Probiotics: Shaping the gut immunological responses

Probiotics are live microorganisms exerting beneficial effects on the host’s health when administered in adequate amounts.Among the most popular and adequately studied probiotics are bacteria from the families Lactobacillaceae,Bifidobacteriaceae and yeasts.Most of them have been shown,both in vitro and in vivo studies of intestinal inflammation models,to provide favorable results by means of improving the gut microbiota composition,promoting the wound healing process and shaping the immunological responses.Chronic intestinal conditions,such as inflammatory bowel diseases(IBD),are characterized by an imbalance in microbiota composition,with decreased diversity,and by relapsing and persisting inflammation,which may lead to mucosal damage.Although the results of the clinical studies investigating the effect of probiotics on patients with IBD are still controversial,it is without doubt that these microorganisms and their metabolites,now named postbiotics,have a positive influence on both the host’s microbiota and the immune system,and ultimately alter the topical tissue microenvironment.This influence is achieved through three axes:(1)By dis-placement of potential pathogens via competitive exclusion;(2)by offering protection to the host through the secretion of various defensive mediators;and(3)by supplying the host with essential nutrients.We will analyze and discuss almost all the in vitro and in vivo studies of the past 2 years dealing with the possible favorable effects of certain probiotic genus on gut immunological responses,highlighting which species are the most beneficial against intestinal inflammation.

The protective role of prebiotics and probiotics on diarrhea and gut damage in the rotavirus-infected piglets

Rotavirus is one of the pathogenic causes that induce diarrhea in young animals, especially piglets, worldwide. However, nowadays, there is no specific drug available to treat the disease, and the related vaccines have no obvious efficiency in some countries. Via analyzing the pathogenesis of rotavirus, it inducing diarrhea is mainly due to disturb enteric nervous system, destroy gut mucosal integrity, induce intracellular electrolyte imbalance, and impair gut microbiota and immunity. Many studies have already proved that prebiotics and probiotics can mitigate the damage and diarrhea induced by rotavirus infection in hosts. Based on these, the current review summarizes and discusses the effects and mechanisms of prebiotics and probiotics on rotavirus-induced diarrhea in piglets. This information will highlight the basis for the swine production utilization of prebiotics and probiotics in the prevention or treatment of rotavirus infection in the future.

Research advances on encapsulation of probiotics with nanomaterials and their repair mechanisms on intestinal barriers

Probiotics participate in various physiological activities and contribute to body health.However,their viability and bioefficacy are adversely affected by gastrointestinal harsh conditions,such as gastric acid,bile salts and various enzymes.Fortunately,encapsulation based on various nanomaterials shows tremendous potential to protect probiotics.In this review,we introduced some novel encapsulation technologies involving nanomaterials in view of predesigned stability and viability,selective adhesion,smart release and colonization,and efficacy exertion of encapsulated probiotics.Furthermore,the interactions between encapsulated probiotics and the gastrointestinal tract were summarized and analyzed,with highlighting the regulatory mechanisms of encapsulated probiotics on intestinal mechanical barrier,chemical barrier,biological barrier and immune barrier.This review would benefit the food and pharmaceutical industries in preparation and utilization of multifunctional encapsulated probiotics.

Effects of oral probiotics on inflammation and intestinal function in adult patients after appendectomy:Randomized controlled trial

BACKGROUND Appendectomy is an acute abdominal surgery that is often accompanied by severe abdominal inflammation.Oral probiotics are one of the postoperative treatments for rapid rehabilitation.However,there is a lack of prospective studies on this topic after appendectomy.AIM To investigate whether the postoperative probiotics can modulate the inflammatory response and restore intestinal function in patients following appendectomy.METHODS This was a prospective,randomized trial.A total of 60 emergency patients were randomly divided into a control group(n=30)and a probiotic group(n=30).Patients in the control group started to drink some water the first day after surgery,and those in the probiotic group were given water supplemented with Bacillus licheniformis capsules for 5 consecutive days postsurgery.The indices of inflammation and postoperative conditions were recorded,and the data were analyzed with RStudio 4.3.2 software.RESULTS A total of 60 participants were included.Compared with those in the control group,the C-reactive protein(CRP),interleukin 6 and procalcitonin(PCT)levels were significantly lower in the probiotic group at 2 d after surgery(P=2.224e-05,P=0.037,and P=0.002,respectively,all P<0.05).This trend persisted at day 5 post-surgery,with CRP and PCT levels remaining significantly lower in the probiotic group(P=0.001 and P=0.043,both P<0.05).Furthermore,probiotics0.028,both P<0.05).CONCLUSION Postoperative oral administration of probiotics may modulate the gut microbiota,benefit the recovery of the early inflammatory response,and subsequently enhance recovery after appendectomy.

