Impact of Probiotics on the Prevention and Treatment of Gastrointestinal Diseases in the Pediatric Population

Abstract

Despite the high prevalence of gastrointestinal disorders (GIDs) in infants and children, especially those categorized as functional GIDs (FGIDs), insufficient knowledge about their pathophysiology has limited both symptomatic diagnosis and the development of optimal therapies. Recent advances in the field of probiotics have made their potential use as an interesting therapeutic and preventive strategy against these disorders possible, but further efforts are still needed. In fact, there is great controversy surrounding this topic, generated by the high variety of potential probiotics strains with plausible therapeutic utility, the lack of consensus in their use as well as the few comparative studies available on probiotics that record their efficacy. Taking into account these limitations, and in the absence of clear guidelines about the dose and timeframe for successful probiotic therapy, our review aimed to evaluate current studies on potential use of probiotics for the prevention and treatment of the most common FGIDs and GIDs in the pediatric population. Furthermore, matters referring to know major action pathways and key safety recommendations for probiotic administration proposed by major pediatric health agencies shall also be discussed.

Placebo-resistant gut bacteria: Akkermansia muciniphila spp. and Familial Mediterranean fever disease

“…In the context of FMF disease (Pepoyan et al, 2017;Balayan et al, 2015;Manzano et al, 2023;Touitou and Pepoyan, 2008;Lancieri et al, 2023;Pepoyan et al, 2019b), placebos are employed to evaluate the impacts of probiotics [microorganisms that confer beneficial effects on humans (Pepoyan et al, 2023;Garcıá-Santos et al, 2023;Harutyunyan et al, 2022), animals (Ataya et al, 2023;Balayan et al, 2019;Rodriguez et al, 2017;Wang et al, 2023;Mirzabekyan et al, 2023;S ̌efcováet al, 2023), and plant host metabolism (Rahman et al, 2018;Pepoyan and Chikindas, 2020;Mockevicǐutėet al, 2023)], along with their metabolites, as well as medications in general (Ben-Zvi et al, 2017;Haviv and Hashkes, 2016;Hashkes and Huang, 2015;Hashkes et al, 2014). While placebos have long served as inert controls in clinical trials (Gupta and Verma, 2013;Finniss et al, 2010;Louhiala and Puustinen, 2017), it is essential to recognize that placebo effects are psychobiological phenomena (Pogany, 2017;Hashmi, 2018;Liu, 2022;Schaefer et al, 2023;Shafir et al, 2023) capable of producing effects similar to certain drugs, even when patients are not knowingly given placebos (Bräscher et al, 2022).…”