The role of gut microbiota in treatment and prevention of metabolic inflammation. Review

At the present stage, the gut microbiota is regarded as a complex ecosystem that performs a number of essential functions within the human body. Disruption of its quantitative and qualitative composition leads to dysfunction not only of the digestive organs, but also of other systems and the organism as a whole, resulting in the development of various pathologies. The mechanisms by which gut dysbiosis influences the development of cardiometabolic diseases involve the impairment of intestinal mucosal integrity, which facilitates the translocation of gut microbiota into the bloodstream and the activation of specific receptors. Additionally, various microbial metabolites contribute to the development of inflammatory processes, endotoxemia, and dysregulation of immune responses. Most researchers consider gut dysbiosis to be a trigger for the onset and progression of metabolic inflammation, which is associated with obesity and related conditions such as metabolic syndrome, type 2 diabetes mellitus, and metabolic‑associated fatty liver disease. The interaction between the gut microbiota, the immune system, and metabolic processes is regarded as a key factor in the pathophysiology of these disorders. Current approaches to the prevention and treatment of metabolic inflammation that target the gut microbiota and its metabolites include dietary interventions, lifestyle modifications, and the use of probiotics, prebiotics, or synbiotics. However, the mechanisms regulating metabolic processes in the macroorganism, as well as the clinical effects and application features of these interventions in patients with metabolic diseases — particularly obesity, metabolic syndrome, type 2 diabetes mellitus, and metabolic‑associated fatty liver disease — require further investigation and discussion.