Posibles aplicaciones de probióticos/simbióticos en la modulación de la fisiopatología de la obesidad y sus resultados: una revisión narrativa

Contenido principal del artículo

Luis Otávio Aguiar Cavicchia
Martha Elisa Ferreira de Almeida

Resumen

Em 2030, 1,12 milhões de pessoas no mundo serão obesas, gerando sérias preocupações de saúde global. A obesidade não se limita a questões estéticas, e está intrinsecamente ligada a distúrbios metabólicos. Embora intervenções farmacológicas, dietéticas, de estilo de vida e educacionais tenham se mostrado eficazes na prevenção e tratamento da obesidade, há uma necessidade crescente de identificar alternativas de baixo custo e risco que possam ser adotadas sem efeitos colaterais prejudiciais. Nesse contexto, a modulação da microbiota intestinal emerge como uma área promissora. A microbiota intestinal desempenha um papel crucial em sistemas como o cardiovascular, imunológico, endócrino, inflamatório, metabolismo e regulação genética. Nos últimos anos, tem havido um aumento nas evidências de que o desequilíbrio da microbiota intestinal está relacionado à obesidade. Assim, essa revisão examina como os probióticos e simbióticos podem ajudar a tratar e prevenir a obesidade, destacando possíveis mecanismos entre o binômio microbiota-hospedeiro e seus efeitos na saúde de pessoas com obesidade ou risco de desenvolvê-la. Foi realizada uma busca nas bases de dados: Pubmed/MEDLINE, ScienceDirect e SciELO. Os resultados permitiram estabelecer um panorama dos usos terapêuticos dos probióticos e simbióticos em indivíduos obesos com ou sem outras patologias, assim como estabelecer hipóteses e correlações entre as alterações da microbiota e modulação obesogênica nos indivíduos. Pode-se concluir que tais intervenções são promissoras e capazes de modular de maneira local e sistêmica o metabolismo, parâmetros bioquímicos e composição corporal alterados pela obesidade e podem ser uma intervenção complementar alternativa de baixo custo e risco para essa patologia.

Descargas

Los datos de descargas todavía no están disponibles.

Detalles del artículo

Cómo citar
Aguiar Cavicchia, L. O., & Ferreira de Almeida, M. E. (2024). Posibles aplicaciones de probióticos/simbióticos en la modulación de la fisiopatología de la obesidad y sus resultados: una revisión narrativa. Revista Brasileira Multidisciplinar, 27(1), 169-189. https://doi.org/10.25061/2527-2675/ReBraM/2024.v27i1.2023
Sección
Artigos de Revisão

Citas

ABENAVOLI, L. et al. Gut Microbiota and Obesity: A Role for Probiotics. Nutrients, v. 11, n. 11, 2019.

AFSHIN, A. et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. The New England journal of medicine, v. 377, n. 1, p. 13–27, 6 jul. 2017.

ÁLVAREZ-ARRAÑO, V.; MARTÍN-PELÁEZ, S. Effects of Probiotics and Synbiotics on Weight Loss in Subjects with Overweight or Obesity: A Systematic Review. Nutrients, v. 13, n. 10, 2021.

ANG, Z.; DING, J. L. GPR41 and GPR43 in Obesity and Inflammation – Protective or Causative? Frontiers in Immunology, v. 7, 2016.

BÄCKHED, F. et al. Mechanisms underlying the resistance to diet-induced obesity in germ-free mice. Proceedings of the National Academy of Sciences, v. 104, n. 3, p. 979–984, 16 jan. 2007.

BAHADUR, T. et al. Toll like receptors (TLRs) in response to human gut microbiota of Indian obese and lean individuals. Journal of Family Medicine and Primary Care, v. 8, n. 5, 2019.

BALLINI, A. et al. Probiotics Efficacy on Oxidative Stress Values in Inflammatory Bowel Disease: A Randomized Double-Blinded Placebo-Controlled Pilot Study. Endocrine, metabolic & immune disorders drug targets, v. 19, n. 3, p. 373–381, 2019.

BARTOCHOWSKI, P. et al. Gut–Kidney Axis Investigations in Animal Models of Chronic Kidney Disease. Toxins, v. 14, n. 9, 2022.

BATISTA, P. et al. Kombucha: Perceptions and Future Prospects. Foods, v. 11, n. 13, 2022.