A Comprehensive Analysis of Efficacy and Safety of Probiotics in Inflammatory Bowel Disease

Introduction: Inflammatory bowel disease (IBD) affects approximately 7 million people worldwide. In the U.S. alone, per the CDC, 1.3% of adults, which is approximately 3,000,000 people, are diagnosed with inflammatory bowel disease-either, Crohn’s disease, or ulcerative colitis. The estimated cost of treatment can be close to $23,000 annually, with treatment regimens comprising biologic agents and anti-inflammatory therapies. Probiotics have recently gathered interest as a low-cost additional therapy option that, in addition to the current regimen of IBD management, allows for reductions in rates of IBD flare-ups by significantly reducing the number of emergency room visits and avoiding the need to constantly escalate treatment by addition of biologic agents in achieving remission. The Analysis Goal: Our research project aimed to see if there was a significant difference in the addition of probiotics to standard therapy in inflammatory bowel disease by comparing existing research studies and trials. We analyzed RCTs published in PubMed to assess the efficacy and safety of probiotics in patients with IBD in preventing frequent disease flare-ups and reducing the cost of care. Research Methods: We did a comparative analysis of available RCTs using a PubMed search and included studies that researched the addition of probiotic strains in patients with IBD (ulcerative colitis and Crohn’s disease). After reviewing the inclusion and exclusion criteria, the trials selected for analysis were reviewed by two independent reviewers. Results: We analyzed 21 RCTs, and 16 RCTs (76.2%) showed that probiotics are an effective therapy for IBD, inducing remission and reducing flare-up rates in patients on a standard treatment regimen. Conclusion: Probiotics given in combination with standard therapy in IBD are effective in decreasing disease activity rates and reducing remission rates. No significant adverse reactions to probiotics were noticed.

Function and Application Progress of Probiotics in Food

Probiotics have a long history of use in human production and life.With the gradual deepening of the research on the functions of probiotics,their various nutritional and health benefits for the human body have also become increasingly clear.Existing research shows that probiotics can regulate intestinal flora,and improve immunity and even the symptoms of some diseases.Therefore,in the food industry,the application of probiotics from traditional fermented foods to functional foods has become more and more extensive.In this paper,the research progress of nutritional function and application of probiotics in food at home and abroad was reviewed,in order to provide some reference for the safe application of probiotics in food.

Effects of Compound Probiotics on Growth Performance and Intestinal Flora of Kunming Mice

[Objectives]This study was conducted to investigate the effects of adding compound probiotics on the growth performance and intestinal flora of Kunming mice.[Methods]Twelve healthy 2-week-old Kunming male mice with body weight of(11.09±0.43)g were selected.They were randomly divided into two treatment groups,namely blank control group(NC)and compound probiotics group(CB+LR+BS),with six mice in each group.The two groups were fed with commercial basal diet,and the compound probiotic experimental group was fed with basal diet supplemented with compound probiotics,in which the contents of Clostridium butyricum spores,Lactobacillus reuteri and Bacillus subtilis spores were 1×1010,1×1011 and 1×1010 CUF/kg,respectively.The body weight,feed intake and water intake of mice were counted every 4 d,and the experimental period was 13 d.On the 13 th day,the cecal contents of the mice were collected for analysis.[Results]There was no significant change in body weight and feed intake when compound probiotics were added to the diet.However,the addition of compound probiotics reduced the abundance of harmful bacteria such as Escherichia coli,urease-negative Helicobacter typhlonius and Salmonella enterica,while increasing the abundance of beneficial bacteria such as Anaerostipes hadrus,and the contents of IgG and IgM increased significantly(P<0.05).[Conclusions]In summary,the addition of compound probiotics could significantly improve the structure of intestinal microbial flora,increase the quantity of beneficial bacteria,reduce the quantity of harmful bacteria,and improve the immune function of mice.

