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Buik en brein: hoe je darmen je gedrag kunnen beïnvloeden

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Buik en brein: hoe je darmen je gedrag kunnen beïnvloeden

  1. 1. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 1 Het effect van het microbioom op gedrag – van wetenschap naar praktijk (en weer terug) Koen Venema Beneficial Microbes Consultancy, Wageningen, The Netherlands, koen.venema@outlook.com
  2. 2. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 2 Logo Yakult Vingerafdruk
  3. 3. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 3 • initiator and organisor of the Beneficial Microbes Conference series • editor-in-chief of the journal Beneficial Microbes • founder and CEO of Beneficial Microbes Consultancy 2008 2010 2012 next: 10-12 Oct. 2016 2015
  4. 4. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 4 Waar gaan we het vandaag over hebben?
  5. 5. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 5 Tijdens deze gast lezing zal ik een uitleggen wat microbiota en probiotica zijn en doen en tevens uitleggen waarom het nodig is om in multidisciplinaire teams de rol van de microbiota en probiotica op moderne ziektes en aandoeningen, zoals overgewicht, allergiën, inflammatoire ziektes, autisme, gedrag, depressie, etc., te onderzoeken. Verwacht een combi van een klein beetje hard-core science met enkele interessante feiten en af en toe wat humor. “If you don't like bacteria, you're on the wrong planet.” ― Stewart Brand “Wanneer je al het meercellige leven van de aarde zou wegvagen, zou het microbiële leven waarschijnlijk een klein beetje verschuiven. Verdwijnt het microbiële leven, dan betekent dat de onmiddelijke dood voor onze planeet.” ― Carl Woese
  6. 6. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 6 Als kinderen geboren worden, komen ze uit een relatief steriele omgeving van de baarmoeder in een wereld vol met bacteriën…
  7. 7. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 7 Script van deel 1 van de presentatie  Microbiota  aandacht in de wetenschap  rol van microbiota bij ziekte en gezondheid  hoe ziet onze microbiota er nu uit?  ontwikkeling microbiota van jong tot oud  probiotica  prebiotica  feces transplantatie (repoopulate)  niet alle probiotica zijn hetzelfde  Take home messages deel 1
  8. 8. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 8 Microbiota in de (wetenschappelijke) pers
  9. 9. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 9
  10. 10. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 10
  11. 11. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 11 .... want de microbiota is betrokken bij: - colon kanker - inflammatory bowel disease (IBD) - allergie (huid, luchtwegen) - overgewicht - type I en II diabetes - levensduur - prikkelbaar darm syndroom (IBS) - angst en depressie - brein ontwikkeling en cognitie - autisme - Parkinson’s - Alzheimer’s - ..... Probiotics and Prebiotics Current Research and Future Trends 2015. Eds. K. Venema & A.P. do Carmo
  12. 12. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 12 Het aantal bacteriën in de darm is 10x zo veel als onze eigen lichaamscellen Volwassenen kunnen ~ 1 kg darmbacteriën met zich meedragen We deponeren per jaar ons eigen gewicht aan bacteriën in het toilet Als we 70 zijn komt dat overeen met 12 olifanten > 50% van feces is bacteriën (natgewicht) Elk persoon heeft meer darm bacteriën dan het aantal mensen dat er ooit op deze planeet geleefd heeft 400 - >1000 species “Soundbites” Courtesy of Roderick Mackie / Glenn Gibson
  13. 13. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 13
  14. 14. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 14 “Exposed to a world of micro-organisms” • Totale oppervlak van de darm is de grootte van een tennis court • Dus dit moet goed verdedigd worden tegen indringers
  15. 15. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 15 Dit is waar uw lunch nu is, met uw levende bacteriele gasten
  16. 16. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 16
  17. 17. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 17 Bacteriën strijden om de aanhechting aan darm-epitheel
  18. 18. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 18 Als kinderen geboren worden, komen ze uit een relatief steriele omgeving van de baarmoeder in een wereld vol met bacteriën…
  19. 19. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 19
  20. 20. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 20 Moedermelk als een bron van gezonde bacteriën Probiotica
  21. 21. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 21
  22. 22. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 22 microbiota verstoring microbiota verstoring ontsteking
  23. 23. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 23 Ziekte van Crohn gereduceerde microbiele genen diversiteit
  24. 24. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 24 Microbiota en overgewicht/obesitas
  25. 25. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 25 microbiota verstoring microbiota verstoring overgewicht
  26. 26. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 26 Kunnen we (een aantal van) die ziektes managen?
