Intestinal microbiota as biomarker and therapeutic agent in inflammatory bowel diseases. Literature review

The paper presents data on haptic changes in intestinal microbiota to improve diagnostic capabilities in everyday clinical practice, such as differentiating between subtypes of inflammatory bowel disease and other diseases (e.g. irritable bowel syndrome and colorectal cancer), identifying the active stage of the disease and distinguishing between remission and active disease, and clarifying the location and severity of intestinal lesions. The characteristic bacterial signatures discovered by the researchers for both inflammatory bowel diseases and their subtypes (ulcerative colitis and Crohn’s disease) are shown. The papper also describes developments in assessing changes in intestinal microbiota as an indicator of damage to different parts of the intestine or the severity of inflammatory bowel disease. Particular attention was paid to the need to study the non‑bacterial component of the intestinal microbiota (fungi, viruses, etc.), since this component also has a significant impact on the pathogenesis of inflammatory bowel diseases, therefore it can be useful as a diagnostic and prognostic marker. No less important in this aspect is the study of changes in the metabolome of the intestinal microbiota. Data are also presented on the effect of virtually all types of traditional treatment of inflammatory bowel diseases on changes in the intestinal microbiota. Attention is paid to the dependence of these changes on the effectiveness of treatment, which also indicates the possibility of using changes in the signature of the intestinal microbiota to predict the response to treatment with a particular drug. Summary data on attempts to modify the intestinal microbiota using pre‑ and/or probiotics in patients with inflammatory bowel diseases are also presented, which indicate the dependence of the effect on certain probiotic strains and the initial severity of the disease course. Separately, the data on the sufficiently high efficiency of the use of fecal microbiota transplantation in patients with inflammatory bowel diseases (especially in ulcerative colitis) are presented. To increase the effectiveness of this technique, preliminary preparation with antibiotics to increase graft survival and careful selection of donor material are important.