Compare Debora, Sgamato Costantino, Nardone Olga Maria, Rocco Alba, Coccoli Pietro, Laurenza Carmen, Nardone Gerardo
Department of Clinical Medicine and Surgery, Gastroenterology, University Federico II of Naples, Naples, Italy.
Dig Dis. 2022;40(1):123-132. doi: 10.1159/000516023. Epub 2021 Mar 22.
Multiple lines of evidence now support the notion that gut microbiota can contribute to digestive and extra-digestive diseases. The emergence of these observations enabled to postulate a bacteria-centric paradigm to rethink the treatment of many diseases. The goal of therapy should not be to eradicate the flora but to modify it in a way that leads to symptomatic improvement; thus, the interest in the use of probiotics to modulate microbiota composition has increased worldwide in both community and healthcare settings.
The results of published studies are conflicting for most probiotic strains and formulations, and clinicians and consumers need a better understanding of probiotic risks and benefits. Currently, clear guidelines on when to use probiotics and the most effective probiotic for different gastrointestinal conditions are still lacking. Here, we reviewed the studies on the use of probiotics in some diseases of relevant interest to gastroenterologists, such as Helicobacter pylori infection, irritable bowel syndrome, and inflammatory bowel disease. Key Message: Although the evidence is relevant and promising for probiotics in general, and for specific strains and combinations of strains, it is not yet sufficient to draw unequivocal conclusions and clear recommendations.
目前有多项证据支持肠道微生物群可导致消化和非消化系统疾病这一观点。这些观察结果的出现促使人们提出一种以细菌为中心的范式来重新思考许多疾病的治疗方法。治疗的目标不应是根除菌群，而是以一种能改善症状的方式对其进行调节；因此，在社区和医疗环境中，全球范围内使用益生菌调节微生物群组成的兴趣都有所增加。
对于大多数益生菌菌株和制剂，已发表研究的结果相互矛盾，临床医生和消费者需要更好地了解益生菌的风险和益处。目前，仍缺乏关于何时使用益生菌以及针对不同胃肠道疾病最有效的益生菌的明确指南。在此，我们回顾了关于益生菌在一些胃肠病学家相关感兴趣疾病中应用的研究，如幽门螺杆菌感染、肠易激综合征和炎症性肠病。关键信息：尽管总体而言，以及对于特定菌株和菌株组合，益生菌的证据相关且有前景，但仍不足以得出明确结论和明确建议。
