Hesteetako hanturazko gaixotasuna: patogenia, tratamenduak eta mikrobiotan oinarritutako biomarkatzaileak: Inflammatory Bowel Disease: pathogenesis, treatments and microbiota-based biomarkers

Abstract

Inflammatory bowel disease (IBD) encompasses two types of idiopathic intestinal diseases, ulcerative colitis (UC) and Crohn's disease (CD). Both are chronic, heterogeneous, and severe inflammatory disorders that primarily affect the intestine. IBD has emerged as a global disease with a sharp increase in worldwide incidence and prevalence. Although the specific underlying cause of UC is unknown, it is considered the result of a complex interaction between the microbiota, immune system, host genetics and environmental factors. The advent of new technologies has enabled the identification of disturbed microbiota composition and function and reduced microbial diversity in IBD patients, termed dysbiosis. Obtained clinical and experimental data points dysbiosis as a key player in IBD pathogenesis, but it is still unclear whether it is the cause of consequence. Although a wide range of therapies are approved for use as treatment for IBD, there is no cure. TNF inhibitors are frequently used to induce clinical remission in severe patients, however a roughly one third of the patients may not respond, and another third may lose response over time. In addition, the cost associated with IBD treatments is increasing over time, mainly due the costs associated with the biologic treatment. Emerging evidence has pointed towards gut microbiota to find a set of biomarkers for diagnosis, and for prediction of disease severity and infliximab treatment response in IBD patients. The human fecal microbiota harbors promising and non-invasive biomarkers, which emphasizes its potential ability to stratify IBD patients and apply personalized therapy for optimal outcomes