Microbial metabolism and pathogenesis in inflammatory bowel diseases: How Enterobacteriaceae take advantage of a compromised mucosal tolerance and how this can play a role in future drug discovery

Abstract

The prevalence of inflammatory bowel diseases (IBD) has been rising in developed countries. Although extensive research has shown that the onset of IBD depends on genetic susceptibility, environmental risk factors and the function of the microbiota, treatment of these diseases has shown limited results. In order to improve the treatment of IBD it is necessary to have a better understanding of the metabolism and survival strategies of bacteria like Salmonella typhimurium and adherent-invasive Escherichia coli (AIEC), two important bacterial strains that play a role in the onset and remission of inflammation in IBD. There are indications that both S. typhimurium and AIEC utilize an energy source to promote their own growth, that cannot be used by the commensal flora. This hypothesis gives rise to new treatment strategies for IBD. To compete with these pathogens, the administration of an extra fermentable carbon source, like oligosaccharides (prebiotics), in combination with the use of selected probiotic strains (together called synbiotics) should be investigated.