Clinical Evaluation of Enteral Nutrition+Probiotics in the Treatment of Gastrointestinal Dysfunction After Severe Traumatic Brain Injury

Objective:To evaluate the therapeutic effect of enteral nutrition+probiotics in patients with gastrointestinal dysfunction after severe craniocerebral injury.Methods:From September 2018 to February 2023,80 patients(20-82 years old)with gastrointestinal dysfunction who were admitted to the Intensive Care Unit at the Third People’s Hospital of Xining were included in the study.Their primary condition was severe craniocerebral injury,and all of them received conventional symptomatic treatment.Group A received enteral nutrition+probiotic therapy,whereas group B received enteral nutrition only.The differences in the following indicators were compared before and after treatment:nutritional and biochemical indicators,gastrointestinal function indicators,Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA),APACHE II score,serum procalcitonin(PCT),neutrophil(N)ratio,and C reactive protein(CRP).Result:The nutritional and biochemical indicators in group A were higher than those in group B,P<0.05;the time to first passage of flatus,time to first passage of stool,and bowel sound recovery time in group A were shorter than those in group B,P<0.05;the GCS of group A was higher than that of group B,P<0.05;the SOFA and APACHEⅡscores of group A were not different from those of group B,P>0.05;and the PCT,N ratio,and CRP levels of group A were lower than those of group B,P<0.05.Conclusion:In patients with gastrointestinal dysfunction after severe craniocerebral injury,enteral nutrition+probiotic therapy is highly effective and feasible,as it can optimize various nutritional indicators,shorten the gastrointestinal function recovery time,and reduce the body’s stress response.

Research progress on the mechanism of exercise fatigue and the role of probiotics in counteracting it

Exercise fatigue is a physiological phenomenon where the body cannot maintain a specific level after being stimulated by excessive exercise.Its five main theories include“energy depletion”,“accumulation of metabolites”,“homeostasis disorder of the internal environment”,“free radicals”,and“central nervous system protection inhibition”.The imbalance of intestinal flora caused by vigorous exercise can further lead to fatigue.Therefore,maintaining healthy intestinal flora is crucial for athlete health and performance.Recent studies have demonstrated that probiotics can regulate intestinal flora and alleviate exercise fatigue;however,there are no systematic reviews on the anti-fatigue effects of probiotics.Based on the mechanisms of exercise-induced fatigue,this article summarizes the effects and mechanisms by which probiotics combat exercise fatigue,aiming to provide research ideas for the development of probiotics that prevent exercise fatigue.

Effect of Early Enteral Nutrition Combined with Probiotics on the Nutritional Status of Patients with Severe Craniocerebral Injury

Objective:To observe the effect of early enteral nutrition combined with probiotics on the nutritional status of patients with severe craniocerebral injury.Methods:Thirty-five patients with severe craniocerebral injury were divided into the study group(17 patients)and the control group(18 patients)according to the method of a randomized numerical table;both groups of patients started enteral nutrition via nasogastric tube within 24–48 hours after admission to the hospital,and probiotics were given in addition to the study group.Hemoglobin,total plasma protein,albumin,prealbumin,cholinesterase,fasting blood glucose,and other indexes were monitored before and early morning after enteral nutrition support,and upper arm circumference(AC),triceps skinfold thickness(TSF),and upper arm muscle circumference(AMC)were measured,and gastrointestinal response and time to first defecation of the patients were observed and compared with GCS score.Results:The hemoglobin,serum albumin,prealbumin,cholinesterase,and total plasma protein levels in the study group were significantly higher and fasting blood glucose levels were significantly lower than those in the control group after treatment(P<0.05).The incidence of reflux and constipation in the study group was lower than that in the control group,and the time to first defecation was shorter than that in the control group(P<0.05).After treatment,AC,TSF,and AMC were higher in the study group than in the control group(P<0.05).GCS scores were significantly higher in both groups after treatment,but the trend was more pronounced in the study group(P<0.05).Conclusion:Compared with simple enteral nutrition,enteral nutrition combined with probiotics can better correct metabolic disorders after heavy craniocerebral injury and improve the nutritional status of patients.

