Microbial-Based and Microbial-Targeted Therapies for Inflammatory Bowel Diseases

Area of Science:

• Gastroenterology and Immunology
• Microbiology
• Drug Discovery

Background:

• Inflammatory bowel diseases (IBD) involve chronic intestinal inflammation due to immune dysregulation and gut microbiota imbalance (dysbiosis).
• Current IBD therapies (immunosuppressives, biologics) have limited efficacy and significant side effects, with only a minority of patients achieving sustained remission.
• Dysbiosis is increasingly recognized as a key driver of immune dysfunction and inflammation in IBD, supporting microbiota-targeted therapies.

Purpose of the Study:

• To review current evidence and therapeutic mechanisms of microbiota modulation for IBD.
• To outline future prospects for IBD treatment using novel microbial-based and microbial-targeted approaches.
• To explore the potential of microbiota manipulation as primary or adjuvant therapy for IBD.

Main Methods:

• Review of clinical studies on microbiota modulation in IBD.
• Analysis of preclinical and early clinical results of novel therapeutic strategies.
• Discussion of mechanisms of action for microbial-based therapies.

Main Results:

• Fecal microbiota transplant (FMT) shows promise, providing proof of principle for microbiota targeting.
• Rationally designed oral biotherapeutic products (LBPs) show impressive preclinical results.
• Emerging resident microbial-based and targeted therapies are demonstrating favorable early clinical results for IBD.

Conclusions:

• Microbiota modulation represents a promising therapeutic avenue for IBD.
• Novel approaches like LBPs, bacteriophages, and engineered bacteria offer new treatment possibilities.
• Personalized microbial manipulation may serve as safer adjuvant or solo therapies for achieving sustained IBD remission.