Das Mikrobiom bei chronischen Erkrankungen: Darmbakterien bei chronisch-entzündlichen und Stoffwechselkrankheiten

Background: The intestinal microbiome plays an essential role in the development of chronic inflammatory diseases, such as inflammatory bowel disease (IBD) or metabolic disorders. Objectives: What is the pathophysiological role of the intestine as an interface between bacterial and host functions? Methods: Recent findings related to intestinal function and microbe–host interactions in the context of inflammatory and metabolic disorders are reviewed. Results and conclusions: Changes in gut microbiota composition and function (dysbiosis) are associated with a variety of different pathologies. Dysbiosis in combination with the loss of gut barrier and immune functions are shared in inflammatory and metabolic disorders. Causal mechanisms for the interaction of dysbiotic microbial communities in the gut and disease onset require additional clinical and experimental validation including prospective cohort and gnotobiotic animal studies. Fecal microbiota transplantation and targeted microbial therapies are promising strategies for clinical intervention; however many questions need to be addressed including disease-specific selection of donor microbiota or synthetic bacterial consortia, application strategies and risk evaluation.