Modulating the microbiota in inflammatory bowel diseases: prebiotics, probiotics or faecal transplantation?

Verbeke, Kristin; Boesmans, Leen; Boets, Eef

doi:10.1017/s0029665114000639

Cited by 37 publications

(21 citation statements)

References 103 publications

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“…It has been hypothesized that the beneficial activities might include altering the composition of the microbiota by competition for adhesion sites and nutrients or by secretion of bacteriocins and lactic acids, enhancement of intestinal barrier function (via increased production of mucus and anti-microbial peptides by epithelia), and modulation of immune cell responses. 35,36 There are only few reports on the use of probiotic bacteria in dogs with gastroenteritis. Earlier in vitro studies have confirmed the ability of a lyophilized probiotic cocktail (e.g., 3 different Lactobacillus spp strains) to modulate the expression of regulatory vs. pro-inflammatory cytokines in dogs with chronic enteropathies.…”

Section: Discussionmentioning

confidence: 99%

Randomized, controlled trial evaluating the effect of multi-strain probiotic on the mucosal microbiota in canine idiopathic inflammatory bowel disease

et al. 2017

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The intestinal microbiota is increasingly linked to the pathogenesis of idiopathic inflammatory bowel disease (IBD) in dogs. While studies have reported alterations in fecal (luminal) microbial populations, only limited information is available about the mucosal microbiota of IBD dogs at diagnosis and following medical therapy. Our aim was to characterize the mucosal microbiota and determine the clinical, microbiological, and mucosal homeostatic effects of probiotic treatment in dogs with IBD. Thirty four IBD dogs were randomized to receive standard therapy (ST = diet + prednisone) with or without probiotic. Tissue sections from endoscopic biopsies were evaluated by fluorescence in situ hybridization (FISH) on a quantifiable basis. Disease activity and changes in mucosal microbiota and tight junction protein (TJP) expression were assessed before and after 8 weeks of IBD therapy. ST and ST/probiotic therapy modulated the number of mucosal bacteria of IBD dogs in a similar fashion. Both treatments increased the numbers of total bacteria and individual species residing within adherent mucus, with ST therapy increasing Bifidobacterium spp. and ST/probiotic therapy increasing Lactobacillus spp (P < 0.05 for both), respectively. Both treatments were associated with rapid clinical remission but not improvement in histopathologic inflammation. Probiotic therapy was associated with upregulated (P < 0.05) expression of TJPs E-cadherin, occludin, and zonulin versus ST. The probiotic effect on mucosal bacteria is similar to that of IBD dogs receiving ST. IBD dogs fed probiotic had increased TJP expression suggesting that probiotic may have beneficial effects on mucosal homeostasis.

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Section: Discussionmentioning

confidence: 99%

Randomized, controlled trial evaluating the effect of multi-strain probiotic on the mucosal microbiota in canine idiopathic inflammatory bowel disease

et al. 2017

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“…In addition, butyrate is the primary metabolic fuel for distal colonic epithelial cells. Multiple studies demonstrate efficacy of oral prebiotics, either alone or in combination with probiotics (synbiotics) in experimental colitis [90], but proof of efficacy in human CD in UC patients is still limited [23,90,91]. A controlled four-week trial of fructo-oligosaccharides demonstrated no effect on remission rates in patients with active CD [92].…”

Section: Prebioticsmentioning

confidence: 99%

Therapeutic Manipulation of the Microbiome in IBD: Current Results and Future Approaches

