RESISTÊNCIA AO TRATAMENTO DA DOENÇA DE CROHN: A RELAÇÃO DA DISBIOSE INTESTINAL COM A EFICÁCIA TERAPÊUTICA
RESISTÊNCIA AO TRATAMENTO DA DOENÇA DE CROHN: A RELAÇÃO DA DISBIOSE INTESTINAL COM A EFICÁCIA TERAPÊUTICA
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DOI: https://doi.org/10.22533/at.ed.64225011014
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Palavras-chave: Doença de Crohn; Microbiota intestinal; Disbiose; Tratamento; Resistência
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Keywords: Crohn’s disease; Intestinal microbiota; Dysbiosis; Treatment; Resistance
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Abstract: Understanding the relationship between intestinal dysbiosis and therapeutic efficacy in Crohn’s disease (CD) may open new perspectives for managing this autoimmune disorder. Through a literature review, this study investigated evidence linking treatment resistance in CD with intestinal dysbiosis. The search was conducted in the PubMed and LILACS databases between 2015 and 2025, in Portuguese and English, using the following descriptors: treatment, resistance, Crohn’s disease, intestinal microbiota, and dysbiosis. To refine the search, terms were combined with the Boolean operator AND. Analysis of the studies revealed that alterations in the gut microbiota, such as an increase in the phyla Actinobacteria, Bacteroidetes, and Proteobacteria, along with a reduction in Firmicutes, negatively affect immune responses and the metabolism of standard pharmacological therapies. Additional factors that exacerbate immune dysfunction include the growth of multidrug-resistant pathogens, such as adherent-invasive Escherichia coli (AIEC) and multidrug-resistant Klebsiella pneumoniae (Kp-MDR), as well as biofilm formation. In this context, novel therapeutic approaches aimed at correcting dysbiosis and reducing inflammation caused by excessive release of pro-inflammatory cytokines have been explored, including the use of bacteriophages, prebiotics, probiotics, and targeted immunobiological therapies. Modulation of the gut microbiota should therefore be considered a central therapeutic target in CD, requiring integrative approaches to improve clinical outcomes.
- Pedro Henrique Lorenzetti
- Amanda Castellini Zdunek Waltrich
- Carolina de Oliveira Machado da Cruz Ribeiro
- Manoella Ender
- Renata Araujo Machado Torres
- Altair Rogério Ambrósio