Title:The Crosstalk between Gut Microbiota, Intestinal Immunological
Niche and Visceral Adipose Tissue as a New Model for the Pathogenesis
of Metabolic and Inflammatory Diseases: The Paradigm of Type 2
Diabetes Mellitus
Volume: 29
Issue: 18
Author(s): Rossella Cianci*, Laura Franza, Maria Grazia Massaro, Raffaele Borriello, Antonio Tota, Maria Pallozzi, Francesco De Vito and Giovanni Gambassi
Affiliation:
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione
Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Keywords:
Type II diabetes mellitus, gut microbiota, adipose tissue, immunity, pathogenesis, inflammation diseases.
Abstract: Gut microbiota (GM) comprises more than one thousand microorganisms between
bacterial species, viruses, fungi, and protozoa and represents the main actor of a
wide net of molecular interactions, involving, among others, the endocrine system, immune
responses, and metabolism. GM influences many endocrine functions, such as adrenal
steroidogenesis, thyroid function, sexual hormones, IGF-1 pathway and peptides, produced
in the gastrointestinal system. It is fundamental in glycaemic control and obesity,
while also exerting an important function in modulating the immune system and associated
inflammatory disease. The result of this crosstalk in gut mucosa is the formation of
the intestinal immunological niche. Visceral adipose tissue (VAT) produces about 600
different peptides and it is involved in lipid and glucose metabolism, and some immune
reactions, through several adipokines. GM and VAT interact in a bidirectional fashion:
while gut dysbiosis can modify VAT adipokines and hormone secretion, VAT hyperplasia
modifies GM composition. Acquired or genetic factors leading to gut dysbiosis or increasing
VAT (i.e., Western diet) induce a pro-inflammatory condition, which plays a
pivotal role in the development of dysmetabolic and immunologic conditions, such as diabetes
mellitus. Diabetes is associated with specific patterns of GM alterations, an abundance
or reduction of GM species involved in controlling mucosal barrier status, glycaemic
levels and exerting a pro- or anti-inflammatory activity. All these factors could explain
the higher incidence of several inflammatory conditions in Western countries; furthermore,
besides the specific alterations observed in diabetes, this paradigm could represent
a common pathway acting in many metabolic conditions and could pave the way to
new, interesting therapeutic approaches.
