Microflora of GIT

Dr S Gokhale
 Let’s play with numbers
• Microorganisms that live in the digestive
tract.
• Human body – 10 trillion cells
• No of organisms 10 times the cells
• Gut flora genes=human genomeX100
• Anerobes 99%
• Microflora – forgotten organ
• 60% of dry mass of feces made
by bacteria
• 300-1000 different species
• 99% of all bacteria from 30-40
species
• Fungi and protozoa??????
 Who are these?
• Not all identified/cultured
• Bacteroides 30%
• Clostridium, Fusobacterium, Eubacterium,
Bifidobacterium
• Ruminococcus, Peptococcus,
Peptostreptococcus,
• Esch coli, Lactobacilli
• Candida, Saccharomyces, Aspergillus, Penicillium
 Relationship

• Commensal
• Mutualistic
 Functions
• Fermentation, absorption
• Trg immune system
• Preventing pathogen growth
• Regulating development of gut
• Vitamin production – biotin, vit K
• Hormones to direct fat storage
Predicting human gut microflora
• Geographical variation
• Fairly constant within an
individual
• Changes with life style, diet,
medication, age
 The downside

• Infection
• Cancer risk
 How do we acquire it?
• Fetus – sterile
• Infant – from vagina, maternal feces, air,
handlers
• Vaginal birth – 1 month
• Cesarean section – 6 months to
establish flora
• Oral and cutaneous flora of mother –
suckling, kissing, caressing
 Infant
• Initial - E coli
• Produce reducing environment – promote
anerobes
• Bifidobacterial growth factor in breast milk –
promote bifidobacter, Ruminococcus,
bacteroides, clostridia
• Formula fed infants – Enterobacteriaceae,
enterococci, bacteroides, clostridia
 Functions
• Carb fermentation and absorption
• Starches, fiber, ologosaccharides –
broken down
• Oligosaccharides metabolism (beans) –
flatulence
• Enhance absorption and storage of
lipids and vit K
• Saccharolytic fermentation (conversion
to short chain fatty acids) – acetic acid,
propionic acid, butyric acid – energy
source, help absorb minerals Ca, Mg, Fe.
• Acetic acid – used by muscles
• Propionic acid – produces ATP in liver
• Butyric acid – energy to gut cells,
prevents cancer
• Flora increases water absorption
• Competitive exclusion- reduces
pathogenic microorg
• Stimulates growth of indigenous
flora
 The downside

• Proteolytic fermentation
• Produces toxins and carcinogens
• Low protein- low toxins
 Trophic effects
• Increases growth of intestinal
epithelium
• Controls proliferation and
differentiation
• Promotes growth of GALT
• Alter expression of cell surface proteins
as Na/glucose transporters
 Competitive exclusion

• Physical occupation
• Attaching to epithelium
• Competing for nutrition
• Bacteriocin production
• pH manipulation
 Gut immunity
• Early development of GALT
• Training of GALT – tolerance
• Expression of Toll like receptors (TLR) – help
repair the damage by radiation etc
• TLR influence surface enterocytes, M cells
and Dendritic cells
• TLR regulate inflammatory molecule
production
• Establish oral tolerance
 Preventing allergy
• High C difficile and S aureus in gut
associated with more allergies
• Hyper reaction to allergens
• Bacteroides and Bifidobacterium –
less allergies
 Inflammatory bowel disease
• Linked to “More hygienic” society, lack
of breast feeding, consumption of more
animal fat and sucrose
• Fruits, unprocessed food, vegetables
prevents IBD
• Probiotics helps in IBD
 Metabolic functions
• Intestinal epithelium development
and differentiation
• Fe, Mg, Ca, biotin and folate
absorption
• Metabolise dietary carcinogens like
heterocyclic amines (HCA)
 Translocation
• Overgrowth of commensals
• Immunosuppression
• Increased gut lining permeability
• Breach of mucosal layer
• Perforation
 Effects of antibiotics

• Broad spectrum antibiotics

• Affects digestion of food
• Antibiotic associated diarrhoea
(AAD)
• Allows pathogenic bacteria to
overgrow
• Produces antibiotic resistant strains
 Pharmabiotics
• Therapeutic exploitation of commensal flora
• Anti-inflammatory effect
• Prebiotics- dietary components help foster
growth of microbe
• Synbiotics – genetically modified commensals
• Used in IBD, atopy, infection, diarrhoea,
cancer, arthritis
• Stool transplantation therapy
 Further reading
• http://en.wikipedia.org/wiki/Gut_flora
• http://www.ncbi.nlm.nih.gov/pmc/articles/P
MC1500832/
• http://textbookofbacteriology.net/normalflora
.html