DIET-MICROBE INTERACTIONS IN THE GUT This pageintentionallyleftblank DIET-MICROBE INTERACTIONS IN THE GUT Effects on Human Health and Disease Edited by K T IERAN UOHY DepartmentofFoodQualityandNutrition,ResearchandInnovationCentre, FoundationEdmundMach(FEM),SanMicheleall’Adige,Trento,Italy D D R ANIELE EL IO DepartmentofFoodScience,UniversityofParma,Parma,Italy AMSTERDAM(cid:129)BOSTON(cid:129)HEIDELBERG(cid:129)LONDON NEWYORK(cid:129)OXFORD(cid:129)PARIS(cid:129)SANDIEGO SANFRANCISCO(cid:129)SINGAPORE(cid:129)SYDNEY(cid:129)TOKYO AcademicPressisanimprintofElsevier AcademicPressisanimprintofElsevier 32JamestownRoad,LondonNW17BY,UK 225WymanStreet,Waltham,MA02451,USA 525BStreet,Suite1800,SanDiego,CA92101-4495,USA Copyrightr2015ElsevierInc.Allrightsreserved Nopartofthispublicationmaybereproduced,storedinaretrievalsystemortransmittedin anyformorbyanymeanselectronic,mechanical,photocopying,recordingorotherwisewithout thepriorwrittenpermissionofthepublisher PermissionsmaybesoughtdirectlyfromElsevier’sScience&TechnologyRights DepartmentinOxford,UK:phone(144)(0)1865843830;fax(144)(0)1865853333; email:[email protected],visittheScienceandTechnologyBooks websiteatwww.elsevierdirect.com/rightsforfurtherinformation Notice Noresponsibilityisassumedbythepublisherforanyinjuryand/ordamagetopersonsorproperty asamatterofproductsliability,negligenceorotherwise,orfromanyuseoroperationofany methods,products,instructionsorideascontainedinthematerialherein.Becauseofrapidadvances inthemedicalsciences,inparticular,independentverificationofdiagnosesanddrugdosages shouldbemade Medicineisanever-changingfield.Standardsafetyprecautionsmustbefollowed,but asnewresearchandclinicalexperiencebroadenourknowledge,changesintreatmentanddrug therapymaybecomenecessaryorappropriate.Readersareadvisedtocheckthemostcurrent productinformationprovidedbythemanufacturerofeachdrugtobeadministeredtoverify therecommendeddose,themethodanddurationofadministrations,andcontraindications.Itis theresponsibilityofthetreatingphysician,relyingonexperienceandknowledgeofthepatient, todeterminedosagesandthebesttreatmentforeachindividualpatient.Neitherthepublisher northeauthorsassumeanyliabilityforanyinjuryand/ordamagetopersonsorproperty arisingfromthispublication. BritishLibraryCataloguing-in-PublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressCataloging-in-PublicationData AcatalogrecordforthisbookisavailablefromtheLibraryofCongress ISBN:978-0-12-407825-3 ForinformationonallAcademicPresspublications visitourwebsiteatelsevierdirect.com TypesetbyMPSLimited,Chennai,India www.adi-mps.com PrintedandboundinUSA 14 15 16 17 10 9 8 7 6 5 4 3 2 1 Contents Foreword...................................................................................................................................................ix Acknowledgements....................................................................................................................................xi List of Contributors.................................................................................................................................xiii 1. The Microbiota of the Human Gastrointestinal Tract: A Molecular View..........................................1 KIERANM.TUOHYANDKARENP.SCOTT Introduction................................................................................................................................................................................1 Gut Microbiota MetabolisminHealth and Disease.................................................................................................................1 Methodologies for Studying the Human Gut Microbiota.........................................................................................................3 Spatial Distribution ofthe Gut Microbiota andInteractionswith Diet..................................................................................6 Models toStudy Microbial Ecology.........................................................................................................................................10 Conclusions...............................................................................................................................................................................11 References.................................................................................................................................................................................11 2. A Nutritional Anthropology of the Human Gut Microbiota.............................................................17 CARLOTTADEFILIPPOANDKIERANM.TUOHY Human Diet orMicrobiota,Which Came First?.....................................................................................................................17 Metagenomics and Cultivation-IndependentAssessment ofHumanGut Microbiota.........................................................18 MicrobiomeandHuman Nutritional Phenotype....................................................................................................................18 The Gut Microbiota inHuman Evolution..............................................................................................................................19 Population Metagenomic Variation within the Human Microbiota......................................................................................21 The Western Diet Metagenome Is Obesity Prone..................................................................................................................24 Conclusions...............................................................................................................................................................................25 References.................................................................................................................................................................................25 3. Probiotic Microorganisms for Shaping the Human Gut Microbiota (cid:1) Mechanisms and Efficacy into the Future ......................................................................................................................27 LORENZOMORELLIANDVANIAPATRONE Introduction..............................................................................................................................................................................27 Let’sStartWith the Definition ofProbiotics..........................................................................................................................27 Shaping the Microbiota............................................................................................................................................................28 The Neonatal Period................................................................................................................................................................29 Adult Lifeand the Proposed Enterotype Classification..........................................................................................................31 The Aged Period.......................................................................................................................................................................32 Mechanisms and Efficacy.........................................................................................................................................................33 Efficacy inHealthyPeople.......................................................................................................................................................33 Conclusions...............................................................................................................................................................................37 