The microbiome landscape in pediatric Crohn’s disease and therapeutic implications

Abstract

Dysbiosis of the gut microbiome and a pathological immune response in intestinal tissues form the basis of Crohn’s disease (CD), which is a debilitating disease with relevant morbidity and mortality. It is increasing in childhood and adolescents, due to western life-style and nutrition and a large set of predisposing genetic factors. Crohn’s disease-associated genetic mutations play an essential role in killing pathogens, altering mucosal barrier function, and protecting the host microbiome, suggesting an important pathogenic link. The intestinal microbiome is highly variable and can be influenced by environmental factors. Changes in microbial composition and a reduction in species diversity have been shown to be central features of disease progression and are therefore the target of therapeutic approaches. In this review, we summarize the current literature on the role of the gut microbiome in childhood, adolescent, and adult CD, current therapeutic options, and their impact on the microbiome.

Persistent dysbiosis of duodenal microbiota in patients with controlled pediatric Crohn’s disease after resolution of inflammation

“…3 B) and decreased Actinobacillus (family Pasteurellaceae ) (Fig. 3 C) were associated with controlled pediatric Crohn’s disease, which contradicts finding from active pediatric disease 48 . As Actinobacillus in pediatric Crohn’s is not well documented this may be an area for future study.…”

Faecal volatile organic compounds differ according to inflammatory bowel disease sub‐type, severity, and response to treatment in paediatric patients

“…Given that the metabolism of the gut microbiota is the main source of faecal VOCs, 2 these findings are consistent with the reduced microbial diversity and dysbiosis reported in IBD in adults 2 and children. 13 …”

Effects of fructooligosaccharides andSaccharomyces boulardiion the compositional structure and metabolism of gut microbiota in students

“…On the other hand, S. boulardii , as a fungal probiotic with therapeutic effects, is widely used in the adjuvant treatment of various intestinal diseases, such as antibiotic-associated diarrhea and gastrointestinal disorders (47, 48). It is well known that the gut microbiome of adolescents and children is unstable, and various intestinal diseases are often caused by gut microbiota dysbiosis (49). However, in our in vitro fermentation model, the addition of S. boulardii alone did not provide much benefit in regulating the fecal microbiota among healthy students.…”