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Metabolic Disease Puts Up a Fight: Microbes, metabolism and medications

Nature Medicine volume 19, pages 1218–1219 (2013)Cite this article

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The key role of intestinal flora, also known as the gut microbiome, in human health has long been established; it serves as a mucosal barrier, contributes to immune function and affects epithelial growth and differentiation. The gut flora also have metabolic homeostatic functions that involve fermentation of undigested residues that lead to recovery of metabolic energy as well as generation of short-chain fatty acids that may serve as metabolic substrates for the host1. However, potential effects on host metabolism have only recently received attention2.

A crucial study stimulating interest in the gut microbiome in metabolic disease showed that the mouse gut flora can be 'humanized' through fecal transplants and fecal flora from subjects consuming high-fat diets, promoting obesity3. Although the overall composition of the human intestinal flora is relatively stable in a given healthy individual eating a constant diet4, there are regional population differences5, and, thus far, no particular human population seems resistant to obesity once excess calories become available. Furthermore, the actual contribution of nutrients metabolized by intestinal flora to total host caloric input is not known, and mass and composition of the human gut microbiome is difficult to estimate. Despite these unknowns, the mutualistic interaction of gut flora and humans is clearly important for the host metabolism.

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Figure 1: Metabolic effects of metformin in the host and gut microbiota.

Katie Vicari

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  1. Eleftheria Maratos-Flier is at the Department of Medicine, Division of Endocrinology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,

    Eleftheria Maratos-Flier

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  1. Eleftheria Maratos-Flier
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Correspondence to Eleftheria Maratos-Flier.

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Maratos-Flier, E. Metabolic Disease Puts Up a Fight: Microbes, metabolism and medications. Nat Med 19, 1218–1219 (2013). https://doi.org/10.1038/nm.3373

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