Current understanding of microbiota- and dietary-therapies for treating inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) is a result of chronic inflammation caused, in some part, by dysbiosis of intestinal microbiota, mainly commensal bacteria. Gut dysbiosis can be caused by multiple factors, including abnormal immune responses which might be related to genetic susceptibility, infection, western dietary habits, and administration of antibiotics. Consequently, the disease itself is characterized as having multiple causes, etiologies, and severities. Recent studies have identified >200 IBD risk loci in the host. It has been postulated that gut microbiota interact with these risk loci resulting in dysbiosis, and this subsequently leads to the development of IBD. Typical gut microbiota in IBD patients are characterized with decrease in species richness and many of the commensal, and beneficial, fecal bacteria such as Firmicutes and Bacteroidetes and an increase or bloom of Proteobacteria. However, at this time, cause and effect relationships have not been rigorously established. While treatments of IBD usually includes medications such as corticosteroids, 5-aminosalicylates, antibiotics, immunomodulators, and anti-TNF agents, restoration of gut dysbiosis seems to be a safer and more sustainable approach. Bacteriotherapies (now called microbiota therapies) and dietary interventions are effective way to modulate gut microbiota. In this review, we summarize factors involved in IBD and studies attempted to treat IBD with probiotics. We also discuss the potential use of microbiota therapies as one promising approach in treating IBD. As therapies based on the modulation of gut microbiota becomes more common, future studies should include individual gut microbiota differences to develop personalized therapy for IBD.

Recombinant Probiotics and Microbiota Modulation as a Good Therapy for Diseases Related to the GIT

“…In this context, the search for therapeutic strategies that minimize the development and progression of pathologies caused directly and indirectly by the unbalance of the commensal microbiota has grown. The consumption of probiotic bacteria is one of these strategies, as they present several effects, such as ability to improve the intestinal barrier, stimulate the systemic and mucosal immune system, regulate the composition of the intestinal microbiota, and provide essential micronutrients (such as vitamins and SCFAs) and other bioactive compounds (metabolites) with potential health benefits for the host [100][101][102][103].…”

Manipulating resident microbiota to enhance regulatory immune function to treat inflammatory bowel diseases

“…Prebiotics, non-digestible carbohydrates that are metabolized by resident bacteria, can improve the composition and metabolic function of beneficial resident intestinal bacterial species [124]. Inulin, fructo-oligosaccharide, galacto-oligosaccharide, and lactulose are commonly used as prebiotics [124,125]. Those prebiotics can increase the synthesis of SCFA, which improve barrier function, enhance regulatory immune responses and prevent pathobiont invasion by reducing pH levels in the intestine [125,126].…”

“…Inulin, fructo-oligosaccharide, galacto-oligosaccharide, and lactulose are commonly used as prebiotics [124,125]. Those prebiotics can increase the synthesis of SCFA, which improve barrier function, enhance regulatory immune responses and prevent pathobiont invasion by reducing pH levels in the intestine [125,126]. In clinical practice, prebiotics can provide beneficial effect in IBD treatment, but their effects are modest with inconsistent results [28,116,125].…”

“…Those prebiotics can increase the synthesis of SCFA, which improve barrier function, enhance regulatory immune responses and prevent pathobiont invasion by reducing pH levels in the intestine [125,126]. In clinical practice, prebiotics can provide beneficial effect in IBD treatment, but their effects are modest with inconsistent results [28,116,125]. More mechanistic studies underlying the interactions among prebiotics, IBD-related dysbiosis and regulatory immune cells are required.…”

Parenteral Nutrition in Patients with Inflammatory Bowel Disease Systematic Review, Meta-Analysis and Meta-Regression

“…IBD involves an inflammatory process of the intestinal layers and could cause abdominal swelling, fever, fatigue, weight loss, abdominal pain, diarrhea, bloody feces, etc. [7].…”