Complementary and Alternative Medicine Strategies for Therapeutic Gut Microbiota Modulation in Inflammatory Bowel Disease and their Next-Generation Approaches

Abstract

SUMMARY The human gastrointestinal tract is resident to a vastly diverse microbial consortium that co-exists through strict rules of invasion, dominance, resilience and succession. While some members possess stronger capabilities for survival than others, each one retains a genome characteristic of their bacterial denomination which subsequently determines survival and ultimately the composition of a human gut microbiome. Collective evidence advocates the concept of gut microbiota modulation via dietary compounds, with or without nutraceutical supplementation. However, consistent reports of strong individuality in responsiveness suggest that initial composition of host microbiota mediates the effect of nutrition modulation. There is also a strong potential for the interaction between mind and microbe to influence responsiveness, although mechanistic understanding of these complex exchanges remains in its infancy at best. Synthetic stool for FMT is a next-generation microbiome-therapy shown effective in treating C.difficile [417] which could provide a feasible alternative to current methods for patients with IBD. Nevertheless, studies investigating optimum timing for FMT administration are essential. Animal and human studies are only starting to highlight the Pandora of interactions that endure between members of gut microbiome, their associated metabolites, dietary compounds, as well as host neurological and immune systems, all of which characteristic to each individual. Advanced research technologies have excelled the scientific evidence in support of CAM and toward generating NG-CAM systems designed for treatment of specific disease states, such as IBD. While the majority of envisioned NG-CAM strategies presently exist in their experimental and discovery phases, many show promise for future clinical application.

‘Cyclical Bias’ in Microbiome Research Revealed by A Portable Germ-Free Housing System Using Nested Isolation

“…Although the use of GF mice in scientific publications has tripled over the last decade, GF facilities remain relatively scarce due to their high technical costs. Improving current GF research efficiency and experimental capabilities will allow more laboratories to adopt GF infrastructure to conduct more complex and parallel studies of diverse microbiotas 10 , as numerous diseases could be better treated with an improved causal understanding of microbes-diet-genomic interactions 11 – 13 . Novel complementary strategies to promote paralleled microbiome research are also needed since cross-contamination of cages in standard multi-cage pressurized isolators is a common and difficult problem to control when cages are enclosed together 14 – 16 .…”

Limosilactobacillus fermentum CECT5716: Mechanisms and Therapeutic Insights

“…Thus, gut microbiota in IBD patients differs from healthy individuals, as it is characterized by a reduced diversity, increased abundance of Enterobacteriaceae and reduced abundance of Firmicutes and Bacteroidetes phyla [ 85 ]. As well as gut microbiota is key for the maintenance of gut homeostasis, it could also promote chronic inflammation and the development of IBD [ 86 , 87 , 88 ] ( Table 4 ).…”

Regulation of the intestinal microbiota: An emerging therapeutic strategy for inflammatory bowel disease

“…Hence, an increasing number of researchers have shifted their attention to traditional medicine in order to identify potentially therapeutic compounds in Chinese herbal medicine and/or traditional prescriptions. So far, various potent compounds have been found, some of which exhibit the effects of relieving intestinal inflammation, at least in part by regulating the intestinal microbiota[ 17 ]. However, paucity of data can actually reflect the therapeutic effect in human clinical trials[ 74 ].…”

“…Furthermore, numerous IBD patients do not respond to clinically approved drugs[ 16 ], necessitating the development of novel therapies or complementary and alternative medicine for IBD. It is worth mentioning that, with the rapid advancement in metagenomics, complementary and alternative therapies for IBD based on modulation of gut microbiota have developed rapidly and preliminary achievements have been reported[ 17 ]. Pro/prebiotics, herbal medicinal products, and fecal bacteria transplantation (FMT) are emerging therapeutic strategies for IBD that target intestinal microbiota in a direct or indirect way, thus benefiting intestinal health[ 18 ].…”