Relationship between Crohn’s disease and gut microbiota in the elderly: a literature review
- Authors: Borodkina L.V.1, Vereschagina A.D.2, Vladimirova V.S.2, Dulepova R.V.3, Raevskii K.P.4, Smirnova T.K.2, Shelyakina A.V.1
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Affiliations:
- I.P. Pavlov First St. Petersburg State Medical University
- North-Western State Medical University named after I.I. Mechnikov
- Saint-Petersburg State Pediatric Medical University
- Lomonosov Moscow State University
- Issue: Vol 31, No 4 (2025)
- Pages: 407-414
- Section: Reviews
- Submitted: 26.03.2025
- Accepted: 05.06.2025
- Published: 08.09.2025
- URL: https://medjrf.com/0869-2106/article/view/677754
- DOI: https://doi.org/10.17816/medjrf677754
- EDN: https://elibrary.ru/HWLEGP
- ID: 677754
Cite item
Abstract
Crohn disease is a chronic inflammatory disease of the gastrointestinal tract that develops as a result of complex interaction between the immune system and the gut microbiota. The incidence of the disease has recently increased, especially in the young and elderly population.
This article examines current data on microbiota changes in patients with Crohn disease with an emphasis on the elderly population and the influence of the intestinal microflora composition on the disease course. An analysis of literature over the past 5 years from scientific databases, such as Medline, PubMed Central, eLIBRARY.RU, and Cyberleninka, has shown that the intestinal dysbiosis characteristic of the majority of patients with Crohn disease leads to a decrease in bacterial diversity and excessive growth of pathogenic microorganisms. In addition to the bacterial flora, an important role in the pathogenesis and course of the disease play fungi, viruses, and parasites, which is directly related to the worsening of the condition. The findings emphasize the importance of studying the role of microbiota in the development and course of the disease, which may contribute to the development of new treatment and prevention options.
Full Text

About the authors
Lidiia V. Borodkina
I.P. Pavlov First St. Petersburg State Medical University
Email: borodkinalv00@mail.ru
ORCID iD: 0009-0003-2498-5182
Russian Federation, Saint Petersburg
Alexandra D. Vereschagina
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: alexver20010419@gmail.com
ORCID iD: 0009-0004-7880-8314
Russian Federation, 41 Kirochnaya st, Saint Petersburg, 191015
Veronica S. Vladimirova
North-Western State Medical University named after I.I. Mechnikov
Email: vladimirovav19@yandex.ru
ORCID iD: 0009-0000-2652-6279
Russian Federation, 41 Kirochnaya st, Saint Petersburg, 191015
Regina V. Dulepova
Saint-Petersburg State Pediatric Medical University
Email: reginakrrz@gmail.com
ORCID iD: 0009-0001-7145-4718
Russian Federation, Saint Petersburg
Kirill P. Raevskii
Lomonosov Moscow State University
Email: raevskiikp@my.msu.ru
ORCID iD: 0000-0002-9939-3443
SPIN-code: 9133-3802
MD
Russian Federation, MoscowTatyana K. Smirnova
North-Western State Medical University named after I.I. Mechnikov
Email: frutany91@gmail.com
ORCID iD: 0009-0002-9568-1322
Russian Federation, 41 Kirochnaya st, Saint Petersburg, 191015
Alina V. Shelyakina
I.P. Pavlov First St. Petersburg State Medical University
Email: shelyakinalina@yandex.ru
ORCID iD: 0009-0006-5932-3850
Russian Federation, Saint Petersburg
References
- Lagutina SN, Zuikova AA, Dobrynina IS, et al. Changes in the intestinal microbiota as a predictor of the development of colorectal cancer in the elderly persons: a case study. Journal of Clinical Practice. 2022;13(3):109–113. doi: 10.17816/clinpract110706 EDN: AXRQLW
- Aldars-García L, Chaparro M, Gisbert JP. Systematic review: the gut microbiome and its potential clinical application in inflammatory bowel disease. Microorganisms. 2021;9(5):977. doi: 10.3390/microorganisms9050977 EDN: TFMFEN
- Gebrayel P, Nicco C, Al Khodor S, et al. Microbiota medicine: towards clinical revolution. J Transl Med. 2022;20(1):111. doi: 10.1186/s12967-022-03296-9
