Gut mycobiome and dysmycobiosis: clinical significance and therapeutic perspectives

The gut mycobiome comprises no more than 0.1% of its microbiota; however, it plays an important role in human health and disease. The balance of the mycobiome affects the stability of the microbiome, while the interaction between gut bacteria and fungi can be both beneficial and detrimental to the latter. The interaction between the mycobiome and the host is achieved through modulating the immune system and affecting the metabolism, which, in turn, can modulate the outcome of the disease. Fungal gut dysbiosis, for which we propose the term “dysmycobiosis”, is closely related not only to gastrointestinal disorders (such as inflammatory bowel diseases, irritable bowel syndrome, celiac disease, colorectal cancer, and pancreatic ductal adenocarcinoma), but also to various extraintestinal pathologies, including chronic liver disease, metabolic disorders, and neurological disorders. The investigation of the mechanisms underlying gut dysmycobiosis will promote the development of novel diagnostic and therapeutic targets for inflammatory and other human diseases. Gut mycobiome modulation is a promising therapeutic strategy encompassing dietary interventions, probiotics (both bacterial and fungal), and non-toxic metabolites. Key words: Candida albicans, gut mycobiome, dysmycobiosis, inflammatory bowel disease, fungal metabolites, probiotics, Saccharomyces boulardii, Saccharomyces cerevisiae