  27. 27. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 27 Probiotics: definition live microorganisms which, when administered in adequate amounts, confer a health benefit on the host FAO/WHO 2001
  28. 28. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 28 De term probiotica mag sinds 14 Dec 2013 niet meer gebruikt worden
  29. 29. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 29 The “Health Claim Games”
  30. 30. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 30 The “Health Claim Games”
  31. 31. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 31 De wetenschappelijke wereld gebruikt de term nog steeds per de definitie van FAO/WHO2001 De term probiotica mag sinds 14 Dec 2013 niet meer gebruikt worden
  32. 32. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 32
  33. 33. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 33 Hoe voorkom je bijvoorbeeld reizigers diarhee?
  34. 34. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 34
  35. 35. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 35 <105 106 107 108 109 CFU/ml Niet alle probiotica zijn gelijk! Slide van Ger Rijkers #55 #22 #36 0 1 2 3 4 5 6 Time (hrs) Lactobacillus acidophilus
  36. 36. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 36 Hoe werken probiotica? Hoe kunnen op het brein inwerken als ze in de darm zitten? barrier/ mucosal integrity lumen/ resilience immune system dendritic cell epithelial cell microbiota probiotics
  37. 37. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 37
  38. 38. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 38
  39. 39. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 39 Hoe kies je dan het juiste probiotica? Courtesy of Ger Rijkers
  40. 40. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 40 Hoe blijf je op de hoogte? Welke publicaties zijn van goede kwaliteit? Wat voor type bewijs is voldoende?
  41. 41. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 41 Graad A Graad B Graad C Graad D Aanbeveling op basis van bewijs Systematische review of meta-analyse (minstens) 1 RCT (minstens) 1 goed opgezette en gecontroleerde studie (minstens) 1 cohort studie Goed opgezette beschrijvende studies, case control, case series Verslagen van expert comitees, klinishe ervaring van experts
  42. 42. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 42 Zijn DBPCRT altijd nodig? Double-Blind Placebo-Controlled Randomized Trials Courtesy of Eric Claassen
  43. 43. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 43 Zijn DBPCRT altijd nodig? Double-Blind Placebo-Controlled Randomized Trials DBPCRT leveren graad A bewijs en zijn het meest overtuigend.... .... als ze op de juiste manier uitgevoerd worden!
  44. 44. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 44
  45. 45. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 45 Prebiotics: definition a selectively fermented ingredient * that results in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon host health * largely restricted to carbohydrates until now Blatchford, Venema and others 2014, Intl J Probiotics Prebiotics 8(4)
  46. 46. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 46
  47. 47. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 47 Effect van probiotica op maagdarm ziektes
  48. 48. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 48 Effect van soort probiotica n
  49. 49. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 49
  50. 50. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 50 ■ genome stability Sybesma et al. AEM 2013
  51. 51. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 51 Antibiotica gebruik & C. difficile C. difficile bacterie
  52. 52. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 52 • C. difficile vaak ongevoelig voor antibiotica • dat is juist de reden dat na een antibioticum kuur C.diff uitgroeit • en is tegelijk de reden dat een volgende antibioticum kuur niet goed helpt • veel patienten hebben recidiverende C.diff infecties • soms/vaak zijn die levensbedreigend • vaak is dan de enige optie nog ..... • FECES TRANSPLANTATIE • cure-rate van ~90% !! • geen medicijn is zo goed ! Antibiotica gebruik & C. difficile
  53. 53. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 53 Feces transplantaties..... ....
  54. 54. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 54 Graad A Graad B Graad C Graad D
  55. 55. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 55 Do you (have to) believe what a company tells you? Is makkelijker opschrijven in ENG dan NL  Wanneer geen probiotica? immunocompromised? kritiek zieke mensen? zeer jong kinderen? ouderen met een verminderde weerstand? zwangere vrouwen? In veel van deze gevallen worden probiotica al gebruikt.
  56. 56. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 56
  57. 57. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 57
  58. 58. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 58 understatement Bij veel van de hedendaagse problemen kunnen probiotica een gezonde bijdrage leveren
  59. 59. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 59 Wrap up and Take home messages
  60. 60. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 60 Conclusies Deel 1 • Probiotica werken! Maar het maakt wel uit welke stam (of mengsel) je kiest.
