A Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies

Abstract

Irritable bowel syndrome (IBS), one of the most frequent digestive disorders, is characterized by chronic and recurrent abdominal pain and altered bowel habit. The origin seems to be multifactorial and is still not well defined for the different subtypes. Genetic, epigenetic and sex-related modifications of the functioning of the nervous and immune-endocrine supersystems and regulation of brain-gut physiology and bile acid production and absorption are certainly involved. Acquired predisposition may act in conjunction with infectious, toxic, dietary and life event-related factors to enhance epithelial permeability and elicit mucosal microinflammation, immune activation and dysbiosis. Notably, strong evidence supports the role of bacterial, viral and parasitic infections in triggering IBS, and targeting microbiota seems promising in view of the positive response to microbiota-related therapies in some patients. However, the lack of highly predictive diagnostic biomarkers and the complexity and heterogeneity of IBS patients make management difficult and unsatisfactory in many cases, reducing patient health-related quality of life and increasing the sanitary burden. This article reviews specific alterations and interventions targeting the gut microbiota in IBS, including prebiotics, probiotics, synbiotics, non-absorbable antibiotics, diets, fecal transplantation and other potential future approaches useful for the diagnosis, prevention and treatment of IBS.

The Evolving Role of Gut Microbiota in the Management of Irritable Bowel Syndrome: An Overview of the Current Knowledge

“…Several studies aiming to characterize and map the microbiome signature of IBS have shown divergent results. Nonetheless, data suggest that there is a relative richness of proinflammatory bacterial species containing Enterobacteriaceae, with a parallel decline in Lactobacillus and Bifidobacterium [38,39]. A decreased percentage of Lactobacillus and Bifidobacterium species has also been described in the IBS microbiota, leading to disturbances in short-chain fatty acid production and in immunologic and bactericidal activity, with a negative effect on microbiota function and stability [40][41][42][43][44][45][46].…”

Effectiveness of the probiotic B. bifidum 1 for the prevention of recurrent respiratory infections in children of 7–11 years old with functional and chronic disorders of gastrointestinal tract

“…Наибольшие преимущества, по имеющимся данным, вероятно, получат дети младших возрастных групп с повторными ОРЗ в зимний сезон [20]. Однако в проведенных кли-нических исследованиях пациенты, как правило, не были стратифицированы по сопутствующим состояниям и фоновым заболеваниям, которые могут определять структурные характеристики микрофлоры и иммунной системы и тем са-мым влиять на эффективность пробиотиков [25,26]. Настоящее исследование проведено у детей 7-10 лет с фоновой функциональной или хро-нической патологией ЖКТ и повторными ОРЗ.…”

Ensuring the future of functional foods

“…Postbiotics, also referred to as ‘parabiotics’ are claimed to be inactivated probiotics or ‘ghost probiotics’ and refer to non‐viable bacterial cells, furthermore they can be comprised of whole‐cell or cell‐free extracts, purified cell wall components or culture supernatant administered in the same way as probiotics, these postbiotics have shown significant immunomodulatory effects (Aguilar‐Toalá et al ., ). It is also postulated that these postbiotics may hold safety advantages as risk of infection or enhanced inflammatory responses may be reduced in consumers with already compromised immune systems (Korpela, ; Rodiño‐Janeiro et al ., ; Rout et al ., ).…”

“…These postbiotics have been shown to possess different functional properties including systemic effects such as antioxidant, hypocholesterolemic, antihypertensive, antiobesogenic and hepato‐protective properties through modulation of the immune system (de Almada et al ., ; Aguilar‐Toalá et al ., ; Korpela, ; Pojić et al ., ; Rodiño‐Janeiro et al ., ). These postbiotics could be an interesting alternative strategy for use in functional food products as they have a favourable safety profile as there is reduced opportunity for antibiotic resistance genes to be passed via horizontal transfer mechanisms that can occur in some probiotic strains (Taverniti & Guglielmetti, ; Imperial & Ibana, ).…”