Key studies published in 2021 demonstrated mechanisms that drive macrophage–fibroblast pathogenicity in Crohn’s disease, developed multi-omics profiles to predict response to biological therapy, and suggested potential complementary treatments and new therapeutic agents in inflammatory bowel disease (IBD) therapy. These results represent important progress towards precision medicine for patients with IBD.
Key advances
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Loss of NOD2 function enhanced pathogenic activation of a macrophage–fibroblast niche that drives fibrogenesis in Crohn’s disease through a STAT3-dependent pathway, and glycoprotein 130 blockade might benefit anti-tumour necrosis factor non-responders6.
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Integrating multi-omics including faecal metagenomic, serum metabolomic and proteomic profiles can predict differential response to either anti-cytokine or anti-integrin therapy in inflammatory bowel disease (IBD)7.
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Engineered self-tunable yeast probiotics for modulation of extracellular ATP–adenosine balance suppressed intestinal inflammation in mouse models of IBD, circumventing unwanted adverse effects such as fibrosis and microbial dysregulation10.
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References
Chang, J. T. Pathophysiology of inflammatory bowel diseases. N. Engl. J. Med. 383, 2652–2664 (2020).
Schleidgen, S., Klingler, C., Bertram, T., Rogowski, W. H. & Marckmann, G. What is personalized medicine: sharpening a vague term based on a systematic literature review. BMC Med. Ethics 14, 55 (2013).
Fiocchi, C. et al. Results of the Seventh Scientific Workshop of ECCO: precision medicine in IBD — what, why, and how. J. Crohns Colitis 15, 1410–1430 (2021).
West, N. R. et al. Oncostatin M drives intestinal inflammation and predicts response to tumor necrosis factor-neutralizing therapy in patients with inflammatory bowel disease. Nat. Med. 23, 579–589 (2017).
Martin, J. C. et al. Single-cell analysis of Crohn’s disease lesions identifies a pathogenic cellular module associated with resistance to anti-TNF therapy. Cell 178, 1493–1508 (2019).
Nayar, S. et al. A myeloid–stromal niche and gp130 rescue in NOD2-driven Crohn’s disease. Nature 593, 275–281 (2021).
Lee, J. W. J. et al. Multi-omics reveal microbial determinants impacting responses to biologic therapies in inflammatory bowel disease. Cell Host Microbe 29, 1294–1304 (2021).
Plichta, D. R., Graham, D. B., Subramanian, S. & Xavier, R. J. Therapeutic opportunities in inflammatory bowel disease: mechanistic dissection of host-microbiome relationships. Cell 178, 1041–1056 (2019).
Petrosino, J. F. The microbiome in precision medicine: the way forward. Genome Med. 10, 12 (2018).
Scott, B. M. et al. Self-tunable engineered yeast probiotics for the treatment of inflammatory bowel disease. Nat. Med. 27, 1212–1222 (2021).
Acknowledgements
The authors thank C. Fiocchi, X. Li and X. Lin for their help in preparing this manuscript. R.M. was supported by the National Natural Science Foundation of China (NSFC grant no. 81970483 and no. 82170537).
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Mao, R., Chen, M. Precision medicine in IBD: genes, drugs, bugs and omics. Nat Rev Gastroenterol Hepatol 19, 81–82 (2022). https://doi.org/10.1038/s41575-021-00555-w
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DOI: https://doi.org/10.1038/s41575-021-00555-w