Unraveling the Therapeutic Potential of the Microbiota-Gut-Brain Axis: A Novel Approach for Obesity and Type 2 Diabetes Management

The gut-brain two-way communication network has long been known to have tremendous therapeutic promise in the treatment of common metabolic diseases, including obesity and type 2 diabetes mellitus (T2DM), but its full therapeutic potential has not been adequately studied. All the components of the Microbiota-Gut-Brain Axis (MGBA), such as gut microbiota, vagus nerve, enteric neurons, and enteric endocrine cells, communicate with each other to regulate metabolic processes and also participate in regulating appetite and feeding behavior in conjunction with the central nervous system. Studies have shown that alterations in these communication pathways can lead to metabolic, inflammatory, and neurological diseases. This review aims to outline the dynamic relationship between MGBA elements and their signaling pathways in the control of energy balance, food consumption, and glucose metabolism, as well as the MGBArelated factors that promote the development and advancement of obesity and T2DM. It also addresses existing treatment modalities that regulate MGBA activity, such as GLP-1 receptor agonists, prebiotics, probiotics, synbiotics, and fecal microbiota transplantation (FMT), as well as new clinical trials that may help develop interventions to manage metabolic diseases. The future progress of MGBA approaches will enable the establishment of tailored therapies, targeted dietary treatments, and integrative metabolic therapies that could potentially enhance the treatment and outcomes of obesity and T2DM.