The Effects of Pro-, Pre-, and Synbiotics on Muscle Wasting, a Systematic Review—Gut Permeability as Potential Treatment Target

• Main Authors: Sandra J. van Krimpen, Fleur A. C. Jansen, Veerle L. Ottenheim, Clara Belzer, Miranda van der Ende, Klaske van Norren
• Format: Article
• Language: English
• Published: MDPI AG 2021-03-01
• Series: Nutrients
• Subjects: muscle wasting; cachexia; sarcopenia; probiotics; prebiotics; <i>Lactobacillus</i>
• Online Access: https://www.mdpi.com/2072-6643/13/4/1115

Muscle wasting is a frequently observed, inflammation-driven condition in aging and disease, known as sarcopenia and cachexia. Current treatment strategies target the muscle directly and are often not able to reverse the process. Because a reduced gut function is related to systemic inflammation, this might be an indirect target to ameliorate muscle wasting, by administering pro-, pre-, and synbiotics. Therefore, this review aimed to study the potential of pro-, pre-, and synbiotics to treat muscle wasting and to elucidate which metabolites and mechanisms affect the organ crosstalk in cachexia. Overall, the literature shows that <i>Lactobacillus species pluralis</i> (spp.) and possibly other genera, such as <i>Bifidobacterium</i>, can ameliorate muscle wasting in mouse models. The beneficial effects of <i>Lactobacillus</i> spp. supplementation may be attributed to its potential to improve microbiome balance and to its reported capacity to reduce gut permeability. A subsequent literature search revealed that the reduction of a high gut permeability coincided with improved muscle mass or strength, which shows an association between gut permeability and muscle mass. A possible working mechanism is proposed, involving lactate, butyrate, and reduced inflammation in gut–brain–muscle crosstalk. Thus, reducing gut permeability via <i>Lactobacillus</i> spp. supplementation could be a potential treatment strategy for muscle wasting.