Gut Microbial Dysbiosis and Pharmacotherapy in Disorders of Gut Brain Interaction and Metabolic Disease: Unraveling the Context And/or Causality

Of all microorganisms in the human body, the largest and most complex population resides in the gut. The gut microbiota continuously adapts to the host environment and serves multiple critical functions for their hosts, including regulating host immunity, procuring energy from food, and preventing the colonization of pathogens. Functional gastrointestinal disorders are currently known as disorders of gut-brain interactions (DGBIs). DGBIs, for instance, irritable bowel syndrome (IBS), functional dyspepsia (FD), and gastroparesis, are common conditions needing referral to gastroenterology clinics and are also highly prevalent in the community. Furthermore, more than half of diabetic patients are also diagnosed with DGBI. Proof of concept studies directly connected metabolic and DGBIs through microbial dysbiosis. Moreover, recent state-of-the-art studies noted intestinal barrier dysfunction (leaky gut), brought about by gut microbial dysbiosis, is a core pathophysiological mechanism for DGBIs and metabolic disease. Current research has focused on discovering associations between these disorders and gut microbial dysbiosis; however, whether these associations are a consequence or cause is still mostly unexplored. Accumulating evidence has noted how gut microbes communicate with our body systems through microbiota-derived molecules and how they are able to modulate host physiology. Gut microbiota-directed therapeutic intervention is an area of immense scientific interest. The current knowledge gaps warrant a modern approach for a holistic view to characterize patients with DGBIs linked with metabolic manifestations based on the multi-omic data from the gut microbiome, metabolome, transcriptome, host epigenome, and dietary profiles. Integrating these factors with physiological changes will enable us to develop targeted approaches to treat the patients, relieving symptoms and restoring gut and glucose homeostasis.

We welcome submission of all article types (full-length reviews/original research/editorials) to contribute the field with latest discoveries and clinical insights and perspectives on gut microbial dysbiosis and pharmacotherapy in DGBIs (Gastroparesis, irritable bowel syndrome, functional dyspepsia, slow transit constipation) and metabolic disorders (diabetes and obesity). The proposed topic would fuel the conception and realization of pathophysiological mechanisms and therapeutic clues to improve the management and clinical care of DGBIs and metabolic disorders. We hope that this Research Topic will entice many researchers to investigate the mechanistic and functional implications of the host-gut microbiota interactions in health and disease. The goal and sub-themes of this Research Topic are to address several outstanding questions in the field, which include, but are not limited to:

1. To unravel the pathophysiological mechanisms of DGBIs and diabetes mediated by gut microbiota dysbiosis

2. Despite gut microbiota having an essential role in health, its precise functions in these disorders are cloudy. Given the fact that the gut microbiome varies between person, race, ethnicity, nationality, and even neighboring communities, what constitutes a healthy microbiome? Furthermore, how do the host-cells and gut microbiome interactions modulate these physiological and pathophysiological mechanisms?

3. Current challenges of microbiome-based therapies

4. Post-infection DGBIs: Underpinning the symptoms and pathophysiology