Inflamación intestinal como moduladora de las enfermedades endocrinas: revisión narrativa crítica de los mecanismos fisiopatológicos, la evidencia clínica y las perspectivas terapéuticas
DOI:
https://doi.org/10.55204/trc.v6i2.e702Keywords:
microbiota intestinal; inflamación intestinal; disbiosis; permeabilidad intestinal; enfermedades endocrinas; inmunometabolismo; endotoxemia metabólica.Abstract
La alteración de la microbiota intestinal y la inflamación asociada participan en el desarrollo de diversas enfermedades endocrinas al deteriorar la barrera epitelial, activar respuestas inmunitarias y mantener una inflamación sistémica crónica de bajo grado el objetivo es analizar críticamente la influencia de la inflamación intestinal sobre la fisiología endocrina y valorar sus posibles aplicaciones diagnósticas y terapéuticas. Se realizó una revisión narrativa crítica de la literatura científica mediante búsquedas en PubMed/MEDLINE y PubMed Central, complementadas con fuentes de alto impacto como Nature Reviews, Frontiers, SpringerLink y Annual Reviews. Se priorizaron metaanálisis, revisiones sistemáticas y ensayos clínicos publicados principalmente entre 2015 y 2026. La base documental incluyó 38 referencias verificadas con sus fuentes originales. La evidencia indica que la disbiosis, el aumento de la permeabilidad intestinal y la endotoxemia metabólica activan vías proinflamatorias como TLR4, NF-κB y el inflamasoma NLRP3. Estos mecanismos favorecen la aparición de obesidad, diabetes mellitus tipo 1 y 2, enfermedad hepática esteatósica asociada a disfunción metabólica, tiroidopatías autoinmunes y síndrome de ovario poliquístico, también denominado síndrome ovárico metabólico poliendocrino. En contraste, metabolitos bacterianos beneficiosos, como los ácidos grasos de cadena corta, y hormonas intestinales como GLP-1 y PYY contribuyen al mantenimiento de la homeostasis metabólica.
Downloads
References
Alkader, D. A. A., Asadi, N., Solangi, U., Singh, R., Rasuli, S. F., Farooq, M. J., Raheela, F. N. U., Waseem, R.,
Gilani, S. M., Abbas, K., Ahmed, M., Tanoh, D. B., Shah, H. H., Dulal, A., Hussain, M. S., & Talpur, A. S. (2023). Exploring the role of gut microbiota in autoimmune thyroid disorders: A systematic review and meta-analysis. Frontiers in Endocrinology, 14, Article 1238146. https://doi.org/10.3389/fendo.2023.1238146
Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas, 103, 45–53. https://doi.org/10.1016/j.maturitas.2017.06.025
Blok, L., Hanssen, N., Nieuwdorp, M., & Rampanelli, E. (2025). From microbes to metabolites: Advances in gut microbiome research in type 1 diabetes. Metabolites, 15(2), Article 138. https://doi.org/10.3390/metabo15020138
Cani, P. D. (2018). Human gut microbiome: Hopes, threats and promises. Gut, 68(9), 1716–1725. https://doi.org/10.1136/gutjnl-2018-316723
Cani, P. D., & Van Hul, M. (2024). Gut microbiota in overweight and obesity: Crosstalk with adipose tissue. Nature Reviews Gastroenterology & Hepatology, 21(3), 164–183. https://doi.org/10.1038/s41575-023-00867-z
Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., & Zhao, L. (2018). Inflammatory responses and inflammation-associated diseases in organs. Oncotarget, 9(6), 7204–7218. https://doi.org/10.18632/oncotarget.23208
G. W., Harmsen, H. J., & Vaarala, O. (2013). Fecal microbiota composition differs between children with β-cell autoimmunity and those without. Diabetes, 62(4), 1238–1244. https://doi.org/10.2337/db12-0526
de Vos, W. M., Tilg, H., Van Hul, M., & Cani, P. D. (2022). Gut microbiome and health: Mechanistic insights. Gut, 71(5), 1020–1032. https://doi.org/10.1136/gutjnl-2021-326789
Dmytriv, T. R., Storey, K. B., & Lushchak, V. I. (2024). Intestinal barrier permeability: The influence of gut microbiota, nutrition, and exercise. Frontiers in Physiology, 15, Article 1380713. https://doi.org/10.3389/fphys.2024.1380713
Donath, M. Y., & Shoelson, S. E. (2011). Type 2 diabetes as an inflammatory disease. Nature Reviews Immunology, 11(2), 98–107. https://doi.org/10.1038/nri2925
