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Published on: July 31, 2019
Herbal medicines modulate gut microbiota in metabolic diseases: a review
Xin Lan1, Yuankui Wei2, Yuanyu Zhao1
1Department of Pathology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China.
Background:
Metabolic diseases-including obesity, type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD)-affect over 1 billion individuals globally and are characterized by insulin resistance, chronic inflammation, and gut microbiota dysbiosis. Herbal medicines offer multi-component therapeutic potential through microbiota modulation, but mechanistic insights remain fragmented.
Objective:
This review synthesizes recent advances in herbal medicine-mediated gut microbiota regulation in metabolic diseases and delineates underlying molecular mechanisms.
Methods:
A comprehensive literature search was conducted across PubMed and Web of Science. Search strategies employed MeSH terms and free-text keywords encompassing herbal medicines, gut microbiota, and metabolic diseases. Two authors performed study selection and data extraction. Evidence synthesis was structured according to intervention type and metabolic disease category.
Results:
Herbal polysaccharides and other compounds consistently increased beneficial bacteria and promoted short-chain fatty acids (SCFAs) production, improving intestinal barrier integrity via ZO-1/Occludin upregulation and attenuating TLR4/NF-κB-mediated inflammation. Herbal formulations exerted synergistic effects by remodeling microbial community structure, correcting SCFA/bile acid imbalances, and activating IRS1/PI3K/AKT insulin signaling. Notably, Lactobacillus and Akkermansia emerged as recurrent beneficial targets across multiple herbal interventions. However, evidence is predominantly preclinical, and translational validity to humans requires further validation.
Conclusion:
Herbal medicines ameliorate metabolic diseases through multi-target gut microbiota modulation, involving SCFA production, bile acid metabolism, and inflammatory pathway attenuation. These mechanistic insights support the development of microbiota-targeted herbal therapeutics, though clinical translation necessitates standardized formulations and rigorous human trials.
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