Multiple indirect cellular and microbiome mediators

The designation Multiple indirect cellular and microbiome mediators refers to a therapeutic paradigm where the clinical efficacy is derived from systemic or ecological changes rather than binding to a specific human protein target. This is particularly relevant for microbiome-directed therapies, where the target is the collective genome and metabolic activity of trillions of microorganisms (Cani, P. D., 2018, Gut). Interventions such as fecal microbiota transplants or certain non-absorbed antibiotics work by reshaping the microbial landscape, which in turn alters the profile of signaling metabolites like short-chain fatty acids and bile acids (Surawicz et al., 2013, American Journal of Gastroenterology). These metabolites interact with various host receptors to modulate inflammation, glucose homeostasis, and gut barrier function (Forslund et al., 2015, Nature). Consequently, this category encompasses treatments for diverse conditions ranging from enteric infections to metabolic and autoimmune diseases. Because the mechanism involves a complex network of indirect interactions, identifying a single molecular target is often impossible or biologically inaccurate.

Other names

Microbiome-mediated pathwaysIndirect cellular mediatorsNon-specific microbial modulationCommensal microbiota modulation

Modulation of the gut microbiota composition and the subsequent production of bioactive metabolites (e.g., short-chain fatty acids, bile acids) that influence host physiological pathways (Nature Reviews Microbiology, 2013).