Gut microbiota in inflammatory bowel diseases: moving from basic science to clinical applications
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PERSPECTIVE
Gut microbiota in inflammatory bowel diseases: moving from basic science to clinical applications Valerie Collij1,2 · Marjolein A. Y. Klaassen1,2 · Rinse K. Weersma1 · Arnau Vich Vila1,2 Received: 28 May 2020 / Accepted: 16 August 2020 © The Author(s) 2020
Abstract In recent years, large efforts have been made to unravel the role of the gut microbiota in inflammatory bowel disease (IBD), which is a chronic inflammatory disorder of the gastro-intestinal tract. Considering the heterogeneity patients with IBD display in their disease course and response to treatment, there is a big need in translating these findings towards clinical practise. In this perspective article, we discuss strategies to facilitate the transition from basic science on gut microbiota in IBD to clinical applications. We suggest that setting gold standards, improving and increasing the biobanking efforts, and studying other members of the gut microbiota are a necessary step to reveal the exact role of the gut microbiota in IBD. In addition, we discuss the potential of the gut microbiome as a clinical tool for the diagnoses, prediction and/or treatment of the disease. We believe that the growing interest in the gut microbiota will reveal its potential in the management of IBD in a not too distant future.
The role of the gut microbiota in IBD Crohn’s disease (CD) and ulcerative colitis (UC) are the two main forms of inflammatory bowel disease (IBD), which is a chronic disorder characterized by relapsing intestinal inflammation. Therapeutic management is aimed at reducing intestinal inflammation, however, within 10 years after diagnosis, 50% of the patients with CD and 16% of patients with UC require surgical resection of the affected intestine. The therapeutic management of IBD remains a major challenge because of the partially unknown mechanisms triggering IBD. Furthermore, patients with IBD show a large clinical heterogeneity in their disease course. The presence of symptoms caused by inflammation such as fatigue, weight loss, rectal bleeding and diarrhea and complications such as strictures and development of fistulae, is in some patients hardly present, whilst others have these symptoms frequently and, therefore, require multiple medical interventions. Moreover, the disease can be present at different locations of the gastrointestinal tract and extra-intestinal manifestations such as * Arnau Vich Vila [email protected] 1
Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
2
arthritis and uveitis could also be present. This heterogeneity introduces difficulties in assigning the right treatment for each patient (Torres et al. 2017; Ungaro et al. 2017). In recent years, large efforts have been made in unravelling the pathogenesis of IBD in which the gut microbiome has been suggested to play an important role (Torres et al. 2017; Ungaro et al. 2017). This is for example shown
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