- Davydova AYu, Repnikova RV. Extraintestinal manifestations of crohn's disease: difficulties in diagnosis. Fundamental and Clinical Medicine. 2020;5(2):119–122. doi: 10.23946/2500-0764-2020-5-1-119-122 EDN: IERWTR
- Zhestkov AV, Khalitova YuA, Myakisheva YuV. The role of the microbiota of the gastrointestinal tract in the pathogenesis of inflammatory bowel diseases. Astrakhan Medical Journal. 2023;18:3:33–42. doi: 10.29039/1992-6499-2023-3-33-42 EDN: HVDERS
- Di Tommaso N, Gasbarrini A, Ponziani FR. Intestinal barrier in human health and disease. Int J Environ Res Public Health. 2021;18(23):12836. doi: 10.3390/ijerph182312836 EDN: XNQAJG
- Nigam M, Devi K, Coutinho HDM, Mishra AP. Exploration of gut microbiome and inflammation: A review on key signalling pathways. Cell Signal. 2024;118:111140. doi: 10.1016/j.cellsig.2024.111140 EDN: SUZCQF
- Bakulin IG, Skalinskaya MI, Skazyvaeva EV. North-western register of patients with inflammatory bowel disease: achievements and lessons learned. Koloproktologia. 2022;21(1):37–49. doi: 10.33878/2073-7556-2022-21-1-37-49 EDN: ITCUJP
- Tarasova LV, Kucherova NY, Stepashina TE. Features of symptoms, diagnosis and treatment of inflammatory bowel diseases in elderly patients. Lechaschi Vrach. 2023;26(2):32–38. doi: 10.51793/OS.2023.26.2.005 EDN: VLDPGP
- González MB, Olmedo Martín RV, Morales Bermúdez AI, Jiménez Pérez M. Characterization of inflammatory bowel disease in the elderly according to age of onset. J Clin Med. 2024;13(24):7581. doi: 10.3390/jcm13247581 EDN: QCTLSS
- Danielou M, Sarter H, Pariente B, et al. Natural history of perianal fistulising lesions in patients with elderly-onset crohn's disease: A population-based study. J Crohns Colitis. 2020;14(4):501–507. doi: 10.1093/ecco-jcc/jjz173
- Sousa P, Bertani L, Rodrigues C. Management of inflammatory bowel disease in the elderly: A review. Dig Liver Dis. 2023;55(8):1001–1009. doi: 10.1016/j.dld.2022.12.024 EDN: WLVCNR
- Cross E, Saunders B, Farmer AD, Prior JA. Diagnostic delay in adult inflammatory bowel disease: A systematic review. Indian J Gastroenterol. 2023;42(1):40–52. doi: 10.1007/s12664-022-01303-x EDN: TNDLWI
- Uspenskiy YuP, Ivanov SV, Fominykh YuA, et al. Features of the complicated course and extraintestinal manifestations of inflammatory bowel diseases. University Therapeutic Journal. 2023;5(2):68–83. doi: 10.56871/UTJ.2023.72.18.006 EDN: RUDNKI
- Liu A, Lv H, Wang H, et al. Aging increases the severity of colitis and the related changes to the gut barrier and gut microbiota in humans and mice. J Gerontol A Biol Sci Med Sci. 2020;75(7):1284–1292. doi: 10.1093/gerona/glz263 EDN: OXXXRW
- Andreeva IN, Shulinski RS, Mikhalenka AP, et al. Studying the gut microbiome in people over 60. Molekuljarnaja i prikladnaja genetika. 2022;(32):81. doi: 10.47612/1999-9127-2022-32-81-87 EDN: CNHKYE
- Wu J, Ren W, Chen L, et al. Age-related changes in the composition of intestinal microbiota in elderly chinese individuals. Gerontology. 2022;68(9):976–988. doi: 10.1159/000520054 EDN: KYGQFT
- Ryan FJ, Ahern AM, Fitzgerald RS, et al. Colonic microbiota is associated with inflammation and host epigenomic alterations in inflammatory bowel disease. Nat Commun. 2020;11(1):1512. doi: 10.1038/s41467-020-15342-5 EDN: YFUOYY
- Kim AD, Lepekhova SA, Chashkova EY, et al. Results of the microbiota assessment in experimental ulcerative colitis. Bulletin of Siberian Medicine. 2021;20(1):59–66. doi: 10.20538/1682-0363-2021-1-59-66 EDN: KYVRBA
- Danpanichkul P, Suparan K, Arayakarnkul S, et al. Global epidemiology and burden of elderly-onset inflammatory bowel disease: A decade in review. J Clin Med. 2023;12(15):5142. doi: 10.3390/jcm12155142 EDN: FJWXUY
- Lagutina SN, Zuykova AA, Chizhkov PA, et al. Features in biodiversity of intestinal microbiota in inflammatory bowel diseases: a clinical case. Siberian Medical Review. 2023;(2):97–100. doi: 10.20333/25000136-2023-2-97-100 EDN: CGNSXW
