Gut Microbiome and Individual Response to Immunological Therapies in Chronic Inflammatory Diseases

The gut microbiome is a critical determinant of immune homeostasis and therapeutic outcomes in chronic inflammatory and autoimmune diseases. This review synthesizes evidence on the role of gut microbiota composition and function as predictive biomarkers for response to biological therapies, including anti-cytokine agents in inflammatory bowel disease (IBD) and immune checkpoint inhibitors (ICI) in oncology. Systematic analyses reveal that favorable responses to anti-TNFα, anti-integrin, and anti-IL-۱۲/۲۳ therapies are associated with increased microbial diversity, enrichment of butyrate-producing taxa (e.g., Faecalibacterium prausnitzii), and elevated anti-inflammatory metabolites. Conversely, dysbiotic features such as expansion of Proteobacteria predict non-response. In cancer immunotherapy, virome status and bacterial diversity metrics correlate with objective response rates and survival outcomes. Mechanistically, microbiota influence treatment efficacy via modulation of intestinal barrier integrity, immune cell differentiation, and inflammatory signaling pathways (e.g., NAD⁺ salvage/p۳۸ MAPK). Emerging microbiome-targeted interventions, including fecal microbiota transplantation, probiotics, postbiotics, and dietary modulation, hold promise as personalized adjuvant strategies. Integrating multi-omics data and conducting longitudinal clinical trials are essential to translate these insights into precision medicine paradigms.

کلیدواژه ها:

Gut microbiome ، Biological therapy ، Immune checkpoint inhibitors ، Inflammatory bowel disease ، Dysbiosis ، microbiota-immune axis