Zonulina como marcador de permeabilidade intestinal relacionado ao consumo de pre/probióticos: uma revisão de literatura

Abstract

Alterations in the composition of the microbiota, termed dysbiosis, have been associated with various inflammatory diseases, such as metabolic disorders, obesity, insulin resistance, type 2 diabetes, anxiety, and depression. These disorders can lead to the breakdown of tight junctions, causing intestinal permeability and facilitating endotoxemia. Zonulin levels can be a good molecular marker for staging these pathologies or for providing parameters in the clinical approach using probiotics. The objective of this study was to conduct a narrative review of the literature to analyze the use of prebiotics and probiotics correlated with zonulin levels. Sixteen studies were selected, representing a sample of 646 patients. Zonulin levels were reduced in 6 studies (37.5%) that used 36 different species, with special emphasis on B. lactis, B. breve, B. bifidum, B. longum, L. plantarum, L. bulgaricus, L. acidophilus, and S. thermophilus, which represent 69.4% of the effective strains. The duration of supplementation in the studies varied from 14 to 180 days, with an average duration of 74 days, and was longer in the articles that reduced zonulin (112.7 days). No single prebiotic or probiotic was able to reduce zonulin levels when administered alone. Prebiotics/probiotics seem to directly affect the integrity of the intestinal barrier, especially in health conditions such as obesity and diabetes. Furthermore, the duration and the form of administration, either multi-strain or symbiotic, seem to be determining factors for the outcome.