BEN OTHMAN, R. et al. A clinical trial about effects of prebiotic and probiotic supplementation on weight loss, psychological profile and metabolic parameters in obese subjects. Endocrinology, Diabetes & Metabolism, v. 6, n. 2, p. e402, 1 mar. 2023.

BENDOR, C. D. et al. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovascular diabetology, v. 19, n. 1, p. 79, 13 jun. 2020.

BJARNASON, I.; SISSION, G.; HAYEE, B. A randomised, double-blind, placebo-controlled trial of a multi-strain probiotic in patients with asymptomatic ulcerative colitis and Crohn’s disease. Inflammopharmacology, v. 27, n. 3, p. 465–473, 1 jun. 2019.

BORTHAKUR, A. et al. The probiotic Lactobacillus plantarum counteracts TNF-α-induced downregulation of SMCT1 expression and function. American Journal of Physiology-Gastrointestinal and Liver Physiology, v. 299, n. 4, p. G928–G934, 1 out. 2010.

BRETON, J.; GALMICHE, M.; DÉCHELOTTE, P. Dysbiotic Gut Bacteria in Obesity: An Overview of the Metabolic Mechanisms and Therapeutic Perspectives of Next-Generation Probiotics. Microorganisms, v. 10, n. 2, 2022.

CAMPANIELLO, D. et al. A narrative review on the use of probiotics in several diseases. Evidence and perspectives. Frontiers in Nutrition, v. 10, 2023.

CHEN, Y.-Y. et al. Microbiome–metabolome reveals the contribution of gut–kidney axis on kidney disease. Journal of Translational Medicine, v. 17, n. 1, p. 5, 3 jan. 2019.

CHENG, Z. et al. The critical role of gut microbiota in obesity. Frontiers in Endocrinology, v. 13, 2022.

CLARKE, S. F. et al. The gut microbiota and its relationship to diet and obesity: new insights. Gut microbes, v. 3, n. 3, p. 186–202, jun. 2012.

CORBIN, K. D. et al. Host-diet-gut microbiome interactions influence human energy balance: a randomized clinical trial. Nature Communications, v. 14, n. 1, p. 3161, 31 maio 2023.

CROVESY, L.; EL-BACHA, T.; ROSADO, E. L. Modulation of the gut microbiota by probiotics and symbiotics is associated with changes in serum metabolite profile related to a decrease in inflammation and overall benefits to metabolic health: a double-blind randomized controlled clinical trial in women with obesity. Food & function, v. 12, n. 5, p. 2161–2170, 15 mar. 2021.

DAVANI-DAVARI, D. et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods, v. 8, n. 3, 2019.

ECTON, K. E. et al. Toll-like receptor 4 deletion partially protects mice from high fat diet-induced arterial stiffness despite perturbation to the gut microbiota. Frontiers in Microbiomes, v. 2, 2023.

EROGLU, N. et al. Role of ChREBP and SREBP-1c in gestational diabetes: two key players in glucose and lipid metabolism. International Journal of Diabetes in Developing Countries, v. 43, n. 4, p. 587–591, 1 ago. 2023.

FURET, J.-P. et al. Differential Adaptation of Human Gut Microbiota to Bariatric Surgery–Induced Weight Loss: Links With Metabolic and Low-Grade Inflammation Markers. Diabetes, v. 59, n. 12, p. 3049–3057, 28 set. 2010.

GANESAN, R. et al. Recent Trends of Microbiota-Based Microbial Metabolites Metabolism in Liver Disease. Frontiers in Medicine, v. 9, 2022.

GANESAN, R.; SUK, K. T. Therapeutic Potential of Human Microbiome-Based Short-Chain Fatty Acids and Bile Acids in Liver Disease. Livers, v. 2, n. 3, p. 139–145, 2022.

GOMES, A. C.; HOFFMANN, C.; MOTA, J. F. The human gut microbiota: Metabolism and perspective in obesity. Gut microbes, v. 9, n. 4, p. 308–325, 4 jul. 2018.

GUO, Y. et al. The Gut–Organ-Axis Concept: Advances the Application of Gut-on-Chip Technology. International Journal of Molecular Sciences, v. 24, n. 4, 2023.

HADI, A. et al. Clinical and psychological responses to synbiotic supplementation in obese or overweight adults: A randomized clinical trial. Complementary Therapies in Medicine, v. 47, p. 102216, 1 dez. 2019.

HIBBERD, A. A. et al. Probiotic or synbiotic alters the gut microbiota and metabolism in a randomised controlled trial of weight management in overweight adults. Beneficial microbes, v. 10, n. 2, p. 121–135, 13 mar. 2019.

