Gastrointestinal Microbiota and Type 1 Diabetes Mellitus: The State of Art

Abstract

The incidence of autoimmune type 1 diabetes (T1DM) is increasing worldwide and disease onset tends to occur at a younger age. Unfortunately, clinical trials aiming to detect predictive factors of disease, in individuals with a high risk of T1DM, reported negative results. Hence, actually there are no tools or strategies to prevent T1DM onset. The importance of the gut microbiome in autoimmune diseases is increasingly recognized and recent data suggest that intestinal dysbiosis has a pathogenic role in T1DM by affecting both intestinal immunostasis and the permeability of the gut barrier. An improved understanding of the mechanisms whereby dysbiosis in the gut favors T1DM development may help develop new intervention strategies to reduce both the incidence and burden of T1DM. This review summarizes available data on the associations between gut microbiota and T1DM in both experimental animals and humans and discusses future perspectives in this novel and exciting area of research.

Keywords: auto-immunity; gut permeability; microbiome; microbiota; type 1 diabetes.

Figure 1

Interplay between genetics, environment, and gut microbiota in T1DM pathogenesis. Specific HLA allele can increase susceptibility to the development of type 1 diabetes and influence the composition of the gut microbiota. Many environmental factors can also shape the gut microbiota. Abnormalities in the gut microbiome are believed to favor autoimmunity against pancreatic b-cells by modulating the gut immune/inflammatory response and by enhancing the gut barrier permeability both directly and indirectly through reduced production of short-chain fatty acids (SCFAs).