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Rizzetto L, Fava F, Tuohy KM, Selmi C. Connecting the immune system, systemic chronic inflammation and the gut microbiome: The role of sex. J Autoimmun 2018; 92:12-34. [PMID: 29861127 DOI: 10.1016/j.jaut.2018.05.008] [Citation(s) in RCA: 210] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 12/12/2022]
Abstract
Unresolved low grade systemic inflammation represents the underlying pathological mechanism driving immune and metabolic pathways involved in autoimmune diseases (AID). Mechanistic studies in animal models of AID and observational studies in patients have found alterations in gut microbiota communities and their metabolites, suggesting a microbial contribution to the onset or progression of AID. The gut microbiota and its metabolites have been shown to influence immune functions and immune homeostasis both within the gut and systematically. Microbial derived-short chain fatty acid (SCFA) and bio-transformed bile acid (BA) have been shown to influence the immune system acting as ligands specific cell signaling receptors like GPRCs, TGR5 and FXR, or via epigenetic processes. Similarly, intestinal permeability (leaky gut) and bacterial translocation are important contributors to chronic systemic inflammation and, without repair of the intestinal barrier, might represent a continuous inflammatory stimulus capable of triggering autoimmune processes. Recent studies indicate gender-specific differences in immunity, with the gut microbiota shaping and being concomitantly shaped by the hormonal milieu governing differences between the sexes. A bi-directional cross-talk between microbiota and the endocrine system is emerging with bacteria being able to produce hormones (e.g. serotonin, dopamine and somatostatine), respond to host hormones (e.g. estrogens) and regulate host hormones' homeostasis (e.g by inhibiting gene prolactin transcription or converting glucocorticoids to androgens). We review herein how gut microbiota and its metabolites regulate immune function, intestinal permeability and possibly AID pathological processes. Further, we describe the dysbiosis within the gut microbiota observed in different AID and speculate how restoring gut microbiota composition and its regulatory metabolites by dietary intervention including prebiotics and probiotics could help in preventing or ameliorating AID. Finally, we suggest that, given consistent observations of microbiota dysbiosis associated with AID and the ability of SCFA and BA to regulate intestinal permeability and inflammation, further mechanistic studies, examining how dietary microbiota modulation can protect against AID, hold considerable potential to tackle increased incidence of AID at the population level.
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Affiliation(s)
- Lisa Rizzetto
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy.
| | - Francesca Fava
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - Kieran M Tuohy
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - Carlo Selmi
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Italy; BIOMETRA Department, University of Milan, Italy
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Scott FW, Pound LD, Patrick C, Eberhard CE, Crookshank JA. Where genes meet environment-integrating the role of gut luminal contents, immunity and pancreas in type 1 diabetes. Transl Res 2017; 179:183-198. [PMID: 27677687 DOI: 10.1016/j.trsl.2016.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 12/25/2022]
Abstract
The rise in new cases of type 1 diabetes (T1D) in genetically susceptible individuals over the past half century has been attributed to numerous environmental "triggers" or promoters such as enteroviruses, diet, and most recently, gut bacteria. No single cause has been identified in humans, likely because there are several pathways by which one can develop T1D. There is renewed attention to the role of the gut and its immune system in T1D pathogenesis based largely on recent animal studies demonstrating that altering the gut microbiota affects diabetes incidence. Although T1D patients display dysbiosis in the gut microbiome, it is unclear whether this is cause or effect. The heart of this question involves several moving parts including numerous risk genes, diet, viruses, gut microbiota, timing, and loss of immune tolerance to β-cells. Most clinical trials have addressed only one aspect of this puzzle using some form of immune suppression, without much success. The key location where our genes meet and deal with the environment is the gastrointestinal tract. The influence of all of its major contents, including microbes, diet, and immune system, must be understood as part of the integrative biology of T1D before we can develop durable means of preventing, treating, or curing this disease. In the present review, we expand our previous gut-centric model based on recent developments in the field.