- Safina DD, Abdulkhakov SR, Amirov NB. Gut microbiota and its importance for human health. The Bulletin of Contemporary Clinical Medicine. 2021;14(5):81–94. doi: 10.20969/VSKM.2021.14(5).81-94 EDN: SFURDU
- Kaibysheva VO, Zharova ME, Filimendikova KYu, Nikonov EL. Diseases associated with disturbed intestinal microbiota. Doctor.ru. 2021;20(4):40–45. doi: 10.31550/1727-2378-2021-20-4-40-45 EDN: ODBQHS
- Skalinskaya MI, Deev RV, Presnyakov EV, et al. Histione of the intestinal epithelial barrier in inflammatory bowel diseases: morphofunctional characteristics and clinical significance. Russian Medical Inquiry. 2023;7(5):292–299. doi: 10.32364/2587-6821-2023-7-5-7 EDN: IADSZQ
- Banzragch M, Sanli K, Stensvold CR, et al. Metabarcoding of colonic cleansing fluid reveals unique bacterial members of mucosal microbiota associated with Inflammatory Bowel Disease. Scand J Gastroenterol. 2023;58(11):1253–1263. doi: 10.1080/00365521.2023.2223708 EDN: WGFONR
- Zhang L, Liao J, Chen Q, et al. Characterization of the gut microbiota in frail elderly patients. Aging Clin Exp Res. 2020;32(10):2001–2011. doi: 10.1007/s40520-019-01385-2 EDN: EINPIU
- Gaus OV, Belyakov DG. Modern views on the gut microbiota role in intestinal pathology. RMJ. 2021;29(4):10–16. EDN: EXQQXD
- Siniagina MN, Laikov AV, Markelova MI, et al. Competitive ability of Escherichia Coli strains in the intestinal microbiota of patients with Crohn's disease and healthy volunteers: Physiological, biochemical and genetic characteristics. Journal of Microbiology Epidemiology Immunobiology. 2022;99(6):669–681. doi: 10.36233/0372-9311-192 EDN: MZLEZC
- Kaybysheva VO, Zharova ME, Filimendikova KYu, Nikonov EL. Human microbiome: age-related changes and functions. Russian Journal of Evidence-Based Gastroenterology. 2020;9(2):42–55. doi: 10.17116/dokgastro2020902142 EDN: YKXBBQ
- Karpeeva YuS, Novikova VP, Khavkin AI, et al. Microbiota and human diseases: dietary correction. Russian Bulletin of Perinatology and Pediatrics. 2020;65(5):116–125. doi: 10.21508/1027-4065-2020-65-5-116-125 EDN: RUUHYT
- Hernández-Rocha C, Turpin W, Borowski K, et al. After surgically induced remission, ileal and colonic mucosa-associated microbiota predicts Crohn's disease recurrence. Clin Gastroenterol Hepatol. 2025;23(4):612–620.e10. doi: 10.1016/j.cgh.2024.06.022 EDN: GAKJSI
- Caparrós E, Wiest R, Scharl M, et al. Dysbiotic microbiota interactions in Crohn's disease. Gut Microbes. 2021;13(1):1949096. doi: 10.1080/19490976.2021.1949096 EDN: CXMDSH
- Sukhina MA, Yudin SM, Zagainova AV, et al. Peculiarities of microbiota in patients with inflammatory intestinal diseases. Annals of The Russian Academy of Medical Sciences. 2022;77(3):165–171. doi: 10.15690/vramn1480 EDN: GKHMWL
- Hu Y, Chen Z, Xu C, et al. Disturbances of the gut microbiota and microbiota-derived metabolites in inflammatory bowel disease. Nutrients. 2022;14(23):5140. doi: 10.3390/nu14235140 EDN: RNNTGQ
- Sun M, Ju J, Xu H, Wang Y. Intestinal fungi and antifungal secretory immunoglobulin A in Crohn's disease. Front Immunol. 2023;14:1177504. doi: 10.3389/fimmu.2023.1177504 EDN: DAISPT
- Nesterenko ZV, Khavkin AI, Novikova VP, Listopadova AP. Intestinal microbiota and cardiovascular diseases. Experimental and Clinical Gastroenterology. 2022;3:125–133. doi: 10.31146/1682-8658-ecg-199-3-125-133
- Al Bander Z, Nitert MD, Mousa A, Naderpoor N. The gut microbiota and inflammation: an overview. Int J Environ Res Public Health. 2020;17(20):7618. doi: 10.3390/ijerph17207618 EDN: DGZZDV
- Bolte LA, Vich Vila A, Imhann F, et al. Long-term dietary patterns are associated with pro-inflammatory and anti-inflammatory features of the gut microbiome. Gut. 2021;70(7):1287–1298. doi: 10.1136/gutjnl-2020-322670
- Fang X, Kang L, Qiu YF, et al. Yersinia enterocolitica in Crohn's disease. Front Cell Infect Microbiol. 2023;13:1129996. doi: 10.3389/fcimb.2023.1129996 EDN: UOLKCB
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