Digestion was once viewed as a host-driven process, dependent on salivary, gastric, pancreatic, and intestinal enzymes to break down macronutrients. However, new insights into the gut microbiota have redefined this view, highlighting digestion as a cooperative effort between host and microbial enzymes. Host enzymes initiate nutrient breakdown, while microbial enzymes, especially in the colon, extend this process by fermenting resistant polysaccharides, modifying bile acids, and transforming phytochemicals and xenobiotics into bioactive compounds. These microbial actions produce metabolites like short-chain fatty acids, which influence gut barrier function, immune regulation, and metabolism. I propose two frameworks to describe this interaction: the “duet,” emphasizing sequential enzymatic cooperation, and the “orchestra,” reflecting a spatially and temporally coordinated system with host–microbiota feedback. Disruption of this symbiosis, through antibiotics, inflammation, diet, or aging, leads to dysbiosis, impaired digestion, and contributes to metabolic, neurologic, cardiovascular, and inflammatory diseases. Recognizing digestion as a dynamic, integrated system opens new paths for therapies and nutrition. These include enzyme-targeted prebiotics, probiotics, postbiotics, and personalized diets. Embracing this systems-level perspective enables innovative diagnostics and treatments, aiming to restore enzymatic balance and improve digestive and systemic health.
Volodymyr I. Lushchak (Mon,) studied this question.
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