Manipulation of Intestinal Microbial Flora for Therapeutic Benefit in Inflammatory Bowel Diseases: Review of Clinical Trials of Probiotics, Prebiotics and Synbiotics
Abstract:Pathogenesis of Inflammatory Bowel Diseases(Ulcerative Colitis, Crohn's disease and Pouchitis) includes an abnormal immunological response to disturbed intestinal microflora. Therapeutic strategies are designed to intervene in these abnormal host microbial communications. A novel approach in the last decade has been to use other bacteria or selective foods to induce beneficial bacteria to normalize inflammation. In this review we discuss rationale for such use and describe 46 clinical trials gleaned from the l… Show more
“…These PP were chosen based on previous studies showing improved GI tract physiology and/or decreased inflammation (5,6,10). PP treatment alone did not affect plasma viral loads or CD4 + T cell numbers in blood or the GI tract (Supplemental Figure 2).…”
Section: Resultsmentioning
confidence: 99%
“…The increased mortality in ARV-treated, HIV-infected individuals is associated with inflammation and cardiovascular disease, which are in turn associated with GI mucosal damage and microbial translocation that do not resolve completely with ARV treatment (1,3). Probiotic and prebiotic supplements have improved outcomes in several diseases characterized by GI tract inflammation (4)(5)(6), and probiotics have safely been administered to HIV-infected individuals resulting in modest improvements in CD4 + T cell counts and clinical GI symptoms even without ARV treatment (7)(8)(9). We therefore studied potential benefits of synbiotic supplementation of ARVs in SIV-infected Asian macaques.…”
“…These PP were chosen based on previous studies showing improved GI tract physiology and/or decreased inflammation (5,6,10). PP treatment alone did not affect plasma viral loads or CD4 + T cell numbers in blood or the GI tract (Supplemental Figure 2).…”
Section: Resultsmentioning
confidence: 99%
“…The increased mortality in ARV-treated, HIV-infected individuals is associated with inflammation and cardiovascular disease, which are in turn associated with GI mucosal damage and microbial translocation that do not resolve completely with ARV treatment (1,3). Probiotic and prebiotic supplements have improved outcomes in several diseases characterized by GI tract inflammation (4)(5)(6), and probiotics have safely been administered to HIV-infected individuals resulting in modest improvements in CD4 + T cell counts and clinical GI symptoms even without ARV treatment (7)(8)(9). We therefore studied potential benefits of synbiotic supplementation of ARVs in SIV-infected Asian macaques.…”
“…However, this suppression was limited to the ileum in CD. Probiotics including LGG have general been less effective in CD than UC 42 and adverse responses have been reported. [43][44][45][46] Given the immunoregulatory potential of bacteroides species 36 the question arises whether B. theta might be a potentially useful probiotic agent in CD.…”
We provide the first ex vivo data to support the notion that aberrant mucosal recognition of commensal bacteria may contribute to pediatric CD. While IL-8 responses to O42 and LGG varied with disease status and anatomical location, B. theta consistently induced significant IL-8 both in ileal and colonic CD tissue, which was not seen in control, healthy tissue.
“…The effects of these prebiotics in people with gut diseases (for example, see MacFarlane et al, 2008;Hedin et al, 2007;Heilpern and Szilagyi, 2008) are beyond the scope of this review.…”
The bifidogenic effect of inulin and oligofructose is now well established in various studies, not only in adult participants but also in other age groups. This bifidogenic shift in the composition of the colonic microbiota is likely the basis for the impact of these prebiotic compounds on various parameters of colonic function. Mainly from animal and in vitro studies and also from some human trials, there are indications, for instance, that inulin-type fructans may reduce the production of potentially toxic metabolites and may induce important immune-mediated effects. This review discusses how these changes in the composition and activity of the colonic microbiota may affect gut health in healthy people, including in those who may experience some form of gastrointestinal discomfort.
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