Intestinal microbiota pathogenesis and fecal microbiota transplantation for inflammatory bowel disease

Abstract

The intestinal microbiota plays an important role in inflammatory bowel disease (IBD). The pathogenesis of IBD involves inappropriate ongoing activation of the mucosal immune system driven by abnormal intestinal microbiota in genetically predisposed individuals. However, there are still no definitive microbial pathogens linked to the onset of IBD. The composition and function of the intestinal microbiota and their metabolites are indeed disturbed in IBD patients. The special alterations of gut microbiota associated with IBD remain to be evaluated. The microbial interactions and host-microbe immune interactions are still not clarified. Limitations of present probiotic products in IBD are mainly due to modest clinical efficacy, few available strains and no standardized administration. Fecal microbiota transplantation (FMT) may restore intestinal microbial homeostasis, and preliminary data have shown the clinical efficacy of FMT on refractory IBD or IBD combined with Clostridium difficile infection. Additionally, synthetic microbiota transplantation with the defined composition of fecal microbiota is also a promising therapeutic approach for IBD. However, FMT-related barriers, including the mechanism of restoring gut microbiota, standardized donor screening, fecal material preparation and administration, and long-term safety should be resolved. The role of intestinal microbiota and FMT in IBD should be further investigated by metagenomic and metatranscriptomic analyses combined with germ-free/human flora-associated animals and chemostat gut models.

The nasal microbiome: opening new clinical research avenues for allergic disease

“…Introducing beneficial bacteria in the form of probiotics or inducing a change in benefit of specific commensals by inoculation using fecal transplant has been used in the treatment of inflammatory gastrointestinal diseases [16]. Whether alterations in the nasal microbiome towards a more sustained and symbiotic combination in humans are feasible is a matter for future research.…”

Qualitative and Quantitative Characteristics of Selected Bacterial Groups in Children with Inflammatory Bowel Diseases

“…Many microorganisms are being analysed, e.g. Escherichia coli, Yersinia, Listeria, but none of them have been isolated from all patients with IBD (Lakatos et al, 2006;Wank et al, 2014;Maukonen et al, 2015). Some researchers associate causes of the disease with Bacteroides fragilis.…”

Practical Considerations and the Intestinal Microbiome in Disease: Antibiotics for IBD Therapy

“…In spite of the proximity, abundance and interaction of the gut microflora with the affected tissues, both targeted (i.e., probiotics and prebiotics) and un-targeted (i.e., fecal microbiota transplantation) alterations of the microflora have not yet produced any significant and durable therapeutic advantages in IBD as reviewed elsewhere [4,6,7] . The use of broad spectrum antibiotics in the treatment of Crohn's disease and ulcerative colitis has yielded conflicting results.…”

“…The exact mechanisms involving the initiation and perpetuation of these inflammatory bowel diseases sp. [4] . Another microbe-oriented feature is that patients with IBD have a substantial decrease in the diversity of their intestinal microbiota [5] .…”