Probiotics in Inflammatory Bowel Disease: Are We Back to Square One?

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the alimentary tract whose incidence has been increasing over the past few years. Even though there is a complex interplay of several factors in the pathogenesis of IBD, a decrease in the diversity of intestinal microbiome is commonly found in patients. Extensive research is directed towards the alteration of this microbiome to improve the symptoms of IBD. Probiotics, prebiotics, antibiotics, and diet are studied in this regard extensively. Among them, probiotics have gained more interest as some of the studies showed them to be effective in decreasing gut inflammation in vitro and in vivo. Although there is no cure for IBD as of today, the available medications do decrease gut inflammation and help prolong remission and decrease relapse rates. But their side effects preclude their long-term use. Probiotics may be a ray of hope among IBD patients as they are apparently safe. This article reviews each of the available literature from the past 10 years to see if there is any certain role of probiotics in induction, maintenance of remission, prevention of relapse, and improvement in the quality of life in IBD patients.

Prebiotics, Probiotics, Synbiotics, Paraprobiotics and Postbiotic Compounds in IBD

“…They analyzed three RCTs—two of them showed a significant improvement in patients’ QoL, and one study found no difference. The researchers concluded that the results of their analysis may indicate that probiotics improve the QoL of patients with IBD [ 68 ].…”

Strains producing different short-chain fatty acids alleviate DSS-induced ulcerative colitis by regulating intestinal microecology

“…10 Probiotics usually promote health by regulating the endostasis of intestinal microorganisms, and Lactobacillus , Bifidobacterium and various probiotic complexes are widely used in UC alleviation studies. 11 In addition, the metabolites and components of probiotics, also known as postbiotics, are functional bioactive compounds produced during microbial fermentation, such as proteins, extracellular polysaccharides, bacteriocins and short-chain fatty acids (SCFAs). 12 SCFAs (mainly acetic acid, propionic acid and butyric acid) can be sensed by G protein-coupled receptors and thus participate in downstream immune responses in the gut.…”

Lentilactobacillus kefiri SGL 13 and Andrographis paniculata alleviate dextran sulfate sodium induced colitis in mice

“…Among IBD patients, probiotics have gained a great interest due to their feature to alleviate clinical symptoms and to improve the quality of life, either during periods of exacerbation or remission (13)(14)(15). In animal model, different strains of lactic acid bacteria, e.g., Bifidobacterium longum (16), Lactococcus lactis (17), Lactobacillus plantarum (recently reclassified as Lactiplantibacillus plantarum) (18), Lactobacillus reuteri (recently renamed Limosilactobacillus reuteri) (19) have been reported to modulate the gut microbiota composition leading to a restored intestinal barrier function.…”