The Ageing Gut - in health and inflammation

The ageing gut – in health and inflammation

Research from our group shows that as many as 65% over 65 years of age, living independently, suffer from one or several gastrointestinal (GI) symptoms  (1). The most common symptoms are dyspepsia, constipation and diarrhoea. Recently, we were able to show that moderate problems with constipation and diarrhoea in elderly people are linked to increased psychological distress and changes in the intestinal barrier function(2). The intestinal barrier is one of the body's most important barriers to foreign substances. A breach in the intestinal barrier will allow  bacterial produces as well as contamination products in the food to enter the body, this could eventually lead to inflammation. A dysfunctinoal intestinal barrier function might be one of the mechanisms behind age-associated gastrointestinal symptoms. An impaired gut barrier is a hallmark of inflammatory bowel disease (IBD) (3). IBD usually affects younger adults, but the number of elderly people who get the disease increases. Recently, we were able to show, in collaboration with Jonas Halfvarson, (4) that a deteriorated intestinal barrier with increased permeability is due to genetic predisposition in adult onset of IBD. However, late onset of the disease seems to be more dependent on environmental factors. In one of the research projects, risk factors in the surrounding environment are now being investigated in blood from IBD patients and control subjects, in further studies the effect of these substances on the intestinal barrier will be studied. An important part of treating IBD is to suppress the inflammation in the gut e.g. by anti-TNF treatment, this will also strengthen the intestinal barrier and reduces the passage and uptake of bacteria (3,5). This means that different ways of strengthening the intestinal barrier function could also make the intestine more resistant to stress or exposure of various bacteria and possibly reduce gastrointestinal symptoms in the elderly. In collaboration with Åsa V Keita at Linköping University, we were recently able to show that a dietary fiber extracted from yeast (beta-glucan) strengthens the intestinal barrier towards stress in patients with IBD (6). We also found that the same beta-glucan could strengthen the intestinal barrier in elderly people with moderate problems of constipation and diarrhoea (7). This means that a deteriorated gut barrier might be one of the mechanisms behind age-associated GI symptoms. To follow up these results, two clinical studies were performed with the aim to elucidate whether supplements containing dietary fibers can alleviate GI symptoms among elderly and/or make the barrier more resistant towards intake of non-steroid anti-inflammatory drugs. Moreover, the effect on the microbiotic composition and intestinal permeability is also elucidated.

The research group work in close collaboration with Prof. Jonas Halfvarson, Prof. Annica Kihlgren, Prof. Tuulia Hyötyläinen. At Linköping University, there is close collaboration with Associate Professor Åsa V. Keita. Important co-laborators are also located at Kiel Life Science, Kiel, Germany, Canada, Kerry, Minneapolis, the United States, the University of Calgary, Calgary, and the University of California, Davis, USA.

1. F. Fart et al. Gut health, nutrient intake and well-being among community dwelling older adults, under review, 2019.
2. Ganda Mall JP et al. Are self-reported gastrointestinal symptoms associated with increased intestinal permeability and psychological distress? BMC Geriatrics, 2018
3. Schoultz I and Keita AV. Cellular and molecular therapeutic targets in inflammatory bowel disease – focusing on intestinal barrier function, Cells, 2019
4. Keita AV et al. Gut barrier dysfunction – A primary defect in Twins with Crohn’s Disease predominantly caused by genetic predisposition, Journal of Crohn’s and colitis, 2018
5. Yakymenko O et al. Infliximab restores colonic barrier to adherent-invasive E.coli in Crohn’s disease via effects on epithelial lipid rafts. Scand J Gastro, 2018
6. Ganda Mall JP et al. A Beta-Glucan-based dietary fiber reduces mast cell-induced hyperpermeability in ileum from patients with Crohn’s disease and control subjects. Inflammatory bowel disease, 2017
7. Ganda Mall JP et al. Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptoms. Scientific reports, 2018