A systematic scoping review of study methodology for randomized controlled trials investigating probiotics in athletic and physically active populations

Background:The purported ergogenic and health effects of probiotics have been a topic of great intrigue among researchers,practitioners,and the lay public alike.There has also been an increased research focus within the realm of sports science and exercise medicine on the athletic gut microbiota.However,compared to other ergogenic aids and dietary supplements,probiotics present unique study challenges.The objectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with probiotics in athletes and physically active individuals.Methods:Four databases(MEDLINE,CINAHL,Cochrane CENTRAL,and Cochrane Database of Systematic Reviews)were searched for randomized controlled studies involving healthy athletes or physically active individuals.An intervention with probiotics and inclusion of a control and/or placebo group were essential.Only peer-reviewed articles in English were considered,and there were no date restrictions.Results were extracted and presented in tabular form to detail study protocols,characteristics,and outcomes.Bias in randomized controlled trials was determined with the RoB 2.0 tool.Results:A total of 45 studies were included in the review,with 35 using a parallel group design and 10 using a cross-over design.Approximately half the studies used a single probiotic and the other half a multi-strain preparation.The probiotic dose ranged from 2×10^(8)to 1×10^(11)colony forming units daily,and the length of intervention was between 7 and 150 days.Fewer than half the studies directly assessed gastrointestinal symptoms,gut permeability,or the gut microbiota.The sex ratio of participants was heavily weighted toward males,and only 3 studies exclusively investigated females.Low-level adverse events were reported in only 2 studies,although the methodology of reporting varied widely.The risk of bias was generally low,although details on randomization were lacking in some studies.Conclusion:There is a substantial body of research on the effects of prob iotic supplementation in healthy athletes and physically active individuals.Considerable heterogeneity in probiotic selection and dosage as well as outcome measures has made clinical and mechanistic interpretation challenging for both health care practitioners and researchers.Attention to issues of randomization of participants,treatments and interventions,selection of outcomes,demographics,and reporting of adverse events will facilitate more trustworthy interpretation of probiotic study results and inform evidence-based guidelines.

Effects of Compound Probiotics on Intestine and Intestinal Aeromonas hydrophila of Fish

[Objective] This study was conducted to develop compound probiotics that can be used as the alternatives of chemical drugs and antibiotics in aquaculture. [Method] Different concentrations of EM （effective microorganisms） and Bacillus amyloliquefaciens were mixed at a ratio of 1：1, and sprayed on fish feed. The growth of intestinal villi of the fishes that had been fed with the feed mixed with compound probiotics for three months was observed; meanwhile, the content of in- testinal Aeromonas hydrophila was detected by real-time quantitative PCR. ｜Result] The compound probiotics promoted the development of intestinal villi, and inhibited the growth of A. hydrophila, and the effects were also concentration dependent. However, the compound probiotics did not increase the thickness of the intestinal serous layer, muscular layer and submucosal layer. [Conclusion] The compound probiotics we prepared can be used and popularized in aquiculture as it can inhibit the growth of A. hydrophila.

Effects of Different Concentrations of Homologous Probiotics on Small Intestinal Mucosa Structure of 42-day-old Broilers

In the study, the methods of applied histology and histochemistry were used to determine intestinal villus length, crypt depth, the ratio of intestinal villus length to crypt depth, mucous membrane thickness and intestinal wall thickness of duodenum, jejunum and ileum of 42-day-old broilers, so as to study the effects of different conncentrations of homologous probiottcs on small intestinal mucosa struc- ture of the broilers. The results showed that the effect of 0.3% probiotics on small intestine mucosal structures was the best, such as the length of intestinal villus was the longest, the ratio of villus length to crypt depth was the largest, the thins of mucous membrane and intestinal wall was the thickest. These showed that 0,3% probiotics had best effect on improving and enhancing the digestion-absorption func- tion of the small intestine of the broilers.

Probiotics and postbiotics in colorectal cancer:Prevention and complementary therapy

Colorectal cancer(CRC)is a leading cause of human mortality worldwide.As conventional anticancer therapy not always being effective,there is growing interest in innovative“drug-free”cancer treatments or interventions that improve the efficacy of established therapy.CRC is associated with microbiome alterations,a process known as dysbiosis that involves depletion and/or enrichment of particular gut bacterial species and their metabolic functions.Supplementing patient treatment with traditional probiotics(with or without prebiotics),nextgeneration probiotics(NGP),or postbiotics represents a potentially effective and accessible complementary anticancer strategy by restoring gut microbiota composition and/or by signaling to the host.In this capacity,restoration of the gut microbiota in cancer patients can stabilize and enhance intestinal barrier function,as well as promote anticarcinogenic,anti-inflammatory,antimutagenic or other biologically important biochemical pathways that show high specificity towards tumor cells.Potential benefits of traditional probiotics,NGP,and postbiotics include modulating gut microbiota composition and function,as well as the host inflammatory response.Their application in CRC prevention is highlighted in this review,where we consider supportive in vitro,animal,and clinical studies.Based on emerging research,NGP and postbiotics hold promise in establishing innovative treatments for CRC by conferring physiological functions via the production of dominant natural products and metabolites that provide new host-microbiota signals to combat CRC.Although favorable results have been reported,further investigations focusing on strain and dose specificity are required to ensure the efficacy and safety of traditional probiotics,NGP,and postbiotics in CRC prevention and treatment.