References.................................................................................................................................................................................37 4. Bifidobacteria of the Human Gut: Our Special Friends......................................................................41 MARCOVENTURA,FRANCESCATURRONIANDDOUWEVANSINDEREN TaxonomyofBifidobacteria.....................................................................................................................................................41 Bifidobacterial Ecology.............................................................................................................................................................43 v vi CONTENTS Bifidobacterial Populations inthe HumanGut......................................................................................................................43 Bifidobacteria as Probiotics......................................................................................................................................................44 Bifidobacterial Genomics.........................................................................................................................................................45 Comparative Genomics and Bifidobacteria.............................................................................................................................46 Interaction Between Bifidobacteriaand TheirHosts.............................................................................................................47 Conclusions...............................................................................................................................................................................48 References.................................................................................................................................................................................49 5. Shaping the Human Microbiome with Prebiotic Foods (cid:1) Current Perspectives for Continued Development......................................................................................................................53 KIERANM.TUOHY,DUNCANT.BROWN,ANNETTKLINDER,ADELECOSTABILEANDFRANCESCAFAVA Introduction..............................................................................................................................................................................53 Linking Microbiome Structure and Function..........................................................................................................................54 Probiotics...................................................................................................................................................................................55 Prebiotics...................................................................................................................................................................................56 Testing Prebiotics......................................................................................................................................................................59 Conclusion................................................................................................................................................................................65 References.................................................................................................................................................................................66 6. Bioactivation of High-Molecular-Weight Polyphenols by the Gut Microbiome...............................73 PEDROMENA,LUCACALANI,RENATOBRUNIANDDANIELEDELRIO Introduction..............................................................................................................................................................................73 Proanthocyanidins....................................................................................................................................................................73 Hydrolyzable Tannins (Gallotannins andEllagitannins)........................................................................................................85 Conclusions...............................................................................................................................................................................98 References.................................................................................................................................................................................98 7. Gut Microbial Metabolism of Plant Lignans: Influence on Human Health.....................................103 SETHC.YODER,SAMUELM.LANCASTER,MEREDITHA.J.HULLARANDJOHANNAW.LAMPE Introduction............................................................................................................................................................................103 ConversionofPlant Lignans toEnterolignans byGut Bacteria..........................................................................................104 Associations Between Lignan Exposureand Human Health...............................................................................................107 Interindividual Differences inLignan Metabolism...............................................................................................................110 Conclusions.............................................................................................................................................................................114 Acknowledgements.................................................................................................................................................................114 References...............................................................................................................................................................................114 8. Gut Microbiome Modulates Dietary Xenobiotic Toxicity: The Case of DON and Its Derivatives....................................................................................................................................119 MARTINACIRLINI,RENATOBRUNIANDCHIARADALL’ASTA Introduction............................................................................................................................................................................119 Gastric Stability ofDON Derivatives....................................................................................................................................121 Bacterial Transformation andIntestinal Absorptionof DON and Its Derivatives..............................................................121 DON and DON-ConjugatesImpact onthe Human Gut.....................................................................................................123 References...............................................................................................................................................................................124 9. Gut Microbiota(cid:1)Immune System Crosstalk: Implications for Metabolic Disease...........................127 FRANCESCAFAVA GutMicrobial Recognition by the Immune System.............................................................................................................127 Intestinal Barrier,Gut Permeability and Metabolic Inflammation......................................................................................129 vii CONTENTS Effects ofIntestinal Bacterial Short-Chain Fatty Acids (SCFAs)on Inflammation and Metabolism...............................130 Dietary Fat Metabolism,Bile Acids andGut Microbiota.....................................................................................................131 Diet, TMAO, Gut Microbiota and Atherosclerosis..............................................................................................................132 Immune Versus Metabolic Functions inIntestinal Epithelial Cells Gene Networks..........................................................133 Conclusion..............................................................................................................................................................................134 References...............................................................................................................................................................................135 10. The Interplay of Epigenetics and Epidemiology in Autoimmune Diseases: Time for Geoepigenetics.......................................................................................................................... 