Gut Bacteria Changes May Affect Eye Disease in Diabetes

Scientists are finding that the tiny bugs in our gut might play a role in diabetic retinopathy, a serious eye problem for people with diabetes. Changes in gut bacteria could affect eye health.
By Newsroom | Health, Science |

New research suggests a connection between the health of gut bacteria and the worsening of diabetic retinopathy, a major cause of vision loss in people with diabetes. Investigations point to specific changes in gut bacteria and their byproducts as potential indicators and contributors to the disease.

Gut Microbiota Dysbiosis is a Factor in Diabetic Retinopathy - European Medical Journal - 1

The Gut-Eye Connection: A Growing Area of Study

Diabetic retinopathy (DR) is a serious complication of diabetes that affects the eyes. It happens when high blood sugar levels damage the blood vessels in the retina, the light-sensitive tissue at the back of the eye. This damage can lead to vision loss.

Gut Microbiota Dysbiosis is a Factor in Diabetic Retinopathy - European Medical Journal - 2

Recent scientific interest has focused on a potential link between the gut microbiome—the community of bacteria and other microbes living in our intestines—and the development and progression of diabetic retinopathy. This connection is often referred to as the "gut-eye axis."

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Gut Microbiota Dysbiosis is a Factor in Diabetic Retinopathy - European Medical Journal - 3

Evidence of Gut Microbiota Alterations in Diabetic Retinopathy

Several studies indicate that people with diabetic retinopathy may have different gut bacteria compositions compared to those without the condition.

Gut Microbiota Dysbiosis is a Factor in Diabetic Retinopathy - European Medical Journal - 4

  • Changes in bacterial profiles: Research has observed distinct differences in the types and amounts of gut bacteria found in individuals with type 2 diabetes and diabetic retinopathy when compared to those without DR or to healthy individuals. This suggests that the gut environment is altered in the context of this eye disease.

  • Inflammation as a key factor: Inflammation is widely recognized as a central player in diabetes-related eye conditions like retinopathy. Disruptions in the gut microbiota, known as dysbiosis, are thought to contribute to and exacerbate this inflammation.

  • Specific metabolites are implicated: Studies have identified that certain substances produced by gut bacteria, such as indolepropionic acid (IPA), may play a role. In individuals with type 2 diabetes, reduced absorption of tryptophan, an amino acid vital for healthy gut bacteria, can lead to lower levels of protective metabolites like IPA.

Investigating the Mechanisms: What is Dysbiosis?

Gut dysbiosis refers to an imbalance in the gut microbial community. This imbalance can have widespread effects on overall health.

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  • Weakening the gut barrier: Some types of gut bacteria can damage the lining of the intestines, weakening the gut barrier. This weakened barrier might allow harmful substances to enter the bloodstream, potentially triggering or worsening inflammation throughout the body, including in the eyes.

  • Reduced protective compounds: An unhealthy gut microbiome may produce fewer beneficial compounds. This depletes the body's natural defenses and can promote disease progression.

  • Targeting the imbalance: The concept of dysbiosis suggests that restoring a healthier balance of gut bacteria, perhaps through probiotics or other interventions, could be a way to support gut health and potentially influence the course of diabetic retinopathy.

The Role of Tryptophan and Metabolites

One area of focus is the metabolism of tryptophan, an essential amino acid.

  • Tryptophan's importance: Tryptophan is crucial for various bodily functions and for maintaining a healthy gut microbiome.

  • Impaired absorption in diabetes: In people with type 2 diabetes, the intestines may not absorb tryptophan as effectively. This reduces the availability of this important nutrient for gut bacteria.

  • Biomarker potential: Lower levels of circulating IPA, a metabolite derived from tryptophan by gut bacteria, have been observed and may serve as a biomarker for diabetic retinopathy in individuals with type 2 diabetes. This suggests a measurable link between gut activity and the eye condition.

  • Preventing or reversing damage: Research indicates that restoring tryptophan metabolism in the gut microbiome could potentially prevent or even reverse some of the damage associated with diabetic retinopathy.

Current Knowledge and Future Directions

The precise ways in which gut microbiota changes affect diabetic retinopathy are still being explored.

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  • Inconsistent findings: While many studies point to a link, there can be some variation in the specific gut bacteria identified as being altered in different patient groups. This highlights the complexity of the gut microbiome and its interactions with disease.

  • Therapeutic potential: The growing understanding of the gut-eye axis presents new possibilities for treatment. Targeting the gut microbiome could become a complementary strategy alongside existing treatments for diabetic retinopathy.

  • Further research needed: Continued investigation is required to fully unravel the causal relationships and to develop effective and reliable therapeutic interventions based on modulating the gut microbiome.

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Frequently Asked Questions

Q: What is diabetic retinopathy?
It is a problem with the eyes that can happen when people with diabetes have high blood sugar for a long time. It damages the blood vessels in the eye.
Q: How might gut bacteria be linked to this eye problem?
Some studies show that people with diabetic retinopathy have different gut bacteria. These bacteria can cause swelling in the body, which might also affect the eyes.
Q: What is gut dysbiosis?
Gut dysbiosis means the bacteria in your gut are not balanced. This imbalance can cause health problems.
Q: Could changing gut bacteria help?
Scientists are studying if helping the gut bacteria get back into balance could help with diabetic retinopathy. This might be a new way to help protect vision.