Gut Microbiota Dysbiosis in Human Obesity: Impact of Bariatric Surgery

Abstract

Purpose of review: In this review, we summarize what is currently described in terms of gut microbiota (GM) dysbiosis modification post-bariatric surgery (BS) and their link with BS-induced clinical improvement. We also discuss how the major inter-individual variability in terms of GM changes could impact the clinical improvements seen in patients.

Recent findings: The persisting increase in severe obesity prevalence has led to the subsequent burst in BS number. Indeed, it is to date the best treatment option to induce major and sustainable weight loss and metabolic improvement in these patients. During obesity, the gut microbiota displays distinctive features such as low microbial gene richness and compositional and functional alterations (termed dysbiosis) which have been associated with low-grade inflammation, increased body weight and fat mass, as well as type-2 diabetes. Interestingly, GM changes post-BS is currently being proposed as one the many mechanism explaining BS beneficial clinical outcomes. BS enables partial rescue of GM dysbiosis observed during obesity. Some of the GM characteristics modified post-BS (composition in terms of bacteria and functions) are linked to BS beneficial outcomes such as weight loss or metabolic improvements. Nevertheless, the changes in GM post-BS display major variability from one patient to the other. As such, further large sample size studies associated with GM transfer studies in animals are still needed to completely decipher the role of GM in the clinical improvements observed post-surgery.

Keywords: Adjustable gastric banding; Akkermansia muciniphila; BMI; Bacteroidetes; Bariatric surgery; Faecalibacterium prausnitzii; Firmicutes; Gammaproteobacteria; Gut microbiota; HbA1c; Illumina; Metabolism; Metagenomics; Microbial gene richness; Obesity; Proteobacteria; Remission; Richness; Roseburia intestinalis; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type-2 diabetes.