Probiotics, Prebiotics and Synbiotics in Inflammatory Bowel Diseases

Abstract

Inflammatory bowel diseases (IBD), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic inflammatory diseases of the digestive tract with periods of remission and relapses. The etiopathogenesis of IBD is multifactorial and has not been fully understood. Hence, only symptomatic treatment of these diseases is possible. The current pharmacological treatment has variable efficacy and is associated with the risk of significant side effects. Therefore, there is a constant need to search for new types of therapies with a high safety profile. Considering that the qualitative and quantitative profile of the gastrointestinal microbiome is often different in patients with IBD than in healthy individuals, there is a need for looking for therapies aimed at restoring intestinal microbiome homeostasis. Thus, the use of strictly defined probiotics, prebiotics and synbiotics may become an alternative form of IBD therapy. There is evidence that treatment with certain probiotic strains, e.g., VSL#3 and Escherischia coli Nissle 1917, is an effective form of therapy to induce remission in patients with mild to moderate UC. So far, the effectiveness of the use of probiotics, prebiotics and synbiotics in inducing or maintaining remission in patients with CD has not been confirmed. There are also reports of possible beneficial effects of fecal microbiota transplantation (FMT) on the course of IBD, especially UC. Further, well-planned studies on a large group of patients are needed to determine the role of specific probiotic strains, prebiotics, synbiotics and FMT in the treatment of IBD in adults and in children.

KDP, a Lactobacilli Product from Kimchi, Enhances Mucosal Immunity by Increasing Secretory IgA in Mice and Exhibits Antimicrobial Activity

“…S. cerevisiae in pig diets increases the activity of IgA and IgM against pathogens and enhances intestinal development and function [24]; B. bifidum increases polymeric immunoglobulin receptor expression, which in turn augments the exporting of IgA across the intestinal epithelium and increased sIgA secretion [25]; and dairy yogurt containing B. lactis, L. paracasei, and heat-killed L. plantarum enhances the immune function [26]. Interestingly, the use of the action of strictly defined commensal species of microorganisms that protect the intestinal mucosa by modulating the immune response may in the future become one of the forms of therapy of patients with chronic gastrointestinal diseases of various etiology, e.g., inflammatory bowel diseases [27].…”

“…In mice, the use of VSL#3 was shown to inhibit NF-κB and TNF-α expression through the TLR4-NF-κB signaling pathway. This results in a reduction in the expression of pro-inflammatory cytokines and Toll-like receptors (TLRs) and may help to prevent exacerbations and induce remission in patients with ulcerative colitis [27].…”

The Immunomodulatory Functions of Butyrate

“…140 It should be noted that due to overall discrepancy in the evidence, there remains a lack of SCFA or butyrate related guidelines from GI and Nutrition Societies. 141,142 Although most studies utilizing the gut microbiota reprogramming by means of probiotics, prebiotics, and synbiotics, 143 or the fecal microbiota transplantation in patients with UC or CD have produced positive results, [144][145][146] the exact mechanism behind this complex interaction between the gut microbiome and the host is not clearly understood, requiring further investigations to determine the role and implications of butyrate in management of this complex inflammatory disorder.…”

Lactobacillus rhamnosus GG Derived Extracellular Vesicles Modulate Gut Microbiota and Attenuate Inflammatory in DSS-Induced Colitis Mice

“…In addition, prebiotics might change the composition of gut microbiota, improve the function of the intestinal barrier, enhance intestinal immunity. It was shown that prebiotic fructans and resveratrol treatment could increase the amount of Bifidobactrium and Lactobacillus in DSS-induced colitis [6]. Therefore, prebiotics and probiotics may represent a valid armamentarium to alleviate colitis, while the mechanism of the action is still unclear.…”