Medical Research on the gut microbiome has often been compared to the parable of the blind men and the elephant. Just as examining only an elephant’s tail reveals little about the entire animal, studying stool samples — the most accessible material — has overlooked crucial microbes in the small intestine. This is now changing.
Some scientists consider the microbiome, comprising tens of trillions of microorganisms living on and in the human body, as another human organ. These tiny sentinels protect body surfaces from pathogens and, in the upper intestine, aid in digestion, metabolism, and immunity. Technological advancements now enable us to explore the small intestine microbiome, offering new insights into disease understanding and treatment (1^✔ ✔Trusted Source
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Transformative Potential of Small Intestine Microbes

Certain small intestine microbes are associated with obesity, while others correlate with healthy metabolism. These microbes assist digestion by converting simple carbohydrates into essential building blocks for gut and overall health.

While the colon’s microbiome is known for fiber-derived metabolites, the small intestine produces distinct metabolites. Some of these regulate the production of GIP (Glucose-Dependent Insulinotropic Polypeptide), a hormone related to GLP-1 (Glucagon-Like Peptide-1). The synthetic GLP-1 is used in weight loss and type 2 diabetes drugs like Wegovy and Ozempic. Together with PYY (Peptide YY), these hormones play a critical role in managing appetite and blood sugar.

Mounjaro is a dual agonist for the glucose-dependent insulinotropic polypeptide (GIP) receptor and the glucagon-like peptide-1 (GLP-1) receptor. This dual mechanism is intended to enhance glycemic control in adults with type 2 diabetes mellitus, making it potentially more potent than other GLP-1 receptor agonists such as Wegovy (semaglutide) and Ozempic (semaglutide).

Beyond the Gut: Immune Implications

Disruptions in the small intestine microbiome have been linked to gut diseases such as irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Crohns disease, and Celiac disease. For instance, Celiac disease involves the microbiome’s reduced ability to digest gluten, while IBS and SIBO result from excessive fermentation of fibers and sugars. High FODMAP foods, such as wheat, garlic, onion, beans, and lactose-rich dairy, can exacerbate symptoms in those with SIBO and IBS.

The small intestine microbiome’s influence extends beyond metabolism and digestion. The gut lining hosts immune cells that monitor microbial and nutritional antigens. Compromises in these security systems may trigger autoimmune diseases by confusing the body’s immune responses.

Research has connected inflammatory changes in the small intestine microbiome to type 1 diabetes and the extra-intestinal symptoms of Celiac disease, where immune cells can cause damage in the eyes, skin, and joints.

Advances in Small Intestine Research

Historically, small intestine research has been slow, reliant on invasive procedures like upper endoscopies or surgeries creating direct access points. However, new technologies are revolutionizing this field. Camera capsules with fine filaments and devices that sample the gut non-invasively have greatly improved access to the small intestine. These advancements, akin to exploring the human body with “The Magic School Bus,” are revealing the microbiome’s hidden secrets.

Early therapies based on microbiome research include probiotics, fecal transplants, prebiotics, and fermented foods. Probiotics play a crucial role in health, disease prevention, and nutrition by promoting gut eubiosis, which can be disrupted by poor diet and antibiotics. They aid in treating GI disorders, infections, inflammatory diseases, obesity, and diabetes. Future research should use multidisciplinary approaches to enhance our understanding of the gut microbiome’s impact on health and disease, improving therapeutic and preventive strategies.

While these treatments are still developing, studying the small intestine microbiome holds promise for advancing therapeutic approaches. Potential future treatments may involve tailored prebiotics that prevents fermentation in the small intestine and specific bacterial partnerships to enhance gut health.

Understanding the complexities of the small intestine microbiome opens doors to novel therapeutic approaches and improved health outcomes.

Reference:

1. MOUNJARO- tirzepatide injection, solution – (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0)

Source-Medindia