Akkermansia Muciniphila: An Important Microbe in Gut Disorders?

Is it just me or have you also been hearing more about Akkermansia muciniphila recently?

I suspect that the increased chatter about this microorganism has something to do with the emergence and expansion of direct-to-consumer gut microbiome testing companies such as Ubiome.

More specifically, I have encountered several individuals with IBS and/or SIBO whose Ubiome results show nonexistent or low levels of A. muciniphila.

Many individuals in the gut health community have been eager to submit poo samples in exchange for a report that provides a glimpse into the composition of critters living in their gut.

The test is quite easy to perform.  But it’s mildly graphic to describe.

The company mails you a kit that contains a swab resembling a long Q-tip.  You rub it against soiled toilet paper, then twirl it around in a mini test tube sorta thing.  Close the lid, put the tube in a little plastic bag, and send it back in the provided mailer.  Wah-la!

A few (or more) weeks go by and you receive an email that your results are ready! Login to your account, and you will see a report that resembles the above (if ordering the SmartGut test).  Akkermansia muciniphila is also measured on the more basic “Gut Explorer” test.

Intro to Akkermansia muciniphila

Akkermansia muciniphila (A. muciniphila) is a gram-negative bacteria that is present in the gut of approximately 90 percent of adults.

In healthy adults, A. muciniphila comprises 1-3% of the gut microbiota [1].

A. muciniphila is a mucin-degrading microbe.  Meaning that it feeds on mucin.  Mucin is a part of the mucus gel layer of the gut lining.  It serves as a barrier between bacteria living in the gut and human cells residing on the other side.

Roles of A. muciniphila

It is believed that A. muciniphila may play the following roles in the gut:

• Maintaining tolerance to beneficial microorganisms [2]
• Stimulating mucus renewal [2]
• Maintaining integrity of the gut lining (protecting against leaky gut) [2]
• Increasing intestinal levels of endocannabinoids (which has downstream effects on metabolism and insulin sensitivity) [3]

Related Conditions

The following conditions have been found in research to be associated with low levels of A. muciniphila:

• Obesity [3]
• Type 2 diabetes [3]
• Appendicitis [4]
• Autism [5]
• Crohn’s disease [5]
• Ulcerative colitis [5]
• Elderly population [5]
• Psoriasis [8]

Low FODMAP Diet & A. muciniphila

Compared to a moderate FODMAP diet, consuming a low FODMAP diet results in five times less A. muciniphila [6].

Lower consumption of FODMAP-containing foods among those with IBS/SIBO could potentially be a reason why these individuals have very little A. mucinphila on their Ubiome results.  However, I can tell you that all three of my personal Ubiome tests have shown ZERO growth of A. muciniphila and I actually eat quite a bit of FODMAPs nowadays so I would have expected to see some growth on the second and third tests. That’s why I suspect there is more to the story (keep reading!).

There is some concern that long-term consumption of a low FODMAP diet may be problematic due to potentially decreasing the level of A muciniphila in the gut.

Strategies to Increase A. muciniphila

The following substances and procedures are associated with increased levels of A. muciniphila:

• Curcumin [3]- found in turmeric
• EGCG [3]- found in green tea
• Phytochemicals [3]- compounds found in plants
• Prebiotics [3]- such as are found in high FODMAP foods
• Bariatric surgery [7]- for those suffering from obesity
• Metformin [7]- for those with type 2 diabetes or metabolic syndrome
• Human breast milk [7]- this organism is present in breast milk and may provide further support for the beneficial role of breastfeeding in building an infant’s microbiome
• Polyphenols [9]- found in cranberries, pomegranates, blueberries, dark chocolate, and other deep-colored foods

It may seem like common sense that if you have low levels of A. muciniphila, you should try to increase it. But it might not be that simple.  Keep reading…

More Questions than Answers?

It is important to remember that gut microbiome testing is still quite new.  And we don’t fully know what to do with it yet.

So to is the research on A. muciniphila.  The microbe was only discovered in 2004.  While the majority of research points toward this microbe being beneficial, there are still lots of questions.

For example, not everyone is in agreement that simply increasing A. muciniphila is the answer to great gut health.  In human studies, it has been shown that an increase in A. muciniphila is associated with increased abdominal pain in individuals with IBS [10].  Some researchers hypothesize that under certain conditions (such as in the presence of harmful microbes), A. muciniphila actually promotes intestinal inflammation [11].  This would explain why individuals with gut dysbiosis (such as is seen in many with IBS) would feel better on a diet that decreases A. muciniphila (low FODMAP, for example).

What are your thoughts?  Did your Ubiome test show low levels of Akkermansia muciniphila?  Have you tried increasing your intake of prebiotics and polyphenols? What was your experience?

References:

[1] Derrien M, Collado MC, Ben-amor K, Salminen S, De vos WM. The Mucin degrader Akkermansia muciniphila is an abundant resident of the human intestinal tract. Appl Environ Microbiol. 2008;74(5):1646-8.

[2] Earley H, Lennon G, Balfe A, et al. A Preliminary Study Examining the Binding Capacity of Akkermansia muciniphila and Desulfovibrio spp., to Colonic Mucin in Health and Ulcerative Colitis. PLoS ONE. 2015;10(10):e0135280.

[3] Bland J. Intestinal Microbiome, Akkermansia muciniphila, and Medical Nutrition Therapy. Integr Med (Encinitas). 2016;15(5):14-16.

[4] Van passel MW, Kant R, Zoetendal EG, et al. The genome of Akkermansia muciniphila, a dedicated intestinal mucin degrader, and its use in exploring intestinal metagenomes. PLoS ONE. 2011;6(3):e16876.

[5] Wang L, Christophersen CT, Sorich MJ, Gerber JP, Angley MT, Conlon MA. Low relative abundances of the mucolytic bacterium Akkermansia muciniphila and Bifidobacterium spp. in feces of children with autism. Appl Environ Microbiol. 2011;77(18):6718-21.

[6] Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Muir JG, Gibson PR. Consistent Prebiotic Effect on Gut Microbiota With Altered FODMAP Intake in Patients with Crohn’s Disease: A Randomised, Controlled Cross-Over Trial of Well-Defined Diets. Clin Transl Gastroenterol. 2016;7:e164.

[7] Cani PD, De vos WM. Next-Generation Beneficial Microbes: The Case of Akkermansia muciniphila. Front Microbiol. 2017;8:1765.

[8] Tan L, Zhao S, Zhu W, et al. The Akkermansia-muciniphila is a gut microbiota signature in psoriasis. Exp Dermatol. 2017;

[9] Roopchand DE, Carmody RN, Kuhn P, et al. Dietary Polyphenols Promote Growth of the Gut Bacterium Akkermansia muciniphila and Attenuate High-Fat Diet-Induced Metabolic Syndrome. Diabetes. 2015;64(8):2847-58.

[10] Zhou SY, Gillilland M, Wu X, et al. FODMAP diet modulates visceral nociception by lipopolysaccharide-mediated intestinal inflammation and barrier dysfunction. J Clin Invest. 2018;128(1):267-280.

[11] Ganesh BP, Klopfleisch R, Loh G, Blaut M. Commensal Akkermansia muciniphila exacerbates gut inflammation in Salmonella Typhimurium-infected gnotobiotic mice. PLoS ONE. 2013;8(9):e74963.