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Affiliation(s)
- Fraser W Scott
- Chronic Disease Program, The Ottawa Hospital Research Institute, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada.
| | - Lynley D Pound
- Chronic Disease Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Christopher Patrick
- Chronic Disease Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Chandra E Eberhard
- Chronic Disease Program, The Ottawa Hospital Research Institute, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada
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Yeruva L, Spencer NE, Saraf MK, Hennings L, Bowlin AK, Cleves MA, Mercer K, Chintapalli SV, Shankar K, Rank RG, Badger TM, Ronis MJJ. Formula diet alters small intestine morphology, microbial abundance and reduces VE-cadherin and IL-10 expression in neonatal porcine model. BMC Gastroenterol 2016; 16:40. [PMID: 27005303 PMCID: PMC4804644 DOI: 10.1186/s12876-016-0456-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/15/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Breastfeeding is associated with a variety of positive health outcomes in children and is recommended exclusively for the first 6 months of life; however, 50-70 % of infants in the US are formula-fed. To test the hypothesis that immune system development and function in neonates and infants are significantly influenced by diet, 2-day old piglets were fed soy or milk formula (n = 6/group/gender) until day 21 and compared to a sow-fed group (n = 6/gender). METHODS Histomorphometric analyses of ileum, jejunum and Peyer's patches were carried out, to determine the inflammation status, mRNA and protein expression of pro-inflammatory, anti-inflammatory and growth-related chemokines and cytokines. RESULTS In formula-fed animals, increases in ileum and jejunum villus height and crypt depth were observed in comparison to sow-fed animals (jejunum, p < 0.01 villus height, p < 0.04 crypt depth; ileum p < 0.001 villus height, p < 0.002 crypt depth). In formula-fed the lymphoid follicle size (p < 0.01) and germinal centers (p < 0.01) with in the Peyer's patch were significantly decreased in comparison to sow-fed, indicating less immune education. In ileum, formula diet induced significant up-regulation of AMCFII, IL-8, IL-15, VEGFA, LIF, FASL, CXCL11, CCL4, CCL25 and down-regulation of IL-6, IL-9, IL-10, IL-27, IFNA4, CSF3, LOC100152038, and LOC100736831 at the transcript level. We have confirmed some of the mRNA data by measuring protein, and significant down-regulation of anti-inflammatory molecule IL-10 in comparison to sow-fed piglets was observed. To further determine the membrane protein expression in the ileum, VE-cadherin, occludin, and claudin-3, Western blot analyses were conducted. Sow fed piglets showed significantly more VE-Cadherin, which associated with levels of calcium, and putrescine measured. It is possible that differences in GI tract and immune development are related to shifts in the microbiome; notably, there were 5-fold higher amounts of Lactobacillaceae spp and 3 fold higher Clostridia spp in the sow fed group in comparison to milk formula-fed piglets, whereas in milk formula-fed pigs Enterobacteriaceae spp was 5-fold higher. CONCLUSION In conclusion, formula diet alters GI morphology, microbial abundance, intestinal barrier protein VE-cadherin and anti-inflammatory molecule IL-10 expression. Further characterization of formula effects could lead to modification of infant formula to improve immune function, reduce inflammation and prevent conditions such as allergies and infections.
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MESH Headings
- Animals
- Animals, Newborn
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Cadherins/genetics
- Cadherins/metabolism
- Calcium/metabolism
- Cytokines/drug effects
- Cytokines/genetics
- Cytokines/metabolism
- Diet
- Down-Regulation
- Fas Ligand Protein/drug effects
- Fas Ligand Protein/genetics
- Fas Ligand Protein/metabolism
- Gastrointestinal Microbiome/drug effects
- Humans
- Ileum/drug effects
- Ileum/metabolism
- Ileum/microbiology
- Ileum/pathology
- Infant Formula/pharmacology
- Infant, Newborn
- Interferon-alpha/drug effects
- Interferon-alpha/genetics
- Interferon-alpha/metabolism
- Interleukin-10/genetics
- Interleukin-10/metabolism
- Interleukin-15/genetics
- Interleukin-15/metabolism
- Interleukin-27/genetics
- Interleukin-27/metabolism
- Interleukin-6/genetics
- Interleukin-6/metabolism
- Interleukin-8/drug effects
- Interleukin-8/genetics
- Interleukin-8/metabolism
- Interleukin-9/genetics
- Interleukin-9/metabolism
- Intestine, Small/drug effects
- Intestine, Small/metabolism
- Intestine, Small/microbiology
- Intestine, Small/pathology
- Jejunum/drug effects
- Jejunum/metabolism
- Jejunum/microbiology
- Jejunum/pathology
- Leukemia Inhibitory Factor/drug effects
- Leukemia Inhibitory Factor/genetics
- Leukemia Inhibitory Factor/metabolism
- Milk
- Peyer's Patches/drug effects
- Peyer's Patches/immunology
- RNA, Messenger/drug effects
- RNA, Messenger/metabolism
- Soy Foods
- Swine
- Up-Regulation
- Vascular Endothelial Growth Factor A/drug effects
- Vascular Endothelial Growth Factor A/genetics
- Vascular Endothelial Growth Factor A/metabolism
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Affiliation(s)
- Laxmi Yeruva
