The Role of Probiotic Lactic Acid Bacteria and Bifidobacteria in the Prevention and Treatment of Inflammatory Bowel Disease and Other Related Diseases: A Systematic Review of Randomized Human Clinical Trials

Abstract

Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammation of the small intestine and colon caused by a dysregulated immune response to host intestinal microbiota in genetically susceptible subjects. A number of fermented dairy products contain lactic acid bacteria (LAB) and bifidobacteria, some of which have been characterized as probiotics that can modify the gut microbiota and may be beneficial for the treatment and the prevention of IBD. The objective of this review was to carry out a systematic search of LAB and bifidobacteria probiotics and IBD, using the PubMed and Scopus databases, defined by a specific equation using MeSH terms and limited to human clinical trials. The use of probiotics and/or synbiotics has positive effects in the treatment and maintenance of UC, whereas in CD clear effectiveness has only been shown for synbiotics. Furthermore, in other associated IBD pathologies, such as pouchitis and cholangitis, LAB and bifidobacteria probiotics can provide a benefit through the improvement of clinical symptoms. However, more studies are needed to understand their mechanisms of action and in this way to understand the effect of probiotics prior to their use as coadjuvants in the therapy and prevention of IBD conditions.

An overview of the bacterial contribution to Crohn disease pathogenesis

“…Dietary manipulation, for example, with prebiotics (non-digestible food ingredients that promote targeted growth of beneficial micro-organisms) (Schrezenmeir & de Vrese, 2001) along with probiotics (micro-organisms that have a beneficial health effect when ingested) (Schrezenmeir & de Vrese, 2001), has been shown to modify the intestinal microbiome by promoting growth and metabolic activity of the commensal bacterial species (Macfarlane & Macfarlane, 2013). This approach is of importance in treating and/or preventing chronic inflammatory diseases including IBD (Saez-Lara et al, 2015). Prebiotics were found to alter microbial diversity, enhance mucosal barrier function via production of short-chain fatty acids and mediate direct anti-inflammatory responses (Hold et al, 2014).…”

The long-term effects of probiotics in the therapy of ulcerative colitis: A clinical study

“…microbiological studies have detected a significant reduction of Bifidobacteria and lactobacilli and an overgrowth of specific pathogenic strains, such as deltaproteobacteria and Bilophila wadsworthia. The use of probiotics in combination with the standard treatment, improves patients' quality of life and life expectancy, reducing significantly clinical symptoms and minimizing side effects [21][22][23][24][25] . The results of our study confirm the beneficial effects of probiotics on Uc activity, partly by improving patient's response to anti-inflammatory treatment.…”

Medicinal plants with anti-inflammatory activities

“…Ulcerative colitis and Crohn's disease are the two most prevailing forms of IBD. Pharmacological strategies developed in recent years have been oriented to monoclonal antibodies targeting pro-inflammatory cytokines and adhesion molecules which regulate leukocytes infiltration into the intestinal mucosa (Radulovic & Niess 2015;Saez-Lara et al 2015).…”