Lessons from diversion studies and antibacterial interventions.
If bacteria cause IBD, then it should be possible to target the bacteria with therapies and cure or at least treat the disease. Discovery of a successful intervention, unless found by chance, will depend on knowing more about which bacteria are involved, where they are and how to remove them. Some evidence for the possible role of bacteria has come from in vivo studies of the effects of diverting the faecal stream away from sites of IBD. Alternative hypotheses arise from the diversion studies that could incriminate other components of the faecal stream that include bile acids and dietary components. Antibiotics will only really be adequately tested when we know what the target bacteria are and where they are, e.g. whether in the lumen or mucosa and whether intracellular or extracellular. Some encouraging responses have been observed, however, with empirical antibiotic therapy.
Gastroenterology, University of Liverpool, Liverpool, UK.
Paul K
PK
Flanagan
Barry J
BJ
Campbell
Jonathan M
JM
Rhodes
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D004032:Diet; D004750:Enteral Nutrition; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000382:microbiology*
D000900:Anti-Bacterial Agents