Microbiome-Based Biomarkers for IBD

• Published in: Inflammatory bowel diseases Vol. 26; no. 10; pp. 1463 - 1469
• Main Author: Ananthakrishnan, Ashwin N
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.10.2020
• Subjects: Adalimumab; Biological markers; Crohn's disease; Development and progression; Medical research; Medicine, Experimental; Prognosis; Ulcerative colitis; Crohn disease; ulcerative colitis; biomarker; microbiome
• ISSN: 1078-0998; 1536-4844
• DOI: 10.1093/ibd/izaa071

Abstract Crohn disease and ulcerative colitis are complex immune-mediated diseases that are characterized by a heterogeneity in presentation and clinical course. Although various clinical covariates predict adverse outcomes in these patients, they are insufficiently informative. The gut microbiome likely plays a central role in the pathogenesis of these diseases. Consequently, microbiome-based biomarkers may play an important role in risk stratification and disease prediction. Initial cross-sectional studies showed a reduced gut microbial diversity in patients with Crohn disease or ulcerative colitis, a depletion of phyla with anti-inflammatory effects such as those belonging to Firmicutes, and an increased abundance of potentially pathogenic bacteria in specific disease phenotypes. Subsequent studies longitudinally tracking microbial changes and clinical outcomes have shown dynamic changes correlating with or predictive of disease activity and resistance to therapy. The development of multicenter cohorts using harmonized protocols is essential to robustly validate these biomarkers and facilitate the integration of their evaluation into clinical practice.   The microbiome plays an important role in the pathogenesis of Crohn disease and ulcerative colitis. Microbiome-based biomarkers thus have the potential to aid in risk stratification, prognostication, and prediction of important outcomes including therapy response in these diseases.