Features of the gut microbiota in the pathogenesis and clinical course of diverticular disease (review)

AIM: to assess the most promising areas in the field of studying the microbiome of the colon in patients with complicated forms of diverticular disease, which can be used in clinical practice.MATERIALS AND METHODS: a systematic literature search of electronic databases (PubMed, EMBASE, Cochrane, Research gate, Scopus) for the past 20 years was done. Initially, 14 meta-analyses, 342 reviews, 116 clinical studies, and 27 experimental studies were found. After screening and evaluating the summary, 12 meta-analyses, 24 reviews, 22 clinical studies, and 5 experimental studies were selected. This article has been prepared in accordance with PRISMA standards.RESULTS: there is a decrease in the representation of Bacteroidetes, Fusobacterium, Clostridium clusters IV and IX, Lactobacillaceae, and other microorganisms with anti-inflammatory properties and the ability to synthesize shortchain fatty acids. In addition, in all types of diverticular disease, there is an increase in the population of Roseburia hominis and Akkermansia muciniphila. With a complicated course of diverticular disease, there is an increase in the number of representatives of the Proteobacteria family, and with symptomatically uncomplicated diverticular disease — Firmicutes. According to studies, there is a change in the concentration of specific urinary and fecal biomarkers in the blood — hippurate, kininurenine and short-chain fatty acids, therefore, the assessment of the metabolome may be considered a justified goal in determining and predicting changes in the microbiome in these patients with diverticular disease.CONCLUSION: there is evidence that an increase in the severity of inflammation in diverticular disease may be associated with an increase in the generic diversity of the fecal microbiota. Other bacterial metabolites can act as diagnostic and prognostic markers of the severity of the disease.