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Correspondence to Author: Felipe Santos Teixeira Martiniano¹, Maria Beatriz Mendonça Ventura², Délio Tiago Martins Malaquias³, Regilane da Silva Batista³, Giovana Casarini Yamashiro⁴, Aline Cristina Couto da Silva³, José Carlos Ferreira da Silva³, Mateus Assunção Costa⁸*, Rubens Rodrigues Tudela⁸, Ana Paula Valente Pinho Mafetano⁵, Lorena Dalla Torre Cury⁵, Elisa Lavezzo Amadeu⁵, Ana Laura Nogueira Ervilha⁵, Herbert Marchioro Drai⁴, José Antônio do Nascimento Neto⁶, Rafaela Ribeiro Bari³, Christian Emmanuel da Silva Pelaes³, Douglas Hipólito Carvalho⁴, Joel Eloi Belo Junior⁷, Roselene de Oliveira Carvalho³, Erica Miriam Fernandes Miranda Vão³, Camila Faria dos Santos Dainez⁹, Thiago Augusto Rochetti Bezerra ^1_10. 

1. Resident Medical at Beneficência Portuguesa Hospital, Santos, São Paulo, Brazil.
2. Medical graduated from São Judas Tadeu University, Cubatão, São Paulo, Brazil.
3. Medical student, Ribeirão Preto University (UNAERP), Guarujá, SP, Brazil.
4. Medical student, Nove de Julho University (UNINOVE), São Bernardo do Campo, São Paulo, Brazil.
5. Medical Student, São José dos Campos School of Medical Sciences (FCMSJC, Humanitas), São José dos Campos, São Paulo, Brazil.
6. Medical Student, Central University of Paraguay. Ciudad del Este, Paraguay.
7. Master’s Degree in Human Operational Performance; Master’s Degree in Intellectual Property and Technology Transfer for Innovation, Brazilian Air Force; Brazil.
8. Medical Student, São Judas Tadeu University, Cubatão, São Paulo, Brazil.
8.*Medical Doctor from São Judas Tadeu University, Cubatão, São Paulo, Brazil.
9. Medical student at Unoeste Medical University, Guarujá Campus, São Paulo.
10. Doctor of Medical Sciences, Ribeirão Preto School of Medicine, São Paulo, Brazil.

DOI: 10.52338/tajoph.2026.5296

Abstract:

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.

Keywords: Gut microbiota; Immune modulation; Dysbiosis; Chronic gastroenteropathies; Inflammatory bowel diseases; Probiotics; Prebiotics; Synbiotics; Fecal microbiota transplantation; Mucosal immunity

Citation:

Dr. Thiago Augusto Rochetti Bezerra , Intestinal Microbiota and Immune Modulation: New Perspectives for the Treatment of Chronic Gastroenteropathies. The American Journal of Public Health 2026.