Investigating the Interplay between the Gut Microbiota and Host Immunity in Gastroenteric Disorders: The Potential of Combined Drug Therapies to Restore Microbial-immune Homeostasis
Abstract
This study examines the interaction between the microbiota and the immune system in diseases of the gastrointestinal tract, with a special emphasis on the synergistic use of pharmacological agents.
This was a retrospective, observational study of 100 patients with moderate to severe gastrointestinal disorders, including irritable bowel syndrome and inflammatory bowel disease, receiving control, monotherapy, or combination therapy.
Over 12 weeks, combination therapy demonstrated superior efficacy in enhancing gut microbial diversity. Improvements were achieved in alpha diversity, and a decrease in inflammatory indices and a shift in the immune phenotype were observed. Patients experienced significant improvements in symptom severity, pain, and general health. In addition, the general health of patients also improved. Importantly, the combination therapy group had better responses compared with the other groups. With respect to the identified factors, regression analysis revealed that microbial diversity, immune system regulation, and inflammation had positive effects on disease symptom alleviation.
These findings therefore help support the perspective of combination therapy as a more comprehensive mode of approaching and treating gastroenteric diseases.
2. Honda K, Littman DR. The microbiota in adaptive immune homeostasis and disease. Nature. 2022;584(7819):298–307.
3. Zhang YJ, Li S, Gan RY. Impacts of gut bacteria on human health and diseases. Int J Mol Sci. 2020;21(2):627.
4. Jin L, Shi X, Zhang Y. Gut microbiota and immune regulation in autoimmune diseases. Cell Mol Immunol. 2021;18(5):1165–75.
5. Gevers D, Kugathasan S, Denson LA. The role of gut microbiota in pediatric Crohn’s disease. Nat Med. 2021;27(6):911–9.
6. Tap J, Derrien M, Simrén M. Microbiota and IBS severity. Gastroenterology. 2020;159(1):111–23.
7. Feng Q, Liang S, Zhang D. Gut microbiome development along the colorectal adenoma–carcinoma sequence. Nat Commun. 2021;11(1):1–13.
8. Hale VL, Jeraldo P, Chen J. Dysbiosis and gastrointestinal motility disorders. J Gastroenterol. 2022;57(1):21–30.
9. Schwabe RF, Jobin C. The microbiome and cancer. Nat Rev Cancer. 2020;20(3):131–47.
10. Camilleri M, Carlson P. Low grade inflammation and altered immune activation in irritable bowel syndrome. Gastroenterology. 2021; 160(4):1231–1243.
11. Sanders ME, Merenstein DJ. Probiotics and their role in maintaining gut health. Nat Rev Gastroenterol Hepatol. 2020;17(2):95–108.
12. Zhao Q, Yang Z, Liu X. High-fiber diets and gut health. Front Microbiol. 2022;13(8):2231.
13. Cammarota G, Ianiro G, Tilg H. Fecal microbiota transplantation. Nat Rev Gastroenterol Hepatol. 2020;17(2):70–78.
14. El Salhy M, Hatlebakk JG, Gilja OH. Irritable bowel syndrome: Recent developments in pathophysiology, diagnosis, and treatment. Gastroenterol Clin North Am. 2021;50(3):551–71.
15. Khan MT, Chousalkar K, Jain R. Antibiotic immunotherapy synergy in Crohn’s disease. Lancet Microbe. 2021;2(4):324–36.
16. Torres J, Mehandru S, Colombel JF. Crohn’s disease: Antibiotics and immunomodulators. Clin Gastroenterol Hepatol. 2022;20(4):753–67.
17. Ford AC, Moayyedi P, Chey WD. Efficacy of probiotics in irritable bowel syndrome. Lancet Gastroenterol Hepatol. 2020;5(6):490–503.
18. Ungaro R, Mehandru S, Colombel JF. Biologics in inflammatory bowel disease management. Lancet Gastroenterol Hepatol. 2021;6(3):218–230.
19. Miele E, Pascarella F, Giannetti E. Probiotics and inflammatory bowel disease. Pediatr Res. 2021;89(4):839–47.
20. Ianiro G, Tilg H, Gasbarrini A. Probiotics in gut health and disease. Nat Rev Gastroenterol Hepatol. 2022;19(10):625–39.
21. Agus A, Sokol H, Pigneur B. The role of gut microbiota in inflammatory bowel diseases. Cell Host Microbe. 2021;19(4):444–52.
22. Petersen C, Round JL. Defining dysbiosis and its role in disease. Trends Microbiol. 2020;8(10):750–61.
23. Zhang X, Deuring J, Suchiman EH. Personalized medicine in inflammatory bowel diseases. Gastroenterology. 2021;160(2):339–344.
24. Vich Vila A, Imhann F, Collij V. Machine learning in microbiome based personalized medicine. Nat Med. 2022;28(5):784–92.
25. Kuhn ML, Papoutsakis ET. Advances in gut microbiota based drug delivery systems. J Biotechnol. 2022;326(2):15–26.
26. Ghosh S, Shanahan F, O’Mahony L. Gut microbiota modulation in inflammatory bowel disease: New directions for management. Nat Rev Gastroenterol Hepatol. 2021;8(7):481–492.
27. Kostic AD, Xavier RJ, Gevers D. The microbiome in inflammatory bowel disease. Gastroenterology. 2021;160(2):553–66.
28. Neurath MF. Current challenges in inflammatory bowel disease research. Gastroenterology. 2021;160(5):1428–39.
29. Zhang YJ, Li S, Gan RY. Impacts of gut bacteria on human health and diseases. Int J Mol Sci. 2020;21(2):627.
| Files | ||
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| Drug therapy Immune system Inflammation Irritable bowel syndrome gastrointestinal diseases Gastrointestinal microbiome | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
