What is Akkermansia muciniphila (and how can it help you)?

November 18, 2020 Stephen Riffle

**This article was originally published on Pendulum Therapeutic’s blog

Learn more about this key beneficial bacterial strain.

Deep within the human gut there is an obscure bacteria that may play a surprisingly important role in protecting us from conditions like type 2 diabetes and obesity. This guardian, known as Akkermansia muciniphila, reminds us that small actions can have a profound impact on our health.

**What is Akkermansia muciniphila?**

Akkermansia muciniphila is a type of Gram-negative bacteria (meaning it has an outer membrane) that makes up about 3-5% of the bacteria in the human gut microbiome. Among its many roles, Akkermansia muciniphila helps maintain a healthy gut lining[2].

**What are the benefits of Akkermansia muciniphila?**

Studies in mice and humans show that Akkermansia muciniphila plays an important role in reducing obesity and type 2 diabetes, in part, by suppressing gut inflammation and promoting a healthy, diverse microbiome[3-6].

**How does Akkermansia muciniphila work?**

Akkermansia muciniphila causes a chain reaction that ultimately leads to several benefits (such as improved blood glucose).

Promoting a healthy microbiome

Akkermansia muciniphila slowly breaks down the proteins that make up the gut’s mucus layer (a protective layer that coats the gut’s surface) and uses it as a source of nitrogen and carbon (96% of the human body's mass is made up of just four elements: nitrogen, carbon, oxygen, and hydrogen). It also helps us break down the fiber in our diet[14].

In return, Akkermansia muciniphila produces key by-products known as short-chain fatty acids (SCFA). These metabolites can serve as food for other beneficial microbes.

This means that, by converting mucus into more-readily digested byproducts that other microbes love, Akkermansia muciniphila may be able to promote a diverse and healthy microbiome[2,3,5].

Promoting a healthy mucus layer

It may seem counterintuitive, but when Akkermansia muciniphila consumes mucus, it stimulates the body to make more mucus.

As it breaks down mucus, it releases chemicals and proteins that diffuse a short distance away from it.

Eventually, it gets close enough to the gut lining that the chemicals and proteins it releases come into contact with the body’s gut cells. This contact tells the cells to make more mucus.

Even though Akkermansia muciniphila consumes mucus, the body is able to replenish its mucus layer and ultimately has a healthier mucus layer because of it [2,3,5,7].

Promoting a strong cell barrier

The chemicals and proteins that Akkermansia muciniphila release don’t just encourage mucus production, they also cause the gut’s cells to form tighter bonds with one another.

The result is a more complete barrier that is harder for invaders, and even some proteins, to pass [2,3,5,7].

Suppressing inflammation

When the microbiome isn’t diverse, it becomes easier for opportunistic and harmful bacteria to grow.

And if the mucus layer isn’t healthy (and if the cell barrier isn’t strong), pathogenic microbes can burrow into the mucus and get close to the gut’s cells.

These microbes release chemicals and proteins that can slip past a weak cell barrier (also known as leaky gut). The immune system then recognizes these microbial by-products as potentially dangerous.

In response, the immune system becomes activated—resulting in a low level of inflammation that can spread beyond the gut to the entire body.

Because Akkermansia muciniphila helps promote a healthy mucus layer, a diverse microbiome, and a stronger cell barrier, this helps suppress inflammation.

**What is the link between Akkermansia muciniphila and type 2 diabetes mellitus?**

Type 2 diabetes is a complex disease that scientists are still working to fully understand.

We know that many factors like your diet, how much exercise you get, and your gut microbiome can all influence the development and progression of diabetes.

In recent years, Akkermansia muciniphila has gained attention from scientists around the world owing to its potential role in protecting us from diabetes.

In fact, numerous studies have found that people with diabetes, prediabetes and obesity often have much lower levels of Akkermansia muciniphila-—indicating that it’s likely important [3-5,6,8].

Numerous studies in diabetic mice have shown that a decrease in the amount of Akkermansia muciniphila in the gut microbiome correlates with diabetes development.

It’s also been shown that, when given supplements of Akkermansia muciniphila, diabetic mice exhibited better blood glucose control and were able to avoid blood sugar spikes after eating.

Similar findings have been observed in humans.

