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World J Gastroenterol. Mar 14, 2013; 19(10): 1513-1516
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1513
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1513
Microbial manipulation as primary therapy for Crohn's disease
Randy S Longman, Arun Swaminath, Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States
Author contributions: Longman RS and Swaminath A wrote the manuscript.
Correspondence to: Arun Swaminath, Assistant Professor, Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, 622 West 168th Str VC5, New York, NY 10032, United States. as3576@mail.cumc.columbia.edu
Telephone: +1-212-3051021 Fax: +1-212-3055576
Received: June 20, 2012
Revised: February 5, 2013
Accepted: February 7, 2013
Published online: March 14, 2013
Revised: February 5, 2013
Accepted: February 7, 2013
Published online: March 14, 2013
Abstract
While antimicrobials are clinically effective in preventing post-operative recurrence, the role for antibiotics in primary therapy for Crohn’s disease (CD) remains unclear. The recent multicenter phase 2 trial by Prantera et al received wide attention because it demonstrated an increase in the week 12 remission rate in patients with moderately active CD treated with rifaximin and renewed interest in microbial manipulation as primary therapy for CD. In this commentary, we discuss aspects of durability, immune cell polarization, and safety of microbial manipulation as primary therapy for CD.
Keywords: Inflammatory bowel disease; Rifaximin; Microbiome