Akkermansia muciniphila

Akkermansia muciniphila, a Gram-negative, anaerobic bacterium, resides predominantly in the mucus layer of the gut epithelium.  

First isolated in 2004 by Dr. Willem M. de Vos and his team, this bacterium is known for its ability to degrade mucin, a key glycoprotein in the protective mucus layer lining the intestinal tract. 

Found in about 90% of healthy humans, Akkermansia muciniphila constitutes 1-3% of the fecal microbiota.

Akkermansia muciniphila plays a crucial role in maintaining gut barrier integrity and metabolic homeostasis.  By degrading mucin, it promotes the renewal of the mucus layer, serving as a barrier against pathogens and toxins. 

It has been linked to improved metabolic health, with higher levels associated with better glucose regulation and lower incidences of obesity and type 2 diabetes. 

Conversely, lower levels of this bacterium are linked to increased adiposity, insulin resistance, and inflammation. 

Recent studies have shown that foods rich in polyphenols such as cranberries, grapes, and pomegranates, can boost Akkermansia levels, highlighting its potential as a target for dietary strategies to improve metabolic health.

What is Akkermansia Muciniphila?

Akkermansia Muciniphila, a member of the Verrucomicrobia phylum, is a Gram-negative, anaerobic bacterium that predominantly resides in the mucus layer of the gut epithelium. 

Taxonomy and Characteristics of Akkermansia Muciniphila

Akkermansia Muciniphila was first isolated and characterized by Dr. Willem M. de Vos and his colleagues in 2004. It is characterized by its ability to degrade mucin, the glycoprotein component of the protective mucus layer lining the intestinal epithelium. 

It is found in about 90% of healthy humans, comprising 1-3% of the fecal microbiota.

Unlike many other gut bacteria, Akkermansia Muciniphila is strictly anaerobic and thrives in the hypoxic environment of the mucus layer.

Role of Akkermansia Muciniphila in the Gut Microbiome

Akkermansia Muciniphila plays a crucial role in maintaining gut barrier integrity and metabolic homeostasis.  By degrading mucin, Akkermansia Muciniphila promotes the turnover of the mucus layer, which serves as a physical barrier against pathogens and toxins. 

Additionally, Akkermansia Muciniphila has been implicated in the regulation of host metabolism, particularly lipid metabolism and glucose homeostasis. 

The abundance of A. muciniphila in the gut microbiome has been inversely correlated with several disease states, including inflammatory bowel diseases (IBD), obesity, and type 2 diabetes. [10.] 

Higher levels of A. muciniphila are generally associated with a healthier metabolic status, improved glucose homeostasis, and better clinical outcomes after dietary interventions like calorie restriction in overweight/obese individuals.  [4.]

Conversely, lower levels of A. muciniphila have been linked to increased adiposity, insulin resistance, and a pro-inflammatory state.  [10.]

Significance of Akkermansia Muciniphila in Human Health

The presence of Akkermansia Muciniphila in the gut microbiome is considered a marker of gut health and resilience.  Higher levels of Akkermansia Muciniphila have been associated with a reduced risk of gut barrier dysfunction, inflammation, and metabolic dysregulation.  [4., 10.]

Conversely, reductions in Akkermansia Muciniphila abundance have been linked to gut dysbiosis, increased intestinal permeability, and systemic inflammation.  [2., 7., 10.] 

Studies have shown a strong link between intestinal barrier integrity and metabolic diseases such as obesity and type 2 diabetes (T2D).  Akkermansia muciniphila has been highlighted for its role in reducing gut barrier disruption and insulin resistance, at least in part by promoting the turnover of the mucus layer that protects the gastrointestinal barrier.  [2.]

Additionally, Akkermansia has been shown to modulate gut hormone secretion: A. muciniphila can stimulate the secretion of gut hormones like GLP-1, which regulate satiety, glucose homeostasis, and energy expenditure.  [13.]

Akkermansia may also provide potential neuroprotective effects: some studies suggest that A. muciniphila may have beneficial effects in neurological disorders like autism, depression, epilepsy, and Alzheimer's disease.  [13.]

Research has also consistently shown lower levels of this bacterium in individuals with inflammatory bowel diseases.  Recent studies indicate that A. muciniphila supplementation can restore gut mucus thickness and reduce metabolic endotoxemia, as well as improving metabolic profiles in obese and diabetic mice.  [14.]

The bacterium’s ability to enhance gut barrier function and its association with beneficial short-chain fatty acid production make it a highly promising probiotic for preventing and treating metabolic disorders.

Laboratory Testing for Akkermansia Muciniphila Levels

Test Type, Sample Collection and Preparation

Akkermansia muciniphila levels are assessed in stool samples.  Stool samples may be collected from the comfort of home.  

Testing may require avoidance of certain medications and/or supplements including probiotics prior to sample collection.  It is important to consult with the ordering provider for full test preparation instructions.  

Interpretation of Test Results

Optimal Levels of Akkermansia muciniphila

There is no universally agreed-upon optimal level for Akkermansia muciniphila in stool tests, based on available research.  However, better health outcomes are associated with higher levels of Akkermansia muciniphila, indicating that a higher level is considered optimal.

It is important to consult with the laboratory company used for test interpretation.  

One lab company provides the following reference range for Akkermansia muciniphilia levels: 1.0e1 - 8.2e6 org/g  [12.]

Clinical Implications of High Akkermansia Muciniphila

Clinically, higher levels of Akkermansia muciniphila are considered optimal.  

In the setting of bacterial overgrowth or SIBO, elevated levels of Akkermansia muciniphila may be discovered along with elevated levels of other bacteria.  This is typically accompanied by symptoms including gas, bloating, abdominal pain or discomfort, constipation or loose stool, or other symptoms.  

