Crohn´s disease and the hologenome paradigm

SALVUCCI E

CROHN’S DISEASE: ETIOLOGY, DIAGNOSIS AND TREATMENT OPTIONS

Nova Science Publishers, Inc

Lugar: Hauppauge, NY; Año: 2013; p. 19 - 32

Microbiome defines the collective of microorganisms associated with a host. Human gut microbiome is taxonomically complex, constitutes ecologically dynamic community and it influences development, maturation, regulation (stimulation and suppression) of the immune system. The human body is a complex network with ten microbial cells for each unique human cell, plus the eukaryotic microorganisms and phages and genetic mobile elements. The latter two constitute the mobilome, which is a flexible genetic pool that responds to every change of the environment. All these parts are interacting and influencing each other constituting an intricate metabolism. The hologenome theory considers that the host and their microbiome constitute a unity, the holobiont. This superorganism is a result of cohabitation of different organism integrated as one, and it can be considered a result of symbiopoiesis, or codevelopment of the host and symbiont. Holistic views like hologenome theory represent a modern theoretical framework to understand the increased incidence of a group of diseases since the industrial era. These new epidemics, like Crohn´s disease, are related to a hyperreactive or unbalanced immune system. These alterations can be understand as a result of the separation of our partners along the last thousands years. Changes in the social organization, the appearance of modern medicine, improved in sanitary conditions, the growth of new technologies, the westernized way of life, the changes in dietary practices are factors that allowed the loss of part of our evolutionary partners. This effect is known as biome depletion. Considering this evolutionary perspective, new therapies are emerging in the last years related to biome restoration. In addition to the use of lactic acid bacteria as probiotic whose beneficial effects are well known, it is postulated the use of helminthes in autoimmune and inflammatory diseases like Crohn´s disease. Immunotherapy with drugs is based in the manipulation of the immune system to produce a desired outcome. In the same way, there are a heap of data and preliminary scientific evidence that support an immunoregulatory role for helminthic infection in animal models and the human host. These studies allow us to consider helminthic therapies as a valid alternative in patients with Crohn´s disease.