Intestinal Microbiota and Immune Modulation: New Perspectives for the Treatment of Chronic Gastroenteropathies

The gut microbiota plays essential roles in regulating immune homeostasis, and its alteration is directly associated with the development and progression of several chronic gastroenteropathies.This systematic review, conducted according to the PRISMA 2020 guidelines, analyzed studies published between 2019 and 2024 in the PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases, with the aim of synthesizing evidence on the interaction between microbiota, the immune system, and therapeutic interventions based on microbial modulation.After screening 2,384 records, 57 studies met the PICOS criteria and were included in the final analysis.Quantitative results showed that interventions such as probiotics, prebiotics, synbiotics, high-fiber diets, and fecal microbiota transplantation promoted significant reductions in inflammatory markers, including IL-6, TNF-α, and fecal calprotectin, as well as an increase in regulatory T cell populations.In clinical studies, inflammatory reductions ranged from 15% to 70%, with more robust effects observed in fecal microbiota trans .Qualitatively, restoration of microbial diversity, an increase in butyrate-producing species, and significant clinical improvement were observed, especially in inflammatory bowel diseases.The synthesis of the findings demonstrates that microbiota modulation represents a promising therapeutic strategy, capable of influencing immune pathways and reducing chronic inflammation.However, gaps remain regarding the standardization of interventions and longterm follow-up.It is concluded that the intestinal microbiota is a relevant strategic target for innovative therapies in the management of chronic gastroenteropathies.