  61. 61. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 61 Script van deel 2 van de presentatie  gut-brain axis  rol van microbiota  preclinische aanwijzingen  klinische studies  niet alle probiotica zijn hetzelfde  Take home messages deel 2
  62. 62. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 62 .... want de microbiota is betrokken bij: - colon kanker - inflammatory bowel disease (IBD) - allergie (huid, luchtwegen) - overgewicht - type I en II diabetes - levensduur - prikkelbaar darm syndroom (IBS) - brein ontwikkeling en cognitie - autisme - ..... control rat autistic rat
  63. 63. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 63 Anxiety BALB/c SPF mice w/o antibiotics ATM = neomycin 5 mg/mL, bacitracin 5 mg/mL, and pimaricin 1.25 μg/mLAfter ATM: more explorative
  64. 64. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 64 Anxiety BALB/c SPF mice w/o antibiotics After ATM: biochemical changes in the brain. BDNF: Brain-derived neurotrophic factor, a protein which is active in areas vital to learning, memory, and higher thinking
  65. 65. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 65 Anxiety – microbiota transplant
  66. 66. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 66 Anxiety – microbiota transplant
  67. 67. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 67 Birth delivery mode alters anxiety-like behaviour (8-9 wks) Original setup Natural birth Cross-fostered C-section marble bury test
  68. 68. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 68 Stress alters the gut-brain axis coritsol cytokines adrenocorticotropic hormone serotonin (5-HT) barrier function of the gut Increased permeability translocation of endotoxin increased colonic transit mucosal inflammation changes in colonic morphology etc. Altered levels and metabolism of: Altered:
  69. 69. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 69 Immune O’Mahony et al. Psychopharmacology (2011) Endocrine Visceral Pain Open Field Increased colonic transit, intestinal permeability, mucosal inflammation, colonic morphology (O’Malley et al., 2010, Stress)
  70. 70. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 70 Autism Spectrum Disorders control rat autistic rat + PA Single intracerebroventricular (ICV) infusions (4 µL of 0.26 M solution over 4 min) of propionic acid (PA)
  71. 71. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 71 http://apc.ucc.ie Desbonnet et al 2014
  72. 72. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 72 Social deficit after propionate infusion control rat autistic rat + PA Single intracerebroventricular (ICV) infusions (4 µL of 0.26 M solution over 4 min) of propionic acid (PA)
  73. 73. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 73 Odds Ratio: 1.23 (1.07, 1.40) 1,191,920 participants, 12,897 of which had ASD
  74. 74. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 74 Parkinson’s disease Parkinson’s disease is the second most common neurodegenerative disease and is characterized by region- specific loss of dopaminergic neuromelanin-containing neurons in the brain Parkinson’s disease patients suffer from gastrointestinal discomfort nearly half of all Parkinson’s disease patients report long- term constipation Parkinson’s disease patients had a significantly increased intestinal permeability Future studies might elucidate further links between gut and brain function in Parkinson’s disease, and should preferably comprise investigations of the gut microbiota. Pro- and/or prebiotics that strengthen the epithelial barrier function might be beneficial to these patients
  75. 75. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 75 Amyloid protein precursor (APP) is a pivotal protein in the formation of the plaque-inducing amyloid-β protein, which causes neuronal degeneration in the brain of Alzheimer’s disease patients systemic administration of LPS in mice has been shown to increase APP expression and caused neuronal cell death significantly increased plasma levels of LPS in Alzheimer’s disease patients compared with healthy controls were detected, which might suggest that Alzheimer’s disease patients suffer from elevated intestinal permeability Pro and/or prebiotics that have an anti-inflammatory effect or reduce bacterial and/or LPS translocation might be beneficial for these patients Alzheimer’s disease
  76. 76. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 76 Probiotic Alters GABA Receptors in various brain areas Bravo et al., PNAS Sept 2011 L. rhamnosus JB-1 reduces anxiety and behavioural despair
  77. 77. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 77 Defensive Marble Burying Elevated Plus Maze 174 1205 Esc = escitalopram
  78. 78. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 78 Log10[Latency](s) W ater/Sal W ater/LPS B G O S/Sal B G O S/LPS 0.0 0.5 1.0 1.5 2.0 * * * Timeinlight(s) W ater/Sal W ater/LPS B G O S/Sal B G O S/LPS 0 25 50 75 100 * * * Prebiotic BGOS feeding is anxiolytic less anxious
  79. 79. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 79 [BDNF](pg/mgprotien) frontal cortex hippocampus 0 50 100 150 200 *water FOS GOS Anxiolytic changes coincided with changes in brain biochemistry, and....
  80. 80. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 80 0.0 0.2 0.4 0.6 * * [TNFa](pg/mgprotein) 0 2 4 6 8 ** * [IL1b](pg/mgprotein) 0.00 1.75 3.50 5.25 7.00 * [IL6](pg/mgprotein) 0.0 3.5 7.0 10.5 14.0 [IL10](pg/mgprotein) .... a reduction in inflammatory cytokines
  81. 81. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 81 Human trials
  82. 82. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 82 Human trials (1) in order of publication date • 124 healthy volunteers; mean age 61.8 years • Double-blind, placebo (milk) controlled study • Lactobacillus casei Shirota in milk-drink for 3 weeks • Mood and cognition were measured at baseline, and after 10 and 20 days of consumption.
