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Publication
A doença inflamatória intestinal, a microbiota e a alimentação
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Abstract(s)
A Doença Inflamatória Intestinal (DII) é uma condição cada vez mais comum na sociedade e que ainda é um obstáculo clínico em relação à sua identificação, gestão e tratamento. Recentemente, tem sido enfatizada a importância da microbiota intestinal no complexo processo de desenvolvimento de doenças, abrindo caminho para a investigação de novas ferramentas de diagnóstico e tratamento, no sentido de atender às necessidades atuais na prática clínica da DII. Uma das partes que compõem a fisiopatologia da DII é confirmada pela microbiota intestinal, com a diminuição de bactérias do grupo Firmicutes e um aumento das do grupo Proteobacteria, destacando- se como principais alterações. Diferentes aspectos como a idade, a alimentação, o ambiente e as substâncias estranhas parecem afetar a microbiota neste sentido. Modificações na composição da flora microbiana dos doentes podem ser um promissor ponto de partida para a criação de biomarcadores diagnósticos, realçando a Collinsella e a Nocardiopsis dassonville como possíveis marcadores distintivos entre a Colite Ulcerosa (CU) e a Doença de Crohn (DC). Conjuntamente, a severidade destas doenças parece ser indicada pela composição da microbiota intestinal, com os Clostridiales assumindo o papel de potenciais indicadores preditivos de resposta ao Infliximab. Quanto ao tratamento, a intervenção na microbiota intestinal tem sido comprovada como benéfica na CU com recurso a ensaios clínicos que revelam a eficácia dos probióticos e apoiam o possível uso do transplante de microbiota fecal no futuro. Neste sentido, são várias as alternativas terapêuticas que revelam resultados encorajadores, destacando o transplante de microbiota fecal, os probióticos e as alterações alimentares.
A ênfase na padronização das metodologias utilizadas para avaliar a composição da microbiota intestinal, juntamente com a interpretação dos resultados em relação ao seu impacto na DII, é considerada a principal prioridade neste contexto. Assim sendo, a realização de maiores estudos clínicos focados na microbiota intestinal pode ser a chave para personalizar o tratamento da CU e da DC.
Inflammatory Bowel Disease (IBD) is an increasingly common condition in society that still poses a clinical obstacle in terms of its identification, management and treatment. Recently, the importance of the intestinal microbiota in the complex process of disease development has been emphasized, paving the way for research into new diagnostic and treatment tools to meet current needs in IBD clinical practice. One of the parts that make up the pathophysiology of IBD is confirmed by the intestinal microbiota, which shows a decrease in bacteria from the Firmicutes group and an increase in those from the Proteobacteria group, standing out as the main changes. Different aspects such as age, diet, environment and foreign substances seem to affect the microbiota in this sense. Changes in the composition of patients' microbial flora could be a promising starting point for the creation of diagnostic biomarkers, highlighting Collinsella and Nocardiopsis dassonville as possible distinguishing markers between Ulcerative Colitis (UC) and Crohn's Disease (CD). Together, the severity of these diseases seems to be indicated by the composition of the intestinal microbiota, with the Clostridiales assuming the role of possible predictive indicators of response to Infliximab. As for treatment, intervention in the intestinal microbiota has been proven to be beneficial in UC, with clinical trials revealing the efficacy of probiotics and supporting the possible use of fecal microbiota transplantation in the future. In this sense, there are several therapeutic alternatives for IBD, such as fecal microbiota transplantation, dietary changes, probiotics and prebiotics, all of which have shown encouraging results. The emphasis on standardizing the methodologies used to assess the composition of the gut microbiota, along with the interpretation of the results in relation to their impact on IBD, is considered the main priority in this context. Therefore, conducting more clinical studies focused on the gut microbiota could be the key to personalizing the treatment of UC and CD.
Inflammatory Bowel Disease (IBD) is an increasingly common condition in society that still poses a clinical obstacle in terms of its identification, management and treatment. Recently, the importance of the intestinal microbiota in the complex process of disease development has been emphasized, paving the way for research into new diagnostic and treatment tools to meet current needs in IBD clinical practice. One of the parts that make up the pathophysiology of IBD is confirmed by the intestinal microbiota, which shows a decrease in bacteria from the Firmicutes group and an increase in those from the Proteobacteria group, standing out as the main changes. Different aspects such as age, diet, environment and foreign substances seem to affect the microbiota in this sense. Changes in the composition of patients' microbial flora could be a promising starting point for the creation of diagnostic biomarkers, highlighting Collinsella and Nocardiopsis dassonville as possible distinguishing markers between Ulcerative Colitis (UC) and Crohn's Disease (CD). Together, the severity of these diseases seems to be indicated by the composition of the intestinal microbiota, with the Clostridiales assuming the role of possible predictive indicators of response to Infliximab. As for treatment, intervention in the intestinal microbiota has been proven to be beneficial in UC, with clinical trials revealing the efficacy of probiotics and supporting the possible use of fecal microbiota transplantation in the future. In this sense, there are several therapeutic alternatives for IBD, such as fecal microbiota transplantation, dietary changes, probiotics and prebiotics, all of which have shown encouraging results. The emphasis on standardizing the methodologies used to assess the composition of the gut microbiota, along with the interpretation of the results in relation to their impact on IBD, is considered the main priority in this context. Therefore, conducting more clinical studies focused on the gut microbiota could be the key to personalizing the treatment of UC and CD.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Doença inflamatória intestinal Microbiota Alimentação Disbiose Etiologia Mestrado Integrado - 2024