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The gut microbiome as a target for IBD treatment: are we there yet
Abstract
Purpose of review This review aims to highlight recent research on the gut microbiome in IBD and the application of microbiome-modulating therapies for the treatment of IBD including the use of the microbiome as an indicator for disease severity and treatment response. Recent findings Despite the high number of gut microbiome studies and emerging evidence supporting the gut microbiome's involvement in disease pathogenesis, no single microorganism has been identified as a pathogenic agent in IBD. Retrospective studies and meta-analyses on antibiotic use in ulcerative colitis and Crohn's disease and long-term outcomes are conflicting. Similarly, the use of probiotics for the treatment of IBD remains inconclusive; however, some encouraging results are emerging as microbial concoctions are optimized to include beneficial bacterial strains. Fecal microbial transplantation (FMT) is currently emerging as one of the more promising microbiome-modulating IBD therapies. FMT studies in ulcerative colitis have shown improved remission rates compared to placebo; however, relatively small study sample sizes and varied treatment methods, limit definitive conclusions. With clear evidence of an IBD gut dysbiosis, novel therapies to treat and prevent disease relapse will undoubtedly require a microbiome-modulating approach. The complexity and variability of IBD disease pathogenesis (disease phenotype, gut microbiome, host genetic susceptibility, and environmental factors) will likely require a personalized and multidimensional treatment approach where microbiome-modulating therapy is coupled with other therapies to target other IBD disease components.
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Metadata
- Authors
- Knox, N. C., Forbes, J. D., Van Domselaar, G., & Bernstein, C. N.
- Affiliations
- Public Health Agency of Canada (CA)
- University of Toronto (CA)
- University of Manitoba (CA)
- Corresponding author
- Bernstein, Charles N.
- Venue
- Current Treatment Options in Gastroenterology
- Published
- 2019-01-19
- Volume
- 17
- Issue
- 1
- Pages
- 115-126
- ISSN
- 1092-8472 (ISSN-L)
- 1534-309X
- OpenAlex
- W2911082921
- Cited by
- 117
- References
- 54
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 10 · 2023: 19 · 2022: 19 · 2021: 28 · 2020: 22 · 2019: 11
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Treatment Options in Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Keywords
- gut microbiota, inflammatory bowel disease, fecal microbiota transplantation, probiotics, antibiotic use, ulcerative colitis, Crohn's disease, gut dysbiosis, disease severity markers, treatment response, personalized medicine, relapse prevention
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