The Microbiota and the Immune Response: What Is the Chicken and What Is the Egg? - 09/05/19

Doi : 10.1016/j.giec.2019.02.005

Julia Fritsch, BS ^a, Maria T. Abreu, MD ^b,^⁎
^a Microbiology and Immunology, Center for Crohn’s and Colitis, University of Miami Miller School of Medicine, 1011 North West 15th Street (D-149), Gautier Building, Suite 537B, Miami, FL USA
^b Department of Medicine, Division of Gastroenterology, Crohn's & Colitis Center, University of Miami Miller School of Medicine, 1011 North West 15th Street (D-149), Gautier Building, Suite 510, Miami, FL USA

^∗Corresponding author.

Résumé

The underlying factors driving the onset and progression of inflammatory bowel disease (IBD) include the interplay between host genetics, microbiota, and mucosal inflammation. The same environmental triggers that are a risk factor for IBD also alter the microbiota, suggesting a link between the microbiome and IBD. Specific IBD-associated genetic polymorphisms change the microbiome linking host genetics to the microbiota. Microbial changes occur at least simultaneously with new onset IBD, and fecal microbial transplant can ameliorate certain types of IBD. A current debate in the field is which comes first, dysbiosis or inflammation? Can restitution of the microbiome “cure” IBD?

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Keywords : Intestinal inflammation, Colitis, Bacterial translocation, Host-microbe interactions, Crohn’s disease, Ulcerative colitis, Innate immunity, Dysbiosis

Plan

Key points

Introduction

Modification of the microbiome

Dysbiosis in inflammatory bowel disease

Dysbiosis causes inflammation

Inflammation causes dysbiosis

Which came first, dysbiosis or inflammation?

Current and potential future therapies to treat inflammatory bowel disease

Summary

Disclosure Statement: We have read the journal's policy and the authors of this article have the following competing interests: M.T. Abreu has served as a consultant to Prometheus Laboratories, Takeda, UCB Inc., Pfizer, Janssen, Focus Medical Communications and Eli Lilly Pharmaceuticals. M.T. Abreu serves as trainer or lecturer for CME Outfitters and Imedex, Inc. M.T. Abreu serves on the scientific advisory board of AbbVie Laboratories, Celgene Corporation, Shire Pharmaceuticals, Roche Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, AMGEN, Allergan, SERES, Nestle Health Science, and GILEAD, and on the board of directors for the GI Health Foundation. This does not alter the authors’ adherence to the journal’s policies on sharing data and materials. All other authors declare no conflict of interest.

This work was supported by grants from the National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases R01DK099076, R01DK104844 and T32DK11678; Crohn's and Colitis Foundation Award IBD-0389R; Florida Academic Cancer Center Alliance (FACCA) Award; Pfizer ASPIRE Award; and Takeda Pharmaceuticals Investigator Initiated Research (IIR) Award. Additional funding was provided by The Micky & Madeleine Arison Family Foundation Crohn's & Colitis Discovery Laboratory and Martin Kalser Chair.