A Physicians' Wish List for the Clinical Application of Intestinal Metagenomics: e1001627

• Published in: PLoS medicine 2014-04, Vol.11 (4)
• Main Authors: Klymiuk, Ingeborg, Högenauer, Christoph, Halwachs, Bettina, Thallinger, Gerhard G, Fricke, W Florian, Steininger, Christoph
• Format: Article
• Language: English
• Subjects: Clinical medicine; Inflammatory bowel disease; Medical research; Studies
• ISSN: 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1001627

Abbreviations: FMT, fecal microbiota transplantation; IBD, inflammatory bowel disease Provenance: Not commissioned; externally peer reviewed Summary Points * Multiple infectious, autoimmune, metabolic, and neoplastic diseases have been associated with changes in the intestinal microbiome, although a cause-effect relationship is often difficult to establish. * Here we discuss the problems, applications, and visionary requirements for the integration of microbiome analysis into clinical routine diagnostics. * Metagenomics is increasingly used for the culture-independent and largely unbiased characterization of complex bacterial habitats at high resolution. [...]clinical observations have long suggested that the intestinal microbiome plays a critical role in the pathogenesis of inflammatory bowel disease (IBD) (Crohn disease and ulcerative colitis): (1) inflammation in Crohn disease disappears if the involved bowel segment is excluded from the fecal stream and recurs after re-anastomosis with reexposure to intestinal contents [11]; (2) IBD responds at least partially to antimicrobials [12] and some probiotics (live bacteria or yeast preparations) [13]; (3) some studies have shown for IBD a decreased bacterial diversity and a shift from anti-inflammatory commensals to pro-inflammatory pathogens (dysbiosis)--particularly to an overrepresentation of proteobacteria and to a reduction in Faecalibacterium prausnitzii and other beneficial butyrate-producing bacteria [14]-[16].