Due to differences in dietary fats in the western world in the United States versus Europe [22], it is likely that the diet-induced changes in intestinal microbiota composition could partly explain the controversy regarding, e.g. the Firmicutes/Bacteroidetes ratio in humans [4, 14]. Nevertheless, Hydroxychloroquine solubility dmso it is now accepted that intestinal microbiota are involved in obesity, as germ-free ob/ob mice on both normal chow and high-fat diets remain

significantly leaner than conventionally raised mice, despite a significantly higher food intake [23]. In line with this, metagenomic sequencing of the caecum microbiome of these ob/ob mice revealed that an enrichment of genes was involved in the breakdown

of complex dietary polysaccharides [18]. Similar alterations showing enriched bacterial genes involved in carbohydrate sensing and degradation have also been observed in obese humans [24]. Studying intestinal microbial composition in well-phenotyped human subjects enrolled in relatively large metagenome-wide association studies (MGWAS) in both Chinese and European populations has further increased our understanding of the gut microbiota in the development of obesity and insulin resistance [25-27]. Karlsson et al. detected an enrichment of L. gasseri and S. mutans (both Palbociclib in vitro commensal bacteria in the mouth and upper intestinal tract) to predict development of insulin resistance in their cohort of postmenopausal obese Caucasian females [26]. Conversely, Qin et al.’s Chinese T2DM cohort demonstrated that Escherichia coli, a Gram-negative Cediranib (AZD2171) bacterium which is associated with development of low-grade endotoxaemia, was more abundant. Moreover, clusters of genomic sequences acted as the database signatures for specific groups of bacteria and both studies found independently that subjects with T2DM were characterized by decreased

short chain fatty acid (SCFA) butyrate-producing Clostridiales bacteria (Roseburia and F. prausnitzii), and greater amounts of non-butyrate producing Clostridiales and pathogens such as C. clostridioforme, underscoring a potential unifying pathophysiological mechanism. It has long been recognized that insulin resistance and development of type 2 diabetes are characterized by systemic and adipose inflammation [19, 28]. The lipopolysaccharides (LPS) produced in the intestine due to the lysis of Gram-negative bacteria triggers proinflammatory cytokines that result in insulin resistance both in mice [5] and humans [29]. A more causal role was defined when germ-free mice were colonized with E. coli, as this promoted macrophage accumulation and up-regulation of proinflammatory cytokines resulting in low-grade inflammation [30].