Penghambat Alfa-Glukosidase: Keterkaitan Antara Mikrobiota Usus dan Regulasi Imunitas Mukosal

Gut microbiotas play an important role in maintaining mucosal immune homeostasis through metabolite production and preservation of epithelial barrier integrity. Alpha-glucosidase inhibitors (AGIs), such as acarbose and voglibose, may modulate the gut microbiota by increasing carbohydrate substrate availability in the distal intestine. This narrative review discusses the relationship between alpha-glucosidase inhibition, gut microbiota alterations, and mucosal immune regulation. The main topics include short-chain fatty acids (SCFAs), intestinal barrier function, macrophage responses, and the balance between regulatory T cells (Tregs) and Th17 cells. Tryptophan-derived metabolites and bile acids are also considered as potential pathways involved in immune regulation. Preclinical evidence suggests associations between AGI administration, changes in microbial metabolites, and improvements in inflammatory parameters. However, the causal contributions of these pathways, particularly to the intestinal Th1/Treg balance, remain insufficiently established and require further investigation.