Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

According to a new review published last month in Frontiers in Immunology, researchers investigated the role of Akkermansia muciniphila in patients with IBD.

Although previous research has shown differences in the gut microbiome in IBD patients, this review investigates how changes in the microbiome can contribute to an inflammatory response.

This review has demonstrated the potential protective effect of A.muciniphila in the process and development of intestinal inflammation. An abnormal decrease in the abundance of A.

muciniphila maybe a hallmark of IBD, which is associated with dysbiosis, decreased intestinal barrier function, and altered immune response.

It is important to note that the role of commensal A. muciniphila in IBD is still controversial as in too high of levels it can contribute to intestinal inflammation, which might be due to difference in genotypes and strain specificity of A. muciniphila.

Therefore, we should always hold a reasonable dose of expectation and skepticism in terms of the overwhelming “good effects” of A. muciniphila in health and disease states.

A. muciniphila therapies are now considered a valuable therapeutic approach to treat IBD patients. There is an A. muciniphila probiotic that has recently become available. In addition, A. muciniphila can also be increased with an increased intake of foods rich in polyphenols or supplementation with polyphenols including blueberry, cranberry, pomegranate, and quercetin.

It is important to know what bacteria are present and how these bacteria shift as the patient’s symptoms exacerbate or improve.

Previous research has identified that in healthy people, the gut microbiome was much more stable than those with IBD. Patients with IBD have dramatic shifts in their microbiomes with some bacteria disappearing almost completely at times.

Medication to treat IBD can also affect the microbiome. Individuals who take steroids for part of their treatment have more fluctuations in their microbiome and those who were experiencing a flare-up in their symptoms are more likely to have dramatic fluctuations in their microbiome.

These results further support the functional medicine approach to assess the microbiome regularly in these patients so one can take an individualized approach to manipulate the microbiome and keep IBD patients in remission, especially if medications like corticosteroids can be shift the microbiome leading to an exacerbation of the disease.

Probiotics, fish oil, glutamine, polyphenols, and mucilaginous botanicals are helpful in immunomodulation and for their anti-inflammatory properties. Other common deficiencies include magnesium, vitamin D, and iron. A low FODMAP diet or elimination diet can improve gastrointestinal function and decease disease activity.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Zheng M, Han R, et al. The role of Akkermansia muciniphila in inflammatory bowel disease: Current knowledge and perspectives. Front Immunol. 2023. Jan 6;13:1089600.

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