Prebiotic and probiotic Role in Menopause-Related Diseases
The human microbiota is a complex community that exists in a mutually beneficial relationship with its host. Menopause is associated with dysbiosis, and changes in the microflora composition of different sites (gut, vagina, and oral cavity) may play a role in menopause-related diseases (such as osteoporosis, breast cancer, endometrial hyperplasia, periodontitis, and cardiometabolic disease). play a role in the pathogenesis of disease).
The critical role of the microbiota in postmenopausal women's health, in particular its (a) ability to increase intestinal calcium absorption thereby preventing osteoporosis, (b) associated with reduced risk of breast cancer and type 1 endometrial hyperplasia risk, (c) reduced gingival inflammation and menopausal periodontitis, and (d) beneficial effects on multiple cardiometabolic risk factors (i.e. obesity, inflammation, glucose and lipid metabolism). However, whether oral probiotic supplementation can be used to treat menopause-related dysbiosis still needs further elucidation.
The microbiota is made up of microorganisms (bacteria, fungi and viruses) that live inside and outside the body. In the gut, microbial species live in harmony with the host, helping to (1) increase the metabolic capacity to ferment indigestible carbohydrates; (2) produce vitamins, namely B2, B12, K, and folic acid; (3) prevent colonization by pathogenic bacteria; and (4) promote the normal development of immune cell maturation and function, and inhibit toxins and carcinogens. According to microbial classification at the phylum level, the following gut bacteria have been identified: Firmicutes (60%-80%, i.e. Ruminococcus, Clostridium, Lactobacillus, Enterococcus), Bacteroidetes (20% -30%, i.e. Bacteroides, Prevotella, Xylanibacter), Actinomycetes (less than 10%, i.e. Bifidobacterium) and Proteobacteria (less than 1%, i.e. Escherichia , Enterobacteriaceae). However, the composition of the gut microbiota may vary according to host-related factors (age, sex, latitude, race, disease), lifestyle (physical activity, habitual diet, use of probiotics and/or probiotics) and Changes in antibiotic therapy. Dramatic changes in the composition of the gut microbiota—the so-called dysbiosis—are thought to be a major cause of several diseases, such as asthma, eczema, obesity, type 2 diabetes, nonalcoholic fatty liver disease, colon cancer, Heart disease and neurological or neuropsychiatric disease. Among the factors influencing the composition of the gut microbiota, the role of gender and sex hormones has not been fully studied.
Accumulating evidence suggests that sex and sex hormones may play key roles in modulating human responses to external factors through differential effects on the microbiota. For example, in the study by Org et al., male and female mice showed striking differences in the abundance of several microbial species. Interestingly, this sex-associated composition of the microbiota explained variability in the metabolic response of mice to a high-fat, high-sucrose diet for 8 weeks. Furthermore, to determine whether these findings were mediated by sex hormones, gonadectomized and hormone-treated mice were fed the same diet. The results showed that male hormonal status had a greater effect on microbiota composition in males fed a normal diet, while this effect was more pronounced in females fed a high-fat diet. Thus, these experiments highlight the role of sex in targeting gut microbiota composition and response to dietary interventions.
In other studies, estrogen has been shown to affect the gut microbiota, which in turn can significantly affect estrogen levels. Indeed, some microbial species (also known as estrabolome) can regulate circulating estrogen by secreting β-glucuronidase, a bacterial enzyme that converts active forms of estrogen and Phytoestrogens uncouple so that they can be reabsorbed in the gut and enter the bloodstream (the blood that circulates in the body).
Dysbiosis can reduce the estrabolome, whereby estrogens and phytoestrogens uncouple into their circulating active forms and impair estrogen receptor activation. This condition can predispose to diseases such as polycystic ovary syndrome (PCOS), obesity and obesity-related metabolic diseases, cardiovascular disease (CVD), cognitive decline, type 1 endometrial hyperplasia, and endometrial cancer and breast cancer (BC). In addition, estrogen regulates the microbial environment of the female reproductive tract by maintaining epithelial thickness, glycogen levels, mucus secretion, and lowering vaginal pH by promoting Lactobacillus colonization and lactic acid production. Thus, during menopause, the abundance of vaginal Lactobacilli decreases in response to hormonal and epithelial changes. Finally, in the normal female life cycle, menopause is marked by a dramatic decrease in estrogen and other female sex hormones. Overall, this evidence suggests that the composition of the microbiota may play a key role in the development or progression of certain menopause-associated clinical diseases.
Therefore, the aim of this review is to review the relationship between microbial dysbiosis and the most common menopause-related diseases (postmenopausal osteoporosis, BC, endometrial hyperplasia, periodontitis, obesity and cardiovascular disease). In addition, the evidence on the effect of Prebiotic and probiotic supplementation in postmenopausal women is discussed to assess whether probiotic supplementation can be used as a therapeutic strategy for the prevention/treatment of menopause-related diseases.
Source of this artical:
Curr Nutr Rep. 2023 Mar;12(1):83-97. doi: 10.1007/s13668-023-00462-3. Epub 2023 Feb 7. PMID: 36746877; PMCID: PMC9974675.(IF:4.9, 中科院2区).