccharides (LPS), as well as the translocation of intestinal bacteria from the gut microbiota into the bloodstream ( 22 ).…”

Renal Health Improvement in Diabetes through Microbiome Modulation of the Gut–Kidney Axis with Biotics: A Systematic and Narrative Review of Randomized Controlled Trials

“…As per the most recent consensus statements of the International Scientific Association for Probiotics and Prebiotics (ISAPP), probiotics are defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host” [ 23 ]; prebiotics as “a substrate that is selectively utilized by host microorganisms conferring a health benefit” [ 24 ]; and lastly, synbiotics as “a mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host” [ 25 ]. Previously, we have shown that such nutraceuticals may improve inflammation, oxidative stress, liver damage, glycemia, and insulinemia in T2D patients [ 26 , 27 , 28 ]. Recently, researchers have also successfully investigated their role in obesity-related kidney disease and hypertension [ 29 , 30 ].…”