Approach to the diagnosis and management of dysbiosis

Abstract

All microorganisms like bacteria, viruses and fungi that reside within a host environment are considered a microbiome. The number of bacteria almost equal that of human cells, however, the genome of these bacteria may be almost 100 times larger than the human genome. Every aspect of the physiology and health can be influenced by the microbiome living in various parts of our body. Any imbalance in the microbiome composition or function is seen as dysbiosis. Different types of dysbiosis are seen and the corresponding symptoms depend on the site of microbial imbalance. The contribution of the intestinal and extra-intestinal microbiota to influence systemic activities is through interplay between different axes. Whole body dysbiosis is a complex process involving gut microbiome and non-gut related microbiome. It is still at the stage of infancy and has not yet been fully understood. Dysbiosis can be influenced by genetic factors, lifestyle habits, diet including ultra-processed foods and food additives, as well as medications. Dysbiosis has been associated with many systemic diseases and cannot be diagnosed through standard blood tests or investigations. Microbiota derived metabolites can be analyzed and can be useful in the management of dysbiosis. Whole body dysbiosis can be addressed by altering lifestyle factors, proper diet and microbial modulation. The effect of these interventions in humans depends on the beneficial microbiome alteration mostly based on animal studies with evolving evidence from human studies. There is tremendous potential for the human microbiome in the diagnosis, treatment, and prognosis of diseases, as well as, for the monitoring of health and disease in humans. Whole body system-based approach to the diagnosis of dysbiosis is better than a pure taxonomic approach. Whole body dysbiosis could be a new therapeutic target in the management of various health conditions.

Keywords: dysbiosis; gut biotics; microbiome; microbiota; virtual organ.

Figure 1

Overview of the gut-organ axis. Disruptions in the gut microbiome can lead to a decrease number of short-chain fatty acid producing bacteria and increased toxin producing bacteria. Along with this, there may be disruptions in the intestinal barriers leading to bacterial translocation that may influence systemic inflammation. (A) The gut-brain axis, (B) gut-heart axis, (C) gut-skin axis, (D) gut-kidney axis, (E) gut-bone, (F) gut-genitourinary axis, (G) gut-liver axis, (H) gut-adipose, and (I) gut-lung axis.

Figure 2

Dynamic changes of microbiome over the life span of humans. Throughout each stage of life (top row) there are factors that can have an influence and impact the human microbiome. Each blue arrow highlights what specific factors are most likely to alter the microbiome at that stage of life, with the effects potentially remaining throughout the rest of life. The bottom arrow indicates influences on the microbiome that are non-modifiable (host genetics) or that can occur throughout all stages of life.