Chapter 18, Problem 1CS

CASE STUDY| Your microbiome may be a riskfactor for disease

A number of genes involved in susceptibility to inflammatory bowel disorders (IBDs), including Crohn disease and ulcerative colitis, have been identified. However, it is clear that other risk factors, both genetic and nongenetic, are important in triggering the onset of these diseases. Recent research has centered on understanding the role of the gut microbiome and its interactions with the host genome in IBD. It is known that the microbiome of those with IBD is different from that of those whose IBD is in remission, and it is also different from that of people who do not have IBD. These observations suggest that transfer of microbiota from unaffected individuals via fecal microbial transplantation (FMT) might be a successful treatment for IBD. This idea is supported by the use of FMT as an effective treatment in IBD individuals for a potentially life-threatening infection caused by the bacterium Clostridium difficile. Currently, four clinical trials are underway to evaluate the use of FMT as a treatment for IBD.

If you had IBD, how would you react if your physician recommended that you enroll in one of these clinical studies to evaluate fecal transplants as a treatment?

Summary Introduction

To review:

As an individual with inflammatory bowel disorder(IBD), how one would react if recommended by a physician to participate in the clinical trial for IBD treatment.

Introduction:

IBD is an inflammatory disorder that has recently been associated with gut microbiome. Several genetic and non-genetic factors have been identified to be associated with IBD. Recent researches have suggested an important role of the microbiome and its interaction with the host genome in IBD patients. Research has supported the evidence that there is a difference in the gut microbiome of individuals with IBD and the ones who do not have. Therefore, transfer of microbiota from unaffected individuals throughfecal microbial transplantation (FMT) might be a successful treatment for IBD. To advocate this hypothesis, four clinical trials are undergoing.

Explanation of Solution

FMT is a therapy to transfer fecal microbiota from unaffected to the affected individual. This therapy has helped in treating a potentially life-threatening infection caused by bacterium Clostridiumdifficile.

Depending on the intensity of the disease, one must see whether it is a better option or not. In case IBD is detected at a very early age, one should not agree to undergo clinical trials. It is better to first been treated with conventional anti-inflammatory drugs. On the other hand, if the disease is chronic and no positive results have been seen with drugs, in such case one can opt to participate in the clinical trial in a hope to get rid of the disorder.

Conclusion

Therefore, it can be concluded that based on the degree of disease and the time period since its onset, it must be decided whether to participate or not in the clinical trials.