The Gut-Organ Axis within the Human Body: Gut Dysbiosis and the Role of Prebiotics

Mindfulness, Gut-Brain Axis, and Health-Related Quality of Life: The Paradigm of IBD Patients

Health-related quality of life (HRQoL) is a comprehensive measure that evaluates an individual's well-being across physical, mental, and social dimensions. Enhancing HRQoL, particularly in individuals with chronic conditions like inflammatory bowel diseases (IBD), necessitates a holistic approach. Mindfulness, a scientifically supported strategy for managing anxiety, has shown promise in improving both physical and mental health. Its benefits may be partly explained through its effects on the gut-brain axis (GBA), a bidirectional communication link between the gastrointestinal system and the central nervous system. By exploring the interplay between mindfulness and the GBA, this study aims to uncover how these elements collectively influence HRQoL in both healthy individuals and those with IBD, offering insights into potential therapeutic pathways. A cross-sectional investigation involved 338 adults, including 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterranean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, anthropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate correlation with the MAAS-15 scale (r = 0.389, p < 0.05) and a low correlation with 14-MEDAS (r = 0.131, p < 0.05). IBD patients exhibited significantly lower mean EQ-5D-5L scores than healthy individuals (0.75 vs. 0.85, p < 0.05). MAAS-15 demonstrated a robust correlation (r = 0.414, p < 0.001) with EQ-5D-5L in IBD patients. Elevated mindfulness levels emerged as predictive factors for higher HRQoL in IBD patients (OR: 1.101, 95% CI: 1.008, 1.202, p < 0.05, compared to low mindfulness). In summary, factors influencing the GBA, including mindfulness and the Mediterranean diet, exhibit positive associations with HRQoL. Increased mindfulness levels predict better HRQoL in IBD patients, emphasizing the potential for clinical trials to validate these cross-sectional study findings.

Epilactose as a Promising Butyrate-Promoter Prebiotic via Microbiota Modulation

Epilactose is a disaccharide composed of galactose and mannose, and it is currently considered an "under development" prebiotic. In this study, we described the prebiotic potential of epilactose by in vitro fermentation using human fecal inocula from individuals following a Mediterranean diet (DM) or a Vegan diet (DV). The prebiotic effect of epilactose was also compared with lactulose and raffinose, and interesting correlations were established between metabolites and microbiota modulation. The production of several metabolites (lactate, short-chain fatty acids, and gases) confirmed the prebiotic properties of epilactose. For both donors, the microbiota analysis showed that epilactose significantly stimulated the butyrate-producing bacteria, suggesting that its prebiotic effect could be independent of the donor diet. Butyrate is one of the current golden metabolites due to its benefits for the gut and systemic health. In the presence of epilactose, the production of butyrate was 70- and 63-fold higher for the DM donor, when compared to lactulose and raffinose, respectively. For the DV donor, an increase of 29- and 89-fold in the butyrate production was obtained when compared to lactulose and raffinose, respectively. In conclusion, this study suggests that epilactose holds potential functional properties for human health, especially towards the modulation of butyrate-producing strains.

Current progresses and challenges for microbiome research in human health: a perspective

It is becoming increasingly clear that the human microbiota, also known as "the hidden organ", possesses a pivotal role in numerous processes involved in maintaining the physiological functions of the host, such as nutrient extraction, biosynthesis of bioactive molecules, interplay with the immune, endocrine, and nervous systems, as well as resistance to the colonization of potential invading pathogens. In the last decade, the development of metagenomic approaches based on the sequencing of the bacterial 16s rRNA gene via Next Generation Sequencing, followed by whole genome sequencing via third generation sequencing technologies, has been one of the great advances in molecular biology, allowing a better profiling of the human microbiota composition and, hence, a deeper understanding of the importance of microbiota in the etiopathogenesis of different pathologies. In this scenario, it is of the utmost importance to comprehensively characterize the human microbiota in relation to disease pathogenesis, in order to develop novel potential treatment or preventive strategies by manipulating the microbiota. Therefore, this perspective will focus on the progress, challenges, and promises of the current and future technological approaches for microbiome profiling and analysis.

Role of traditional Chinese medicine in age-related macular degeneration: exploring the gut microbiota's influence

The pathogenesis of age-related macular degeneration (AMD), a degenerative retinopathy, remains unclear. Administration of anti-vascular endothelial growth factor agents, antioxidants, fundus lasers, photodynamic therapy, and transpupillary warming has proven effective in alleviating symptoms; however, these interventions cannot prevent or reverse AMD. Increasing evidence suggests that AMD risk is linked to changes in the composition, abundance, and diversity of the gut microbiota (GM). Activation of multiple signaling pathways by GM metabolites, including lipopolysaccharides, oxysterols, short-chain fatty acids (SCFAs), and bile acids (BAs), influences retinal physiology. Traditional Chinese medicine (TCM), known for its multi-component and multi-target advantages, can help treat AMD by altering GM composition and regulating the levels of certain substances, such as lipopolysaccharides, reducing oxysterols, and increasing SCFA and BA contents. This review explores the correlation between GM and AMD and interventions for the two to provide new perspectives on treating AMD with TCM.

Dementia, osteoporosis and fragility fractures: Intricate epidemiological relationships, plausible biological connections, and twisted clinical practices

Dementia, osteoporosis, and fragility fractures are chronic diseases, often co-existing in older adults. These conditions pose severe morbidity, long-term disability, and mortality, with relevant socioeconomic implications. While in the research arena, the discussion remains on whether dementia is the cause or the consequence of fragility fractures, healthcare professionals need a better understanding of the interplay between such conditions from epidemiological and physiological standpoints. With this review, we summarized the available literature surrounding the relationship between cognitive impairment, dementia, and both low bone mineral density (BMD) and fragility fractures. Given the strength of the bi-directional associations and their impact on the quality of life, we shed light on the biological connections between brain and bone systems, presenting the main mediators, including gut microbioma, and pathological pathways leading to the dysregulation of bone and brain metabolism. Ultimately, we synthesized the evidence about the impact of available pharmacological treatments for the prevention of fragility fractures on cognitive functions and individuals' outcomes when dementia coexists. Vice versa, the effects of symptomatic treatments for dementia on the risk of falls and fragility fractures are explored. Combining evidence alongside clinical practice, we discuss challenges and opportunities related to the management of older adults affected by cognitive impairment or dementia and at high risk for fragility fracture prevention, which leads to not only an improvement in patient health-related outcomes and survival but also a reduction in healthcare cost and socio-economic burden.