  83. 83. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 83 Human trials (1); LcS POMS = profile of mood state • An unexpected finding was that the consumption of probiotics resulted in a slightly-poorer performance on two measures of memory.
  84. 84. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 84 • 31 chronic fatigue syndrome patients • RDBPC study • Lactobacillus casei Shirota in sachet-format for 8 weeks • Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) at baseline and after 8 w. Human trials (2)
  85. 85. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 85 Human trials (2); LcS • there was a significant improvement in anxiety among those taking the active LcS compared to the placebo. The differences as assessed by the BDI did not reach statistical significance. BDI: a 21-question multiple-choice self-report inventory, one of the most widely used psychometric tests for measuring the severity of depression BAI: is a 21-question multiple-choice self-report inventory that is used for measuring the severity of anxiety in children and adults
  86. 86. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 86 • 55 volunteers with a score of ≤12 in the HADS- anxiety subscale and in the HADS-depression subscale and ≤ 20 in the HADS total score on initial examination • RDBPC study • L.helveticus R0052 + B. longum R0175 in a stick format, or placebo (xylitol, maltodextrin, plum flavour and malic acid) for 30 days • Tests: HSCL-90; HADS; PSS, CCL • Urinary cortisol Human trials (3)
  87. 87. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 87 Human trials (3); L.h R0052 / B.l R0175 Hopkins Symptom Checklist-90.The HSCL-90 is a 90-item self-reported multidimensional questionnaire screening a broad range of psychopathological disorders Hospital Anxiety and Depression Scale: The HADS, is a 14-item self-assessment instrument, often applied and convenient for measuring psychological distress in subjects with somatic or psychosomatic disorders Perceived Stress Scale: The PSS is a 14-item self-reported questionnaire assessing the degree to which recent life situations are appraised as stressful Coping Checklist: The CCL is a validated 29-item questionnaire measuring five types of coping strategies when confronting an adverse event: ‘problem solving’; ‘avoidance with wishful thinking’; ‘seeks social support’; ‘positive re-evaluation’; ‘self-blamed’.
  88. 88. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 88 Human trials (3); L.h R0052 / B.l R0175 Probiotics-treated subjects had a lower global severity index of the HSCL-90 over time, due to lower values for somatisation, depression and anger–hostility. The potential usefulness of the probiotics as an anti-stress/anti-anxiety agent was supported by diminished HADS global scores over time. Taken together, probiotics appears to show a beneficial effect on general signs of anxiety and depression, but this did not generalise to the PSS, although all three tests comprise self-reported measures. In the CCL test the two groups differed in emotional reactivity, with subjects administered probiotics reducing their self-blame score. L. helveticus R0052 and B. longum R0175 taken in combination display beneficial psychological effects in healthy human volunteers
  89. 89. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 89 • Same study as the previous one, but now in a subpopulation of 25 subjects with urinary free cortisol (UFC) levels less than 50 ng/ml at baseline • More scores were beneficially affected by the probiotics in this subpopulation Human trials (3a)
  90. 90. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 90 • 36 healthy women, age 30 y +/- 10.4 • RDBPC study • B. animalis subsp lactis DN-173 010, Streptococcus thermophilus CNCM I-1630, 2 strains of L. bulgaricus, CNCM I-1632 and CNCM I-1519 and Lactococcus lactis subsp lactis CNCM I-1631fermented milk, non- fermented milk or no intervention for 4 weeks • functional magnetic resonance imaging before and after the intervention to measure brain response to an emotional faces attention task and resting brain activity. Human trials (4)
  91. 91. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 91 Human trials (4) A fermented milk product with probiotic resulted in robust alterations in the response of a widely distributed brain network to a validated task probing attention to negative context, which have been associated with the dampening of emotional and sensory responsiveness.
  92. 92. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 92 • 44 university students who performed strenuous exercise daily • RDBPC study • Lactobacillus gasseri OLL2809, OLL2809 + α- lactalbumin, or placebo for 4 weeks • Profile of Mood States (POMS) questionnaire Human trials (5)
  93. 93. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 93 Human trials (5) LG2809 ingestion was effective elevating mood from a depressed state.
  94. 94. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 94 • 224 healthy volunteers • RDBPC study • yogurt containing L. gasseri SBT2055 and B. longum SBT2928, or control yoghurt for 12 weeks • levels of two stress-induced hormones, adrenocorticotrophic hormone (ACTH) and cortisol Human trials (6)
  95. 95. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 95 Human trials (6) These results suggest that the probioticcontaining test yogurt confers health benefits by alleviating stress.
