Inflammatory bowel disease (IBD) comprises chronic and relapsing disorders of the gastrointestinal tract, characterized by dysregulated immune responses to the gut microbiome. The gut microbiome and diet are key environmental factors that influence the onset and progression of IBD and can be leveraged for treatment. In this review, we summarize the current evidence on the role of the gut microbiome and diet in IBD pathogenesis, and the potential of microbiome-directed therapies and dietary interventions to improve IBD outcomes. We discuss available data and the advantages and drawbacks of the different approaches to manipulate the gut microbiome, such as fecal microbiota transplantation, next-generation and conventional probiotics, and postbiotics. We also review the use of diet as a therapeutic tool in IBD, including the effects in induction and maintenance, special diets, and exclusive enteral nutrition. Finally, we highlight the challenges and opportunities for the translation of diet and microbiome interventions into clinical practice, such as the need for personalization, manufacturing and regulatory hurdles, and the specificity to take into account for clinical trial design.

中文翻译：

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IBD 的饮食和微生物组导向疗法 2.0


炎症性肠病（IBD）包括慢性和复发性胃肠道疾病，其特征是对肠道微生物组的免疫反应失调。肠道微生物组和饮食是影响 IBD 发病和进展的关键环境因素，可用于治疗。在这篇综述中，我们总结了关于肠道微生物组和饮食在 IBD 发病机制中的作用的现有证据，以及微生物组导向疗法和饮食干预改善 IBD 结果的潜力。我们讨论了现有数据以及操纵肠道微生物组的不同方法的优缺点，例如粪便微生物群移植、下一代和传统益生菌以及后生元。我们还回顾了饮食作为 IBD 治疗工具的应用，包括诱导和维持、特殊饮食和独家肠内营养的效果。最后，我们强调将饮食和微生物组干预措施转化为临床实践的挑战和机遇，例如个性化的需求、制造和监管障碍，以及临床试验设计要考虑的特殊性。