Bacterial consortia-The latest arsenal to inflammatory bowel disease bacteriotherapy

Abstract

The microbiota based dietary interventions have emerged as an unconventional bacteriotherapeutic approach for the treatment of a plethora of pathological conditions including inflammatory bowel disease. The potential side effects associated with the use of probiotics include systemic infections, deleterious metabolic activities, excessive immune stimulation in susceptible individuals and gene transfer. Moreover, probiotic strains are not very specific in offering health benefits and it is generally considered that a group of such bacteria are more effective than a single strain. Based on this assumption, fecal matter transplantation was proposed as a better alternative. Despite proving to be very effective in certain diseases, fecal microbiota transplantation has not found wide acceptability because of its poor aesthetic appeal, associated risk for infection transmission, and challenges in standardization and regulation policies. Bacterial consortia, however, emerge as multi-strain, more specific biotherapeutic agents with known composition of probiotics that are free from any risk for infections or uncertain metabolic processes. These are a group of complex microbial communities having ecological interactions among themselves. While offering therapeutic profile similar to fecal matter transplantation, bacterial consortia are free from the associated side effects. Bacterial consortia have demonstrated significant effectiveness in treatment of irritable bowel syndrome. Inflammatory bowel disease represents multifactorial inflammatory ailments comprising of both ulcerative colitis and Crohn's disease. It is generally attributed to disturbance in immunological and environmental factors while genetic factors are also known to play their role. Among all of the above, changes in gut microbiota (dysbiosis) is the main causative agent in etiology of inflammatory bowel disease. Therefore, changing the composition of microbiota through bacterial consortium offers a realistic option for treatment of inflammatory bowel disease. In this review, we decipher the relationship between dysbiosis and pathogenesis of inflammatory bowel disease. We also discuss various challenges regarding the use of bacterial consortia as inflammatory bowel disease therapy. Diving deeper, the pre-clinical and clinical studies conducted hitherto are also described. The potential and limitations of this emerging biotherapeutic approach are also discussed. Considering the worldwide prevalence of inflammatory bowel disease and constant struggle to find a safe, economical and convenient cure for it, bacterial consortia could be an attractive strategy.