Amity Institute of Pharmacy, Lucknow, Amity University Uttar Pradesh, Sector 125, Noida 201313, Uttar Pradesh, India.
Amity Institute of Pharmacy, Amity University Maharashtra, Mumbai 410206, Maharashtra, India.
World J Gastroenterol. 2023 Apr 14;29(14):2078-2100. doi: 10.3748/wjg.v29.i14.2078.
Experimental evidence supports the fact that changes in the bowel microflora due to environmental or dietary factors have been investigated as implicating factors in the etiopathogenesis of inflammatory bowel disease (IBD). The amassing knowledge that the inhabited microbiome regulates the gut physiology and immune functions in IBD, has led researchers to explore the effectiveness of prebiotics, probiotics, and synbiotics in treating IBD. This therapeutic approach focuses on restoring the dynamic balance between the microflora and host defense mechanisms in the intestinal mucosa to prevent the onset and persistence of intestinal inflammation. Numerous microbial strains and carbohydrate blends, along with their combinations have been examined in experimental colitis models and clinical trials, and the results indicated that it can be an attractive therapeutic strategy for the suppression of inflammation, remission induction, and relapse prevention in IBD with minimal side effects. Several mechanisms of action of probiotics (for species, and species) have been reported such as suppression of pathogen growth by releasing certain antimicrobial mediators (lactic and hydrogen peroxide, acetic acid, and bacteriocins), immunomodulation and initiation of an immune response, enhancement of barrier activity, and suppression of human T-cell proliferation. Prebiotics such as lactulose, lactosucrose, oligofructose, and inulin have been found to induce the growth of certain types of host microflora, resulting in an enriched enteric function. These non-digestible food dietary components have been reported to exert anti-inflammatory effects by inhibiting the expression of tumor necrosis factor-α-related cytokines while augmenting interleukin-10 levels. Although pro-and prebiotics has established their efficacy in healthy subjects, a better understanding of the luminal ecosystem is required to determine which specific bacterial strain or combination of probiotics and prebiotics would prove to be the ideal treatment for IBD. Clinical trials, however, have given some conflicting results, requiring the necessity to cite the more profound clinical effect of these treatments on IBD remission and prevention. The purpose of this review article is to provide the most comprehensive and updated review on the utility of prebiotics, probiotics, and synbiotics in the management of active Crohn's disease and ulcerative colitis/pouchitis.
实验证据支持这样一个事实，即环境或饮食因素引起的肠道微生物群变化已被研究为炎症性肠病 (IBD) 发病机制的牵连因素。人们越来越认识到，栖息的微生物组调节 IBD 中的肠道生理学和免疫功能，这促使研究人员探索益生元、益生菌和合生菌在治疗 IBD 中的有效性。这种治疗方法侧重于恢复肠道黏膜中微生物群与宿主防御机制之间的动态平衡，以防止肠道炎症的发生和持续。许多微生物菌株和碳水化合物混合物及其组合已在实验性结肠炎模型和临床试验中进行了检查，结果表明，它可能是一种有吸引力的治疗策略，可抑制炎症、诱导缓解和预防 IBD 复发，副作用最小。已经报道了益生菌（对于 种和 种）的几种作用机制，例如通过释放某些抗菌介质（乳酸和过氧化氢、乙酸和细菌素）抑制病原体生长、免疫调节和启动免疫反应、增强屏障活性和抑制人 T 细胞增殖。已经发现益生元，如乳果糖、乳蔗糖、低聚果糖和菊粉，可诱导某些类型的宿主微生物群的生长，从而增强肠道功能。这些不可消化的食物膳食成分已被报道通过抑制肿瘤坏死因子-α相关细胞因子的表达同时增加白细胞介素-10 水平来发挥抗炎作用。尽管 pro- 和 prebiotics 已在健康受试者中证实了其疗效，但需要更好地了解腔生态系统，以确定哪种特定的细菌菌株或益生菌和益生元的组合将被证明是治疗 IBD 的理想方法。然而，临床试验给出了一些相互矛盾的结果，需要引用这些治疗方法对 IBD 缓解和预防的更深远的临床效果。本文综述的目的是提供关于益生元、益生菌和合生菌在治疗活动期克罗恩病和溃疡性结肠炎/ pouchitis 中的应用的最全面和最新的综述。