**How might Akkermansia muciniphila help people with diabetes?**

Exactly how Akkermansia muciniphila may be protecting us from diabetes is unclear, but it likely has to do with inflammation.

Several large studies have shown that increased inflammation can cause the body to become less sensitive to insulin—a hallmark of diabetes—and that people with type 2 diabetes often display a higher amount of gut and systemic inflammation.

Akkermansia muciniphila is known to suppress this type of inflammation.

Additionally, Akkermansia muciniphila may slow the digestion of complex sugars in the gut, which would decrease the occurrence of blood sugar spikes after eating.

Probiotics containing Akkermansia muciniphila are being studied as potentially beneficial supplements for people with diabetes.

Pendulum’s Glucose Control, for example, contains Akkermansia muciniphila and has been shown in clinical trials to maintain healthy A1C levels and decrease blood sugar spikes (suggesting a beneficial impact on blood sugar regulation) [3-5,6,8,9].

Akkermansia muciniphila and Metformin

Metformin is a common medication in the treatment of type two diabetes owing to its remarkable ability to help people with diabetes regulate their blood glucose levels.

It is important then to consider how probiotics may cooperate with, or possibly detract from, metformin treatment.

Studies have shown that metformin treatment can increase the amount of Akkermansia muciniphila in a person’s gut and that this may be one of the mechanisms behind metformin's beneficial effects on glucose regulation [10].

While Akkermansia muciniphila appears to be beneficial in the treatment of type 2 diabetes, it is important to always discuss your therapeutic options with your doctor before starting a new supplement—especially when taking medications like metformin.

**What is the link between Akkermansia muciniphila and obesity?**

As in diabetes, Akkermansia muciniphila has garnered significant attention from the scientific community for a potential role in protecting us from obesity.

Several studies in both mice and humans have observed that obese individuals often have significantly decreased levels of Akkermansia muciniphila.

How this microbe might protect us against obesity isn’t well understood at the moment. Studies in mice suggest that increasing the amount of Akkermansia muciniphila in an obese animal’s gut can help reduce their food intake, improve the metabolism of certain fats and sugars, and ultimately limit increases in body fat.

However, mixed results have been observed in non-obese mice, suggesting that the beneficial impact of Akkermansia muciniphila on obesity may be context specific [3,7,11].

**Can Akkermansia muciniphila lead to weight loss?**

Several weight-loss strategies have been shown to increase the amount of Akkermansia muciniphila, such as increased fiber intake and calorie-restricted diets.

However, the cause-and-effect relationship hasn’t been established yet.

Put another way, it’s unclear whether increases in Akkermansia muciniphila will cause weight loss, or whether weight loss causes an increase in Akkermansia muciniphila [3,7,11].

Nonetheless, it’s known that a diverse and healthy gut microbiome can affect how much a person eats and how much body mass they gain.

Increased inflammation is also known to correlate with obesity. Given Akkermansia muciniphila’s role in promoting a healthy gut and suppressing inflammation—and the observations described above in mice—it is reasonably expected that this microbe has a role to play in the prevention of obesity.

**How to promote Akkermansia muciniphila in the gut**

It is likely that we get our Akkermansia muciniphila in our gut microbiome very early in life.

In fact, researchers have found it in the microbiome sample of newborn babies who are just a few weeks old. With time, the amount of Akkermansia muciniphila in the gut increases to a peak amount in adulthood [2].

The amount of Akkermansia muciniphila in our gut can be influenced by a number of factors, including your socioeconomic status, diet, and medications you may be taking.

Research has shown that calorie restriction, diets high in prebiotic fibers, and antioxidant containing foods—such as grapes, cranberries, and green tea—may all increase the amount of Akkermansia muciniphila.

Inversely, high-fat diets and large amounts of alcohol intake appear to decrease the amount of Akkermansia muciniphila.

However, it’s important to emphasize that we still know little about what in these strategies causes Akkermansia muciniphila to increase in numbers and it’s unknown what other factors (environment, age, sex, other foods in diet) may influence the effectiveness of these strategies.

Additionally, much of the work on dietary intervention has been done in rodent models.

And while rodent models can be helpful for research, the results do not always translate to humans [3,7,11,12].

**Are there probiotics that contain Akkermansia muciniphila?**

While it is unknown what foods and in what contexts these foods can increase Akkermansia muciniphila, it has been observed that probiotics can be a successful way to increase the amount of Akkermansia muciniphila in the gut of both mice and humans.

