Abstract
The gut microbiome has recently emerged as a critical modulator of brain function, with the so-called gut-brain axis having multiple links with a variety of neurodegenerative and mental health conditions, including Alzheimer’s Disease (AD). Various approaches for modulating the gut microbiome toward compositional and functional states that are consistent with improved cognitive health outcomes have been documented, including probiotics and prebiotics. While probiotics are live microorganisms that directly confer beneficial health effects, prebiotics are oligosaccharide and polysaccharide structures that can beneficially modulate the gut microbiome by enhancing the growth, survival, and/or function of gut microbes that in turn have beneficial effects on the human host. In this review, we discuss evidence showing the potential link between gut microbiome composition and AD onset or development, provide an overview of prebiotic types and their roles in altering gut microbial composition, discuss the effectiveness of prebiotics in regulating gut microbiome composition and microbially derived metabolites, and discuss the current evidence linking prebiotics with health outcomes related to AD in both animal models and human trials. Though there is a paucity of human clinical trials demonstrating the effectiveness of prebiotics in altering gut microbiome-mediated health outcomes in AD, current evidence highlights the potential of various prebiotic approaches for beneficially altering the gut microbiota or gut physiology by promoting the production of butyrate, indoles, and secondary bile acid profiles that further regulate gut immunity and mucosal homeostasis, which are associated with beneficial effects on the central immune system and brain functionality.
Highlights
Accepted: 2 November 2021Microbiota dysbiosis, characterized as the disproportional increase or decrease in abundance of certain bacterial strains, has been associated with multiple complications, including obesity [1], type 2 diabetes (T2DM) [2], and neurodegenerative diseases such as Alzheimer’s Disease (AD) [3]
Though there is a paucity of human clinical trials demonstrating the effectiveness of prebiotics in altering gut microbiome-mediated health outcomes in AD, current evidence highlights the potential of various prebiotic approaches for beneficially altering the gut microbiota or gut physiology by promoting the production of butyrate, indoles, and secondary bile acid profiles that further regulate gut immunity and mucosal homeostasis, which are associated with beneficial effects on the central immune system and brain functionality
Diets and prebiotic approaches that aim to increase beneficial bacterial species that have been found to be depleted in AD patients such as Bifidobacterium spp., and approaches that aim to decrease the abundance of deleterious bacterial species such as Bilophila may be beneficial for the prevention of AD (Figure 1)
Summary
Microbiota dysbiosis, characterized as the disproportional increase or decrease in abundance of certain bacterial strains, has been associated with multiple complications, including obesity [1], type 2 diabetes (T2DM) [2], and neurodegenerative diseases such as Alzheimer’s Disease (AD) [3]. The links between microbiome composition and AD are intriguing and provide potential ways to ameliorate or even prevent AD progression through modifying the microbiome. This could be achieved via various ways, including fecal transplant and consumption of probiotics or prebiotics. We discuss the evidence linking gut microbiome composition and function with AD and its associated co-morbidities, provide an overview of prebiotic types and their effects, discuss evidence for the effectiveness of prebiotics in modulating gut microbiome composition and microbial metabolite production, and discuss the potential for prebiotics to induce a beneficial shift in the gut microbiome and modify health outcomes relevant for individuals with AD
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