The Potential Role of Gut Microbiota in Alzheimer's Disease: From Diagnosis to Treatment.

Angelica Varesi, Elisa Pierella, Marcello Romeo, Gaia Bavestrello Piccini, Claudia Alfano, Geir Bjørklund, Abigail Oppong, Giovanni Ricevuti, Ciro Esposito, Salvatore Chirumbolo, Alessia Pascale

Journal: Nutrients 2022;14(3):668

PMID: 35277027

Plain Language Summary

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Alzheimer’s Disease (AD) affects 50,000,000 people world-wide. The disease is characterized by the deposition of beta amyloid (Aβ) plaques and tangles of hyperphosphorylated tau neurofibrils, leading to neuroinflammation and progressive cognitive decline. It is not completely clear what causes AD or how it evolves. Different therapeutic options have been proposed but many have not produced significant benefits. Recent studies have liked changes in the gut microbiome to neurodegeneration via the gut microbiota brain axis (GMBA). This review summarises the role of the gut microbiota in brain health and disease and it shows evidence for its dysregulation in AD patients. The review discusses how certain markers of dysbiosis might be used as a diagnostic tool for AD. Therapeutic interventions such as prebiotics, specific probiotics, fecal microbiota transplantation and diets are discussed. Although promising results have been published, more research is needed before considering a clinical application.

Abstract

Gut microbiota is emerging as a key regulator of many disease conditions and its dysregulation is implicated in the pathogenesis of several gastrointestinal and extraintestinal disorders. More recently, gut microbiome alterations have been linked to neurodegeneration through the increasingly defined gut microbiota brain axis, opening the possibility for new microbiota-based therapeutic options. Although several studies have been conducted to unravel the possible relationship between Alzheimer's Disease (AD) pathogenesis and progression, the diagnostic and therapeutic potential of approaches aiming at restoring gut microbiota eubiosis remain to be fully addressed. In this narrative review, we briefly summarize the role of gut microbiota homeostasis in brain health and disease, and we present evidence for its dysregulation in AD patients. Based on these observations, we then discuss how dysbiosis might be exploited as a new diagnostic tool in early and advanced disease stages, and we examine the potential of prebiotics, probiotics, fecal microbiota transplantation, and diets as complementary therapeutic interventions on disease pathogenesis and progression, thus offering new insights into the diagnosis and treatment of this devastating and progressive disease.

Address: Department of Biology and Biotechnology, University of Pavia, 27100 Pavia, Italy.; Almo Collegio Borromeo, 27100 Pavia, Italy.; School of Medicine, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, UK.; Department of Biology and Biotechnology, University of Pavia, 27100 Pavia, Italy.; Emergency Medicine, Université Libre de Bruxelles, 1050 Brussels, Belgium.; Department of Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy.; Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway.; Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy.; Unit of Nephrology and Dialysis, ICS Maugeri, University of Pavia, 27100 Pavia, Italy.; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37121 Verona, Italy.; Section of Pharmacology, Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy.

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