Probiotics for the treatment of ulcerative colitis: a review of experimental research from 2018 to 2022

Abstract

Ulcerative colitis (UC) has become a worldwide public health problem, and the prevalence of the disease among children has been increasing. The pathogenesis of UC has not been elucidated, but dysbiosis of the gut microbiota is considered the main cause of chronic intestinal inflammation. This review focuses on the therapeutic effects of probiotics on UC and the potential mechanisms involved. In animal studies, probiotics have been shown to alleviate symptoms of UC, including weight loss, diarrhea, blood in the stool, and a shortened colon length, while also restoring intestinal microecological homeostasis, improving gut barrier function, modulating the intestinal immune response, and attenuating intestinal inflammation, thereby providing theoretical support for the development of probiotic-based microbial products as an adjunctive therapy for UC. However, the efficacy of probiotics is influenced by factors such as the bacterial strain, dose, and form. Hence, the mechanisms of action need to be investigated further. Relevant clinical trials are currently lacking, so the extension of animal experimental findings to clinical application requires a longer period of consideration for validation.

An integrative multi-omic analysis defines gut microbiota, mycobiota, and metabolic fingerprints in ulcerative colitis patients

“…These results agree with other studies describing the composition of the gut microbiota in IBD and specifically in UC, reinforcing the evidence that bacterial intestinal dysbiosis is a strong signature of this disease. Today, microbial biomarkers are proposed for monitoring and evaluating disease activity, predicting recurrence or response to treatment, and treating diseases ( Guo et al., 2022 ; Zheng et al., 2022 ; Huang et al., 2023 ).…”

Intestinal Fibrogenesis in Inflammatory Bowel Diseases: Exploring the Potential Role of Gut Microbiota Metabolites as Modulators

“…The lack of data related to the study of metabolites as mediators of intestinal fibrogenesis should be addressed, initially with preclinical studies and subsequently with clinical trials, as they could contribute to the development of potential new therapies complementary to those currently available. The interest addressed to preventive strategies and/or alternative/complementary therapeutic strategies based on prebiotics, probiotics, and postbiotics finds place in the fact that current therapies, although effective, do not lack adverse effects [ 184 ]. Further studies on microbial metabolites could not only enhance the understanding of IBD pathogenesis and their treatment but also contribute to a better understanding and treatment of other common and dangerous conditions characterized by fibrosis that can potentially affect any organ.…”

Advances and optimization strategies in bacteriophage therapy for treating inflammatory bowel disease

“…Prolonged use of 5-ASA in IBD patients may lead to side effects such as headaches, diarrhea, nausea, and even severe complications like pneumonia, hepatitis, and myocarditis ( 66 ). Corticosteroids, while potent and rapid in treating IBD, fail to effectively maintain remission and can induce irreversible complications with long-term use, including cataracts, glaucoma, hypertension, and diabetes ( 67 , 68 ). While biologics broaden the therapeutic spectrum for IBD, they unfortunately bring about severe complications such as tuberculosis, fungal infections, cancer, and tumors.…”