Dynamic Changes and Significance of Intestinal Fungal Flora in IBD Patients Treated with Infliximab

Abstract

Objective: To investigate the effect and clinical significance of Infliximab treatment on the changes of intestinal fungal flora in patients with inflammatory bowel disease (IBD). Method: From October 2023 to October 2025, 60 patients with IBD (35 with Crohn's disease
and 25 with ulcerative colitis) were enrolled and randomly divided into an Infliximab treatment group (n=30, combined with conventional
treatment) and a conventional treatment control group (n=30). The changes in three core indicators, including intestinal fungal diversity index,
relative abundance of dominant genera, and serum antifungal antibody levels, were compared after intervention. Result: After intervention,
the diversity index of intestinal fungi in the treatment group was lower than that in the control group. The relative abundance of Candida
genus, fungal bacterial ratio, and serum antifungal antibody level were all higher than those in the control group, and the differences were
statistically significant (P<0.05). Conclusion: Infliximab can significantly alter the structure of intestinal fungal flora in IBD patients, increase
the abundance of Candida species, and enhance antifungal immune response, suggesting that its therapeutic mechanism may involve fungal
microbiota regulation.