Intestinal microecology-based treatment for inflammatory bowel disease: Progress and prospects

Abstract

Inflammatory bowel disease (IBD) is a chronic, recurrent, and debilitating disorder, and includes Crohn’s disease and ulcerative colitis. The pathogenesis of IBD is closely associated with intestinal dysbiosis, but has not yet been fully clarified. Genetic and environmental factors can influence IBD patients’ gut microbiota and metabolism, disrupt intestinal barriers, and trigger abnormal immune responses. Studies have reported the alteration of gut microbiota and metabolites in IBD, providing the basis for potential therapeutic options. Intestinal microbiota-based treatments such as pre/probiotics, metabolite supplementation, and fecal microbiota transplantation have been extensively studied, but their clinical efficacy remains controversial. Repairing the intestinal barrier and promoting mucosal healing have also been proposed. We here review the current clinical trials on intestinal microecology and discuss the prospect of research and practice in this field.

Keywords: Inflammatory bowel disease; Probiotics; Prebiotics; Intestinal metabolites; Fecal microbiota transplantation; Intestinal barrier

Core Tip: The intestinal microecological system plays an important role in the pathogenesis of inflammatory bowel disease (IBD). Reconstructing healthy intestinal microecology is a promising therapeutic strategy, but has not been widely accepted in the routine management of IBD. We herein discuss the progress and prospects of studies on IBD treatment targeting the intestinal microecological system, including disordered gut microbiota, metabolites, and intestinal epithelium.