IIZUKA, K.; TAKAO, K.; YABE, D. ChREBP-Mediated Regulation of Lipid Metabolism: Involvement of the Gut Microbiota, Liver, and Adipose Tissue. Frontiers in Endocrinology, v. 11, 2020.

JIA, X. et al. Impact of Gut Microbiota and Microbiota-Related Metabolites on Hyperlipidemia. Frontiers in Cellular and Infection Microbiology, v. 11, 2021.

JIN, J. et al. Distinctive Gut Microbiota in Patients with Overweight and Obesity with Dyslipidemia and its Responses to Long-term Orlistat and Ezetimibe Intervention: A Randomized Controlled Open-label Trial. Frontiers in Pharmacology, v. 12, 2021.

JUMPERTZ, R. et al. Energy-balance studies reveal associations between gut microbes, caloric load, and nutrient absorption in humans123. The American Journal of Clinical Nutrition, v. 94, n. 1, p. 58–65, 1 jul. 2011.

KANAZAWA, A. et al. Effects of Synbiotic Supplementation on Chronic Inflammation and the Gut Microbiota in Obese Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study. Nutrients, v. 13, n. 2, 2021.

KANG, Y. et al. Lactobacillus acidophilus ameliorates obesity in mice through modulation of gut microbiota dysbiosis and intestinal permeability. Pharmacological Research, v. 175, p. 106020, 1 jan. 2022.

KHAKOO, N. S. et al. Impact of Obesity on Inflammatory Bowel Disease. Current Gastroenterology Reports, v. 24, n. 1, p. 26–36, 1 jan. 2022.

KHALESI, S. et al. A review of probiotic supplementation in healthy adults: helpful or hype? European Journal of Clinical Nutrition, v. 73, n. 1, p. 24–37, 1 jan. 2019.

KHAN, M. J. et al. Role of Gut Microbiota in the Aetiology of Obesity: Proposed Mechanisms and Review of the Literature. Journal of Obesity, v. 2016, p. 7353642, 15 set. 2016.

KIM, J. et al. Lactobacillus gasseri BNR17 Supplementation Reduces the Visceral Fat Accumulation and Waist Circumference in Obese Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of Medicinal Food, v. 21, n. 5, p. 454–461, 1 maio 2018.

KIM, K. N.; YAO, Y.; JU, S. Y. Short Chain Fatty Acids and Fecal Microbiota Abundance in Humans with Obesity: A Systematic Review and Meta-Analysis. Nutrients, v. 11, n. 10, 2019.

KOLIADA, A. et al. Association between body mass index and Firmicutes/Bacteroidetes ratio in an adult Ukrainian population. BMC Microbiology, v. 17, n. 1, p. 120, 22 maio 2017.

KOVACS, G. G. Are comorbidities compatible with a molecular pathological classification of neurodegenerative diseases? Current opinion in neurology, v. 32, n. 2, p. 279–291, abr. 2019.

KRUK, M. et al. Application of the “SCOBY” and Kombucha Tea for the Production of Fermented Milk Drinks. Microorganisms, v. 9, n. 1, 2021.

KRUMBECK, J. A. et al. Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics. Microbiome, v. 6, n. 1, p. 121, 28 jun. 2018.

KUMAR, A. et al. Lactobacillus acidophilus counteracts enteropathogenic E. coli-induced inhibition of butyrate uptake in intestinal epithelial cells. American Journal of Physiology-Gastrointestinal and Liver Physiology, v. 309, n. 7, p. G602–G607, 1 out. 2015.

LAU, E. et al. The role of I-FABP as a biomarker of intestinal barrier dysfunction driven by gut microbiota changes in obesity. Nutrition & Metabolism, v. 13, n. 1, p. 31, 30 abr. 2016.

LEE, Y. R. et al. Prebiotic and Anti-Adipogenic Effects of Radish Green Polysaccharide. Microorganisms, v. 11, n. 7, 2023.

LI, F. et al. Alterations to the Gut Microbiota and Their Correlation With Inflammatory Factors in Chronic Kidney Disease. Frontiers in Cellular and Infection Microbiology, v. 9, 2019.

LIM, S. et al. Effect of Lactobacillus sakei, a Probiotic Derived from Kimchi, on Body Fat in Koreans with Obesity: A Randomized Controlled Study. Endocrinology and metabolism (Seoul, Korea), v. 35, n. 2, p. 425–434, jun. 2020.

