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Darmmikrobiom und chronisch-entzündliche Darmerkrankungen

Intestinal microbiome and inflammatory bowel disease

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Zusammenfassung

Das Darmmikrobiom steht im Zusammenhang mit der Entstehung und dem Verlauf einer chronisch-entzündlichen Darmerkrankung (CED). Diese Zusammenhänge sind bisher aber nur schlecht verstanden. Das Mikrobiom bei bestehender CED ist in seiner Zusammensetzung und Funktion gestört; ein Zustand, der als Dysbiose bezeichnet wird. Die Veränderungen im Mikrobiom können als diagnostischer und prädiktiver Biomarker nützlich sein. Eine therapeutische Modifikation der mikrobiellen Dysbiose (z. B. durch Ernährung, Antibiotika oder Transfer von fäkalem Material [„fecal microbiota transplantation“, FMT]) könnte eine neue Behandlungsstrategie für CED-Patienten darstellen. Obwohl die FMT eine effektive Therapie rezidivierender Clostridium-difficile-Infektionen darstellt, ist ihr Erfolg zur Korrektur einer CED-assoziierten Dysbiose bisher wenig überzeugend und von variablem Patientenansprechen geprägt.

Abstract

The gut microbiota is thought to influence the development and progression of chronic inflammatory bowel disease (IBD) but the mechanisms are only partly understood. In IBD, intestinal dysbiosis occurs that is characterized by altered structure and function of the microbial community. These microbiota changes can serve as diagnostic and predictive biomarkers. A therapeutic modification of gut dysbiosis, e. g. by diet, antibiotics or fecal microbiota transplantation (FMT) could be a novel treatment strategy in patients with IBD. Although FMT is a highly effective treatment for recurrent Clostridium difficile infections, the efficacy of FMT bacteriotherapy for treating IBD-associated microbial dysbiosis is so far not very convincing with a high variability in patient response.

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Authors and Affiliations

  1. Abteilung für pädiatrische Gastroenterologie, Hepatologie und Ernährung, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337, München, Deutschland

    T. Schwerd &  S. Koletzko

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  1. T. Schwerd
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  2. S. Koletzko
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Correspondence to T. Schwerd.

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Interessenkonflikt

T. Schwerd erhält Forschungsgelder von der DFG und vom The Leona M. and Harry B. Helmsley Charitable Trust. Er erhielt Sprecher- bzw. Autorenhonorar von MSD und Falk Pharma. S. Koletzko erhielt Forschungsgelder von Mead Johnson, Nestle-Nutrition und BioGaia. Sie erhielt Sprecher-, Autoren- oder Beratungshonorare von Abbvie, Danone, Janssen, Hipp, Menarini, Nestle Nutrition, Vifor, Boehringer Ingelheim, Biocodex, ThermoFischer und Shire.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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S. Gehring, Mainz

F. Zepp, Mainz

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Schwerd, T., Koletzko, S. Darmmikrobiom und chronisch-entzündliche Darmerkrankungen. Monatsschr Kinderheilkd 167, 420–425 (2019). https://doi.org/10.1007/s00112-019-0683-7

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  • DOI: https://doi.org/10.1007/s00112-019-0683-7

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