Probiotics and their derivatives as treatments for inflammatory bowel disease (original) (raw)
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Probiotics in inflammatory bowel disease—therapeutic rationale and role
Advanced Drug Delivery Reviews, 2004
The intestinal flora has a conditioning effect on intestinal homeostasis, delivering regulatory signals to the epithelium, the mucosal immune system and to the neuromuscular activity of the gut. Beneficial metabolic activities of the enteric flora include nutrient production, metabolism of dietary carcinogens, conversion of prodrugs to active drugs. However, increasing evidence suggests that some components of the enteric flora are essential ingredients in the pathogenesis of inflammatory bowel disease (IBD); this has prompted interest in therapeutic manipulation of the flora with probiotics. Probiotics are biologic control agentsdescribed as live microbial food supplements which confer a health benefit beyond inherent basic nutrition. Multiple potential beneficial effects have been attributed to the probiotic use of lactic acid bacteria, bifidobacteria and other non-pathogenic commensals. At present, much of the promise of probiotics remains outside the realm of evidence-based medicine and awaits the results of prospective trials, now underway. No reliable in vitro predictors of in vivo efficacy of putative probiotics have been identified. Rigorous comparisons of probiotic performance have not been performed and the suitability of a given probiotic for different individuals is largely unexplored. Notwithstanding, an improved understanding of the normal commensal flora and host-flora interactions has the potential to open up new therapeutic strategies for inflammatory disorders of the gut.
Probiotics are live organisms that exert a health benefit on the host, have been used for the management of a range of gastrointestinal disorders, though there have little evidence. Interest in intestinal microflora is increased because of its effect on various gastrointestinal disorders. Inflammatory Bowel Diseases (IBD) is a complex, multifactorial, and the most frequent gastrointestinal disorders all over the world. In more recent time, Probiotics have been explored as a possible treatment for IBD and other gastrointestinal diseases. The mode of action of probiotics has not been fully elucidated. The acceptance of probiotics has been better gradually due to the development of modern molecular methods and well-controlled experimental trials of the results of probiotics on IBD to scrutinize and recognize multifarious bacteria within human intestines. The Probiotic strains, molecular mechanism of probiotic action on human intestine, Probiotic action on IBD disease etiology are reviewed. The effect of probiotics on different gastrointestinal disorders and the consequences from experimental trials of probiotics for the treatment of such disorders are also summarized. These areas of research have great potential and deserve more experimental study at all levels.
[Probiotics and inflammatory bowel disease]
Gastroenterologia y hepatologia, 2002
The aetiology of inflammatory bowel disease (IBD) remains obscure, currently thought to be associated with a genetic predisposition, dysregulation of the mucosal immune system, and a loss of antigen tolerance to enteric microflora, further influenced by a range of other environmental factors. In many cases, disease activity can be unremitting and refractory to treatment, with an unpredictable response to conventional therapy. To this end, new treatment strategies are being pursued on the basis of our understanding of IBD pathogenesis, and there is increasing evidence that at least some components of the enteric flora are primary contributors. Restoring the balance of the colonic microbiota to a less-pathogenic state is therefore a desirable strategy. Probiotics are currently defined as live non-pathogenic microorganisms that, when ingested, exert a positive influence on host health beyond basic nutrition. On this basis, probiotics hold the potential to restore normal intestinal homeostasis. Despite more than a century of anecdotal reports of probiotic efficacy in gastrointestinal disease, only relatively recently have well-controlled, scientific studies and clinical trials, been conducted. Whilst reliable in vitro predictors of potential in vivo efficacy of putative probiotics await development, well-characterised animal model systems are proving valuable for the methodical, pre-clinical development of probiotics. Although early probiotic applications focussed largely on lactic acid bacteria (lactobacilli) and bifidobacteria, the range of candidate probiotics has now expanded significantly. Successful clinical application of the probiotic formulation, VSL#3, for treatment of the pouchitis variant of IBD, has instilled new excitement into the applicability of probiotics to IBD treatment, and the potential importance of probiotic combinations. The availability of new recombinant methodologies to develop 'designer' probiotics, capable of synthesizing and secreting specific factors, ranging from vitamins through to antibodies, further broadens the scope for probiotic application in IBD. Indeed, there are encouraging reports that probiotics may not need to be viable, or even intact, to exert their beneficial effects, with reports of therapeutic benefit from bacterial components such as DNA. In addition to the development of rigorous predictive systems to ascertain probiotic efficacy, challenges for the future will include determining the 3 optimal probiotic, or probiotic combination, and its timing of administration during phases of IBD relapse and remission. At present, our understanding of the intestinal microflora, and the importance of its composition and variability between individuals, is limited. However, once this understanding has been attained, strategically-designed probiotic formulations could ultimately be 'tailored' to suit individual IBD patients.