Hansen

Sartor

2015

Curr Treat Options Gastro

103

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Opinion Statement Despite recent major strides in our understanding of the genetic and microbial influences that contribute to the development of the inflammatory bowel diseases (IBDs), their etiology continues to be enigmatic. Results from experiments in animal models of IBDs overwhelmingly support a causal role of the microbiota in these diseases, though whether such a cause-effect relationship exists in human IBDs is still uncertain. Therefore, virtually all currently-approved, and most often prescribed, treatments for IBDs are directed toward the over-active immune response in these diseases rather than the intestinal bacteria. Nevertheless, there is an important need for non-immunosuppressive therapies that may present a more favorable risk-benefit profile such as those that selectively target the disruptions in gut microbiota that accompany IBDs. This need has led to clinical trials of various microbial-directed therapies including fecal microbial transplant, antibiotics, probiotics, and prebiotics. Unfortunately, these published studies, many of which are small, have generally failed to demonstrate a consistent benefit of these agents in IBDs, thus leading to slow acceptance of microbe-focused treatments for these conditions. In this article, we review and summarize the microbial basis for IBDs and the results of the most recent trials of fecal microbial transplant, antibiotics, probiotics, and prebiotics in IBDs. We also comment on possible safety concerns with these agents, speculate on why they have failed to show efficacy in certain clinical settings, and propose strategies to improve their usefulness.

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“…Observational studies of dysbiosis in IBD [127] and the disparities in host-microbe relationships which play part to the extent, severity, and chronicity of intestinal inflammation led to efforts to restore microbiota to a normal composition [128]. Further, a successful novel management approach in patients suffering from IBD using fecal microbial transplantation (FMT) has been introduced [129,130]. One randomized control trial involving 75 UC cases demonstrated a significantly escalated remission rate (24%) in individuals cases treated with FMT from unrelated/discrete donor enemas than that in the placebo array (5%) [131].…”

Section: Clostridiummentioning

confidence: 99%

The Multifactorial Etiopathogeneses Interplay of Inflammatory Bowel Disease: An Overview

M’Koma

2018

Gastrointestinal Disorders

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The gastrointestinal system where inflammatory bowel disease occurs is central to the immune system where the innate and the adaptive/acquired immune systems are balanced in interactions with gut microbes under homeostasis conditions. This article overviews the high-throughput research screening on multifactorial interplay between genetic risk factors, the intestinal microbiota, urbanization, modernization, Westernization, the environmental influences and immune responses in the etiopathogenesis of inflammatory bowel disease in humans. Inflammatory bowel disease is an expensive multifactorial debilitating disease that affects thousands new people annually worldwide with no known etiology or cure. The conservative therapeutics focus on the established pathology where the immune dysfunction and gut injury have already happened but do not preclude or delay the progression. Inflammatory bowel disease is evolving globally and has become a global emergence disease. It is largely known to be a disease in industrial-urbanized societies attributed to modernization and Westernized lifestyle associated with environmental factors to genetically susceptible individuals with determined failure to process certain commensal antigens. In the developing nations, increasing incidence and prevalence of inflammatory bowel disease (IBD) has been associated with rapid urbanization, modernization and Westernization of the population. In summary, there are identified multiple associations to host exposures potentiating the landscape risk hazards of inflammatory bowel disease trigger, that include: Western life-style and diet, host genetics, altered innate and/or acquired/adaptive host immune responses, early-life microbiota exposure, change in microbiome symbiotic relationship (dysbiosis/dysbacteriosis), pollution, changing hygiene status, socioeconomic status and several other environmental factors have long-standing effects/influence tolerance. The ongoing multipronged robotic studies on gut microbiota composition disparate patterns between the rural vs. urban locations may help elucidate and better understand the contribution of microbiome disciplines/ecology and evolutionary biology in potentially protecting against the development of inflammatory bowel disease.

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Modulating the microbiota in inflammatory bowel diseases: prebiotics, probiotics or faecal transplantation?

Cited by 37 publications

References 103 publications

Randomized, controlled trial evaluating the effect of multi-strain probiotic on the mucosal microbiota in canine idiopathic inflammatory bowel disease

Randomized, controlled trial evaluating the effect of multi-strain probiotic on the mucosal microbiota in canine idiopathic inflammatory bowel disease

Therapeutic Manipulation of the Microbiome in IBD: Current Results and Future Approaches

The Multifactorial Etiopathogeneses Interplay of Inflammatory Bowel Disease: An Overview

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