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Relevance to Human In Vivo Situation

The suitability of the SIMGI fermentation model to reproduce human conditions associated to changes in dietary lifestyles has been evaluated by the simulation of an obesity-associated microbiota in this in vitro system (unpublished results). For this purpose, the three colonic reactors were inoculated with fecal microbiota from an overweight individual after which the system was feeding daily with a high energy nutritive medium for 2 weeks (microbial stabilization period). Increase of energy in the nutritive medium was achieved by increasing the content of simple sugars (fructose), simulating high consumption of sugar-sweetened beverages, and of carbohydrates from simple starches (maize and potato). After the stabilization period a dietary intervention during 7 days was performed by lowering energy of the nutritive medium in order to observe possible changes in microbial composition and metabolism induced by a sharp shift in the diet. This low energy diet was obtained by suppression of simple carbohydrates and reduction of the content of readily fermentable starches. The selection of components of the nutritive media was based on the rational design of media with different energy content described by Payne et al. (2012) to compare the impact of dietary energy on gut microbiota in a three-stage in vitro continuous fermentation model that uses fecal microbiota immobilized within a porous, non-biodegradable polysaccharide matrix (Cinquin et al. 2006).

Fig. 28.3 Changes in concentration (mM) of SCFAs (a) and ammonium (b) in the ascending (AC; circles), transverse (TC; squares) and descending colon (DC; triangles) compartments of the SIMGI at different times after inoculation and feeding with high energy (HE) and low energy (LE) diets

The comparison of short chain fatty acids (SCFA) and ammonium formation under high energy (microbiota stabilization period) and low energy (dietary intervention) diets is shown in Fig. 28.3. Shift to a low energy diet resulted in a twofold decrease in the average content of total SCFA of the three colon compartments compared to the high energy intake period. Additionally, the shift from high to low energy medium caused a twofold increase in the ammonium content of the distal colon compartments (TC and DC) and a remarkable sixfold increase in the proximal colon compartment (AC). The SFCA and ammonium results could be compared with in vivo data from obese subjects, where a significant decrease of SCFA and increase of proteolytic products were observed when the individuals consumed diets high in protein and reduced in total carbohydrates (Russell et al. 2011).

Quality in Relation to Other Models with the Same Applicability

The SIMGI is designed to simulate not only the fermentation process as described above, but also the process of digestion. This is a competitive advantage compared to other systems that simulate digestion and fermentation operating in separate modules (TIM-1 and TIM-2). The whole system is computer controlled through an operator panel and programmable logic controller. It can be set up to sequentially proceed (continuously or feeding the system from 1 to 6 times daily) from the operation of food intake into the stomach throughout the delivery of distal colon content to waste. The system differs from the SHIME model in that the stomach uses peristaltic movements for mixing the ingested food with gastric fluids. Additionally, the computer software allows the definition of pH acidification curves that can be set up according to results obtained from in vivo studies (Marteau et al. 1990). The stomach emptying is programmable to follow the equation described by Elashoff et al. (1982) that allows the modification of the shape of the emptying curve depending on liquid, semisolid or solid foods. This process implies that the gastric content will be delivered to the small intestine at different pH values (up to pH 2). This is an important feature to take into account when evaluating probiotic survival growth under gastric and duodenal conditions (Fernández de Palencia et al. 2008) that would enable their eventual functionality when reaching the large intestine. Another distinctive characteristic of the SIMGI is that the small intestine and the three colon reactors are continuously flushed with nitrogen inducing anaerobic conditions for the oxygen-sensitive intestinal microbial communities, thus allowing a permanent anaerobic atmosphere.

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