Cross talk between the gut microbiome and host immune response in ulcerative colitis: nonpharmacological strategies to improve homeostasis

Abstract

Ulcerative colitis (UC) is a chronic disease that is characterized by diffuse inflammation of the colonic and rectal mucosa. The burden of UC is rising globally with significant disparities in levels and trends of disease in different countries. The pathogenesis of UC involves the presence of pathogenic factors including genetic, environmental, autoimmune, and immune-mediated components. Evidence suggests that disturbed interactions between the host immune system and gut microbiome contribute to the origin and development of UC. Current medications for UC include antibiotics, corticosteroids, and biological drugs, which can have deleterious off-target effects on the gut microbiome, contributing to increased susceptibility to severe infections and chronic immunosuppression. Alternative, nonpharmacological, and behavioral interventions have been proposed as safe and effective treatments to alleviate UC, while also holding the potential to improve overall life quality. This mini-review will discuss the interactions between the immune system and the gut microbiome in the case of UC. In addition, we suggest nonpharmacological and behavioral strategies aimed at restoring a proper microbial-immune relationship.

Keywords: alternative medicine; immune; microbiome; nonpharmacological approaches; ulcerative colitis.

Figure 1.

Healthy versus diseased interactions between the gut microbiome and immune system in ulcerative colitis. Adapted from “Immune Response in IBD” by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Figure 2.

Overview of discussed strategies to improve microbiome-immune interactions in ulcerative colitis. Adapted from “Healthy vs. Diseased Gut Microbiota” by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.