Probiotics and inflammatory bowel disease: Is there a scientific rationale?

Authors
Citation
F. Shanahan, Probiotics and inflammatory bowel disease: Is there a scientific rationale?, INFLAMM B D, 6(2), 2000, pp. 107-115
Citations number
81
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
INFLAMMATORY BOWEL DISEASES
ISSN journal
10780998 → ACNP
Volume
6
Issue
2
Year of publication
2000
Pages
107 - 115
Database
ISI
SICI code
1078-0998(200005)6:2<107:PAIBDI>2.0.ZU;2-Y
Abstract
Most conventional forms of drug therapy suppress or modify the host immunoi nflammatory response and neglect the other contributor to disease pathogene sis-the environmental microflora. Probiotics are live microbial food ingred ients that alter the enteric microflora and have a beneficial effect on hea lth. The rationale for using probiotics in IBD is mainly based on evidence from human studies and experimental animal models implicating intestinal ba cteria in the pathogenesis of these disorders. The relationship between bac teria and intestinal inflammation is complex and does not appear to reflect a simple cause and effect. Similarly, the field of probiotics is complex a nd in need of rigorous research. Until the indigenous flora are better char acterized and mechanisms of probiotic action defined, the promise of probio tics in IBD is unlikely to be fulfilled. Because of strain-specific variabi lity and clinical and therapeutic heterogeneity within Crohn's disease and ulcerative colitis, it cannot be assumed that a given probiotic is equally suitable for all individuals. Although preliminary results of probiotic the rapy in animal models and humans with ulcerative colitis and pouchitis have been encouraging, their efficacy in treatment or maintenance of remission of Crohn's disease remains to be clarified. However, the circumstantial evi dence for some form of biotherapeutic modification of the enteric flora in Crohn's disease seems compelling. In the future, probiotics may offer a sim ple adjunct to conventional therapy with the emphasis on diet shifting from one of nutritional replenishment alone to a more functional role.