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Arkansas Children’s Hospital Research Institute, Little Rock, USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | | | - Manish K. Saraf
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Leah Hennings
- />Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Anne K. Bowlin
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Mario A. Cleves
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Kelly Mercer
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Sree V. Chintapalli
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Kartik Shankar
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Roger G. Rank
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Thomas M. Badger
- />Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- />Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Martin J. J. Ronis
- />Department of Pharmacology & Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, LA USA
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Leifer CA, Dietert RR. Early life environment and developmental immunotoxicity in inflammatory dysfunction and disease. TOXICOLOGICAL AND ENVIRONMENTAL CHEMISTRY 2011; 93:1463-1485. [PMID: 26146439 PMCID: PMC4486307 DOI: 10.1080/02772248.2011.586114] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Components of the innate immune system such as macrophages and dendritic cells are instrumental in determining the fate of immune responses and are, also, among the most sensitive targets of early life environmental alterations including developmental immunotoxicity (DIT). DIT can impede innate immune cell maturation, disrupt tissue microenvironment, alter immune responses to infectious challenges, and disrupt regulatory responses. Dysregulation of inflammation, such as that observed with DIT, has been linked with an increased risk of chronic inflammatory diseases in both children and adults. In this review, we discuss the relationship between early-life risk factors for innate immune modulation and promotion of dysregulated inflammation associated with chronic inflammatory disease. The health risks from DIT-associated inflammation may extend beyond primary immune dysfunction to include an elevated risk of several later-life, inflammatory-mediated diseases that target a wide range of physiological systems and organs. For this reason, determination of innate immune status should be an integral part of drug and chemical safety evaluation.
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Affiliation(s)
- Cynthia A. Leifer
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Rodney R. Dietert
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
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Valladares R, Sankar D, Li N, Williams E, Lai KK, Abdelgeliel AS, Gonzalez CF, Wasserfall CH, Larkin J, Schatz D, Atkinson MA, Triplett EW, Neu J, Lorca GL. Lactobacillus johnsonii N6.2 mitigates the development of type 1 diabetes in BB-DP rats. PLoS One 2010; 5:e10507. [PMID: 20463897 PMCID: PMC2865539 DOI: 10.1371/journal.pone.0010507] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 04/12/2010] [Indexed: 11/24/2022] Open
Abstract
Background The intestinal epithelium is a barrier that composes one of the most immunologically active surfaces of the body due to constant exposure to microorganisms as well as an infinite diversity of food antigens. Disruption of intestinal barrier function and aberrant mucosal immune activation have been implicated in a variety of diseases within and outside of the gastrointestinal tract. With this model in mind, recent studies have shown a link between diet, composition of intestinal microbiota, and type 1 diabetes pathogenesis. In the BioBreeding rat model of type 1 diabetes, comparison of the intestinal microbial composition of diabetes prone and diabetes resistant animals found Lactobacillus species were negatively correlated with type 1 diabetes development. Two species, Lactobacillus johnsonii and L. reuteri, were isolated from diabetes resistant rats. In this study diabetes prone rats were administered pure cultures of L. johnsonii or L. reuteri isolated from diabetes resistant rats to determine the effect on type 1 diabetes development. Methodology/Principal Findings Results Rats administered L. johnsonii, but not L. reuteri, post-weaning developed type 1 diabetes at a protracted rate. Analysis of the intestinal ileum showed administration of L. johnsonii induced changes in the native microbiota, host mucosal proteins, and host oxidative stress response. A decreased oxidative intestinal environment was evidenced by decreased expression of several oxidative response proteins in the intestinal mucosa (Gpx1, GR, Cat). In L. johnsonii fed animals low levels of the pro-inflammatory cytokine IFNγ were correlated with low levels of iNOS and high levels of Cox2. The administration of L. johnsonii also resulted in higher levels of the tight junction protein claudin. Conclusions It was determined that the administration of L. johnsonii isolated from BioBreeding diabetes resistant rats delays or inhibits the onset of type 1 diabetes in BioBreeding diabetes prone rats. Taken collectively, these data suggest that the gut and the gut microbiota are potential agents of influence in type 1 diabetes development. These data also support therapeutic efforts that seek to modify gut microbiota as a means to modulate development of this disorder.
