Probiotics for induction of remission in Crohn's disease

Limketkai, Berkeley N.; Akobeng, Anthony K; Gordon, Morris; Adepoju, Adedayo A.

doi:10.1002/14651858.cd006634.pub3

Cited by 93 publications

(51 citation statements)

References 28 publications

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“…Certain probiotic strains have discrete effects on mucosal immune function, such as that seen with Lactobacillus plantarum TIFN1010 which modulates gene transcription pathways related to cell-cell adhesion and mucosal healing processes (238). However, robust clinical data to support their use remains limited, with systematic reviews in IBD (246)(247)(248), Irritable bowel syndrome (IBS) (249) and C. difficile-associated diarrhoea (CDAD) (250) showing neutral or only qualified evidence for use. Similarly, practice guidelines do not recommend the routine use of probiotics (233), partly due to uncertainty regarding species or strain-dependent effects (251,252).…”

Section: Probioticsmentioning

confidence: 99%

The role of the microbiome in gastrointestinal inflammation

et al. 2021

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The microbiome plays an important role in maintaining human health. Despite multiple factors being attributed to the shaping of the human microbiome, extrinsic factors such diet and use of medications including antibiotics appear to dominate. Mucosal surfaces, particularly in the gut, are highly adapted to be able to tolerate a large population of microorganisms while still being able to produce a rapid and effective immune response against infection. The intestinal microbiome is not functionally independent from the host mucosa and can, through presentation of microbe-associated molecular patterns and generation of microbial-derived metabolites, fundamentally influence mucosal barrier integrity and modulate host immunity. In a healthy gut there is an abundance of beneficial bacteria that help to preserve intestinal homeostasis, promote protective immune responses and limit excessive inflammation. The importance of the microbiome is further highlighted during dysbiosis where a loss of this finely-balanced microbial population can lead to mucosal barrier dysfunction, aberrant immune responses, and chronic inflammation that increases the risk of disease development. Improvements in our understanding of the microbiome are providing opportunities to harness members of a healthy microbiome to help reverse dysbiosis, reduced inflammation and ultimately prevent disease progression.

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Section: Probioticsmentioning

confidence: 99%

The role of the microbiome in gastrointestinal inflammation

et al. 2021

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“…There has been a lack of large clinical trials assessing the efficacy of probiotics in both inducing and maintaining the remission for patients with CD. A Cochrane review published in 2020 assessing the efficacy of probiotics to induce remission in CD patients found two studies that met criteria for inclusion[ 52 ]. One study had 11 subjects with mild-to-moderately active CD that randomized assignment to Lactobacillus rhamnosus strain GG or placebo.…”

Section: The Effect Of Probiotics On Ibdmentioning

confidence: 99%

Can control of gut microbiota be a future therapeutic option for inflammatory bowel disease?

Nishida¹,

Nishino²,

Sakai³

et al. 2021

WJG

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Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract encompassing two main clinical entities, Crohn’s disease and ulcerative colitis. Accumulated evidence indicates that an aberrant immune activation caused by the interplay of genetic susceptibility and environmental impact on the gut microbiota may be involved in the pathogenesis of IBD. Rapid advances in next-generation sequencing technology have enabled a number of studies to identify the alteration of the gut microbiota, termed dysbiosis, in IBD. Moreover, the alteration in the metabolites derived from the gut microbiota in IBD has also been described in many studies. Therefore, microbiota-based interventions such as fecal microbiota transplantation (FMT) have attracted attention as a novel therapeutic option in IBD. However, in clinical trials, the efficacy of FMT for IBD remains controversial. Additional basic and clinical studies are required to validate whether FMT can assume a complementary role in the treatment of IBD. The present review provides a synopsis on dysbiosis in IBD and on the association between the gut microbiota and the pathogenesis of IBD. In addition, we summarize the use of probiotics in IBD and the results of current clinical trials of FMT for IBD.

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“…It is known that the inflammatory state in CD affects the microbial composition ( Craven et al, 2012 ) but also that IBD microbiota can induce intestinal inflammation ( Nagao-Kitamoto et al, 2016 ). In this regard, treatments addressed to restore healthy gut microbiota in IBD, such as administration of prebiotics and probiotics ( Limketkai et al, 2020 ), antibiotic therapy ( Castiglione et al, 2003 ), and fecal microbiota transplantation ( Britton et al, 2020 ) need further investigations.…”

Section: Gut-derived Bacterial Antigen Translocationmentioning

confidence: 99%

Bacterial Translocation as Inflammatory Driver in Crohn’s Disease

Linares

Francés

Gutiérrez

et al. 2021

Front. Cell Dev. Biol.

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Crohn’s disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract responsible for intestinal lesions. The multifactorial etiology attributed to CD includes a combination of environmental and host susceptibility factors, which result in an impaired host–microbe gut interaction. Bacterial overgrowth and dysbiosis, increased intestinal barrier permeability, and altered inflammatory responses in patients with CD have been described in the past. Those events explain the pathogenesis of luminal translocation of bacteria or its products into the blood, a frequent event in CD, which, in turn, favors a sustained inflammatory response in these patients. In this review, we navigate through the interaction between bacterial antigen translocation, permeability of the intestinal barrier, immunologic response of the host, and genetic predisposition as a combined effect on the inflammatory response observed in CD. Several lines of evidence support that translocation of bacterial products leads to uncontrolled inflammation in CD patients, and as a matter of fact, the presence of gut bacterial genomic fragments at a systemic level constitutes a marker for increased risk of relapse among CD patients. Also, the significant percentage of CD patients who lose response to biologic therapies may be influenced by the translocation of bacterial products, which are well-known drivers of proinflammatory cytokine production by host immune cells. Further mechanistic studies evaluating cellular and humoral immune responses, gut microbiota alterations, and genetic predisposition will help clinicians to better control and personalize the management of CD patients in the future.

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Probiotics for induction of remission in Crohn's disease

Abstract: Editorial group: Cochrane Gut Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 7, 2020.

Cited by 93 publications

References 28 publications

The role of the microbiome in gastrointestinal inflammation

The role of the microbiome in gastrointestinal inflammation

Can control of gut microbiota be a future therapeutic option for inflammatory bowel disease?

Bacterial Translocation as Inflammatory Driver in Crohn’s Disease

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