  96. 96. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 96 • 50 healthy participants, mean age 23.22 years • RDBPC study • two strains of L. acidophilus CUL60 and CUL21, B.lactis CUL34 and B.bifidum CUL20 in a capsule, or placebo for 6 weeks • anxiety levels decreased in the probiotic condition whilst increasing in the placebo condition (p=0.042). • ‘continuity of attention’ increased in response to the probiotic treatment and decreased with the placebo • group (p=0.035) Human trials (7) Abstract
  97. 97. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 97 • 75 infants • RDBPC study • L. rhamnosus GG or placebo during the first 6 months of life • attention deficit hyperactivity disorder (ADHD) and Asperger syndrome (AS) • At the age of 13 y, ADHD or AS was diagnosed in 6/35 (17.1%) children in the placebo and none in the probiotic group (P = 0.008). Human trials (8)
  98. 98. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 98 • 40 healthy participants without current mood disorder • RTBPC study • a multispecies probiotic containing B. bifidum W23, B.lactis W52, L.acidophilus W37, L.brevis W63, L.casei W56, L.salivarius W24, and 2 strains of Lactococcus lactis W19 and W58 in a sachet, or placebo • cognitive reactivity to sad mood was assessed using the revised Leiden index of depression sensitivity scale Human trials (9)
  99. 99. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 99 Human trials (9) The LEIDS-r is a self-reported questionnaire with 34 items that assesses to what extent dysfunctional thoughts are activated when experiencing mild dysphoria (i.e., it measures cognitive reactivity to sad mood, also referred to as vulnerability to depression). Rumination is the compulsively focused attention on the symptoms of one's distress, and on its possible causes and consequences, as opposed to its solutions.
  100. 100. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 100 • 30 patients with laryngeal cancer • RDBPC study • Unknown strain of Clostridium butyricum for 2 weeks, twice a day in a capsule, or placebo • Serum corticotropin-releasing factor • The degree of anxiety assessed by the Hamilton Anxiety Scale (HAMA) Human trials (10)
  101. 101. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 101 Human trials (10) m Probiotics can ameliorate the clinical anxiety and biochemical features of stress in patients scheduled for laryngectomy (and other surgery?)
  102. 102. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 102 • 45 healthy medical students under academic examination stress • RDBPC study • L.casei Shirota fermented milk, or placebo for 8 weeks prior to taking national exam • Subjective anxiety scores • Salivary cortisol levels • The presence of physical symptoms Human trials (11) [Epub ahead of print]
  103. 103. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 103 Human trials (11) LcS may prevent hypersecretion of cortisol and physical symptoms (not shown in this presentation) under stressful conditions, possibly through vagal afferent signaling to the brain and reduced stress reactivity in he brain (the latter based on a parallel rat study)
  104. 104. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 104 • 45 healthy volunteers with no history of psychiatric disorders • Double-blind, placebo (maltodextrin) controlled study • FOS, Bimuno®-galacto-oligosaccharides, or maltodextrin, daily for 3 weeks • Awakening salivary cortisol measured on day 0 and day 21 • Emotional test battery on day 21 Human trials (12); prebiotic
  105. 105. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 105 Dot-probe task: Attention to positive stimuli is increased BGOS reduces awakening cortisol and increases attention to positive stimuli in healthy volunteers Human trials (12); prebiotic
  106. 106. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 106 Bepalen onze bacteriën in de darm wat we in de supermarkt uit de schappen halen?
  107. 107. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 107 Other things that could not be covered in this presentation The gut microbiota produces other neuromodulatory molecules, such as serotonin, GABA, melatonin The gut microbiota is involved in brain development and cognition The gut microbiota affects the blood brain barrier Since pro- & prebiotics modulate the gut microbiota composition and activity, they may also be involved in happiness, trustworthiness, depression, sleeping, etc. … ** … in addition to anxiety, stress and autism There is still room for mouse-models to study these gut microbiota-brain interactions ** time for an anekdote?
