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Nervenheilkunde 2022; 41(09): 601-608
DOI: 10.1055/a-1860-3282
Schwerpunkt

Die Bedeutung des Darm-Mikrobioms für die Alzheimer-Demenz

The importance of the gut microbiome for Alzheimer’s dementia
Georg Adler
1  
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ZUSAMMENFASSUNG

Hintergrund Unter dem Darm-Mikrobiom versteht man die Summe der Genome der Mikrobiota des menschlichen Darms. Die Bedeutung des Darm-Mikrobiota für Entwicklung, Verlauf und Behandlung der Alzheimer-Demenz hat in den vergangenen Jahren zunehmendes Interesse gefunden, sodass mittlerweile zahlreiche Untersuchungen zu diesem Thema publiziert wurden.

Ziel Darstellung des aktuellen Stands der Forschung zur Bedeutung des Darm-Mikrobioms für Entwicklung, Verlauf und Behandlung der Alzheimer-Demenz.

Ergebnisse und Diskussion Bei Patienten mit Alzheimer-Demenz wurden Veränderungen des Mikrobioms beschrieben, insbesondere eine Abnahme der Diversität sowie eine Zunahme bzw. Abnahme bestimmter Stämme und Klassen von Bakterien. Ähnliche Veränderungen fanden sich bei Diabetes mellitus und Übergewicht, bekannten Risikofaktoren für die Alzheimer-Demenz, sowie mit zunehmendem Lebensalter. Schließlich sind auch entzündliche Darmerkrankungen mit einem erhöhten Risiko für die Entwicklung einer Alzheimer-Demenz verbunden. Es gibt verschiedene Mechanismen, über die das Darm-Mikrobiom die Krankheitsprozesse, die der Alzheimer-Demenz zugrunde liegen, beeinflussen kann. Am besten belegt erscheint die Verstärkung von Entzündungsprozessen durch eine vermehrte Durchlässigkeit der Darmbarriere für entzündungsfördernde Bakterienmetabolite und -bestandteile. Diese Zusammenhänge haben schon Therapieversuche ausgelöst, die insbesondere mit Pro- und Präbiotika auf eine Modifikation des Darm-Mikrobioms abzielen.

ABSTRACT

Background The gut microbiome is the sum of the genomes of the microbiota of the human gut. The impact of the intestinal microbiota on the development, course and treatment of Alzheimer‘s dementia has attracted increasing interest in recent years, so that meanwhile numerous studies on this topic have been published.

Objective To outline the actual state of research on the impact of the gut microbiome for the development, course, and treatment of Alzheimer’s dementia.

Results and Discussion Changes of the gut microbiome have been described in patients with Alzheimer‘s dementia, in particular a reduction of diversity and an increase or decrease in certain phyla and genera of bacteria. Similar changes were found in diabetes mellitus and obesity, known risk factors for Alzheimer‘s dementia, and with increasing age. Furthermore, inflammatory bowel disease is associated with an increased risk of developing Alzheimer‘s dementia. There are various mechanisms through which the gut microbiome can influence the disease processes underlying Alzheimer‘s dementia. The intensification of inflammatory processes through increased permeability of the intestinal barrier for pro-inflammatory bacterial metabolites and components appears to be best documented. These connections have already stimulated various attempts for therapy, which aim to modify the intestinal microbiome in particular with probiotics and prebiotics.

SCHLÜSSELWÖRTER

Darm-Mikrobiom - Alzheimer-Demenz - Entzündung - Probiotika - Präbiotika

KEY WORDS

Gut microbiome - Alzheimer’s dementia - inflammation - probiotics - prebiotics


Publikationsverlauf

Artikel online veröffentlicht:
12. September 2022

© 2022. Thieme. All rights reserved.

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