Past, present, and future of microbiome-based therapies

Pilar Manrique, Ignacio Montero, Marta Fernandez-Gosende, Noelia Martinez, Claudio Hidalgo Cantabrana, D. Ríos-Covian
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Abstract

Technological advances in studying the human microbiome in depth have enabled the identification of microbial signatures associated with health and disease. This confirms the crucial role of microbiota in maintaining homeostasis and the host health status. Nowadays, there are several ways to modulate the microbiota composition to effectively improve host health; therefore, the development of therapeutic treatments based on the gut microbiota is experiencing rapid growth. In this review, we summarize the influence of the gut microbiota on the development of infectious disease and cancer, which are two of the main targets of microbiome-based therapies currently being developed. We analyze the two-way interaction between the gut microbiota and traditional drugs in order to emphasize the influence of gut microbial composition on drug effectivity and treatment response. We explore the different strategies currently available for modulating this ecosystem to our benefit, ranging from 1st generation intervention strategies to more complex 2nd generation microbiome-based therapies and their regulatory framework. Lastly, we finish with a quick overview of what we believe is the future of these strategies, that is 3rd generation microbiome-based therapies developed with the use of artificial intelligence (AI) algorithms.
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基于微生物组的疗法的过去、现在和未来
随着深入研究人类微生物组的技术进步,人们得以确定与健康和疾病相关的微生物特征。这证实了微生物群在维持体内平衡和宿主健康状况方面的关键作用。如今,有多种方法可以调节微生物群的组成,从而有效改善宿主的健康状况;因此,基于肠道微生物群的治疗方法的开发正在经历快速增长。在这篇综述中,我们总结了肠道微生物群对传染病和癌症发展的影响,这两种疾病是目前正在开发的基于微生物群疗法的两个主要目标。我们分析了肠道微生物群与传统药物之间的双向作用,以强调肠道微生物组成对药物疗效和治疗反应的影响。我们探讨了目前可用于调节这一生态系统使我们获益的不同策略,包括从第一代干预策略到更复杂的第二代微生物疗法及其监管框架。最后,我们简要概述了我们认为这些策略的未来,即利用人工智能(AI)算法开发的第三代基于微生物组的疗法。
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