The Role of the Intestinal Microbiome in Inflammation and Cancer.

Abstract

Changes in the microbiome have been described in many diseases and are thought to play a role in their pathogenesis and progression. In this article, we approach the topic critically and discuss the areas in which the development of microbiome-based clinical applications may soon be expected. We selectively review the literature on diseaseassociated microbiome signatures and therapeutic modulation of the microbiome. We discuss clinical studies as well as relevant preclinical studies that reveal causal relationships between the microbiome and disease. The intestinal microbiome undergoes dynamic regulation by lifestyle factors such as the diet. Particularly in inflammatory and malignant neoplastic diseases, changes in the microbiome have been identified that contribute to the progression of disease in animal models. Studies have also shown that the response to systemic antitumor therapy is regulated by the microbiota. In view of this, initial clinical trials have been conducted that document the efficacy of fecal microbiome transfer and of selective approaches to microbiome modulation in the treatment of several inflammatory and malignant diseases. Evidence from animal models and initial clinical studies indicates that therapeutic modulation of the microbiome can be of benefit to patients suffering from a number of inflammatory and malignant diseases. The further translation of research of this kind into clinical applications will require the validation of these data in controlled trials and the development of targeted approaches to microbiome modulation.