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Affiliation(s)
- Ricardo Valladares
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Dhyana Sankar
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States of America
| | - Nan Li
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States of America
| | - Emily Williams
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Kin-Kwan Lai
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Asmaa Sayed Abdelgeliel
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Claudio F. Gonzalez
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Clive H. Wasserfall
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Joseph Larkin
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Desmond Schatz
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States of America
| | - Mark A. Atkinson
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Eric W. Triplett
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Josef Neu
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States of America
| | - Graciela L. Lorca
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Sonier B, Patrick C, Ajjikuttira P, Scott FW. Intestinal Immune Regulation as a Potential Diet-Modifiable Feature of Gut Inflammation and Autoimmunity. Int Rev Immunol 2009; 28:414-45. [DOI: 10.3109/08830180903208329] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
PURPOSE OF REVIEW Several studies have indicated that children with type 1 diabetes show altered intestinal immune system and, in particular, increased small intestinal permeability. This review discusses the recent research linking the gut and type 1 diabetes, which may reveal novel pathogenic pathways and new possibilities for disease prevention. RECENT FINDINGS Recent studies indicate that not only patients with manifest type 1 diabetes show increased small intestinal permeability and high serum levels of zonulin, that is protein controlling epithelial tight junctions, but prediabetic, normoglycemic individuals with beta-cell autoimmunity show signs of leaking gut. Also studies in BioBreeding-rat model of autoimmune diabetes suggest that high permeability of the intestine precedes autoimmune diabetes. The enteropathy characterized by increased intestinal permeability and inflammation seems to be the basis for the development of beta-cell destruction, as for example zonulin agonist, which decreases the gut permeability, prevents the development of diabetes. SUMMARY The leaking gut syndrome with subclinical inflammation is associated with beta-cell autoimmunity and type 1 diabetes. Furthermore, treatment of the leakiness has been reported to modulate development of autoimmune diabetes in animal models suggesting that intestinal environment plays a key role in the destruction of insulin-producing beta-cells in the pancreas.
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Vaarala O, Atkinson MA, Neu J. The "perfect storm" for type 1 diabetes: the complex interplay between intestinal microbiota, gut permeability, and mucosal immunity. Diabetes 2008; 57:2555-62. [PMID: 18820210 PMCID: PMC2551660 DOI: 10.2337/db08-0331] [Citation(s) in RCA: 353] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Accepted: 07/11/2008] [Indexed: 12/28/2022]
Abstract
It is often stated that type 1 diabetes results from a complex interplay between varying degrees of genetic susceptibility and environmental factors. While agreeing with this principal, our desire is that this Perspectives article will highlight another complex interplay potentially associated with this disease involving facets related to the gut, one where individual factors that, upon their interaction with each another, form a "perfect storm" critical to the development of type 1 diabetes. This trio of factors includes an aberrant intestinal microbiota, a "leaky" intestinal mucosal barrier, and altered intestinal immune responsiveness. Studies examining the microecology of the gastrointestinal tract have identified specific microorganisms whose presence appears related (either quantitatively or qualitatively) to disease; in type 1 diabetes, a role for microflora in the pathogenesis of disease has recently been suggested. Increased intestinal permeability has also been observed in animal models of type 1 diabetes as well as in humans with or at increased-risk for the disease. Finally, an altered mucosal immune system has been associated with the disease and is likely a major contributor to the failure to form tolerance, resulting in the autoimmunity that underlies type 1 diabetes. Herein, we discuss the complex interplay between these factors and raise testable hypotheses that form a fertile area for future investigations as to the role of the gut in the pathogenesis and prevention of type 1 diabetes.
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Affiliation(s)
- Outi Vaarala
- Laboratory for Immunobiology, Department of Viral Diseases and Immunology, National Public Health Institute, Helsinki, Finland.
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