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Manipulating resident microbiota to enhance regulatory immune function to treat inflammatory bowel diseases

Authors
  • Mishima, Yoshiyuki1, 2
  • Sartor, Ryan Balfour2
  • 1 Shimane University,
  • 2 University of North Carolina,
Type
Published Article
Journal
Journal of Gastroenterology
Publisher
Springer Japan
Publication Date
Sep 03, 2019
Volume
55
Issue
1
Pages
4–14
Identifiers
DOI: 10.1007/s00535-019-01618-1
PMID: 31482438
PMCID: PMC6942586
Source
PubMed Central
Keywords
License
Unknown

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.

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