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      Is Open Access

      Gut Frailty: Its Concept and Pathogenesis

      review-article
      Digestion
      S. Karger AG
      Aging, Gut frailty, Izumo Scale, Longevity, Well-being

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          Abstract

          Background

          There is still a considerable gap between average life expectancy and healthy life expectancy in Japan. Recent research has revealed that gut frailty may be a worsening factor for various diseases, a cause of chronic inflammation, and a precursor to frailty.

          Summary

          Among self-reported symptoms, constipation is particularly significant as one of the key symptoms of gut frailty. Studies have demonstrated that individuals with constipation have significantly lower survival rates and are also at a higher risk of developing various diseases such as chronic kidney disease, cardiovascular diseases, and neurodegenerative disorders like Parkinson’s disease. Various molecular mechanisms could contribute to gut frailty, and the decrease in mucus secretion is an extremely early-stage pathology. Dysbiosis of gut microbiota has a major impact on many conditions associated with gut frailty. Prebiotics, probiotics, post-biotics, and fecal microbiota transplantation are under investigation as a treatment option for gut frailty.

          Key Message

          Although the concept of gut frailty has not yet gained widespread recognition, we hope to propose more practical screening methods, diagnostic approaches, and specific interventions in the future.

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          Most cited references31

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          Frailty in Older Adults: Evidence for a Phenotype

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            Gut Microbiota in Patients With Irritable Bowel Syndrome—A Systematic Review

            Irritable bowel syndrome (IBS) is common but difficult to treat. Altering the gut microbiota has been proposed as a strategy for treatment of IBS, but the association between the gut microbiome and IBS symptoms has not been well established. We performed a systematic review to explore evidence for this association.
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              Gut microbiome pattern reflects healthy aging and predicts survival in humans

              The gut microbiome has important effects on human health, yet its importance in human aging remains unclear. Here we demonstrate that, starting in mid-to-late adulthood, gut microbiomes become increasingly unique to individuals with age. We leverage three independent cohorts comprising over 9000 individuals and find that compositional uniqueness is strongly associated with microbially produced amino acid derivatives circulating in the bloodstream. In older age (over ~80 years), healthy individuals show continued microbial drift toward a unique compositional state, whereas this drift is absent in less healthy individuals. The identified microbiome pattern of healthy aging is characterized by a depletion of core genera found across most humans, primarily Bacteroides . Retaining a high Bacteroides dominance into older age, or having a low gut microbiome uniqueness measure, predicts decreased survival in a four-year follow-up. Our analysis identifies increasing compositional uniqueness of the gut microbiome as a component of healthy aging, which is characterized by distinct microbial metabolic outputs in the blood.
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                Author and article information

                Journal
                Digestion
                Digestion
                DIG
                DIG
                Digestion
                S. Karger AG (Basel, Switzerland )
                0012-2823
                1421-9867
                15 November 2023
                January 2024
                : 105
                : 1
                : 49-57
                Affiliations
                [1]Human Immunology and Nutrition Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
                Author notes
                Correspondence to: Yuji Naito, ynaito@ 123456koto.kpu-m.ac.jp
                Article
                534733
                10.1159/000534733
                10777716
                37967548
                d5eaeaef-9241-4736-8210-5d3eb67b3d5a
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ( http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                History
                : 9 July 2023
                : 18 October 2023
                : 2024
                Page count
                Figures: 2, Tables: 2, References: 32, Pages: 9
                Funding
                This work was partly supported by MAFF Commissioned project study on “Project for the realization of foods and dietary habits to extend healthy life expectancy” allotted to Y.N. (Grant No. JPJ009842), and partly supported by COI-NEXT, JST Grant No. JPMJPF2210.
                Categories
                Review

                aging,gut frailty,izumo scale,longevity,well-being
                aging, gut frailty, izumo scale, longevity, well-being

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