Goldiș Adrian, Dragomir Radu, Mercioni Marina Adriana, Goldiș Christian, Sirca Diana, Enatescu Ileana, Belei Oana
Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Department of Obstetrics and Gynecology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Biomedicines. 2025 Mar 26;13(4):795. doi: 10.3390/biomedicines13040795.
Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn's disease, is characterized by chronic gut inflammation driven by microbial dysbiosis and immune dysfunction. Current therapies primarily involve anti-inflammatory and immunomodulatory strategies; however, many patients experience an inadequate response or a gradual loss of efficacy over time. This study evaluates the clinical efficacy of personalized microbiome modulation (PMM)-an AI-driven intervention designed to restore microbial balance and improve key treatment outcomes such as symptom control and remission rates. : This was a single-arm, open-label validation trial involving 27 patients with moderate-to-severe IBD who had experienced prior treatment failure. Participants underwent three months of PMM, which included personalized dietary modifications, targeted probiotic supplementation, and antimicrobial interventions based on gut microbiome sequencing. Primary outcomes included stool frequency and consistency as well as inflammatory markers (C-reactive protein and fecal calprotectin), while secondary outcomes assessed nutritional status, metabolic function, and quality of life. Statistical analyses included paired t-tests and repeated measures ANOVA to determine significant changes over time. : PMM led to significant clinical improvements, including a 58% reduction in stool frequency ( < 0.001) and improved stool consistency. CRP and fecal calprotectin levels decreased markedly ( < 0.001), suggesting reduced systemic inflammation. Additionally, iron, vitamin B12, and vitamin D deficiencies improved ( < 0.001), alongside weight gain and increased energy levels. Notably, patients on anti-TNF biologics showed enhanced response rates, suggesting potential synergistic effects between microbiome modulation and biologic therapy. : This study highlights PMM as a promising adjunctive therapy for IBD, demonstrating benefits across clinical, inflammatory, and metabolic parameters. While findings support the role of microbiome-targeted interventions in disease management, larger randomized controlled trials are required to confirm the long-term efficacy and applicability in broader patient populations.
炎症性肠病(IBD)包括溃疡性结肠炎和克罗恩病,其特征是由微生物群落失调和免疫功能障碍驱动的慢性肠道炎症。目前的治疗主要涉及抗炎和免疫调节策略;然而,许多患者随着时间的推移反应不足或疗效逐渐丧失。本研究评估了个性化微生物群调节(PMM)的临床疗效,这是一种由人工智能驱动的干预措施,旨在恢复微生物平衡并改善关键治疗结果,如症状控制和缓解率。:这是一项单臂、开放标签验证试验,涉及27名中重度IBD患者,这些患者之前的治疗均失败。参与者接受了为期三个月的PMM,包括个性化饮食调整、有针对性的益生菌补充以及基于肠道微生物群测序的抗菌干预。主要结果包括大便频率和稠度以及炎症标志物(C反应蛋白和粪便钙卫蛋白),而次要结果评估营养状况、代谢功能和生活质量。统计分析包括配对t检验和重复测量方差分析,以确定随时间的显著变化。:PMM带来了显著的临床改善,包括大便频率降低58%(<0.001)和大便稠度改善。C反应蛋白和粪便钙卫蛋白水平显著降低(<0.001),表明全身炎症减轻。此外,铁、维生素B12和维生素D缺乏情况得到改善(<0.001),同时体重增加和能量水平提高。值得注意的是,接受抗TNF生物制剂治疗的患者显示出更高的反应率,表明微生物群调节与生物治疗之间可能存在协同作用。:这项研究强调了PMM作为一种有前景的IBD辅助治疗方法,在临床、炎症和代谢参数方面均显示出益处。虽然研究结果支持针对微生物群的干预措施在疾病管理中的作用,但需要更大规模的随机对照试验来证实其在更广泛患者群体中的长期疗效和适用性。