Targeting Dialister-driven succinate accumulation: A novel strategy for Crohn’s disease activity control and recurrence prevention

Abstract

Crohn’s disease (CD) activity and postoperative recurrence significantly affect patients’ quality of life, highlighting the need for new treatment and prevention strategies. We read with interest Boronat-Toscano et al’s study on Dialister-driven succinate accumulation in CD. By analyzing the fecal microbiota, circulating succinate levels, and clinical indices using clinical samples, the researchers explored the roles of Dialister and succinate in CD, a previously unaddressed area. They revealed that active CD is characterized by high succinate levels, which are associated with disease severity and inflammatory indicators. The enrichment of Dialister, linked to impaired succinate clearance and postoperative recurrence, offers new insights. The study identified succinate and Dialister as potential therapeutic targets, advancing understanding of CD pathophysiology and paving the way for further investigations. Future studies should involve large, multicenter cohorts for validation, explore Dialister’s strain-specific metabolic mechanisms, and develop treatments targeting the “succinate axis”, thus connecting fundamental research with clinical applications.

Keywords: Crohn’s disease; Succinate; Therapeutic targets; Gut microbiota; Inflammatory bowel disease; Postoperative recurrence; Dialister

Core Tip: Crohn’s disease (CD) greatly affects patients’ quality of life, necessitating new treatment strategies. Boronat-Toscano et al examined the role of Dialister and succinate in CD by analyzing the fecal microbiota, circulating succinate levels, and clinical indices. They found that high succinate levels are linked to active CD and inflammation, with Dialister enrichment related to impaired succinate clearance and recurrence. These findings highlight succinate and Dialister as therapeutic targets, enhancing understanding of CD and guiding future research. Larger studies should validate these results, explore Dialister’s metabolic mechanisms, and develop treatments targeting the “succinate axis” to link basic research to clinical practice.