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Das Darmmikrobiom in der Pathogenese und Therapie chronisch-entzündlicher Darmerkrankungen

Role of the gut microbiome in the pathogenesis and treatment of inflammatory bowel diseases

  • Schwerpunkt: Mikrobiom
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Zusammenfassung

Chronisch-entzündliche Darmerkrankungen (CED) sind systemische Erkrankungen mit einer Hauptmanifestation am Gastrointestinaltrakt. Aufgrund einer chronischen Beeinträchtigung der intestinalen Homöostase machen sie in den meisten Fällen eine dauerhafte und teilweise systemische Therapie erforderlich. Die genauen Ursachen der CED sind größtenteils unbekannt. Postuliert wird, dass diese komplexen Erkrankungen bei genetisch anfälligen Individuen durch eine fehlgeleitete Immunantwort entstehen, begünstigt durch eine Barrierestörung, Umweltnoxen und das Darmmikrobiom. In diesem Zusammenhang rückt die Bedeutung des Mikrobioms und seiner pathogenen Veränderungen (Dysbiose) für die Pathogenese der CED zunehmend in den Fokus. Im vorliegenden Übersichtsbeitrag wird der aktuelle Forschungsstand zur Rolle des Mikrobioms in der Entstehung chronisch-entzündlicher Darmerkrankungen dargestellt. Ferner werden therapeutische Ansätze diskutiert, die eine Korrektur der intestinalen Dysbiose zum Ziel haben.

Abstract

Inflammatory bowel diseases (IBD) are systemic diseases that mainly manifest in the gastrointestinal tract. Due to chronically impaired intestinal homeostasis, they often require permanent and in some cases systemic therapy. The exact causes of IBD are largely unknown. It is postulated that these complex diseases arise in genetically susceptible individuals through a misdirected immune response, promoted by barrier defects, environmental toxins, and the gut microbiome. In this regard, the importance of the microbiome and its pathogenic changes (dysbiosis) in the pathogenesis of IBD is increasingly coming into focus. This review article presents the current state of research on the role of the microbiome in the development of IBD. Therapeutic approaches aimed at correcting intestinal dysbiosis are also discussed.

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Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik, Zentrum für Innere Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    Jan Kempski &  Samuel Huber

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S. Huber: Vortrags- und Beratertätigkeit für Abbvie, Falk, Ferring, Janssen und Galapagos. J. Kempski gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Fabian Frost, Greifswald

Markus M. Lerch, München

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Kempski, J., Huber, S. Das Darmmikrobiom in der Pathogenese und Therapie chronisch-entzündlicher Darmerkrankungen. Innere Medizin 63, 1022–1027 (2022). https://doi.org/10.1007/s00108-022-01396-8

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  • DOI: https://doi.org/10.1007/s00108-022-01396-8

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