Medically reviewed by Onikepe Adegbola, MD, PhD
Infliximab (IFX), a tumor necrosis factor-alpha medicine (TNF-), was shown to be ineffective in 50% of children with Pediatric Inflammatory Bowel Disease (PIBD). Researchers discovered that “the gut microbiota composition in PIBD patients might predict the response to IFX treatment in the future” after studying the microbiota species in the human gut of 30 PIBD patients.
The study, “The gut fungal and bacterial microbiota in pediatric patients with inflammatory bowel disease introduced to treatment with anti‑tumor necrosis factor‑α” was published in the journal Scientific Reports.
PIBD is an inflammatory bowel disease characterized by gastrointestinal tract inflammation in children, adolescents, and adults. Other examples of these inflammatory bowel diseases include Crohn’s disease (CD) and ulcerative colitis (UC). The common symptoms of this disease are fever, diarrhea, stomach pain, and blood in the stool. It is important to combat this PIBD at the onset of diagnosis as it may lead to further long-term problems like growth delay for children, malnourishment, impairment in developmental growth, and psychosocial issues in the future.
Because there is so little research on this topic, more research on microbiota among PIBD patients taking IFX medication is needed. Researchers from the University of Helsinki’s Children’s Hospital discovered that there is a substantial variation in the microbiome of PIBD patients even before the infusion of IFX medication. Nonresponders to the drug were found to have lower levels of butyrate, Clostridia, and calprotectin. Alternatively, Candida was more present among the nonrespondents. Saccharomyces were found to be more prevalent in respondents to IFX treatment. These results indicate the importance of gut microbiota as a predictor of an anti-TNF alpha therapy response.
While Faecalibacterium prausnitzii was found to be abundant among patients undergoing the IFX treatment in previous research, a recent study found that there is an abundance of Candida found in adult patients with IBD infused with IFX.
30 PIBD patients participated in this study and were introduced to IFX therapy. 85 samples were collected from the participants before IFX infusion. 25 participants were CD patients while the 5 other participants were diagnosed with UC.
Researchers found the possible biomarkers predictive of the response to IFX treatment with the prevalence of higher levels of Bifidobacterium, Eubacterium rectale, Clostridium colinum, Vibrio, and the Clostridiales, and simultaneously, they found the lower levels of Streptococcus mitis.
Overall, the findings of this study show that possible indicators might be detected in the microbiota makeup of PIBD patients’ guts before and after receiving infliximab (tumor necrosis factor-alpha).
Although half of the patients were found to be non-responders to the medicine infliximab, and no ways to predict such response were documented, more research into possible biomarkers in the bacterial microbiome among PIBD patients is advised. The aim of researching this area is to identify possible biomarkers that might predict future pharmaceutical responses and influence IFX therapy improvement or modification. As a result, the cost will be lower, and the disease’s long-term consequences will be eliminated.
Diefenbach, K. A., & Breuer, C. K. (2006). Pediatric inflammatory bowel disease. World journal of gastroenterology, 12(20), 3204–3212. https://doi.org/10.3748/wjg.v12.i20.3204
Ventin-Holmberg, R., Höyhtyä, M., Saqib, S., Korpela, K., Nikkonen, A., Salonen, A., de Vos, W. M., & Kolho, K.-L. (2022, April 22). The gut fungal and bacterial microbiota in pediatric patients with inflammatory bowel disease introduced to treatment with anti-tumor necrosis factor-α. Nature News. Retrieved May 4, 2022, from https://www.nature.com/articles/s41598-022-10548-7
Vos, W. M. de, Tilg, H., Hul, M. V., & Cani, P. D. (2022, May 1). Gut microbiome and health: Mechanistic insights. Gut. Retrieved April 29, 2022, from https://gut.bmj.com/content/71/5/1020