Probiotic-Based Intervention in the Treatment of Ulcerative Colitis: Conventional and New Approaches

Abstract

Although there are number of available therapies for ulcerative colitis (UC), many patients are unresponsive to these treatments or experience secondary failure during treatment. Thus, the development of new therapies or alternative strategies with minimal side effects is inevitable. Strategies targeting dysbiosis of gut microbiota have been tested in the management of UC due to the unquestionable role of gut microbiota in the etiology of UC. Advanced molecular analyses of gut microbiomes revealed evident dysbiosis in UC patients, characterized by a reduced biodiversity of commensal microbiota. Administration of conventional probiotic strains is a commonly applied approach in the management of the disease to modify the gut microbiome, improve intestinal barrier integrity and function, and maintain a balanced immune response. However, conventional probiotics do not always provide the expected health benefits to a patient. Their benefits vary significantly, depending on the type and stage of the disease and the strain and dose of the probiotics administered. Their mechanism of action is also strain-dependent. Recently, new candidates for potential next-generation probiotics have been discovered. This could bring to light new approaches in the restoration of microbiome homeostasis and in UC treatment in a targeted manner. The aim of this paper is to provide an updated review on the current options of probiotic-based therapies, highlight the effective conventional probiotic strains, and outline the future possibilities of next-generation probiotic and postbiotic supplementation and fecal microbiota transplantation in the management of UC.

Translation of Immunomodulatory Effects of Probiotics into Clinical Practice

“…Levels of inflammatory cytokines and recurrence rates leading to repeat surgery were lower among patients who received early VSL#3 (for the entire 365 days). This indicated that this probiotic should be further investigated for prevention of Crohn's disease recurrence [94,95].…”

Effect of Intestinal Microbiota Transplantation on Intestinal Flora and Inflammatory Factor Levels in Patients with Ulcerative Colitis [Letter]

“…Probiotics help maintain remission for a longer time and improve the quality of life for ulcerative colitis patient. 4 …”

“… 1 The method used has been able to assess the effectiveness of intestinal microbiota transplantation, however I recommend adjunctive therapy such as administration of conventional probiotic strains with common approaches applied in disease management to modify gut microbiota, improve gut barrier integrity and function, and maintain a balanced immune response. 4 In addition, intestinal microbiota transplantation can also help doctors predict the success of ulcerative colitis treatment. 5 …”

“… 3 However, I also recommend giving conventional probiotic therapy, which can help maintain remission for a longer time and improve the quality of life of ulcerative colitis patients. 4 …”

Anti-inflammatory and Ameliorative effects of two newly isolated probiotic strains in DSS-induced mouse model of colitis

“…According to the de nition of the World Health Organization (WHO), probiotics are living micro-organisms which, when administered in adequate amounts, confer a health bene t on the host. Regarding their proven health bene ts they have been applied in the management of several disease including gastrointestinal disorders like UC (9)(10)(11)(12)(13). Several protective mechanisms have been de ned for probiotics including improvement of intestinal barrier function, secretion of anti-in ammatory and anti-oxidant metabolites, regulation of tissue brosis, alteration of gut microbial composition, and modulation of immune responses (14,15).…”