Individuals with concern for bacterial overgrowth or SIBO should contact a healthcare professional for additional assessment.  

Clinical Implications of Low Akkermansia Muciniphila

Low levels of Akkermansia have been associated with a variety of conditions including obesity, type 2 diabetes, inflammatory bowel disease, as well as increased intestinal permeability and systemic inflammation.  [2., 7., 10., 14.] 

Akkermansia Muciniphila-Related Biomarkers to Test

In addition to Akkermansia Muciniphila, several other biomarkers are relevant for assessing microbiota composition and gut health. 

Comparison with Other Gut Microbiota and Microbial Markers

Akkermansia Muciniphila levels are just one aspect of gut microbiota composition that can be assessed in clinical samples.  Comparing its abundance and diversity with other microbial markers such as Bacteroidetes, Proteobacteria, Actinobacteria, and other Verrucomicrobia species provides a more comprehensive understanding of gut dysbiosis and its implications for human health. 

Changes in the relative abundance of these microbial taxa have been associated with various metabolic disorders, inflammatory conditions, and gastrointestinal diseases, underscoring the importance of considering multiple biomarkers in microbiota analysis.

Integration of Akkermansia Muciniphila with Markers of Digestive Function

Increasingly, lab companies are offering comprehensive assessments of the microbiome in conjunction with markers of digestive health and inflammation, which can provide a broad assessment of gut health.  

Digestive function markers may include pancreatic enzymes such as elastase, as well as assessments of fat and proteins present in stool.  Markers of digestive inflammation including calprotectin and Eosinophil Protein X may also be considered.  

Finally, the biomarker zonulin may also be assessed in stool samples to assess for a leaky gut process.  

Combining markers of digestive health and inflammation along with a comprehensive microbiome analysis can provide a comprehensive assessment of digestive function. 

Akkermansia Muciniphila Supplements and Foods

Supplements Targeting Akkermansia Muciniphila: Risks and Benefits  [3., 5., 13.] 

Akkermansia muciniphila is a promising probiotic known for its beneficial effects on metabolic health, including improved insulin sensitivity, reduced insulinemia, and lower cholesterol levels. 

It enhances gut barrier function by increasing mucin production and strengthening the intestinal mucus layer. Clinical studies have shown that both live and pasteurized forms of A. muciniphila are safe and well-tolerated, leading to approval as a novel food by the European Food Safety Authority.

However, supplementation of A. muciniphila must be carefully evaluated due to potential risks. In conditions such as inflammatory bowel disease (IBD) and post-antibiotic recovery, excessive enrichment may exacerbate local inflammation and pathogen susceptibility. 

Patients with endocrine and gynecological disorders like polycystic ovary syndrome (PCOS) or endometriosis, who are at higher risk of IBD, should exercise caution in supplementing with Akkermansia.  [3.]

Additionally, elevated levels of A. muciniphila have been observed in neurological conditions such as Parkinson’s disease and multiple sclerosis, suggesting potential negative impacts with supplementation.

Challenges with Sourcing Akkermansia Muciniphila Supplements  [3., 9.]

Finding high-quality Akkermansia muciniphila supplements faces several challenges: 

Maintaining the viability and stability of this anaerobic bacterium during manufacturing, storage, and delivery is difficult, and processing methods like pasteurization can affect its potency. 

Different strains have varying effects, so identifying the optimal strain is crucial. 

The appropriate dosage and administration route are still under investigation. 

Efficacy can be influenced by the host's diet, gut microbiome, and health status, making predictions challenging. 

Regulatory hurdles and extensive safety and efficacy testing are required for commercial approval. 

Additionally, producing consistent, high-quality supplements at a commercial scale demands specialized facilities and rigorous quality control, which can be costly.

Dietary Interventions to Promote Akkermansia Muciniphila Abundance  [1., 8., 11.] 

The healthiest foods for boosting Akkermansia muciniphila in the gut include fruits and vegetables rich in polyphenols. 

Research shows that polyphenols, found abundantly in cranberries, grapes, and pomegranates, enhance the presence of Akkermansia.  For example, cranberry extracts rich in polyphenols have been shown to prevent diet-induced obesity and improve metabolic health in mice by increasing Akkermansia abundance. 

Similarly, grape and pomegranate extracts also promote Akkermansia growth.  

Polyphenols not only support gut health by boosting beneficial bacteria but also improve mucus production, creating a favorable environment for Akkermansia.  Therefore, consuming polyphenol-rich foods like cranberries, grapes, and pomegranates can support gut health and metabolic well-being.

Prebiotic foods and foods containing omega-3 fatty acids have also been shown to increase Akkermansia muciniphila levels.  

Prebiotics like inulin, fructo-oligosaccharides (FOS), and galacto-oligosaccharides (GOS) can stimulate the growth of A. muciniphila by providing fermentable fibers that serve as food sources for this beneficial bacteria.  Studies have reported increased abundance of A. muciniphila after supplementation with prebiotics like inulin and polydextrose.

Also, diets rich in omega-3 polyunsaturated fatty acids (PUFAs) from fish oil have been associated with higher levels of A. muciniphila compared to diets high in saturated fats like lard. 

Mice fed fish oil showed a significant increase in A. muciniphila abundance, and fecal transplants from these mice to lard-fed mice recapitulated the metabolic benefits, suggesting a causal role of the Akkermansia-rich microbiota.

The prebiotic effect of omega-3 PUFAs on A. muciniphila is thought to be mediated by the production of anti-inflammatory metabolites and modulation of the gut environment, creating favorable conditions for the growth of this mucin-degrading bacteria.

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