Harrington Valerie, Lau Lilian, Crits-Christoph Alexander, Suez Jotham
W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
Immunometabolism. 2022;4(2). doi: 10.20900/immunometab20220012. Epub 2022 Apr 18.
Replacing sugar with non-nutritive artificial sweeteners (NAS) is a popular dietary choice for the prevention and management of metabolic syndrome and its comorbidities. However, evidence in human trials is conflicted regarding the efficacy of this strategy and whether NAS may counterintuitively promote, rather than prevent, metabolic derangements. The heterogeneity in outcomes may stem in part from microbiome variation between human participants and across research animal vivaria, leading to differential interactions of NAS with gut bacteria. An increasing body of evidence indicates that NAS can alter the mammalian gut microbiome composition, function, and metabolome, which can, in turn, influence host metabolic health. While there is evidence for microbiome-mediated metabolic shifts in response to NAS, the mechanisms by which NAS affect the gut microbiome, and how the microbiome subsequently affects host metabolic processes, remain unclear. In this viewpoint, we discuss data from human and animal trials and provide an overview of the current evidence for NAS-mediated microbial and metabolomic changes. We also review potential mechanisms through which NAS may influence the microbiome and delineate the next steps required to inform public health policies.
用非营养性人工甜味剂（NAS）替代糖是预防和管理代谢综合征及其合并症的一种流行饮食选择。然而，人体试验中关于该策略的有效性以及NAS是否可能产生与直觉相反的效果，即促进而非预防代谢紊乱的证据存在矛盾。结果的异质性可能部分源于人类参与者之间以及不同实验动物饲养环境中的微生物组差异，导致NAS与肠道细菌的相互作用不同。越来越多的证据表明，NAS可改变哺乳动物的肠道微生物组组成、功能和代谢组，进而影响宿主的代谢健康。虽然有证据表明微生物组介导了对NAS的代谢变化，但NAS影响肠道微生物组的机制以及微生物组随后如何影响宿主代谢过程仍不清楚。在这一观点中，我们讨论了来自人体和动物试验的数据，并概述了目前关于NAS介导的微生物和代谢组学变化的证据。我们还回顾了NAS可能影响微生物组的潜在机制，并阐述了为公共卫生政策提供信息所需的后续步骤。
