Targeting the Gut Microbiota in IBD

Several therapies that modulate gut microbiota, such as antibiotics and probiotics, have been assessed in IBD^1-3:

Antibiotics

Antibiotics may reduce certain symptoms of IBD by decreasing overall bacterial burden; however, their role in clinical practice remains limited.² Antibiotic monotherapy has provided some benefit in managing complications of Crohn’s colitis, such as abscesses and fistulae, and may prevent post-resection recurrence. The use of certain antibiotics in combination may also improve outcomes; however, use is limited due to the risk of resistance development. Currently, no benefits have been found with antibiotic use in ulcerative colitis.^2,10

Probiotics

Probiotics have been used in an attempt to create a healthy balance in the global composition of gut microbiota. While certain probiotics have shown benefits in managing ulcerative colitis, this approach has demonstrated limited efficacy in Crohn’s disease.^1,2

In Development

Research is focusing on the benefits of experimental therapies, such as fecal microbiota transplantation, in IBD. Most microbiome-based therapies require further investigation before they can be used in routine clinical practice. Such modalities will likely require a personalized approach to determine which patients may benefit.^1,2

MICROBIAL IMBALANCE IN CLD

IBD = inflammatory bowel disease

References

Somineni HK, Kugathasan S. The microbiome in patients with inflammatory disease. Clin Gastroenterol Hepatol. 2019;17(2):243-255.
Zuo T, Ng SC. The gut microbiota in the pathogenesis and therapeutics of inflammatory bowel disease. Front Microbiol. 2018;9:2247.
Weingarden AR, Vaughn BP. Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease. Gut Microbes. 2017;8(3):238-252.
Yu LC. Microbiota dysbiosis and barrier dysfunction in inflammatory bowel disease and colorectal cancers: exploring a common ground hypothesis. J Biomed Sci. 2018;25(1):79.
Casén C, Vebø HC, Sekelja M, et al. Deviations in human gut microbiota: a novel diagnostic test for determining dysbiosis in patients with IBS or IBD. Aliment Pharmacol Ther. 2015;42(1):71-83.
Frank DN, St Amand AL, Feldman RA, Boedeker EC, Harpaz N, Pace NR. Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases. Proc Natl Acad Sci U S A. 2007;104(34):13780-13785.
Halfvarson J, Brislawn CJ, Lamendella R, et al. Dynamics of the human gut microbiome in inflammatory bowel disease. Nat Microbiol. 2017;2:17004.
Morgan XC, Tickle TL, Sokol H, et al. Dysfunction of the intestinal microbiome in inflammatory bowel disease and treatment. Genome Biol. 2012;13(9):R79.
Li J, Butcher J, Mack D, Stintzi A. Functional impacts of the intestinal microbiome in the pathogenesis of inflammatory bowel disease. Inflamm Bowel Dis. 2015;21(1):139-153.
Sartor RB, Wu GD. Roles for intestinal bacteria, viruses, and fungi in pathogenesis of inflammatory bowel diseases and therapeutic approaches. Gastroenterology. 2017;152(2):327-339.

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