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World J Gastroenterol. Feb 14, 2025; 31(6): 101266
Published online Feb 14, 2025. doi: 10.3748/wjg.v31.i6.101266
Gut microbiota in Crohn’s disease pathogenesis
Dogukan Ozbey, Suat Saribas, Bekir Kocazeybek
Dogukan Ozbey, Suat Saribas, Bekir Kocazeybek, Department of Medical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul 34098, Türkiye
Dogukan Ozbey, Department of Medical Microbiology, Istanbul Okan University, Faculty of Medicine, Istanbul 34959, Türkiye
Co-first authors: Dogukan Ozbey and Suat Saribas.
Author contributions: Dogukan O, Sarıbaş S, and Kocazeybek B contributed to this paper; Kocazeybek B designed the overall concept and outline of the manuscript; Dogukan O contributed to the writing, discussion and design of the manuscript; Sarıbaş S contributed to the editing the manuscript, illustrations, and review of literature.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bekir Kocazeybek, Professor, Department of Medical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Kocamustafapaşa St No. 53, Istanbul 34098, Türkiye. bzeybek@istanbul.edu.tr
Received: September 9, 2024
Revised: November 24, 2024
Accepted: December 10, 2024
Published online: February 14, 2025
Processing time: 122 Days and 22.3 Hours
Abstract

Inflammatory bowel diseases (IBDs) are classified into two distinct types based on the area and severity of inflammation: Crohn's disease (CD) and ulcerative colitis. In CD, gut bacteria can infiltrate mesenteric fat, causing expansion known as creeping fat, which may limit bacterial spread and inflammation but can promote fibrosis. The gut bacteria composition varies depending on whether the colon or ileum is affected. Fecal microbiota transplantation (FMT) transfers feces from a healthy donor to restore gut microbiota balance, often used in IBD patients to reduce inflammation and promote mucosal repair. The use of FMT for CD remains uncertain, with insufficient evidence to fully endorse it as a definitive treatment. While some studies suggest it may improve symptoms, questions about the duration of these improvements and the need for repeated treatments persist. There is a pressing need for methods that provide long-term benefits, as highlighted by Wu et al's research.

Keywords: Crohn's disease; Fecal microbiota transplantation; Gut microbiota; Inflammatory bowel disease; Mesenteric adipose tissue

Core Tip: Inflammatory bowel diseases include Crohn's disease (CD) and ulcerative colitis, characterized by inflammation in different areas. In CD, gut bacteria can invade mesenteric fat, leading to complications. Fecal microbiota transplantation is explored to restore gut balance, but its effectiveness in CD is still uncertain, with ongoing questions about symptom duration and treatment frequency. There is a critical need for long-term solutions, as emphasized by recent research.