An Update on the Efficacy and Functionality of Probiotics for the Treatment of Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease(NAFLD),which has a global prevalence of 20%–33%,has become the main cause of chronic liver disease.Except for lifestyle medication,no definitive medical treatment has been established so far,making it urgent to find effective strategies for the treatment of NAFLD.With the identification of the significant role played by the gut microbiota in the pathogenesis of NAFLD,studies on probiotics for the prevention and treatment of NAFLD are increasing in number.Bacteria from the Bifidobacterium and Lactobacillus genera constitute the most widely used traditional probiotics.More recently,emerging next-generation probiotics(NGPs)such as Akkermansia muciniphila and Faecalibacterium prausnitzii have also gained attention due to their potential as therapeutic options for the treatment of NAFLD.This review provides an overview of the effects of oral administration of traditional probiotics and NGPs on the development and progress of NAFLD.The mechanisms by which probiotics directly or indirectly affect the disease are illustrated,based on the most recent animal and clinical studies.Although numerous studies have been published on this topic,further research is required to comprehensively understand the specific underlying mechanisms among probiotics,gut microbiota,and NAFLD,and additional large-scale clinical trials are required to evaluate the therapeutic efficacy of probiotics for the treatment of NAFLD,as well as the safety of probiotics in the human body.

Efficacy of probiotics supplementation in amelioration of celiac disease symptoms and enhancement of immune system

Patients with celiac disease(CD)have a mucosal layer that is unable to regulate the gut microbiota,leaving the host vulnerable to dangerous infections and antigens.When compared to healthy people,this dysbiosis is marked by a decrease in intra-and intergeneric biodiversity,which demonstrates an imbalance between helpful bacteria and possibly harmful or proinflammatory species.The early gut microbiota is influenced by the genotype of newborns with the HLADQ2 haplotypes,and this may modify how gluten is handled in the intestinal lumen,polarize innate or adaptive immune responses,and result in glutensensitive enteropathy.The outcome of gluten digestion can vary depending on the composition of the intestinal gut bacteria and the partial conversion of gluten into peptides larger than ten amino acids in the small intestines,which can be immunogenic.In the small intestine,114 different bacterial strains belonging to 32 different species have 27 of them exhibiting peptidolytic activity.Thus,the individual risk of developing a gluten-related illness is further influenced by microbial composition and gluten degrading capacity.The conclusion that lactobacilli and Bifidobacterium spp.may be used as a probiotic supplement in CD patients is based on their shared possession of the most extensive peptidolytic and proteolytic activity thought to be engaged in the breakdown of gluten among all potential bacterial genera present in the gut microbiota.In children with CD autoimmunity,daily oral dose of Lactobacillus.plantarum HEAL9 and Lactobacillus.paracasei 8700:2 was found to modify the peripheral immune response.Bifidobacterium.breve strains have demonstrated a beneficial effect on reducing pro-inflammatory cytokine TNF-production in CD children on gluten-free diets.

Relationship between intestinal microbiota and ulcerative colitis:Mechanisms and clinical application of probiotics and fecal microbiota transplantation

Ulcerative colitis(UC) is an inflammatory disease that mainly affects the colon and rectum. It is believed that genetic factors, host immune system disorders, intestinal microbiota dysbiosis, and environmental factors contribute to the pathogenesis of UC. however, studies on the role of intestinal microbiota in the pathogenesis of UC have been inconclusive. Studies have shown that probiotics improve intestinal mucosa barrier function and immune system function and promote secretion of anti-inflammatory factors, thereby inhibiting the growth of harmful bacteria in the intestine. Fecal microbiota transplantation(FMT) can reduce bowel permeability and thus the severity of disease by increasing the production of short-chain fatty acids, especially butyrate, which help maintain the integrity of the epithelial barrier. FMT can also restore immune dysbiosis by inhibiting Th1 differentiation, activity of T cells, leukocyte adhesion, and production of inflammatory factors. Probiotics and FMT are being increasingly used to treat UC, but their use is controversial because of uncertain efficacy. Here, we briefly review the role of intestinal microbiota in thepathogenesis and treatment of UC.

