Published online Aug 7, 2015. doi: 10.3748/wjg.v21.i29.8787
Peer-review started: November 17, 2014
First decision: March 26, 2015
Revised: May 10, 2015
Accepted: July 3, 2015
Article in press: July 3, 2015
Published online: August 7, 2015
Relation between the gut microbiota and human health is being increasingly recognised. It is now well established that a healthy gut flora is largely responsible for overall health of the host. The normal human gut microbiota comprises of two major phyla, namely Bacteroidetes and Firmicutes. Though the gut microbiota in an infant appears haphazard, it starts resembling the adult flora by the age of 3 years. Nevertheless, there exist temporal and spatial variations in the microbial distribution from esophagus to the rectum all along the individual’s life span. Developments in genome sequencing technologies and bioinformatics have now enabled scientists to study these microorganisms and their function and microbe-host interactions in an elaborate manner both in health and disease. The normal gut microbiota imparts specific function in host nutrient metabolism, xenobiotic and drug metabolism, maintenance of structural integrity of the gut mucosal barrier, immunomodulation, and protection against pathogens. Several factors play a role in shaping the normal gut microbiota. They include (1) the mode of delivery (vaginal or caesarean); (2) diet during infancy (breast milk or formula feeds) and adulthood (vegan based or meat based); and (3) use of antibiotics or antibiotic like molecules that are derived from the environment or the gut commensal community. A major concern of antibiotic use is the long-term alteration of the normal healthy gut microbiota and horizontal transfer of resistance genes that could result in reservoir of organisms with a multidrug resistant gene pool.
Core tip: In this review we present an up-to-date overview of the normal gut microbiota, their functional implications in health, and the mechanistic insights that orchestrate these functions. We also discuss the characteristics that define a healthy gut microbiota and factors that shape and perturb the gut microbial diversity and functions. The evidence that we present here is a composite of observational and experimental studies on humans, germ free and humanized mice.