Microbiota modulation strategies in Inflammatory Bowel Disease management

Inflammatory bowel diseases (IBD), mainly Crohn’s disease (CD) and ulcerative colitis (UC), are chronic disorders. These disorders are proposed to be the result of an inappropriate immune response against the intestinal microbial flora in genetic susceptible hosts, although the exact pathogenesis is still unknown. CD and UC cause serious and unpredictable healthcare problems, such as rectal bleeding, persistent diarrhea and abdominal cramps or pain.  These problems might result in hospitalization or surgery. This sums up to a serious healthcare cost of 5 billion EUR/year directly related to IBD. The current management for these diseases is based on downregulating intestinal inflammation. Treatment strategies are still expanding, however their efficacy remains unsatisfactory, as none of them surpasses 30% remission rates. Further research on the development of new treatment strategies is needed for these patients. Recent research showed a link between intestinal flora and the presence of these disorders.

Therefore, the general challenge of the overall MIMOSA-project is to develop microbiome-targeted treatments in IBD. Hence, a collaboration between the Raes-, Thevelein-, and Vermeire-lab has been set up. Different strategies will be pursued in a translational accelerator (TRAC). These strategies include the improvement of FMT, the repurposing of single-strain probiotics for IBD use and the generation of complex microbial products or probiotic cocktails. In the framework of this PhD-project, biomarkers for efficacy of FMT and strain transferability will be identified and subsequently clinical guidelines for FMT in IBD will be distributed. The preclinical tests of the TRAC-pipeline will be executed and assessed for different products. Finally, we will study the microbiome composition in, above and under the abrupt demarcation of inflammation in UC patients in order to explain this observation.