LIU, B.-N. et al. Gut microbiota in obesity. World journal of gastroenterology, v. 27, n. 25, p. 3837–3850, 7 jul. 2021.

LIU, Y.; WANG, J.; WU, C. Modulation of Gut Microbiota and Immune System by Probiotics, Pre-biotics, and Post-biotics. Frontiers in Nutrition, v. 8, 2022.

IIZUKA, K.; TAKAO, K.; YABE, D. ChREBP-Mediated Regulation of Lipid Metabolism: Involvement of the Gut Microbiota, Liver, and Adipose Tissue. Frontiers in endocrinology, v. 11, p. 587189, 2020.

LÓPEZ-MORENO, A. et al. Probiotic Strains and Intervention Total Doses for Modulating Obesity-Related Microbiota Dysbiosis: A Systematic Review and Meta-analysis. Nutrients, v. 12, n. 7, 2020.

LUNDGREN, P.; THAISS, C. A. The microbiome-adipose tissue axis in systemic metabolism. American Journal of Physiology-Gastrointestinal and Liver Physiology, v. 318, n. 4, p. G717–G724, 1 abr. 2020.

MAGNE, F. et al. The Firmicutes/Bacteroidetes Ratio: A Relevant Marker of Gut Dysbiosis in Obese Patients? Nutrients, v. 12, n. 5, 2020.

PARADA VENEGAS, D. et al. Short Chain Fatty Acids (SCFAs)-Mediated Gut Epithelial and Immune Regulation and Its Relevance for Inflammatory Bowel Diseases. Frontiers in Immunology, v. 10, 2019.

PARNELL, J.; REIMER, R. Prebiotic fiber modulation of the gut microbiota improves risk factors for obesity and the metabolic syndrome. Gut microbes, v. 3, p. 29–34, 1 jan. 2012.

PONTES, K. S. DA S. et al. Effects of probiotics on body adiposity and cardiovascular risk markers in individuals with overweight and obesity: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition, v. 40, n. 8, p. 4915–4931, 1 ago. 2021.

PRAMANIK, S. et al. A systematic review on selection characterization and implementation of probiotics in human health. Food Science and Biotechnology, v. 32, n. 4, p. 423–440, 1 mar. 2023.

RAHAYU, E. S. et al. Effect of probiotic Lactobacillus plantarum Dad-13 powder consumption on the gut microbiota and intestinal health of overweight adults. World journal of gastroenterology, v. 27, n. 1, p. 107–128, 7 jan. 2021.

RINGØ, E. et al. Probiotics, lactic acid bacteria and bacilli: interesting supplementation for aquaculture. Journal of Applied Microbiology, v. 129, n. 1, p. 116–136, 1 jul. 2020.

RINNINELLA, E. et al. What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, v. 7, n. 1, 2019.

RIVERA-PIZA, A.; LEE, S.-J. Effects of dietary fibers and prebiotics in adiposity regulation via modulation of gut microbiota. Applied Biological Chemistry, v. 63, n. 1, p. 2, 7 jan. 2020.

ROGERO, M. M.; CALDER, P. C. Obesity, Inflammation, Toll-Like Receptor 4 and Fatty Acids. Nutrients, v. 10, n. 4, 2018.

SÁEZ-LARA, M. J. et al. Effects of Probiotics and Synbiotics on Obesity, Insulin Resistance Syndrome, Type 2 Diabetes and Non-Alcoholic Fatty Liver Disease: A Review of Human Clinical Trials. International Journal of Molecular Sciences, v. 17, n. 6, 2016.

SCHOELER, M.; CAESAR, R. Dietary lipids, gut microbiota and lipid metabolism. Reviews in Endocrine and Metabolic Disorders, v. 20, n. 4, p. 461–472, 1 dez. 2019.

SERGEEV, I. N. et al. Effects of Synbiotic Supplement on Human Gut Microbiota, Body Composition and Weight Loss in Obesity. Nutrients, v. 12, n. 1, 2020.

STAVROPOULOU, E. et al. Focus on the Gut–Kidney Axis in Health and Disease. Frontiers in Medicine, v. 7, 2021.

SVEGLIATI-BARONI, G. et al. Gut-Pancreas-Liver Axis as a Target for Treatment of NAFLD/NASH. International Journal of Molecular Sciences, v. 21, n. 16, 2020.

