Mishima Y^1,2, Sartor RB³. J Gastroenterol. 2019 Sep 3. doi: 10.1007/s00535-019-01618-1. [Epub ahead of print]

Author information

1 Department of Internal Medicine II, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan.

2 Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Room 7309A MBRB, CB# 7032, Chapel Hill, NC, 27599-7032, USA.

3 Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Room 7309A MBRB, CB# 7032, Chapel Hill, NC, 27599-7032, USA. rbs@med.unc.edu.

Abstract

Altered intestinal microbial composition (dysbiosis) and metabolic products activate aggressive mucosal immune responses that mediate inflammatory bowel diseases (IBD). This dysbiosis impairs the function of regulatory immune cells, which normally promote mucosal homeostasis. Normalizing and maintaining regulatory immune cell function by correcting dysbiosis provides a promising approach to treat IBD patients. However, existing microbe-targeted therapies, including antibiotics, prebiotics, probiotics, and fecal microbial transplantation, provide variable outcomes that are not optimal for current clinical application. This review discusses recent progress in understanding the dysbiosis of IBD and the basis for therapeutic restoration of homeostatic immune function by manipulating an individual patient's microbiota composition and function. We believe that identifying more precise therapeutic targets and developing appropriate rapid diagnostic tools will guide more effective and safer microbe-based induction and maintenance treatments for IBD patients that can be applied in a personalized manner.