The role of heavy metal exposure on the microbiome in the etiology of gastrointestinal disorders: a scoping review

In recent years, epidemiological studies have increasingly recognized the significance of heavy metals as an important pathogenetic factor in many gastrointestinal diseases, particularly those associated with in gut microbiota functions. The toxicity of heavy metals towards essential intestinal microflora goes beyond causing dysbiotic disorders; it can also exacerbate intestinal infections, alter metabolic processes, and influence the development of antibiotic resistance. Since the negative effects of heavy metals are environmental in nature, there is a need to systematize the etiological role between the effects of heavy metals on the microbiome and possible nosological conditions for a more accurate approach to treatment and further research. Given the environmental origins of the abovementioned effects, there is a need to systematize the impact of heavy metals on the microbiome and their role in disease development to improve approaches to treatment and further research. We aimed to analyze the latest scientific evidence on the associations between heavy metals exposure and the intestinal microbiome and its role in the development of gastrointestinal disorders. For this scoping review we used PubMed and eLIBRARY.ru databases. We searched for keywords: «gut microbiota», «intestinal infections» (disorders), «antibiotic resistance» «heavy metals» in both Russian and English. Based on the research reviewed in this study, we can infer that heavy metals act as exogenous toxicants contributing to the development of dysbiotic, metabolic and trophic disorders of the gastrointestinal tract. They also influence the progression of infections and the development of antibiotic resistance in bacteria. Further studies should focus on exploring the toxicity of heavy metals in relation to specific populations of intestinal flora and associations with metal and antibiotic resistance. It is important to consider the therapeutic potential of microbiome modulation in the management of gastrointestinal diseases.