IBD: microbiota manipulation through diet and modified bacteria
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Updated: Apr 19, 2026

An In Vitro Batch-culture Model to Estimate the Effects of Interventional Regimens on Human Fecal Microbiota
Published on: July 31, 2019
Hannah L Simpson1, Barry J Campbell, Jonathan M Rhodes
1Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Background/Aims:
Crohn's disease (CD) and ulcerative colitis (UC) are both typified by an altered intestinal microbiota, and gene associations imply various defects in the mucosal barrier and in the innate immune response to bacteria. This review aims to assess how alterations in diet or use of modified bacteria could have therapeutic effects in CD or UC.
Methods:
A MEDLINE search using the terms 'prebiotic', 'genetically modified bacteria', 'mucosal barrier in association with ulcerative colitis', 'Crohn's disease' or 'microbiota'.
Results:
A large body of data from in vitro and animal studies shows promise for therapeutic approaches that target the microbiota. Approaches include dietary supplementation with fermentable fibres (prebiotics) and soluble fibres that block bacterial-epithelial adherence (contrabiotics), enhancement of the mucosal barrier with phosphatidylcholine, and use of genetically modified bacteria that express IL-10 or protease inhibitors. Vitamin D supplementation also shows promise, acting via enhancement of innate immunity. Clinical trials have shown benefit with enterically delivered phosphatidylcholine supplementation in UC and near-significant benefit with vitamin D supplementation in CD.
Conclusion:
Strategies that target the microbiota or the host defence against it appear to be good prospects for therapy and deserve greater investment.
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