Probiotics and Their Use in Inflammatory Bowel Disease
Alternative Therapies in Health & Medicine, 2018
Context • Crohn's disease and ulcerative colitis result in similar gastrointestinal (GI) symptoms, including pain, diarrhea, stools with mucus or blood, and ulceration or tissue damage within the alimentary canal. Gut microbiota play a crucial role in triggering, maintaining, and exacerbating inflammatory bowel disease (IBD). Probiotics might help to rebalance the gut flora in a positive way, shifting from pro-to anti-inflammatory. Objectives • The study intended to investigate the safety and use of probiotics and the biological effects of probiotic bacteria on IBD. Design • The research team performed a literature review. The team conducted a database search in April 2015 using Google Scholar and PubMed to find studies relevant to probiotics and their use in IBD. Only papers that were published in English were considered, and all available years in each database were searched. The initial search identified 38 published articles, for which the research team obtained full texts and independently read them in full to identify those papers suitable for inclusion in the review. Setting • The study took place in the main library of the University of Lahore (Islamabad, Pakistan). Results • Many strains of probiotics exist, but the most common strains available today are (1) the Bifidobacterium species, (2) Enterococcus faecium, (4) the Lactobacillus strains, (4) Saccharomyces boulardii, (5) the Bacillus species, and (6) Pediococcus, all used to produce beneficial health effects. These species showed their beneficial effects on the host using different mechanisms involving (1) production of proteins, quorum sensing signaling inhibitors, butyrate, immunoglobulin A, and short-chain fatty acids; (2) decreased production of tumor necrosis factor alpha and interleukin 8; (3) increased expression of mucin 2; and (4) increased upregulation of defensin. Conclusions • Studies on probiotics in animal models of IBD are promising, and clinical results in IBD patients are encouraging; however, the data are limited, and few studies are placebo controlled. Additional placebo-controlled, double-blind studies in IBD are required before recommendations can be offered for routine use of probiotics in IBD. Additional organisms may eventually be developed through genetic engineering. The current evidence also indicates that probiotic effects are strain specific; they do not act through the same mechanisms nor are all probiotics indicated for the same health conditions. More research is needed to determine what strains and at what dose probiotics become more useful as part of a clinical intervention. (Altern Ther Health Med. 2018;24(3):16-23.)
2016
Various commensal enteric and pathogenic bacteria may be involved in the pathogenesis of inflammatory bowel diseases (IBDs), a chronic condition with a pathogenic background that involves both immunogenetic and environmental factors. IBDs comprising of Crohn's disease, and ulcerative colitis, and pauchitis are chronic inflammatory conditions, and known for causing disturbed homeostatic balance among the intestinal immune compartment, gut epithelium and microbiome. An increasing trend of IBDs in incidence, prevalence, and severity has been reported during recent years. Probiotic strains have been reported to manage the IBDs and related pathologies, and hence are current hot topics of research for their potential to manage metabolic diseases as well as various immunopathologies. However, the probiotics industry will need to undergo a transformation, with increased focus on stringent manufacturing guidelines and high-quality clinical trials. This article reviews the present state o...
Potential Application of Probiotics in the Prevention and Treatment of Inflammatory Bowel Diseases
Ulcers, 2011
Lactic acid bacteria (LAB) represent a heterogeneous group of microorganisms that are naturally present in many foods and possess a wide range of therapeutic properties. The aim of this paper is to present an overview of the current expanding knowledge of the mechanisms by which LAB and other probiotic microorganisms participate in the prevention and treatment of inflammatory bowel diseases. These include changes in the gut microbiota, stimulation of the host immune responses, and reduction of the oxidative stress due to their antioxidant properties. A brief overview of the uses of genetically engineered LAB that produce either antioxidant enzymes (such as catalase and superoxide dismutase) or anti-inflammatory cytokines (such as IL-10) will also be discussed. This paper will show that probiotics should be considered in treatment protocols of IBD since they provide many beneficial effects and can enhance the effectiveness of traditional used medicines.
