Recommendations for future research priorities

Evidence has accumulated to support an important role for gastrointestinal function and the intestinal microflora in maintaining health and preventing diseases. Disturbances of the intestinal microflora may lead to other disturbances and dysfunctions of the gut. Thus, understanding the normal microflora with regard to its metabolic activity and influence on the immune and endocrine systems remains a key area for future research.

10.1. Intestinal microflora

  • 1) Develop and validate robust methods that are applicable to large-scale human studies of the intestinal microflora.
  • 2) Characterize the normal microflora and its activities in healthy persons of all ages.
  • 3) Identify changes in microflora composition and activity associated with major dysfunctions of the gut.
  • 4) Identify dietary factors that lead to changes in the microflora and the mechanisms that bring about improvement in health.

10.2. Short-chain fatty acids and intestinal microflora

  • 1) The mechanism by which mixed populations of anaerobic gut bacteria produce different amounts and patterns of SCFA needs to be further investigated.
  • 2) The role of butyrate in cell differentiation and growth requires further study, particularly of the butyrate response elements in genes and identification of the genes involved.
  • 3) The role of acetate in metabolism and its regulation, particularly in fasting or starving subjects, requires further study.
  • 4) In vivo production rates of SCFA and their relation to H2 metabolism and microbial growth need to be determined.

10.3. Diet and cancer

  • 1) Determine the role of the intestinal microflora with respect to composition and activities in carcinogenesis, in particular of the colo-rectum.
  • 2) Modulation of these aspects by probiotics and prebiotics requires further study.
  • 3) Novel biomarkers of colorectal carcinogenesis need to be developed and validated.
  • 4) The influence of diet and the intestinal microflora on DNA damage and repair in normal mucosa requires further study.

10.4. Immune system

  • 1) Improve understanding of G ALT function and regulation, and interaction between GALT and the digestive epithelium.
  • 2) Understand the role of the intestinal microflora and its modification by dietary factors in regulating immune function in health and disease.
  • 3) Develop and validate biomarkers for immune function and their long-term effects.

10.5. Gut mucosa

  • 1) Develop novel methodologies to study the function and changes in the intestinal mucosa in human subjects.
  • 2) Characterize the microflora associated with a healthy mucosa and mucus metabolism.
  • 3) Determine the effects of changes in phase I and phase II mucosal enzymes on xenobiotic metabolism and health.

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