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2017 has witnessed key advances in knowledge about the metabolic capacities of the gut microbiota, enabling the progression of our understanding of the principles driving xenobiotic–bacteria–host interplay. This research paves the way for the long road towards personalized medicine and nutrition, which could be based on gut microbial metabolism.
The central studies published in 2017 address novel IBD therapeutic strategies and prediction of the future disease course or response to a distinct therapy. Together, these studies contribute to the understanding of the regulation of mucosal homeostasis and at the same time serve to develop novel personalized treatment algorithms in patients in whom a severe disease course can be predicted.
The challenge to obtain needle biopsy samples from patients with cancer has steered the development of new blood-based diagnostics called 'liquid biopsy'. In 2016, major advances have been made in the use of circulating tumour cells and cell-free DNA for monitoring tumour evolution in patients with cancer of the gastrointestinal tract, with a focus on colorectal cancer.
In 2016, obeticholic acid became the first new licensed therapy for primary biliary cholangitis in >20 years. This therapeutic came at a time of improved disease understanding from biliary and immunological mechanistic insights.
Fascination about the gut microbiota shows no signs of slowing down. The launch of the US National Microbiome Initiative in 2016, and similar efforts across the globe, underscore the continued enthusiasm for microbiome studies in the USA and beyond. Indeed, 2016 has been yet another notable year for gut microbiota research.
In 2016, personalized medicine for IBD has been evolving. Increasing comfort with biosimilar infliximab was achieved with 'real-life' data. Drugs with alternative modes of action confirmed substantial benefit, even in patients failing anti-TNF agents. Adipose-derived mesenchymal stem cells yielded a new treatment option for perianal fistulas.
The burden of HBV infection remains high and new strategies to improve HBV vaccination and therapy are needed. Key research in 2016 highlights the efficacy of current approaches and proposes new concepts for some of the immunological defects that need to be overcome for HBV functional cure.
In 2016, key studies have increased our understanding of the part played by the brain–gut–microbiota axis in disorders as diverse as depression, obesity and autism spectrum disorder. The data indicate that alterations in gut-microbial composition can substantially affect central physiology, and that transplantation of the gut microbiota can transfer a behavioural or physiological phenotype.
