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World J Gastroenterol. Jun 21, 2021; 27(23): 3317-3326
Published online Jun 21, 2021. doi: 10.3748/wjg.v27.i23.3317
Can control of gut microbiota be a future therapeutic option for inflammatory bowel disease?
Atsushi Nishida, Kyohei Nishino, Keitaro Sakai, Yuji Owaki, Yoshika Noda, Hirotsugu Imaeda
Atsushi Nishida, Kyohei Nishino, Keitaro Sakai, Yuji Owaki, Yoshika Noda, Hirotsugu Imaeda, Department of Gastroenterology and Hepatology, Nagahama City Hospital, Nagahama 5268580, Shiga, Japan
Author contributions: Nishida A wrote the paper; Nishino K, Sakai K, Owaki Y, Noda Y, and Imaeda H contributed critical revision of the manuscript.
Conflict-of-interest statement: No conflict of interest.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Atsushi Nishida, MD, PhD, Chief Doctor, Department of Gastroenterology and Hepatology, Nagahama City Hospital, 313 Oinuicho, Nagahama 5268580, Shiga, Japan. atsuda@belle.shiga-med.ac.jp
Received: March 17, 2021
Peer-review started: March 17, 2021
First decision: April 17, 2021
Revised: April 23, 2021
Accepted: May 7, 2021
Article in press: May 7, 2021
Published online: June 21, 2021
Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract encompassing two main clinical entities, Crohn’s disease and ulcerative colitis. Accumulated evidence indicates that an aberrant immune activation caused by the interplay of genetic susceptibility and environmental impact on the gut microbiota may be involved in the pathogenesis of IBD. Rapid advances in next-generation sequencing technology have enabled a number of studies to identify the alteration of the gut microbiota, termed dysbiosis, in IBD. Moreover, the alteration in the metabolites derived from the gut microbiota in IBD has also been described in many studies. Therefore, microbiota-based interventions such as fecal microbiota transplantation (FMT) have attracted attention as a novel therapeutic option in IBD. However, in clinical trials, the efficacy of FMT for IBD remains controversial. Additional basic and clinical studies are required to validate whether FMT can assume a complementary role in the treatment of IBD. The present review provides a synopsis on dysbiosis in IBD and on the association between the gut microbiota and the pathogenesis of IBD. In addition, we summarize the use of probiotics in IBD and the results of current clinical trials of FMT for IBD.

Keywords: Inflammatory bowel disease, Dysbiosis, Fecal microbiota transplantation, Short chain fatty acid, Probiotics

Core Tip: In this review, we discuss the gut microbiota in inflammatory bowel disease and gut microbiota-derived metabolites, especially short chain fatty acids. The anti-inflammatory function of short chain fatty acids on the mucosal immune system in the gastrointestinal tract is also discussed. In addition, we review the efficacy of probiotics on inflammatory bowel disease and the current clinical trials on the effectiveness of fecal microbiota transplantation on inflammatory bowel disease.