  108. 108. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 108 Wrap up and Take home messages
  109. 109. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 109 Conclusions Part 2 • The gut microbiota is involved in brain functioning • Pro-, pre- (and synbiotics) modulate the gut microbiota and thereby can influence brain functioning as well • Although mostly evidenced in animal studies, some clinical trials show very promising results
  110. 110. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 110 Script van deel 3 van de presentatie  dynamische, computer gestuurd in vitro model van het maag-darm kanaal  TIM-1  TIM-2  modulatie van de microbiota samenstelling en activiteit  mogelijkheid om te kijken naar parameters, microorganismen, dieet componenten die gedrag beinvloeden  Take home messages deel 3
  111. 111. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 111 A model to simulate the GI tract ? requirements for such models • simulating successive dynamics conditions • sampling in time at different intestinal segments • validation in vitro versus in vivo In the late 1980’s, TNO started the development of the TNO dynamic in vitro models of the GI tract, nick-named TIM
  112. 112. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 112 Successive dynamic conditions in the GI tract peristalsis, gastric acid, salivary and gastric enzymes, gastric emptying secretion of digestive enzymes, bile, intestinal transit time absorption of (digestion) products and water cecum and colon transit dense active microbiota, microbial metabolites biotransformation enzymes
  113. 113. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 113 TIM-1 gastric-small-intestinal model 1. stomach 6. gastric secretion 2. duodenum 7. intestinal secretion 3. jejunum 4. ileum 5. ileo-caecal valve 8. pH electrodes 9. prefilter 10 absorption system 1 2 3 4 5 9 10 9 10 7 6 8 8 8 8
  114. 114. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 114 Schematic view of TIM-1 with sampling ports
  115. 115. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 115 Peristaltic movements Gastro-intestinal transit
  116. 116. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 116 Stomach and ileal delivery and pH curves 0 20 40 60 80 100 120 0 1 2 3 4 5 6 time (h) pH adult liquid adult semi-solid baby 0 2 4 6 8 10 0 60 120 180 240 300 360 time (min) gastric pH duodenal pH jejunal pH ileal pH mealdelivery(%ofintake)
  117. 117. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 117 TNO’s in vitro model of the colon (TIM-2) 1. colon compartment; 2. inlet ileum effluent; 3. level sensor; 4. pH control; 5a.dialysate; 5b. membrane; 6. sampling / colon effluent; 7. nitrogen flush.
  118. 118. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 118 Schematic view of the large-intestinal model
  119. 119. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 119 Physiological concentrations of metabolites 0 100 200 300 400 0 1 2 3 4 5 6 7 8 9 SCFA(mmol/L) Time (hours) dialysis on dialysis off Physiological range TIM-2 dialysis system – unique and required
  120. 120. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 120
  121. 121. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 121 human models: babies, adults, elderly healthy vs. patients average vs. extremes pig model pre-ruminant calf model dog model (FIDO) TIM-systems available at UM
  122. 122. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 122 human models: babies, adults, elderly healthy vs. patients average vs. extremes pig model pre-ruminant calf model dog model (FIDO) TIM-systems (soon) available at UM
  123. 123. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 123 Validation of the TIM-systems for food studies TIM-1 has been validated with respect to protein digestion carbohydrate digestion fat digestion survival of probiotic microorganisms bioaccessability of fat-soluble vitamins TIM-2 has been validated with respect to the composition of the microbiota the metabolic acitivity of the microbiota
  124. 124. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 124 Validation survival LAB during GI passage in vitro (i.v.) versus humans (h) J. Dairy Sci. 80:1031, 1997 0 5 10 15 20 25 30 35 0 60 120 180 240 300 360 time (min) cumulativedelivery(%ofintake) Bif. (i.v.) Bif. (h) L.ac (i.v.) L.ac (h)
  125. 125. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 125 Mäkivuokko et al., MEHD 2012 - 23: 28-34 TIM-1 Stomach and small intestine model
  126. 126. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 126
  127. 127. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 127concept of intestinal flora (microbiota) is old, but little is known about it Hieronymous Bosch (ca.1450–1516) - Garden of earthly delights painted in 1503-1504; on display in Museo del Prado in Madrid
  128. 128. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 128 Saccharolytic and proteolytic activity • Saccharolysis leads primarily to SCFA and gasses • SCFA: acetate, propionate, butyrate • lactate -> only accumulates when there is a fast fermentation • CO2, CH4, H2 • Proteolysis in addition leads to toxic metabolites • BCFA: iso-butyrate, iso-valerate • ammonia • phenolics: phenol, indol, p-cresol, skatol • H2S, CH3SH, etc
  129. 129. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 129 Colonic metabolites some examples • Butyrate: • 70% of the fuel of colonocytes • lack -> epithelial atrophy • reduces cancer promotion in transformed tissue • possibly reverses transformation by induction of differentiation • H2S, CH3SH: • block butyrate oxidation • ammonia: • liver cirrhosis • etc.
