Gut Microbiota Resilience: Definition, Link to Health and Strategies for Intervention

Abstract

The gut microbiota is a new frontier in health and disease. Not only many diseases are associated with perturbed microbiota, but an increasing number of studies point to a cause-effect relationship. Defining a healthy microbiota is not possible at the current state of our knowledge mostly because of high interindividual variability. A resilient microbiota could be used as surrogate for healthy microbiota. In addition, the gut microbiota is an "organ" with frontline exposure to environmental changes and insults. During the lifetime of an individual, it is exposed to challenges such as unhealthy diet, medications and infections. Impaired ability to bounce back to the pre-challenge baseline may lead to dysbiosis. It is therefore legitimate to postulate that maintaining a resilient microbiota may be important for health. Here we review the concept of resilience, what is known about the characteristics of a resilient microbiota, and how to assess microbiota resilience experimentally using a model of high fat diet challenge in humans. Interventions to maintain microbiota resilience can be guided by the knowledge of what microbial species or functions are perturbed by challenges, and designed to replace diminished species with probiotics, when available, or boost them with prebiotics. Fibers with multiple structures and composition can also be used to increase microbiota diversity, a characteristic of the microbiota that may be associated with resilience. We finally discuss some open questions and knowledge gaps.

Keywords: fiber; health; microbiome; probiotic; resilience.

FIGURE 1

Conceptual illustration depicting the native state of an ecosystem, its perturbation, the possibility of returning to its original state or transitioning to a new state (alternative stable state) (inspired by Folke et al., 2004).

FIGURE 2

Conceptual illustration depicting the perturbation of the gut microbiota under stress. Resilience describes the capacity of an ecosystem to maintain its state or recover from disturbances. Resilience is determined by the capacity to reduce the impact (resistance) and to recover from the impact of disturbance (recovery) (Ingrisch and Bahn, 2018).