The Regulatory Roles of the Gut Microbiota in Multisystem Diseases

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 1035

Special Issue Editors


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Guest Editor
1. Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, 00168 Rome, Italy
2. Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), 00168 Rome, Italy
Interests: autoinflammatory diseases; metabolic storage diseases; gut–brain axis

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Guest Editor
Department of Translational Medicine and Surgery, Catholic University, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
Interests: clinical and cellular immunology; microbiota and the immune system: crosstalk in health and diseases
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Special Issue Information

Dear Colleagues,

Biomedical science is currently witnessing a turning point—the so-called microbiota revolution. Accumulating evidence highlights the pivotal role of the microbiota in multisystem disease pathophysiology, leading to more awareness and ongoing research in this field. Clarifying this complex interaction can enhance our knowledge and potentially facilitate the development of increasingly precise, patient-targeted therapeutic strategies.

The focus in research has shifted from analyzing bacterial populations to studying broader aspects of microbial elements. Of these, bacteriophages, particularly engineered ones, are proving significant, being promoted as preventive and therapeutic agents.

This Special Issue aims to garner high-quality contributions that examine the importance of the microbiota in common and less common diseases, with particular emphasis on internal medicine. The improved survival rates of patients with inherited metabolic diseases, such as Fabry disease and phenylketonuria, pose new clinical challenges that require innovative pathophysiological insights and new treatment approaches.

We welcome original research articles, reviews, and case-based discussions of the diagnostic, therapeutic, and translational importance of the microbiota. They can be presented as mechanistic observations, clinical applications, and novel conceptual treatment strategies—varying from probiotics and postbiotics to bacteriophage and microbiota-guided treatments.

The Special Issue seeks to address the challenges and emerging opportunities in this novel and rapidly expanding field.

Dr. Mario Caldarelli
Dr. Rossella Cianci
Guest Editors

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Keywords

  • microbiota
  • multisystem diseases
  • bacteriophage therapy
  • metabolic disorders
  • precision medicine

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Published Papers (1 paper)

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12 pages, 2177 KB  
Case Report
Fecal Microbiota Transplantation in Refractory Immune-Mediated Colitis: Case Series and Review of the Literature
by Marin Golčić, Laura Radoš, Iva Skočilić, Ivona Badovinac, Goran Hauser, Irena Krznarić Zrnić, Marina Šantić, Dora Fučkar Čupić, Sara Francetić, Karla Lisica, Lea Juras, Marija Škrtić, Ana Bešvir Džubur, Robert Šeparović, Vedran Tomašić, Ana Tečić Vuger and Ivana Mikolašević
Pharmaceuticals 2025, 18(11), 1719; https://doi.org/10.3390/ph18111719 - 12 Nov 2025
Viewed by 753
Abstract
Background/Objectives: Immune checkpoint inhibitors (ICI) represent a significant breakthrough in cancer management, but they can cause adverse effects such as immune-mediated colitis (IMC). The standard first-line treatment is corticosteroids, and second-line treatment is infliximab or vedolizumab. However, a proportion of immune-mediated colitis (IMC) [...] Read more.
Background/Objectives: Immune checkpoint inhibitors (ICI) represent a significant breakthrough in cancer management, but they can cause adverse effects such as immune-mediated colitis (IMC). The standard first-line treatment is corticosteroids, and second-line treatment is infliximab or vedolizumab. However, a proportion of immune-mediated colitis (IMC) cases are refractory to immunosuppressive treatment, which has led to the exploration of novel approaches such as fecal microbiota transplantation. Methods: We present two patients who both developed grade III IMC following application of durvalumab and pembrolizumab, respectively. Both patients were refractory to corticosteroid therapy, while the first one also showed no improvement to infliximab. We performed two separate applications of FMT on both patients, from different donors, as a rescue treatment. Results: After unsuccessful immunosuppressive treatment and following rescue FMT, both patients demonstrated a rapid and sustained improvement in inflammatory markers, clinical symptoms, quality-of-life scores, and colonoscopy findings, without additional immunosuppressive treatment. Conclusions: FMT appears to be safe and a potentially effective treatment option for patients with refractory IMC both as second- and third-line therapy options. Continued efforts toward rigorous donor screening, use of standardized biobanks, and standardizing FMT protocols will further enhance safety and reproducibility. Full article
(This article belongs to the Special Issue The Regulatory Roles of the Gut Microbiota in Multisystem Diseases)
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