  130. 130. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 130 Prolonged carbohydrate fermentation proximal colon: primarily saccharolytic fermentation transverse colon: combination of saccharolytic and proteolytic fermentation distal colon: primarily proteolytic fermentation distal colon: colon cancer and IBD
  131. 131. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 131 Experiments were done in TNO’s in vitro model of the colon (TIM-2): • healthy adult microbiota • average parameters in the proximal colon • standardized conditions
  132. 132. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 132 BCFA production BCFA control 0 2 4 6 8 0 20 40 60 80 100 120 time (hrs) mmol i-butyrate i-valerate BCFA inulin 0 2 4 6 8 0 20 40 60 80 100 120 time (hrs) mmol BCFA control + Clostridium difficile 0 2 4 6 8 0 20 40 60 80 100 120 time (hrs) mmol BCFA inulin + Clostridium difficile 0 2 4 6 8 0 20 40 60 80 100 120 time (hrs) mmol Van Nuenen et al., MEHD 2003 15: 137-144
  133. 133. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 133 Phenolics production 0 200 400 600 phenol p-cresol indol skatol p-cresol/indol(μmol/l) 10*phenol(μmol/l) control inulin Van Nuenen et al., MEHD 2003 15: 137-144
  134. 134. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 134 DNA micro-array (I-chip)
  135. 135. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 135 TIM-2 results; FOS/inulin TNO I-Chip close to 400 probes 5-40 fold Maathuis et al., AJCN 2010; Rose et al., BJN 2010
  136. 136. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 136 • Many unknown Oligosaccharides gradually degraded in 6 hours 2.2 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0 52.8 Time [min] -17.5 -15.0 -10.0 -5.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 46.7 min nC Response TIM t 0h TIM t 15min TIM t 2h TIM t 6h TIM t 24 Quite slow fermentable fiber, thus may reach the distal colon. Oligosaccharide profile of TIM-2 fermentation Fibersol-2® over 24 hours – with HPAEC
  137. 137. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 137 Oligosaccharide profile of TIM S11 (beta-glucan) over 24 hours – with high performance anion exchange chromatographie TIM t0 TIM t 0:15 TIM t1 TIM t2 TIM t4 TIM t6 TIM t24 Oligosaccharide profile of TIM-2 fermentation of beta-glucan over 24 hours – with HPAEC
  138. 138. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 138 Fermentation of beta-glucan leads to increase in immunomodulation – BMDCs from TLR2/4 KO mice
  139. 139. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 139 pectin branched arabinan linear arabinan IL-10 IL-4 IL-12 MCP-1 LA BA -C +C Fermentation of pectin leads to immunomodulatory structures – from BA to LA
  140. 140. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 140 How to study the gut microbiota
  141. 141. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 141 Limited accessibility of the colon
  142. 142. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 142 Tool 2: Carbohydrates labeled with stable isotopes Stable (not radioactive) isotope 13C Substrates were uniformly labeled (each 12C -> 13C) Different isotopes follow the same biochemical route with no preference for one isotope over the other * Due to differences in mass between the different isotopes, they can be traced in microbial metabolism * We have some evidence that this may not be entirely true isotope: natural abundance:
  143. 143. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 143 Incubation 13C-labeled substrate 13C ends up in microbial metabolites 13C ends up in microbial biomass (incl. DNA/RNA) Principle: Use of stable isotopes De Graaf and Venema, AMP 2008 using various 13C-labeled substrates: inulin, starch, lactose, GOS, 6’-SL
  144. 144. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 144 [U-13C]Glc CO2 intracellular extracellular Protein & Fatty acids VEMP VFHL VWLP VLDH VACK VLACt VFORt VACt VPYR VACCOA Pyr AcCoA AcAcetylCoA Lactate Acetate CO2 Butyrate Formate CO2 Acetate Lactate Formate Acetate Butyrate VPFL H2 VPDH VBUK VBUt VLACex VFORex VACex VBUex 89.1 mmol/min 82.7 16.0 54.5 209.0 48.4 162.6 35.799.3 176.4 208.2 99.3 155.1 7.5 209.0 48.4 97.2 Unlabeled substrates 13C labeled substrate > 90% reversibility 130 Computer model: Flux within intestinal microbiota
  145. 145. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 145 Baby microbiota: - No propionate (C3) on FOS and GOS - No butyrate (C4) on GOS - Succinate (Succ) on both substrates Elderly microbiota: - No Succ on either substrate - Alanine (Ala) on both Both microbiotas: - Ethanol (EtOH) production - Differences in the amount of acetate (C2), butyrate (C4) and lactate (Lac) Summer Course Glycosciences (12th European Training Course on Carbohydrates) 3-7 June 2012 Groningen, The Netherlands © TNO 145 FOS/GOS Comparison - 2D NMR t=4h
  146. 146. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 146 Incubation 13C-labeled substrate 13C ends up in microbial metabolites 13C ends up in microbial biomass (incl. DNA/RNA) Principle: Use of stable isotopes De Graaf and Venema, AMP 2008
