Can control of gut microbiota be a future therapeutic option for inflammatory bowel disease?

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract encompassing two main clinical entities, Crohn’s disease and ulcerative colitis. Accumulated evidence indicates that an aberrant immune activation caused by the interplay of genetic susceptibility and environmental impact on the gut microbiota may be involved in the pathogenesis of IBD. Rapid advances in next-generation sequencing technology have enabled a number of studies to identify the alteration of the gut microbiota, termed dysbiosis, in IBD. Moreover, the alteration in the metabolites derived from the gut microbiota in IBD has also been described in many studies. Therefore, microbiota-based interventions such as fecal microbiota transplantation (FMT) have attracted attention as a novel therapeutic option in IBD. However, in clinical trials, the efficacy of FMT for IBD remains controversial. Additional basic and clinical studies are required to validate whether FMT can assume a complementary role in the treatment of IBD. The present review provides a synopsis on dysbiosis in IBD and on the association between the gut microbiota and the pathogenesis of IBD. In addition, we summarize the use of probiotics in IBD and the results of current clinical trials of FMT for IBD.

Keywords: Inflammatory bowel disease; Dysbiosis; Fecal microbiota transplantation; Short chain fatty acid; Probiotics

Core Tip: In this review, we discuss the gut microbiota in inflammatory bowel disease and gut microbiota-derived metabolites, especially short chain fatty acids. The anti-inflammatory function of short chain fatty acids on the mucosal immune system in the gastrointestinal tract is also discussed. In addition, we review the efficacy of probiotics on inflammatory bowel disease and the current clinical trials on the effectiveness of fecal microbiota transplantation on inflammatory bowel disease.