Effects of Probiotics on Growth Performance and Blood Biochemical Indexes of Cherry Valley Ducks

In order to investigate the effects of probiotics on growth performance, blood biochemical indexes and economic benefits of Cherry Valley ducks, different probiotics were added into the feed of Cherry Valley ducks. Total 240 1-d-old Cherry Valley ducks were selected, and they were randomly divided into 4 groups, including 1 control group and 3 treatment groups. There were 3 replicates for each group and there were 20 ducks for each replicate. The ducks in the control group were fed the basal diet, and the ducks in the 3 treatment groups were fed the basal diet added with Lactobacillus, Bacillus natto and florfenicol, respectively. The test lasted for 42 d. The results showed that the addition of Lactobacillus and Bacillus natto could improve the average daily weight gain and final average weight （P〈0.05） of Cherry Valley ducks, and reduce the glutamic-pyruvic transaminase ac- tivity, alkaline phosphatase activity and serum urinary nitrogen content in duck blood （P〈0.05） and reduce the creatinine content and total cholesterol content in Cherry Valley ducks （P〉0.05）; at the same time, adding probiotics to feed could also in- crease the grass economic benefits of Cherry Valley ducks. In overall, the effects of adding probiotics were better than those of adding antibiotic.

Effects of probiotics on nonalcoholic fatty liver disease:A meta-analysis

AIM:To investigate the relationship between the gutliver axis and nonalcoholic fatty liver disease(NAFLD),we performed a meta-analysis to evaluate the effects of probiotic therapy in NAFLD.METHODS:We searched PubMed,Medline,Embase,Web of Science,the Cochrane Library and Chinese Biomedicine Database for all relevant randomized controlled trials on probiotics in patients with NAFLD/nonalcoholic steatohepatitis(NASH).A statistical analysis was performed using RevMan 5.0 software.RESULTS:Four randomized trials involving 134 NAFLD/NASH patients were included.The results showed that probiotic therapy signifcantly decreased alanine aminotransferase(ALT),aspartate transaminase(AST),total-cholesterol(T-chol),high density lipoprotein(HDL),tumor necrosis factor(TNF)-αand homeostasis model assessment of insulin resistance(HOMAIR)[ALT:weighted mean difference(WMD)-23.71,95%CI:-33.46--13.95,P<0.00001;AST:WMD-19.77,95%CI:-32.55--7.00,P=0.002;T-chol:WMD-0.28,95%CI:-0.55--0.01,P=0.04;HDL:WMD-0.09,95%CI:-0.16-0.01,P=0.03;TNF-α:WMD-0.32,95%CI:-0.48--0.17,P<0.0001;HOMA-IR:WMD-0.46,95%CI:-0.73--0.19,P=0.0008].However,the use of probiotics was not associated with changes in body mass index(BMI),glucose(GLU)and low density lipoprotein(LDL)(BMI:WMD 0.05,95%CI:-0.18-0.29,P=0.64;GLU:WMD 0.05,95%CI:-0.25-0.35,P=0.76;LDL:WMD-0.38,95%CI:-0.78-0.02,P=0.06).CONCLUSION:Probiotic therapies can reduce liver aminotransferases,total-cholesterol,TNF-αand improve insulin resistance in NAFLD patients.Modulation of the gut microbiota represents a new treatment for NAFLD.

Probiotics and prebiotics in chronic inflammatory bowel diseases

The prokaryotic and eukaryotic cells of the colon exist in a highly complex, but harmonious relationship. Disturbances in this remarkable symbiosis can result in the development of inflammatory bowel diseases (IBD). Although the etiology of IBD is not entirely understood, it is known that the chronic inflammation of Crohn’s disease, ulcerative colitis and chronic pouchitis are a result of an overly aggressive immune response to the commensal intestinal flora in genetically susceptible hosts. Recent studies have enhanced our ability to understand the interaction between the host and its intestinal microflora and the role the microflora plays in maintaining intestinal homeostasis. As we begin to understand the benefi ts conferred to the intestine by the microflora, the notion of modifying the composition of the bacterial load to improve human health has arisen. A signifi cant body of research now exists investigating the role of probiotics and prebiotics in ameliorating chronic intestinal inflammation. This article will begin with an overview of the role of the commensal microflora in maintaining mucosal immune homeostasis, and how a dysregulated immune response to the intestinal microflora results in IBD. This will be followed by a summary of the use of probiotics and prebiotics in experimental and human IBD.