  147. 147. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 147 16S rRNA Stable Isotope Probing (SIP) Incubation RNA extraction Density gradient ultracentrifugation (CsTFA) 13C-labeled substrate Gradient fractionation Molecular analyses heavy vs. light fractions  16S rRNA - based molecular fingerprinting of microbial diversity  Cloning and sequencing of 16S rRNA De Graaf and Venema, AMP 2008
  148. 148. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 148 1 3 5 7 t0 t1 t2 t4 t8 0 25 50 ratio(%) fractiontime(h) Bifidobacterium bifidum t0 t1 t2 t4 t8 SIP after 13C-GOS feeding Maathuis et al., J Nutr, in press micro-array analysis
  149. 149. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 149 Determination of caloric value of fermented carbs • 1 gram of inulin has a caloric value of 2.05 kcal • similarly, 1 gram of lactose has a caloric value of 2.41 kcal 1 gram of starch 1.69 kcal • Therefore, depending on the fermentable substrate, the energy-harvest of the body is different ----> link of microbiota with obesity Venema (2010) Curr Opin Clin Nutr Metab Care - implication for obesity
  150. 150. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 150 Obesity and microbiota - enterotypes Current TIM-2 pooled microbiota TIM-2 of the future 1. Microbiota of lean en obese individuals 2. Microbiota of 3 enterotypes
  151. 151. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 151 L = lean O = obese Not in all cases obese (O) ↑ than lean (L) GOS: energy extraction equal, despite clear differences in SCFA and lactate production Lactulose: highest production, plus O ↑ L Pectins: L ↑↑ than O Adult microbiota 874 kJ/mol 1536 kJ/mol 2192 kJ/mol 1364 kJ/mol
  152. 152. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 152 [U-13C]Glc CO2 intracellular extracellular VEMP VFHL VWLP VLDH VACK VLACt VFORt VACt VPYR VACCOA Pyr AcCoA AcAcetylCoA Lactate Acetate CO2 Butyrate Formate CO2 Acetate Lactate Formate Acetate Butyrate VPFL H2 VPDH VBUK VBUt VLACex VFORex VACex VBUex 89.1mmol/min 82.7 16.0 54.5 209.0 48.4 162.6 35.799.3 176.4 208.2 99.3 155.1 7.5 209.0 48.4 97.2 13C labeled substrate 130 microbiota host Host – microbe interaction : relevance for (gut) health
  153. 153. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 153 diet fermentation by gut microbiota microbial metabolites tissue and organ metabolism host physiological response
  154. 154. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 154 human feeding trials @ Maastricht University hospital Substrate delivery via a nasal tube Colon sampling back through catheter Plasma sampling Breath sampling GC and LC-MS analyses 13C
  155. 155. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 155 First experiments in humans with lactose!! -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240 deltaplasmaglucose deltabreathCO2 breathhydrogen(ppm) -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240 deltaplasmaglucose deltabreathCO2 breathhydrogen(ppm) -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240 -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240-30 0 30 60 90 120 150 180 210 240 deltaplasmaglucose deltabreathCO2 breathhydrogen(ppm) -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240 -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240-30 0 30 60 90 120 150 180 210 240 deltaplasmaglucose deltabreathCO2 breathhydrogen(ppm) -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240 -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240-30 0 30 60 90 120 150 180 210 240 deltaplasmaglucose deltabreathCO2 breathhydrogen(ppm) -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240-30 0 30 60 90 120 150 180 210 240 -50 0 50 100 150 200 250 individual 213 C-CO2 H2 13 C-glucose -30 0 30 60 90 120 150 180 210 240-30 0 30 60 90 120 150 180 210 240 deltaplasmaglucose deltabreathCO2 breathhydrogen(ppm) - no 13C-glucose in plasma - increase in13C-CO2 and H2 in breath - increase in 13C-acetate in plasma fermentation of 13C-lactose in colon
  156. 156. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 156 Wrap up and Take home messages
  157. 157. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 157 Limitations of the in vitro models no feed-back mechanism except pH and volume no mucosal cells no local or humoral immune system
  158. 158. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 158 Combination with biological models intestinal segments in transport chambers various gastrointestinal areas various species, including humans cultured mucosal cells e.g. Caco-2, HT29 cultured immunocompetent cells
  159. 159. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 159 Conclusions Part 3 • Validated in vitro models of the gastrointestinal tract are excellent tools to study the functionality of pro- & prebiotics, and effects of these and other dietary factors on the gut microbiota. • For more information: koen.venema@outlook.com k.venema@maastrichtuniversity.nl
  160. 160. Yakult seminar “Gut – brain – microbiota” – Almere – 09-Jun-2016 © Beneficial Microbes Consultancy 160 Acknowledgements • Henrike Hamer • Steven Vanhoutvin • Freddy Troost • Daisy Jonkers • Robert-Jan Brummer • Tao He • Roel Vonk April 20, 2011TIFN Satiety screenings study 160 Dank u hartelijk voor uw aandacht!

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