Geographic diversity in inflammatory bowel disease genetics and microbiome

Inflammatory bowel disease (IBD) is characterized by dysregulation of the immune response to gut microbiota, a phenomenon that intertwines with environmental influences and manifests as intestinal inflammation in genetically susceptible hosts. While core pathogenic factors contributing to IBD susceptibility are largely consistent across populations, substantial variations in genetic predispositions, environmental exposures, and gut microbial compositions shaped by geographical diversity may play a profound role in influencing disease risk, progression, and therapeutic responses. This critical dimension has often been overlooked in IBD-related basic and clinical research. In this review, we report differences in IBD determinants in geographically diverse cohorts and unravel the intricate interrelationships that drive disease emergence and progression. We also highlight the importance of embracing geographical and population diversity in the exploration of diagnostic approaches and therapeutic strategies for IBD, and advocate for the inclusion of diverse populations in clinical trials to enhance generalizability and applicability of research findings.