FOR MEDICAL COMMUNITY

KyberKompakt, KyberKompaktPRO and KyberBiom

Intestinal flora diagnostics as modular system

In diseases such as irritable bowel syndrome, inflammatory diseases or food allergies, the bacterial ecosystem in the intestine can be disturbed - with a serious impact on the patient. The intestinal flora does not only play a role in digestion but interplays with the mucosal immune system of the intestine - the center of immune defense. A modified intestinal flora can therefore contribute to an over- or under-reaction of the immune system.

The following diseases are associated with changes of the microbiota:

  • Atopic disorders such as neurodermatitis and pollinosis
  • food allergies
  • irritable bowel syndrome
  • chronic inflammatory bowel diseases
  • overweight, insulin resistance, type 2 diabetes mellitus
  • metabolic syndrome

For the prevention and therapy of these diseases a gut flora diagnostics is useful. It indicates bacterial marker organisms or bacterial keystone species, which are characteristic for the composition of the intestinal flora. This allows the detection of disturbances of the gut microbiota and thus the assessment of negative effects on the immune system, the mucosal integrity and the metabolic processes in the intestine. 

The results help to determine the causes or cofactors of numerous chronic diseases and allow an effective treatment.

An overview of microbial Kyber® diagnostics:


More information about functional groups and keystone species of the gut microbiota which are captured by the Kyber®diagnostics:


Protective Microbiota

The protective microbiota maintains colonisation resistence in the gut and prevents the settlement of unwelcome pathogens.

To the protective microbiota belong the genus of Lactobacillus, Bifidobacterium and Bacteroides.

The intestinal mucosa needs the protection by natural gut bacteria, because its total surface of about 600 m2 provides pathogens with a big target. The protective microbiota can inhibit the colonisation and growth of pathogens via several mechanisms.

The protective microbiota

  • inhibits the settlement of pathogens by occupying mucosal receptors.
  • competes with pathogenes for nutrients, vitamins and growth factors.
  • reduces PH value via acidic metabolic products such as acetic acid.
  • prevents a leaky gut by strengthening the tight junctions.

Lactic acid producing bacteria of the genera Lactobacillus and Bifidobacterium have additionally protective properties. They utilize carbohydrates from food and produce a large quantity of lactid acid at the same time.

Lactid acid acidify the intestinal milieu together with acetic acid and thus offer protection from pathogens. Because they can multiply poorly in the acidic range.

Besides, Lactobacilli can produce bactericidal substances such as bacteriocins and hydrogen peroxide (H2O2). So they inhibit the growth of pathogenss effectively.


Muco-nutritive Microbiota

The muco-nutritive microbiota supplies the intestinal mucosa with butyric acid, enhances their integrity and activates the regeneration of the intestinal mucus.

The gut mucosa has to cope with contrary tasks: On one hand it has to adsorp nutrients. on the other hand it has to reject undigested food components, toxins, allergens and pathogens, but also the natural microbiota. For this a continuously mucus layer covers the epithelium in healthy people.

The layer is divided in two: The more permeable outer mucus layer is an ideal habitat for the gut microbiota. In contrast, the tighter inner layer hardly contains any bacteria.

The intestinal mucus layer perform multiple tasks:

  • It moisturizes the epithelial surface and increases the lubricity of the chyme.
  • At the same time, it forms a barrier against unwanted substances and pathogens. Foreign matter the mucus can envelop, encapsulate and thus render it harmless.

The gut bacteria Akkermansia muciniphila and Faecalibacterium prausnitzii are jointly responsible for a tight inner mucus layer and an intact gut mucosa.

Akkermansia muciniphila lives in the outer mucus layer and uses the mucus as a source of nutrients. The bacterial mucus breakdown causes the goblet cells to produce constantly new mucus and hence to keep the mucus layer intact.

During mucus breakdown Akkermansia muciniphila produces oligosaccharides, acetic acid and propionic acid. With it Akkermansia provides vital nutrients for luminal gut bacteria such as Faecalibacterium prausnitzii. The fiber-degrading microbiota also produces oligosaccharides and acetic acid and therefort supports the growth of Faecalibacterium prausnitzii.

Faecalibacterium prausnitzii converts oligosaccharides and acetic acid into butyric acid - the main source of energy of the epithelial cells. In healthy people Faecalibacterium prausnitzii makes up to five percent of the microbial total cell count; actually it is viewed as most important butyric acid producer.

Butyric acid plays a key role for gut health. It covers up to 80 percent for the feeding of the gut mucosa and act mucosa protective. Besides, it has anti-inflammatory, anti-carcinogenic and anti-diabetogenic properties. The gut mucosa uses the energy provided by butyric acid for producing the protecting mucus.