This has encouraged researchers to look for ways to optimize a probiotic’s effectiveness at increasing Akkermansia muciniphila. One possibility is that this microbe will be more successful at growing when specific other bacterial species are also present [11-13].

Many probiotics are currently available with varying degrees of evidence supporting their effectiveness.

However, Pendulum’s Glucose Control is a medical probiotic that contains Akkermansia muciniphila (among other beneficial bacterial strains) that has been shown in a clinical trial to be effective at maintaining healthy A1C levels and reducing blood glucose spikes in people with type 2 diabetes [9].

Conclusion

Akkermansia muciniphila appears to simply munch on mucus and fibers in the gut. It's a simple action that may have a huge impact on our well-being and may be able to help us prevent (and treat) both diabetes and obesity.

References:

Foster, Claire N., et al. “Animals as Agents in Fire Regimes.” Trends in Ecology & Evolution, vol. 35, no. 4, 2020, pp. 346–356., doi:10.1016/j.tree.2020.01.002.
Geerlings, Sharon Y et al. “Akkermansia muciniphila in the Human Gastrointestinal Tract: When, Where, and How?.” Microorganisms vol. 6,3 75. 23 Jul. 2018, doi:10.3390/microorganisms6030075
Xu, Yu, et al. “Function of Akkermansia muciniphila in Obesity: Interactions With Lipid Metabolism, Immune Response and Gut Systems.” Frontiers in Microbiology, vol. 11, 2020, doi:10.3389/fmicb.2020.00219.
Gurung, Manoj et al. “Role of gut microbiota in type 2 diabetes pathophysiology.” EBioMedicine vol. 51 (2020): 102590. doi:10.1016/j.ebiom.2019.11.051
Tilg, Herbert, and Alexander R Moschen. “Microbiota and Diabetes: an Evolving Relationship.” Gut, vol. 63, no. 9, 2014, pp. 1513–1521., doi:10.1136/gutjnl-2014-306928.
Tai, Ningwen et al. “The role of gut microbiota in the development of type 1, type 2 diabetes mellitus and obesity.” Reviews in endocrine & metabolic disorders vol. 16,1 (2015): 55-65. doi:10.1007/s11154-015-9309-0
Zhou, Kequan. “Strategies to promote abundance of Akkermansia muciniphila, an emerging probiotics in the gut, evidence from dietary intervention studies.” Journal of functional foods vol. 33 (2017): 194-201. doi:10.1016/j.jff.2017.03.045
Harsch, Igor, and Peter Konturek. “The Role of Gut Microbiota in Obesity and Type 2 and Type 1 Diabetes Mellitus: New Insights into ‘Old’ Diseases.” Medical Sciences, vol. 6, no. 2, 2018, p. 32., doi:10.3390/medsci6020032.
Kolterman, Orville G., et al. “758-P: Medical Food (MF) with Butyrate Producing (BP) Mucin Regulating (MR) Microbes Improves Glucose Control (GC) in T2D.” Diabetes, vol. 68, no. Supplement 1, 2019, doi:10.2337/db19-758-p.
Pascale, Alessia, et al. “The Role of Gut Microbiota in Obesity, Diabetes Mellitus, and Effect of Metformin: New Insights into Old Diseases.” Current Opinion in Pharmacology, vol. 49, 2019, pp. 1–5., doi:10.1016/j.coph.2019.03.011.
Naito, Yuji, et al. “A Next-Generation Beneficial Microbe: Akkermansia muciniphila.” Journal of Clinical Biochemistry and Nutrition, vol. 63, no. 1, 2018, pp. 33–35., doi:10.3164/jcbn.18-57.
Bowyer, Ruth C E et al. “Socioeconomic Status and the Gut Microbiome: A TwinsUK Cohort Study.” Microorganisms vol. 7,1 17. 11 Jan. 2019, doi:10.3390/microorganisms7010017
Anhê, Fernando F et al. “Triggering Akkermansia with dietary polyphenols: A new weapon to combat the metabolic syndrome?.” Gut microbes vol. 7,2 (2016): 146-53. doi:10.1080/19490976.2016.1142036
https://www.livescience.com/3505-chemistry-life-human-body.html

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