Propiyonik ve Metilmalonik Asidemide Bağırsak Mikrobiyotasının Etkisi

Abstract

Propionik ve metilmalonik asidemi (PA/MMA), propionil CoA ve/veya metilmalonil CoA birikimi ile karakterize, ciddi metabolik krizlere ve klinik komplikasyonlara neden olan kalıtsal metabolik hastalıklardır. Toplam propionat üretiminin önemli bir kısımı bağırsak mikrobiyotasında olmaktadır ve bu durum da bağırsak mikrobiyotasını modifiye edilebilir bir hedef olarak belirlenmiştir. Propionat üretimini azaltmak için oral antibiyotiklerin kullanımı yaygın bir yaklaşımdır ancak uzun dönem antibiyotik kullanımı hastalarda antibiyotiğe karşı direnç gösteren suşların oluşumuna, normal bağırsak mikrobiyotasının bozulmasına ve santral sinir sistemi toksititesine sebep olabileceği de unutulmamalıdır. Kabızlık, bu hasta popülasyonunda kronik bir sorundur ve propionat üretimini etkileyebilir. Propionat yükünü azaltan ve bu klinik sorunları ele alan daha yeni ve etkili hastalık yönetim tekniklerine ihtiyaç vardır. Bu derleme, PA/MMA'da bağırsakla ilgili faktörlerin potansiyel katkısını özetlemekte ve bir yönetim yaklaşımı olarak bağırsak mikrobiyotasını modifiye etmeyi ele almaktadır.

Keywords

• Propiyonik asidemi
• Metilmalonik asidemi
• Mikrobiyota

Effect of Gut Microbiota on Propionic and Methylmalonic Acidemia

Abstract

Propionic and methylmalonic acidemias (PA/MMA) are inherited metabolic disorders characterized by the accumulation of propionyl CoA and/or methylmalonyl CoA, leading to severe metabolic crises and clinical complications. A significant proportion of total propionate production occurs in the gut microbiota and therefore the gut microbiota has been identified as a modifiable target. The use of oral antibiotics to reduce propionate production is a common approach, but it should be noted that long-term antibiotic use can lead to the formation of antibiotic-resistant strains in patients, disruption of the normal gut microbiota, and central nervous system toxicity. Constipation is a chronic problem in this patient population and can interfere with propionate production. New and more effective disease management approaches are needed to reduce the propionate burden and address these clinical issues. This review summarizes the potential contribution of gut-related factors in PA/MMA and addresses gut microbiota modification as a management approach.

Keywords

• Propionic acidemia
• methylmalonic acidemia
• microbiota

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