 

In case of several diseases such as gastrointestinal infections, acute inflammation and chronic inflammtory bowel diseases the mucus layer is partly thinned out or has been lost totally. Studies have shown decreased cell numbers of Akkermansia muciniphila and Faecalibacterium prausnitzii during acute and chronic inflammatory processes in the gut.[1, 2]

When cell numbers of Akkermansia muciniphila and Faecalibacterium prausnitzii decrease, the supply of the gut mucosa with butyric acid is no longer sufficiently guaranteed. Therefore the mucus layer can get thinner or dissolve completely. Thereby allergens, environmental chemicals and the gut microbiota can not only reach the epithelium, but can partly penetrate into the gut mucosa.


Immunomodulating Microbiota

The immunomodulating mikcobiota is a constant training partner of the immune system. It is jointly responsible for a powerful immune system and a adequate immune tolerance.

An intact intestinal microbiota is the basis for a powerful immune system. About 80 percent of the acquired immunity base upon a contact between antigenes and immune structures in the gut (e.g. Peyer‘s plaques). The mucosa of the intestinal tract accommodates the biggest lymphocyte arsenal: No other immune organ of the body is able to induce the production of comparable amounts of antibodies.

Contact to gut bacteria can activate B lymphocytes. Then they migrate through the lymphatic system into the mesenteric lymph nodes and multiply there. Converted into antibody-secreting plasma cells they enter the bloodstream and spread on different mucosal areas throughout the body.

Most of the plasma cells return into the intestinal wall (plasma cellular homing). About 20 percent of the gut derriving B lymphocytes settle down as plasma cells in other mucosal areas such as mouth, nose and throat, the bronchi or the urogenital tract. There they start with the synthesis of immunoglobulin A, which the mucosa secrete as secretory immunoglobulin A (sIgA). With it the bacterial immune stimulation of the gut is transferred to all mucosal areas throughout the body and strengthens there the colonization resistance.

The immune cells do not only prevent the translocation of microorganism from the intestinal lumen into deeper tissue layers and into blood circulation. They also have important regulatory properties. With help of the microbiota the immune system learns to build up tolerance and to stop unnecessary reactions against harmless antigenes.

Today, due to the impoverishment of species in the gut the immune system often is not able to develop a sufficient immunotolerance. From farm studies, the lack of contact to bacteria has emerged as the most important environmental factor in the developement of allergies. The contact to bacteria can stimulate an immune response as in case of an infection, but without causing an infection. This directs the immune system in a direction of TH1-immune reaction and suppresses step-by-step the TH2-immune reaction, which is necessary for developing a tolerance.

Especially enterococci and E. coli work in this regard immunomodulatoric and serve as constant training partners to the immune system.


Proteolytic Microbiota

The proteolytic microbiota breaks down proteins and partly produces metabolic products which disturb digestion and burden the liver.

The most well known proteolytic bacteria are species of the genera Proteus, Klebsiella and Clostridium and some E. coli subspecies. But also many other bacteria of the gastrointestinal tract are capable of proteolysis. During breakdown of proteins, gut bacteria partly produce harmful metabolic products such as ammonia, sulfides and amines. [3] The substances can have a cytotoxic effect and burden the liver. They are also associated with emergence of colon carcinoma and chronic inflammatory bowel diseases. Generally, the diet should therefore not be permanently to meat-rich.

To which amount gut bacteria break down proteins depends on pH value. During alkaline pH (>7) the proteolytic enzymes are particularly active. Proteolysis produces once again alkaline products increasing the pH value further. During acidig pH (<6,5) the ammonium ion is present as ammonium salt. The intestinal epithelium can hardly absorb ammonium salt, therefore a large quantity is excreted in the faecesl. It must therefore be the goal to keep the stool in acidic range or to move it back there.


Yeasts and molds

Yeasts and molds can increase allergy tendencies and promote indigestion when occur in high cell numbers.

KyberMyk diagnostics detects fungus infections in the digestive tract. Small cell counts of fungi are not medically relevant, but in non-physiological amounts they can cause discomfort.

These include:

  • Watery diarrhea, often alternating with constipation
  • Meteorism, flatulence
  • Itching in the anal area
  • Anal eczema.

Besides, intestinal Mycoses promote vulvovaginal candidiasis and allergies.


PH value of the stool

The measurement of the degree of acidity (pH) gives a hint about enzymatic processes in the large intestine. Many processes depend on pH such as proteolysis which preferentially takes place in an alkaline environment. It results partly in harmful metabolic products.


Related diagnostics

KyberBiom®

KyberKompaktPRO Update with resilience index, additionally funktional groups and FODMAP type

Abdominal discomfort

The biochemical parameters of KyberPlus clarify the causes for unclear abdominal discomfort.