Figure 1.

Interaction of microbiome, intestinal barriers, and translocating bacteria in healthy conditions and active CD. Eubiosis is characterized by stable cluster networks and full species richness which in concert with fully active healthy epithelial and secretory barriers (namely normal intestinal permeability) and normal immune responses to physiological bacterial translocation is the basis for stable remission. The proposed hypothetical scenario on pathophysiology of Crohn’s disease being at least partly primarily due to dysbiosis and loss of cluster network induced in individuals with genetic pre-disposition and/or by lifestyle/exogenous factors is visualized at the bottom. With increasing intestinal hyperpermeability and exaggerated pro-inflammatory immune response inflammation perpetuates fueling into a vitious circle of pathological bacterial translocation and further aggravation of dysbiosis. Thus, the goal of treatment put forward is restoration of eubiosis being the basis for stable remission or if not achieved for recurrence