Microbial manipulation as primary therapy for Crohn's disease

Figure 1 Microbiota regulate immune tolerance and activation in inflammatory bowel disease. Clostridium cluster IV and XIVa can induce regulatory T cell (T_reg) polarization in the lamina propria[7]. One member of this cluster, Fecalibacterium prausnitzii (F. prausnitzii), correlates with reduced post-operative recurrence in Crohn’s disease (CD)[6]. Adherent invasive Escherichia coli (AIEC) are found with greater frequency in ileal CD[11]. Interaction with microbial species may differentially modulate the immune response in early inflammatory disease compared to long-term fibrotic disease[8]. Host genotype may regulate luminal microbial species. NOD2: Nucleotide-binding ligomerization domain-containing protein 2; ATG16L: Autophagy-related protein 16-1[9].