Probiotics and inflammatory bowel disease: Is there a scientific rationale?
Inflammatory Bowel Diseases, 2007
Most conventional forms of drug therapy suppress or modify the host immunoinflammatory response and neglect the other contributor to disease pathogenesis-the environmental microflora. Probiotics are live microbial food ingredients that alter the enteric microflora and have a beneficial effect on health. The rationale for using probiotics in IBD is mainly based on evidence from human studies and experimental animal models implicating intestinal bacteria in the pathogenesis of these disorders. The relationship between bacteria and intestinal inflammation is complex and does not appear to reflect a simple cause and effect. Similarly, the field of probiotics is complex and in need of rigorous research. Until the indigenous flora are better characterized and mechanisms of probiotic action defined, the promise of probiotics in IBD is unlikely to be fulfilled. Because of strain-specific variability and clinical and therapeutic heterogeneity within Crohn's disease and ulcerative colitis, it cannot be assumed that a given probiotic is equally suitable for all individuals. Although preliminary results of probiotic therapy in animal models and humans with ulcerative colitis and pouchitis have been encouraging, their efficacy in treatment or maintenance of remission of Crohn's disease remains to be clarified. However, the circumstantial evidence for some form of biotherapeutic modification of the enteric flora in Crohn's disease seems compelling. In the future, probiotics may offer a simple adjunct to conventional therapy with the emphasis on diet shifting from one of nutritional replenishment alone to a more functional role.
Probiotics and the Management of Inflammatory Bowel Disease
Inflammatory Bowel Diseases, 2004
The demonstration that immune and epithelial cells can discriminate between different microbial species has extended our understanding of the actions of probiotics beyond simple barrier and antimicrobial concepts. Several probiotic mechanisms of action, relative to inflammatory bowel disease, have been elucidated: (1) competitive exclusion, whereby probiotics compete with microbial pathogens for a limited number of receptors present on the surface epithelium; (2) immunomodulation and/or stimulation of an immune response of gut-associated lymphoid and epithelial cells; (3) antimicrobial activity and suppression of pathogen growth; (4) enhancement of barrier function; and (5) induction of T cell apoptosis in the mucosal immune compartment. The unraveling of these mechanisms of action has led to new support for the use of probiotics in the management of clinical inflammatory bowel disease. Though level 1 evidence now supports the therapeutic use of probiotics in the treatment of postoperative pouchitis, only levels 2 and 3 evidence is currently available in support of the use of probiotics in the treatment of ulcerative colitis and Crohn's disease. Nevertheless, one significant and consistent finding has emerged during the course of research in the past year: not all probiotic bacteria have similar therapeutic effects. Rigorously designed, controlled clinical trials are vital to investigate the unresolved issues related to efficacy, dose, duration of use, single or multi-strain formulation, and the concomitant use of prebiotics, synbiotics, or antibiotics.
Role of Probiotics and Their Metabolites in Inflammatory Bowel Diseases (IBDs)
Gastroenterology Insights, 2021
Inflammatory Bowel Disease (IBD) is a term used to describe a group of complex disorders of the gastrointestinal (GI) tract. IBDs include two main forms: Crohn’s Disease (CD) and Ulcerative Colitis (UC), which share similar clinical symptoms but differ in the anatomical distribution of the inflammatory lesions. The etiology of IBDs is undetermined. Several hypotheses suggest that Crohn’s Disease and Ulcerative Colitis result from an abnormal immune response against endogenous flora and luminal antigens in genetically susceptible individuals. While there is no cure for IBDs, most common treatments (medication and surgery) aim to reduce inflammation and help patients to achieve remission. There is growing evidence and focus on the prophylactic and therapeutic potential of probiotics in IBDs. Probiotics are live microorganisms that regulate the mucosal immune system, the gut microbiota and the production of active metabolites such as Short-Chain Fatty Acids (SCFAs). This review will fo...