Fan, Y., & Pedersen, O. (2021). Gut microbiota in human metabolic health and disease. Nature Reviews Microbiology, 19(1), 55–71. https://doi.org/10.1038/s41579-020-0433-9
He, F. F., & Li, Y. M. (2020). Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: A review. Journal of Ovarian Research, 13, Article 73. https://doi.org/10.1186/s13048-020-00670-3
Knip, M., & Siljander, H. (2016). The role of the intestinal microbiota in type 1 diabetes mellitus. Nature Reviews Endocrinology, 12(3), 154–167. https://doi.org/10.1038/nrendo.2015.218
Koh, A., De Vadder, F., Kovatcheva-Datchary, P., & Bäckhed, F. (2016). From dietary fiber to host physiology: Short-chain fatty acids as key bacterial metabolites. Cell, 165(6), 1332–1345. https://doi.org/10.1016/j.cell.2016.05.041
Lau, H. C.-H., Zhang, X., & Yu, J. (2025). Gut microbiome in metabolic dysfunction-associated steatotic liver disease and associated hepatocellular carcinoma. Nature Reviews Gastroenterology & Hepatology, 22(9), 619–638. https://doi.org/10.1038/s41575-025-01089-1
Lindheim, L., Bashir, M., Münzker, J., Trummer, C., Zachhuber, V., Leber, B., Horvath, A., Pieber, T. R., Gorkiewicz, G., Stadlbauer, V., & Obermayer-Pietsch, B. (2017). Alterations in gut microbiome composition and barrier function are associated with reproductive and metabolic defects in women with polycystic ovary syndrome (PCOS): A pilot study. PLoS ONE, 12(1), Article e0168390. https://doi.org/10.1371/journal.pone.0168390
Liu, T., Zhang, L., Joo, D., & Sun, S. C. (2017). NF-κB signaling in inflammation. Signal Transduction and Targeted Therapy, 2, Article 17023. https://doi.org/10.1038/sigtrans.2017.23
Lynch, S. V., & Pedersen, O. (2016). The human intestinal microbiome in health and disease. New England Journal of Medicine, 375(24), 2369–2379. https://doi.org/10.1056/NEJMra1600266
Martin, A. M., Sun, E. W., Rogers, G. B., & Keating, D. J. (2019). The influence of the gut microbiome on host metabolism through the regulation of gut hormone release. Frontiers in Physiology, 10, Article 428. https://doi.org/10.3389/fphys.2019.00428
Matar, A., Damianos, J. A., Jencks, K. J., & Camilleri, M. (2024). Intestinal barrier impairment, preservation, and repair: An update. Nutrients, 16(20), Article 3494. https://doi.org/10.3390/nu16203494
Qi, X., Yun, C., Sun, L., Xia, J., Wu, Q., Wang, Y., Wang, L., Zhang, Y., Liang, X., Wang, L., Gonzalez, F. J.,
Patterson, A. D., Liu, H., Mu, L., Zhou, Z., Zhao, Y., Li, R., Liu, P., Zhong, C., … Qiao, J. (2019). Gut microbiota–bile acid–interleukin-22 axis orchestrates polycystic ovary syndrome. Nature Medicine, 25(8), 1225–1233. https://doi.org/10.1038/s41591-019-0509-0
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the healthy gut microbiota composition? A changing ecosystem across age, environment, diet, and diseases. Microorganisms, 7(1), Article 14. https://doi.org/10.3390/microorganisms7010014
Sapone, A., de Magistris, L., Pietzak, M., Clemente, M. G., Tripathi, A., Cucca, F., Lampis, R., Kryszak, D., Cartenì, M., Generoso, M., Iafusco, D., Prisco, F., Laghi, F., Riegler, G., Carratu, R., Counts, D., & Fasano, A. (2006). Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives. Diabetes, 55(5), 1443–1449. https://doi.org/10.2337/db05-1593
Sawicka-Gutaj, N., Gruszczyński, D., Zawalna, N., Nijakowski, K., Muller, I., Karpiński, T., Salvi, M., & Ruchała,
M. (2022). Microbiota alterations in patients with autoimmune thyroid diseases: A systematic review. International Journal of Molecular Sciences, 23(21), Article 13450. https://doi.org/10.3390/ijms232113450
Starosz, A., Jamiołkowska-Sztabkowska, M., Głowińska-Olszewska, B., Moniuszko, M., Bossowski, A., & Grubczak, K. (2022). Immunological balance between Treg and Th17 lymphocytes as a key element of type 1 diabetes progression in children. Frontiers in Immunology, 13, Article 958430. https://doi.org/10.3389/fimmu.2022.958430
