Genetic Factors and the Intestinal Microbiome Guide Development of Microbe-Based Therapies for Inflammatory Bowel Diseases

Gastroenterology. 2019 Jun;156(8):2174-2189. doi: 10.1053/j.gastro.2019.03.017. Epub 2019 Mar 14.

Abstract

The intestinal microbiota is a dynamic community of bacteria, fungi, and viruses that mediates mucosal homeostasis and physiology. Imbalances in the microbiome and aberrant immune responses to gut bacteria can disrupt homeostasis and are associated with inflammatory bowel diseases (IBDs) in humans and colitis in mice. We review genetic variants associated with IBD and their effects on the intestinal microbiome, the immune response, and disease pathogenesis. The intestinal microbiome, which includes microbial antigens, adjuvants, and metabolic products, affects the development and function of the intestinal mucosa, influencing inflammatory responses in the gut. Therefore, strategies to manipulate the microbiome might be used in treatment of IBD. We review microbe-based therapies for IBD and the potential to engineer patients' intestinal microbiota. We discuss how studies of patients with IBD and mouse models have advanced our understanding of the interactions between genetic factors and the gut microbiome, and challenges to the development of microbe-based therapies for IBD.

Keywords: Host Genetics; Inflammatory Bowel Disease; Microbiome; Mucosal Immunity; Preclinical Therapies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Drugs, Investigational / administration & dosage*
  • Drugs, Investigational / pharmacology
  • Gastrointestinal Microbiome / genetics*
  • Gastrointestinal Microbiome / immunology*
  • Genome, Human
  • Humans
  • Immunotherapy / methods*
  • Inflammatory Bowel Diseases / microbiology
  • Inflammatory Bowel Diseases / pathology
  • Inflammatory Bowel Diseases / therapy*
  • Mice
  • Models, Animal
  • Practice Guidelines as Topic*
  • Prognosis
  • Treatment Outcome

Substances

  • Drugs, Investigational