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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Oś mikrobiota–jelita–mózg a zaburzenia poznawcze u chorych na cukrzycę: niezapomniana podróż

Srinidhi Rai1, Souparnika Sreelatha2, Nayana Devang3, Priya D. Alva1, Arkiath Veettil Raveendran4
Diabetologia Praktyczna 2024;10:9-20.

Streszczenie

Cel: Cukrzyca (DM, diabetes mellitus) wiąże się z powikłaniami wpływającymi na jakość życia. Co ciekawe, mikroflora jelitowa jest ściśle powiązana z metabolizmem glukozy. W tym przeglądzie narracyjnym przedstawiono charakterystykę mikrobioty jelitowej u chorych na cukrzycę, opisano modulację kontroli glikemii gospodarza przez mikrobiotę jelitową, charakterystykę nieszczelności jelit, mechanizmy zaburzeń poznawczych w cukrzycy (DCI, diabetic cognitive impairment) oraz rolę osi mózg–jelita–mikrobiota w DM. Materiał i metody: Przeszukano literaturę w bazach Medline, Scopus, WOS i PubMed, używając słów kluczowych: mikrobiota jelitowa, DM, nieszczelność jelit i DCI (ang. gut microbiota, DM, intestinal permeability, DCI). Wyniki: Dysbioza mikrobioty jelitowej powoduje przerwanie bariery jelitowej, skutkujące przedostaniem się bakterii jelitowych i ich metabolitów do układu krążenia, co może zaburzyć wrażliwość na insulinę, metabolizm glukozy i homeostazę immunologiczną. Mikrobiota jelitowa odgrywa kluczową rolę w regulacji ogólnoustrojowej wrażliwości na insulinę i metabolizmu energetycznego. Uważa się, że dysfunkcja bariery jelitowej wywołana hiperglikemią jest podstawowym mechanizmem infekcji ogólnoustrojowych i reakcji zapalnej u pacjentów z cukrzycą. Zarówno dysbakterioza, jak i cytokiny będą prowadzić do dysfunkcji bariery jelitowej i bariery krew–mózg, ułatwiając przenikanie szkodliwych substancji (końcowych produktów glikacji) do neuronów, a tym samym przyczyniając się do rozwoju DCI. Modulacja przepuszczalności jelit poprzez interwencje żywieniowe może stanowić potencjalny cel w zapobieganiu cukrzycy. Wnioski: Dowody kliniczne na związek między hiperglikemią a dysfunkcją bariery jelitowej u ludzi są nieliczne. Konieczne są dalsze badania kliniczne, aby uzyskać więcej informacji poprzez ocenę markerów integralności bariery jelitowej i statusu glikemicznego oraz ich związku z funkcjami poznawczymi.

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