Tang, W. H. W., Kitai, T., & Hazen, S. L. (2017). Gut microbiota in cardiovascular health and disease. Circulation Research, 120(7), 1183–1196. https://doi.org/10.1161/CIRCRESAHA.117.309715
Teede, H. J., Bahri Khomami, M., Morman, R., Laven, J. S. E., et al. (2026). Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: A multistep global consensus process. The Lancet, 407(10545), 2329–2339. https://doi.org/10.1016/S0140-6736(26)00717-8
Torres, P. J., Siakowska, M., Banaszewska, B., Pawelczyk, L., Duleba, A. J., Kelley, S. T., & Thackray, V. G. (2018). Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism. Journal of Clinical Endocrinology & Metabolism, 103(4), 1502–1511. https://doi.org/10.1210/jc.2017-02153
Vaarala, O. (2008). Leaking gut in type 1 diabetes. Current Opinion in Gastroenterology, 24(6), 701–706. https://doi.org/10.1097/MOG.0b013e32830e6d98
Vatanen, T., Franzosa, E. A., Schwager, R., Tripathi, S., Arthur, T. D., Vehik, K., Lernmark, Å., Hagopian, W. A., Rewers, M. J., She, J. X., Toppari, J., Ziegler, A. G., Akolkar, B., Krischer, J. P., Stewart, C. J., Ajami, N. J., Petrosino, J. F., Gevers, D., Lähdesmäki, H., … Xavier, R. J. (2018). https://doi.org/10.1038/s41586-018-0620-2
Virili, C., & Centanni, M. (2017). “With a little help from my friends” – The role of microbiota in thyroid hormone metabolism and enterohepatic recycling. Molecular and Cellular Endocrinology, 458, 39–43. https://doi.org/10.1016/j.mce.2017.01.053
Virili, C., Fallahi, P., Antonelli, A., Benvenga, S., & Centanni, M. (2018). Gut microbiota and Hashimoto's thyroiditis. Reviews in Endocrine and Metabolic Disorders, 19(4), 293–300. https://doi.org/10.1007/s11154-018-9467-y
Virili, C., Stramazzo, I., & Centanni, M. (2021). Gut microbiome and thyroid autoimmunity. Best Practice & Research Clinical Endocrinology & Metabolism, 35(3), Article 101506. https://doi.org/10.1016/j.beem.2021.101506
Wu, H., Tremaroli, V., & Bäckhed, F. (2015). Linking microbiota to human diseases: A systems biology perspective. Trends in Endocrinology & Metabolism, 26(12), 758–770. https://doi.org/10.1016/j.tem.2015.09.011
Zeng, B., Lai, Z., Sun, L., Zhang, Z., Yang, J., Li, Z., Zhang, W., & Wei, H. (2019). Structural and functional profiles of the gut microbial community in polycystic ovary syndrome with insulin resistance (IR-PCOS): A pilot study. Research in Microbiology, 170(1), 43–52. https://doi.org/10.1016/j.resmic.2018.09.002
Zhang, F., Cui, B., He, X., Nie, Y., Wu, K., Fan, D., & FMT-standardization Study Group. (2018). Microbiota transplantation: Concept, methodology and strategy for its modernization. Protein & Cell, 9(5), 462–473. https://doi.org/10.1007/s13238-018-0541-8
Zhou, H., Sun, L., Zhang, S., Zhao, X., Gang, X., & Wang, G. (2020). Evaluating the causal role of gut microbiota in type 1 diabetes and its possible pathogenic mechanisms. Frontiers in Endocrinology, 11, Article 125. https://doi.org/10.3389/fendo.2020.00125
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Liss Estefanny Orozco Guijarro, Génesis Dayana Moreno Ojeda, Mabel Ximena Velasco Bonifaz, Irene Guadalupe Montenegro Borja
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the moral and patrimonial rights of their works. They only give to the magazine Tesla Revista Científica the right to the first publication of this. Since Tesla Revista Científica is an open access publication, readers can fully or partially reproduce its content as long as they properly credit the corresponding authors and the journal itself. Tesla Revista Científica undertakes not to make commercial use of the texts it receives and/or publishes.
Our journal is governed by the international policies SHERPA/RoMEO: Green journal: They allow the self-archiving of both the pre-print (draft of a paper) and the post-print (the version corrected and reviewed by peers) and even the final version ( layout as it will be published in the journal).
See also "Copyright and licences".
