Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Curr Opin Clin Nutr Metab Care. 2018 Sep;21(5):399-404. doi: 10.1097/MCO.0000000000000487.
To provide an updated perspective on the use of probiotics as adjuvant treatment strategy for patients suffering from or at risk of developing mucositis.
Studies suggest that oral and intestinal microbiota could be relevant to mucositis development and treatment, but no clear high-risk pattern has been identified and no single probiotic formulation has emerged from human clinical trials for strong recommendation. Promising results from available clinical trials suggest their use in patients with peri-implant mucositis or at risk of anticancer treatment-related oral or intestinal mucositis. In general, a positive effects of Lactobacillus species is becoming consistent, particularly Lactobacillus reuteri, in the treatment of peri-implant mucositis and Lactobacillus brevi CD2 in the prevention of chemoradiotherapy-related oral mucositis. However, several limitations still need to be addressed by future research. Nonetheless, their use appears to be safe. Therefore, decision to consider the use of probiotics ultimately depends on the preference of the clinicians.
In the ongoing era of 'precision medicine', efforts should be directed toward the identification of high-risk patient populations which could benefit most from targeted interventions with probiotics enabling an improvement of clinical outcomes and quality of life in a cost-effective manner.
综述目的:提供对益生菌作为治疗粘膜炎患者或有粘膜炎风险患者的辅助治疗策略的最新观点。
最新发现:研究表明,口腔和肠道微生物群可能与粘膜炎的发展和治疗有关,但尚未确定明确的高危模式,也没有任何一种益生菌制剂在人体临床试验中脱颖而出,得到强烈推荐。现有临床试验的结果表明,它们可用于治疗种植体周围粘膜炎或有发生癌症治疗相关口腔或肠道粘膜炎风险的患者。一般来说,越来越多的临床试验结果表明,某些益生菌(如嗜酸乳杆菌)在治疗种植体周围粘膜炎和短双歧杆菌 CD2 预防放化疗相关口腔粘膜炎方面具有积极的效果。然而,未来的研究仍需要解决一些局限性。尽管如此,它们的使用似乎是安全的。因此,是否考虑使用益生菌最终取决于临床医生的偏好。
总结:在当前的“精准医学”时代,应该努力确定最有可能从益生菌靶向干预中受益的高危患者人群,以便以具有成本效益的方式改善临床结果和生活质量。