139 CARLOSELMIANDANGELACERIBELLI The Etiologyand Pathogenesis ofAutoimmune Disease......................................................................................................139 The Rationale for Geoepigenetics.........................................................................................................................................140 GeoepigeneticsofSystemic Lupus Erythematosus (SLE).....................................................................................................141 GeoepigeneticsofRheumatoid Arthritis(RA).....................................................................................................................143 GeoepigeneticsofSystemic Sclerosis.....................................................................................................................................144 Conclusions.............................................................................................................................................................................145 References...............................................................................................................................................................................145 11. Obesity-Associated Gut Microbiota: Characterization and Dietary Modulation...........................149 QINGSHENANDVATSALAMAITIN The Obesity Pandemic...........................................................................................................................................................149 Genetic Determinants ofObesity..........................................................................................................................................149 Obesity AssociatedGut Microbiota.......................................................................................................................................150 Interactionsbetween Gut Microbesand Obesity: “TheEnergy Extraction Theory”..........................................................154 Interactionsbetween Gut Microbesand Obesity: “TheAppetite Control Theory”...........................................................157 Interactionsbetween Gut Microbesand Obesity: “TheInflammation Theory”.................................................................158 Gut Microbiota as aTherapeuticTargetofProbiotics, Prebiotics and Synbiotics..............................................................161 Conclusions.............................................................................................................................................................................166 References...............................................................................................................................................................................166 12. An Apple a Day Keeps the Doctor Away (cid:1) Inter-Relationship Between Apple Consumption, the Gut Microbiota and Cardiometabolic Disease Risk Reduction......................................................................................................................................... 173 ATHANASIOSKOUTSOSANDJULIEA.LOVEGROVE Introduction............................................................................................................................................................................173 Apple Components.................................................................................................................................................................173 The Human Gut Microbiota..................................................................................................................................................178 CardiometabolicDisease Risk (cid:1)Epidemiological Studies...................................................................................................180 CardiometabolicRisk Factors................................................................................................................................................181 Diabetes Risk..........................................................................................................................................................................187 Conclusion..............................................................................................................................................................................187 References...............................................................................................................................................................................188 13. Whole Plant Foods and Colon Cancer Risk....................................................................................195 EMMAM.BROWN,IANROWLAND,NIGELG.TERNAN,PHILIPALLSOPP,GEOFFMCMULLANANDCHRISI.R.GILL Introduction............................................................................................................................................................................195 Diet and Colorectal Cancer...................................................................................................................................................195 Biological Activity and Anticancer Properties ofWhole-Grain Cereals.............................................................................197 Biological Activity and Anticancer Properties ofBrassicaVegetables.................................................................................199 Human Studies........................................................................................................................................................................199 viii CONTENTS Biological Activity andAnticancer Properties ofBerry Fruits.............................................................................................201 Conclusion..............................................................................................................................................................................203 References...............................................................................................................................................................................204 14. Population Level Divergence from the Mediterranean Diet and the Risk of Cancer and Metabolic Disease..............................................................................................................................209 GEORGEPOUNIS,MARIALAURABONACCIO,KIERANM.TUOHY,MARIABENEDETTADONATI, GIOVANNIDEGAETANOANDLICIAIACOVIELLO MediterraneanDiet as the Traditional Diet ofSouthern Europe.........................................................................................209 The Evidence-Based Health Protection by Mediterranean