Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
C
URRENT
O
PINION
Gut nutrient sensing and microbiota function
in the control of energy homeostasis
Gilles Mithieux
a,b,c
Purpose of review
To analyze the respective roles of macronutrient-derived moieties, of a gut mucosal function [intestinal
gluconeogenesis (IGN)] and its capacity of influencing the brain control of energy homeostasis, and of the
microbiota ‘function’ versus ‘genomic composition’ in the control of host metabolism.
Recent findings
Small products deriving from protein digestion (peptides) or from fermentation by the gut microbiota (short-
chain fatty acids and succinate) activate IGN, a mucosal function sensed by the peripheral gut nervous
system, which intitiates metabolic benefits deriving from brain control of energy homeostasis. The
microbiota function (fermentation) rather than its genomic composition is a key in these processes.
Summary
Short-chain fatty acids and succinate produced from the fermentation of macronutrients by the gut
microbiota positively influence the brain’s control of energy homeostasis via the activation of IGN. The
microbiota function rather than genomic composition is a key in these processes.
Keywords
gut microbiota, intestinal gluconeogenesis, nutrient sensing, short chain fatty acids
INTRODUCTION
The maintenance of plasma glucose concentration
at around 1 g/l is a critical requirement for the body,
as most mammals including humans are incapable
of tolerating hypoglycemic episodes for more than a
few minutes. Endogenous glucose production (EGP)
is thus a crucial function for survival, especially
when food is lacking (between the meals or during
the night and of course during fasting). Since Claude
Bernard, we know that the liver is a crucial organ to
produce glucose in blood. After the identification of
the key enzyme operating the final reaction of
hydrolysis of glucose-6 phosphate (glucose-6 phos-
phatase (G6Pase)), the gluconeogenic role of the
kidney was evidenced. Compared with the liver
and kidney, the intestine expresses weaker-specific
G6Pase activity. In addition, it is merged with a high
alkaline phosphatase activity. This explains why the
expression of specific G6Pase remained for a long
time a matter of debate. After the identification of
the gene of G6Pase in the 1990s, the presence of its
mRNA in the small intestine and its modulation by
fasting and diabetes allowed us to firmly assert that
G6Pase is actually expressed in the intestine in rats
and humans. The demonstration of the gluconeo-
genic capacity of the intestine was published soon
later. As fasting settles, the intestinal contribution to
EGP increases from 5–10% to about 20–25% of the
total (for a review, see [1
&&
]).
Interestingly, previous studies suggested that
the delivery of glucose directly in the portal vein
in fasting rats could curb their subsequent food
intake, whether they were reefed,whereas the glu-
cose infusion was maintained. Indeed, glucose may
be sensed by specific neurons in the nerves sur-
rounding the portal vein walls, which is the first
step of a gut to brain neural signalling process
activating the main hypothalamic nuclei control-
ling energy homeostasis [1
&&
]. As intestinal gluco-
neogenesis (IGN) delivers glucose just upstream of
the site of glucose sensing, this led to the hypothesis
that IGN could have the capacity to control food
intake, would it be induced between the meals and/
a
Institut National de la Sante ´ et de la Recherche Me ´dicale,
b
Universite ´ de
Lyon, Lyon and
c
Universite ´ Lyon I, Villeurbanne, France
Correspondence to Gilles Mithieux, PhD, Inserm U1213, Universite ´ Lyon
1, Laennec, 7 rue Guillaume Paradin, 69372 Lyon Cedex 08, France.
Tel: +33 4 78 77 8788; fax: +33 4 7877 87 62;
e-mail: gilles.mithieux@inserm.fr
Curr Opin Clin Nutr Metab Care 2018, 21:273–276
DOI:10.1097/MCO.0000000000000478
1363-1950 Copyright ß 2018 Wolters Kluwer Health, Inc. All rights reserved. www.co-clinicalnutrition.com
REVIEW