Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA, 98109, USA.
Center for Integrative Brain Research, Seattle Children's Hospital & Research Institute, Seattle, WA, 98101, USA.
Endocrine. 2017 Nov;58(2):207-227. doi: 10.1007/s12020-017-1433-z. Epub 2017 Oct 19.
The intestinal microbial composition appears to differ between healthy controls and individuals with Type 2 diabetes (T2D). This observation has led to the hypothesis that perturbations of the intestinal microbiota may contribute to the development of T2D. Manipulations of the intestinal microbiota may therefore provide a novel approach in the prevention and treatment of T2D. Indeed, fecal transplants have shown promising results in both animal models for obesity and T2D and in human clinical trials. To avoid possible complications associated with fecal transplants, probiotics are considered as a viable alternative therapy. An important, however often underappreciated, characteristic of probiotics is that individual strains may have different, even opposing, effects on the host. This strain specificity exists also within the same species. A comprehensive understanding of the underlying mechanisms at the strain level is therefore crucial for the selection of suitable probiotic strains.
The aim of this review is to discuss the mechanisms employed by specific probiotic strains of the Lactobacillus and the Bifidobacterium genuses, which showed efficacy in the treatment of obesity and T2D. Some probiotic strains employ recurring beneficial effects, including the production of anti-microbial lactic acid, while other strains display highly unique features, such as hydrolysis of tannins.
A major obstacle in the evaluation of probiotic strains lays in the great number of strains, differences in detection methodology and measured outcome parameters. The understanding of further research should be directed towards the development of standardized evaluation methods to facilitate the comparison of different studies.
健康对照者和 2 型糖尿病（T2D）患者的肠道微生物组成似乎不同。这一观察结果导致了这样一种假设，即肠道微生物群的紊乱可能有助于 T2D 的发展。因此，操纵肠道微生物群可能为 T2D 的预防和治疗提供一种新方法。事实上，粪便移植在肥胖和 T2D 的动物模型以及人类临床试验中都显示出了有希望的结果。为了避免粪便移植可能带来的并发症，益生菌被认为是一种可行的替代疗法。然而，益生菌的一个重要但往往被低估的特征是，单个菌株可能对宿主产生不同的、甚至相反的影响。这种菌株特异性也存在于同一物种内。因此，在菌株水平上全面了解潜在机制对于选择合适的益生菌菌株至关重要。
本综述的目的是讨论在肥胖和 T2D 治疗中显示出疗效的乳杆菌属和双歧杆菌属特定益生菌菌株所采用的机制。一些益生菌菌株采用反复有益的效果，包括产生抗微生物乳酸，而其他菌株则表现出高度独特的特征，如单宁水解。
评估益生菌菌株的一个主要障碍在于菌株数量众多、检测方法和测量结果参数的差异。进一步研究的重点应该是开发标准化的评估方法，以促进不同研究的比较。
