Abstract
Inflammatory bowel disease (IBD) is an autoimmune disease associated with dysbiosis within the gastrointestinal tract. Characteristic taxonomic shifts of microbial populations are observed in disease progression and remission; however, despite similarities, there are many differences among individuals presenting with IBD including IBD subset, clinical course, and response to therapy. Much is still unknown about how these taxonomic shifts interact with immunotherapy and how genetic variants contribute. In this systematic review, we aimed to compile information on the interactions of the gut microbiome with immunotherapy in the course of disease and treatment of IBD patients. This systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PubMed database was methodically screened for literature search including keywords and Medical Subject Headings (MeSH) terms for relevant articles.The quality appraisal was completed using the Cochrane Tool, Newcastle-Ottawa checklist, and the Scale for the Assessment of Narrative Review Articles (SANRA) checklist, as appropriate, and 11 relevant articles were included in this systematic review. Our review concludes that although there are characteristic taxonomic shifts between diseased and healthy patients, genetic variants are an important consideration in the predictive quality of disease and treatment decisions. The comparison between interactions of microbial populations and treatment in addition to the role of genetic variants may provide insight into treatment non-responders. Due to our limitations in current knowledge including the complexity of the microcosm, ethnic genetic variations among human populations, and our focus on relevant articles published in English over the past six years, we may have missed relevant studies. Future studies should focus on the comparison between Western and other cultural populations as well as further implementation of Genome-Wide Association Studies (GWAS) in clinical predictability.
Highlights
BackgroundOne of the major functional components of the gastrointestinal system is the delicately balanced microbiota within it
Characteristic taxonomic shifts of microbial populations are observed in disease progression and remission; despite similarities, there are many differences among individuals presenting with Inflammatory bowel disease (IBD) including IBD subset, clinical course, and response to therapy
Our review concludes that there are characteristic taxonomic shifts between diseased and healthy patients, genetic variants are an important consideration in the predictive quality of disease and treatment decisions
Summary
BackgroundOne of the major functional components of the gastrointestinal system is the delicately balanced microbiota within it. The unfavorable alteration of this commensal, is linked to several human pathologies [1,2]. This imbalance has been implicated in chronic inflammation, including autoimmune disease in the form of inflammatory bowel disease (IBD) [3]. The two subsets of IBD are different in that ulcerative colitis (UC) continuously affects the large intestine and rectum with epithelial inflammation and superficial ulcers, while Crohn’s disease (CD) unevenly affects both the large and small intestines with fullthickness ulceration [3,4]. Genomewide association studies (GWAS) have identified novel genetic variants associated with differing traits such as early-onset CD (CTLA-4) [6,7]
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