Diet..........................................................................................211 MediterraneanDiet as a Health Protection Model...............................................................................................................214 MediterraneanFoodConsumption andHumanGut Microbiota.........................................................................................216 References...............................................................................................................................................................................219 15. Diet and the Gut Microbiota (cid:1) How the Gut: Brain Axis Impacts on Autism............................225 KIERANM.TUOHY,PAOLAVENUTI,SIMONECUVA,CESAREFURLANELLO,MATTIAGASPEROTTI, ANDREAMANCINI,FLORENCIACEPPA,DUCCIOCAVALIERI,CARLOTTADEFILIPPO,URSKAVRHOVSEK, PEDROMENA,DANIELEDELRIOANDFRANCESCAFAVA Background.............................................................................................................................................................................225 GutMicrobiota and ASD.......................................................................................................................................................226 Amino Acid Metabolism........................................................................................................................................................228 Lipid Metabolismand the Brain............................................................................................................................................230 Short-Chain Fatty Acids (SCFA) and the Brain..................................................................................................................231 GutMicrobiota and DigestiveFunction................................................................................................................................233 Probiotics, Gut MicrobiotaSuccessional Developmentand Brain Function.......................................................................237 Conclusions.............................................................................................................................................................................238 References...............................................................................................................................................................................238 Index......................................................................................................................................................247 Foreword Recent metagenomic studies are confirming what pioneers in gut microbiology have been saying for a long time, that diet:microbe interactions in the gut are critical for human health and disease. Overcoming the limita- tions of culture based microbiology to study the ecology of the mainly anaerobic, culture recalcitrant and fastidi- ous microorganisms present within the human gut, the post genomics technologies of metagenomics and metabolomics are revealing the intricate relationship between microbiota species architecture and metabolic out- put, and diverse host physiological functions linked to health and chronic non-communicable diseases. The gut microbiota is now emerging as an important metabolic and immunological organ in its own right, rivalling (and overcoming) the liver in metabolic diversity and activity, and playing a key role in immune education and homeostasis. This newly recognised metabolic and immunologically paramount organ is closely linked to other bodily systems, including adipose tissue, muscle, and even the brain, through the flux of metabolites produced in, and absorbed from, the gut. Indeed, the gut:brain axis is currently receiving much attention not only for its role in regulating satiety and whole body energy balance, but also for its involvement in regulating brain devel- opment, neurological diseases including autism, depression and dementia, and even mood and sleep patterns. We now know that aberrant microbiota profiles and/or metabolite production are associated with a range of chronic diseases characterised by loss of metabolic homeostasis and unresolved systemic inflammation, including the diseases of obesity, diabetes (type 1 and 2), metabolic syndrome, non-alcoholic fatty liver disease, as well as some cancers, especially colon cancer, and many autoimmune diseases, where unresolved inflammation is thought to contribute to autoantibody formation and trigger disease. While the gut microbiota have been impli- cated in the production of toxic compounds or in the activation of pro-carginogens ingested with food (e.g. cooked food mutagens, xenobiotics and mycotoxins), many microbial metabolites including breakdown products derived by plant polyphenols, short chain fatty acids, deconjugated bile acids returning from the gut via the enterohepatic circulation, and B vitamins produced by bifidobacteria are emerging as key beneficial mediators of human cellular activity throughout the body. These metabolites, which comprise in large part the metabolic flux from the colonic microbiota, have been implicated in regulating glucose and fat uptake and metabolism, energy storage, thermogenesis, host hormone secretion, inflammatory molecule production, and epigenetic processes via histone deacetylase inhibition on the one hand and acetylation and methylation, on the other. In this framework of harmful or beneficial bio-activation of dietary components exerted by the gut microbiota, the emerging remarkable variability in its composition helps explaining the parallel variability observed in the way we react to food intake. Our ability to obtain the maximum benefit from a healthy diet derives not only from our genes, but also from the presence or absence of specific microbial species in our gut. Moreover, it appears that our nutri- tionalanthropology plays an important role in shaping not only the relative abundanceof the gut bacteria or also apparently microbiota composition. Distinct microbiome profiles in distinct populations from diverse corners of the world and accustomed to very different foods, diets and life-styles highlight the need to act quickly to pre- serve the natural history of our gut microbiota before the onslaught of dietary globalization, bereft of safe micro- bial “passengers” and denuded of fibers, prebiotics and plant polyphenols. Indeed, processes within the gut or rather at the gut wall appear to play a critical role in the persistent low grade systemic inflammation characteristic of many chronic human diseases, especially those associated with modern diet and life-styles. Increased intestinal permeability leads to translocation of inflammatory molecules such as lipopolysaccharide across the gut wall, which then act as continuous triggers for low level systemic inflammation. This gut leakiness appears to be strongly influenced by diet, especially high fat - low fiber modern or Western style at one extreme contributing to gut wall permeability, and ancestral or traditional dietary pat- terns such as the Mediterranean diet, high in fermentable fiber, prebiotics, fruit and vegetables (and indeed cer- tain probiotic or fermentative microorganisms) at the other, supporting gut barrier function. Bifidobacteria, lactobacilli, SCFA and bile acid metabolism have been shown to regulate expression of tight junction proteins between intestinal epithelial cells and reduce gut permeability. Similarly gut inflammation and oxidative damage play their part and are intricately regulated by diet:microbe interactions within the intestine. Indeed, this process strongly mirrors the gut leakiness and low grade chronic inflammation characteristic of old age, and at least in ix