SWANSON, K. S. et al. The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics. Nature Reviews Gastroenterology & Hepatology, v. 17, n. 11, p. 687–701, 1 nov. 2020.

SZULIŃSKA, M. et al. Dose-Dependent Effects of Multispecies Probiotic Supplementation on the Lipopolysaccharide (LPS) Level and Cardiometabolic Profile in Obese Postmenopausal Women: A 12-Week Randomized Clinical Trial. Nutrients, v. 10, n. 6, 2018a.

SZULIŃSKA, M. et al. Multispecies Probiotic Supplementation Favorably Affects Vascular Function and Reduces Arterial Stiffness in Obese Postmenopausal Women—A 12-Week Placebo-Controlled and Randomized Clinical Study. Nutrients, v. 10, n. 11, 2018b.

TAN, A. H. et al. Probiotics for Constipation in Parkinson Disease. Neurology, v. 96, n. 5, p. e772–e782, 2021.

TOMÉ-CASTRO, X. M. et al. Probiotics as a therapeutic strategy in obesity and overweight: a systematic review. Beneficial microbes, v. 12, n. 1, p. 5–15, 24 fev. 2021.

TÖRŐS, G. et al. Modulation of the Gut Microbiota with Prebiotics and Antimicrobial Agents from Pleurotus ostreatus Mushroom. Foods, v. 12, n. 10, 2023.

VARGAS, B. K.; FABRICIO, M. F.; ZÁCHIA AYUB, M. A. Health effects and probiotic and prebiotic potential of Kombucha: A bibliometric and systematic review. Food Bioscience, v. 44, p. 101332, 1 dez. 2021.

VINHA, L. I. de L. .; ALMEIDA, M. E. F. de .; BARAKAT , B.; SANTANA, B. F. de .; RIBEIRO, M. G. C. .; PARUSSOLO, G. S. . Intestinal dysbiosis in obese: Literature review. Research, Society and Development, [S. l.], v. 12, n. 4, p. e9712440980, 2023.

WAGENAAR, C. A. et al. The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review. Nutrients, v. 13, n. 9, 2021.

WANG, J. et al. Modulatory effect of Lactobacillus acidophilus KLDS 1.0738 on intestinal short-chain fatty acids metabolism and GPR41/43 expression in β-lactoglobulin–sensitized mice. Microbiology and Immunology, v. 63, n. 8, p. 303–315, 1 ago. 2019.

WANG, S.; QIN, L. Homeostatic medicine: a strategy for exploring health and disease. Current Medicine, v. 1, n. 1, p. 16, 26 set. 2022.

WANG, X.; ZHANG, P.; ZHANG, X. Probiotics Regulate Gut Microbiota: An Effective Method to Improve Immunity. Molecules, v. 26, n. 19, 2021.

WANG, Y. et al. Composite probiotics alleviate type 2 diabetes by regulating intestinal microbiota and inducing GLP-1 secretion in db/db mice. Biomedicine & Pharmacotherapy, v. 125, p. 109914, 1 maio 2020.

WICIŃSKI, M. et al. Probiotics for the Treatment of Overweight and Obesity in Humans—A Review of Clinical Trials. Microorganisms, v. 8, n. 8, 2020.

WIEËRS, G. et al. How Probiotics Affect the Microbiota. Frontiers in Cellular and Infection Microbiology, v. 9, 2020.

WU, D. et al. Cross-Talk Between Gut Microbiota and Adipose Tissues in Obesity and Related Metabolic Diseases. Frontiers in Endocrinology, v. 13, 2022.

XIONG, R.-G. et al. Health Benefits and Side Effects of Short-Chain Fatty Acids. Foods, v. 11, n. 18, 2022.

YU, T. et al. New crosstalk between probiotics Lactobacillus plantarum and Bacillus subtilis. Scientific Reports, v. 9, n. 1, p. 13151, 11 set. 2019.

ZAFAR, H.; SAIER, M. H. Gut Bacteroides species in health and disease. Gut Microbes, v. 13, n. 1, p. 1848158, 1 jan. 2021.

ZHANG, D. et al. Short-chain fatty acids in diseases. Cell Communication and Signaling, v. 21, n. 1, p. 212, 18 ago. 2023.

ZHANG, Z. et al. Intestinal homeostasis and inflammation: Gut microbiota at the crossroads of pancreas–intestinal barrier axis. European Journal of Immunology, v. 52, n. 7, p. 1035–1046, 1 jul. 2022.