Patients with inflammatory bowel disease who responded to certain therapies exhibited consistent changes in their gut microbiome, which could lead to new opportunities for precision medicine, according to results of a meta-analysis.
“Even though the microbiome appears to play a key role in IBD pathogenesis and advances in technology increasingly allow rapid microbiome sequencing, the use of the microbiome as a predictive biomarker of treatment response has been poorly explored,” Fernando Magro, MD, PhD, of the department of biomedicine at the University of Porto in Portugal, and colleagues wrote. “Given the current importance of biologic therapy in IBD, this systematic review aims to summarize the current evidence on the impact of biologic therapies on the gut microbiome, and to correlate microbiome diversity, relative abundance microbial metabolic pathways with the clinical outcome following therapy with biologic agents, therefore exploring the role of the microbiome as a predictive biomarker.”
Investigators searched the literature for studies that explored the association among the microbiomes found in fecal or colon samples, biologic therapies and IBD.
In 10 studies that fit their criteria, researchers found changes in microbiomes did not differ greatly among different biologic agents, but they all produced decreases in relative abundance of certain microbes, specifically Escherichia and Enterococcus. They also helped increased the abundance of genera that produce short-chain fatty acids.
Magro and colleagues found that patients who responded to either anti-TNF or interleukins had higher alpha-diversity and increased relative abundances of genera in the Clostridiales order either at baseline or follow-up. They also found decreased abundance of Roseburia among patients who achieved remission after therapy with antibodies against integrins.
Magro and colleagues wrote that their findings could provide new insight into which patients might respond to certain IBD therapies, leading the way to new opportunities for precision medicine.
“Gut microbiome may be used in the future to estimate the likely benefit the IBD patient will have from biologic treatment (as a predictive biomarker),” they wrote. “However, prior to the application in the clinical practice further validation in independent larger cohorts is necessary.” – by Alex Young
Disclosures: Magro reports serving as a speaker and receiving honoria from AbbVie, Biogen, Falk, Ferring, Hospira, Labatórios Vitória, Merck Sharp & Dohme and Vifor. Please see the full study for all other authors’ relevant financial disclosures.