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Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management.
Aliment Pharmacol Ther 2018; 47(1):26-42AP

Abstract

BACKGROUND

The concept of an altered collective gut microbiota rather than identification of a single culprit is possibly the most significant development in inflammatory bowel disease research. We have entered the "omics" era, which now allows us to undertake large-scale/high-throughput microbiota analysis which may well define how we approach diagnosis and treatment of inflammatory bowel disease (IBD) in the future, with a strong steer towards personalised therapeutics.

AIM

To assess current epidemiological, experimental and clinical evidence of the current status of knowledge relating to the gut microbiome, and its role in IBD, with emphasis on reviewing the evidence relating to microbial therapeutics and future microbiome modulating therapeutics.

METHODS

A Medline search including items 'intestinal microbiota/microbiome', 'inflammatory bowel disease', 'ulcerative colitis', 'Crohn's disease', 'faecal microbial transplantation', 'dietary manipulation' was performed.

RESULTS

Disease remission and relapse are associated with microbial changes in both mucosal and luminal samples. In particular, a loss of species richness in Crohn's disease has been widely observed. Existing therapeutic approaches broadly fall into 3 categories, namely: accession, reduction or indirect modulation of the microbiome. In terms of microbial therapeutics, faecal microbial transplantation appears to hold the most promise; however, differences in study design/methodology mean it is currently challenging to elegantly translate results into clinical practice.

CONCLUSIONS

Existing approaches to modulate the gut microbiome are relatively unrefined. Looking forward, the future of microbiome-modulating therapeutics looks bright with several novel strategies/technologies on the horizon. Taken collectively, it is clear that ignoring the microbiome in IBD is not an option.

Authors+Show Affiliations

School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.Internal Medicine, Gastroenterology and Liver Unit, Gastroenterology Area, Fondazione Policlinico Universitario Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.Royal Hospital for Children, Glasgow, UK.School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29034981

Citation

McIlroy, J, et al. "Review Article: the Gut Microbiome in Inflammatory Bowel Disease-avenues for Microbial Management." Alimentary Pharmacology & Therapeutics, vol. 47, no. 1, 2018, pp. 26-42.
McIlroy J, Ianiro G, Mukhopadhya I, et al. Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management. Aliment Pharmacol Ther. 2018;47(1):26-42.
McIlroy, J., Ianiro, G., Mukhopadhya, I., Hansen, R., & Hold, G. L. (2018). Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management. Alimentary Pharmacology & Therapeutics, 47(1), pp. 26-42. doi:10.1111/apt.14384.
McIlroy J, et al. Review Article: the Gut Microbiome in Inflammatory Bowel Disease-avenues for Microbial Management. Aliment Pharmacol Ther. 2018;47(1):26-42. PubMed PMID: 29034981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management. AU - McIlroy,J, AU - Ianiro,G, AU - Mukhopadhya,I, AU - Hansen,R, AU - Hold,G L, Y1 - 2017/10/16/ PY - 2017/05/05/received PY - 2017/05/29/revised PY - 2017/09/25/accepted PY - 2017/10/17/pubmed PY - 2018/3/7/medline PY - 2017/10/17/entrez SP - 26 EP - 42 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 47 IS - 1 N2 - BACKGROUND: The concept of an altered collective gut microbiota rather than identification of a single culprit is possibly the most significant development in inflammatory bowel disease research. We have entered the "omics" era, which now allows us to undertake large-scale/high-throughput microbiota analysis which may well define how we approach diagnosis and treatment of inflammatory bowel disease (IBD) in the future, with a strong steer towards personalised therapeutics. AIM: To assess current epidemiological, experimental and clinical evidence of the current status of knowledge relating to the gut microbiome, and its role in IBD, with emphasis on reviewing the evidence relating to microbial therapeutics and future microbiome modulating therapeutics. METHODS: A Medline search including items 'intestinal microbiota/microbiome', 'inflammatory bowel disease', 'ulcerative colitis', 'Crohn's disease', 'faecal microbial transplantation', 'dietary manipulation' was performed. RESULTS: Disease remission and relapse are associated with microbial changes in both mucosal and luminal samples. In particular, a loss of species richness in Crohn's disease has been widely observed. Existing therapeutic approaches broadly fall into 3 categories, namely: accession, reduction or indirect modulation of the microbiome. In terms of microbial therapeutics, faecal microbial transplantation appears to hold the most promise; however, differences in study design/methodology mean it is currently challenging to elegantly translate results into clinical practice. CONCLUSIONS: Existing approaches to modulate the gut microbiome are relatively unrefined. Looking forward, the future of microbiome-modulating therapeutics looks bright with several novel strategies/technologies on the horizon. Taken collectively, it is clear that ignoring the microbiome in IBD is not an option. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/29034981/Review_article:_the_gut_microbiome_in_inflammatory_bowel_disease_avenues_for_microbial_management_ L2 - https://doi.org/10.1111/apt.14384 DB - PRIME DP - Unbound Medicine ER -