COVER STORY • 封面專題 2022 UMAGAZINE 26 • 澳大新語 29 If you suspect you are suffering from a neurocognitive disorder (NCD), you might not only need to be administered a brain scan, but also a gut examination. According to the findings of a research team at the University of Macau (UM), analysing the increase or decrease of certain microbes in the gut may help assess the risk of NCDs and neurodegenerative diseases (NDs) such as Alzheimer’s disease (AD) in older people. The Gut: The Second Brain ‘AD mainly affects the elderly, who gradually lose their ability to live independently,’ says Yuan Zhen, head of the Centre for Cognitive and Brain Sciences (CCBS) and professor in the Faculty of Health Sciences at UM. ‘Although some drugs can alleviate the symptoms, there is still no cure for AD. As the population ages, it is likely that more and more people will suffer from AD, posing a huge challenge to global public health. Therefore, scientists have been studying the causes of the disease from different perspectives, with the “brain-gut crosstalk” being one of the focal points.’ The gut and the brain are physically and biochemically connected through a network known as the ‘gut-brain axis’, says Prof Yuan. ‘Experts refer to the gut as “the second brain” because it contains over 100 millions of neurons that send and receive signals with neurons in the brain.’ The gut microbiota, which is the ecosystem of the trillions of bacteria and other microbes in the gut, also affects the brain. For example, some metabolites, which are small molecules produced by bacteria in the gut during metabolism, can enter the brain. Previous studies show that some of these metabolites can cause NCDs. Imbalance of Gut Microbiota Affects the Brain ‘A healthy gut is characterised by the diversity of microbial species, but the diversity of gut microbiota decreases with age. During this process, the proportion of pathogenic bacteria usually increases, causing an imbalance,’ says Zhao Yonghua, assistant professor in the Institute of Chinese Medical Sciences at UM. The research team of Prof Zhao, who is also interim associate head of the Macau Institute for Translational Medicine and Innovation and a registered Chinese medicine doctor, believes that the imbalance in the gut is related to NCDs, and the team has found new evidence to support this hypothesis. Analysis of Gut Microbiota In 2019, Prof Zhao’s team launched a correlated study on the differentiation between Chinese medical ‘Constitution-Disease-Syndrome’ and the characteristics of gut microbiota and metabolomics in the elderly with cognitive dysfunction in Macao. Part of the project was conducted in collaboration with experts from Kiang Wu Nursing College of Macau, Beijing University of Chinese Medicine, Sun Yat-sen University, and Shenzhen People’s Hospital. After recruiting 400 elderly residents in Macao in 2019, 趙永華教授（左）和博士生韓炎 Prof Zhao Yonghua (left) and PhD student Han Yan
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