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Intestinal microbiota, probiotics and prebiotics in inflammatory bowel disease.

Abstract

It has been presumed that aberrant immune response to intestinal microorganisms in genetically predisposed individuals may play a major role in the pathogenesis of the inflammatory bowel disease, and there is a good deal of evidence supporting this hypothesis. Commensal enteric bacteria probably play a central role in pathogenesis, providing continuous antigenic stimulation that causes chronic intestinal injury. A strong biologic rationale supports the use of probiotics and prebiotics for inflammatory bowel disease therapy. Many probiotic strains exhibit anti-inflammatory properties through their effects on different immune cells, pro-inflammatory cytokine secretion depression, and the induction of anti-inflammatory cytokines. There is very strong evidence supporting the use of multispecies probiotic VSL#3 for the prevention or recurrence of postoperative pouchitis in patients. For treatment of active ulcerative colitis, as well as for maintenance therapy, the clinical evidence of efficacy is strongest for VSL#3 and Escherichia coli Nissle 1917. Moreover, some prebiotics, such as germinated barley foodstuff, Psyllium or oligofructose-enriched inulin, might provide some benefit in patients with active ulcerative colitis or ulcerative colitis in remission. The results of clinical trials in the treatment of active Crohn's disease or the maintenance of its remission with probiotics and prebiotics are disappointing and do not support their use in this disease. The only exception is weak evidence of advantageous use of Saccharomyces boulardii concomitantly with medical therapy in maintenance treatment.

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  • Authors+Show Affiliations

    ,

    Rok Orel, Tina Kamhi Trop, Department of Gastroenterology, Hepatology and Nutrition, Children's Hospital, University Medical Centre, 1000 Ljubljana, Slovenia.

    Rok Orel, Tina Kamhi Trop, Department of Gastroenterology, Hepatology and Nutrition, Children's Hospital, University Medical Centre, 1000 Ljubljana, Slovenia.

    Source

    World journal of gastroenterology 20:33 2014 Sep 07 pg 11505-24

    MeSH

    Animals
    Colitis, Ulcerative
    Crohn Disease
    Humans
    Intestines
    Microbiota
    Prebiotics
    Probiotics
    Remission Induction
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    25206258

    Citation

    Orel, Rok, and Tina Kamhi Trop. "Intestinal Microbiota, Probiotics and Prebiotics in Inflammatory Bowel Disease." World Journal of Gastroenterology, vol. 20, no. 33, 2014, pp. 11505-24.
    Orel R, Kamhi Trop T. Intestinal microbiota, probiotics and prebiotics in inflammatory bowel disease. World J Gastroenterol. 2014;20(33):11505-24.
    Orel, R., & Kamhi Trop, T. (2014). Intestinal microbiota, probiotics and prebiotics in inflammatory bowel disease. World Journal of Gastroenterology, 20(33), pp. 11505-24. doi:10.3748/wjg.v20.i33.11505.
    Orel R, Kamhi Trop T. Intestinal Microbiota, Probiotics and Prebiotics in Inflammatory Bowel Disease. World J Gastroenterol. 2014 Sep 7;20(33):11505-24. PubMed PMID: 25206258.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Intestinal microbiota, probiotics and prebiotics in inflammatory bowel disease. AU - Orel,Rok, AU - Kamhi Trop,Tina, PY - 2013/09/21/received PY - 2014/01/06/revised PY - 2014/06/12/accepted PY - 2014/9/11/entrez PY - 2014/9/11/pubmed PY - 2015/7/7/medline KW - Gut KW - Inflammatory bowel disease KW - Microbiota KW - Prebiotic KW - Probiotic SP - 11505 EP - 24 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 20 IS - 33 N2 - It has been presumed that aberrant immune response to intestinal microorganisms in genetically predisposed individuals may play a major role in the pathogenesis of the inflammatory bowel disease, and there is a good deal of evidence supporting this hypothesis. Commensal enteric bacteria probably play a central role in pathogenesis, providing continuous antigenic stimulation that causes chronic intestinal injury. A strong biologic rationale supports the use of probiotics and prebiotics for inflammatory bowel disease therapy. Many probiotic strains exhibit anti-inflammatory properties through their effects on different immune cells, pro-inflammatory cytokine secretion depression, and the induction of anti-inflammatory cytokines. There is very strong evidence supporting the use of multispecies probiotic VSL#3 for the prevention or recurrence of postoperative pouchitis in patients. For treatment of active ulcerative colitis, as well as for maintenance therapy, the clinical evidence of efficacy is strongest for VSL#3 and Escherichia coli Nissle 1917. Moreover, some prebiotics, such as germinated barley foodstuff, Psyllium or oligofructose-enriched inulin, might provide some benefit in patients with active ulcerative colitis or ulcerative colitis in remission. The results of clinical trials in the treatment of active Crohn's disease or the maintenance of its remission with probiotics and prebiotics are disappointing and do not support their use in this disease. The only exception is weak evidence of advantageous use of Saccharomyces boulardii concomitantly with medical therapy in maintenance treatment. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25206258/Intestinal_microbiota_probiotics_and_prebiotics_in_inflammatory_bowel_disease_ L2 - http://www.wjgnet.com/1007-9327/full/v20/i33/11505.htm DB - PRIME DP - Unbound Medicine ER -