Abstract
Chronic inflammatory enteropathy (CIE) refers to a heterogeneous group of idiopathic diseases of the dog characterised by persistent gastrointestinal (GI) clinical signs. If conventional dietary treatment alone would be unsuccessful, management of CIE is traditionally attained by the use of pharmaceuticals, such as antibiotics and immunosuppressive drugs. While being rather effective, however, these drugs are endowed with side effects, which may impact negatively on the animal’s quality of life. Therefore, novel, safe and effective therapies for CIE are highly sought after. As gut microbiota imbalances are often associated with GI disorders, a compelling rationale exists for the use of nonpharmacological methods of microbial manipulation in CIE, such as faecal microbiota transplantation and administration of pre-, pro-, syn- and postbiotics. In addition to providing direct health benefits to the host via a gentle modulation of the intestinal microbiota composition and function, these treatments may also possess immunomodulatory and epithelial barrier-enhancing actions. Likewise, intestinal barrier integrity, along with mucosal inflammation, are deemed to be two chief therapeutic targets of mesenchymal stem cells and selected vegetable-derived bioactive compounds. Although pioneering studies have revealed encouraging findings regarding the use of novel treatment agents in CIE, a larger body of research is needed to address fully their mode of action, efficacy and safety.
Highlights
Chronic inflammatory enteropathy (CIE) is an umbrella term coined to define a group of diseases affecting the enteral system of the dog, whose diagnosis requires the exclusion of known digestive and extradigestive causes of chronic GI signs [1]
CIE is encountered in referral practice with a prevalence as high as 2% [2,3], and it is clinically classified upon treatment response to different therapeutic trials
In a study investigating polymorphisms in canine toll-like receptors (TLRs)-2, -4 and -5 genes, it was concluded that three TLR-5 and two TLR-4 nonsynonymous single-nucleotide polymorphisms are likely to play a mechanistic role in idiopathic inflammatory bowel disease” (IBD) pathogenesis in German shepherd dogs (GSDs) [28]
Summary
Chronic inflammatory enteropathy (CIE) is an umbrella term coined to define a group of diseases affecting the enteral system of the dog, whose diagnosis requires the exclusion of known digestive and extradigestive causes of chronic GI signs [1]. Characterised by a fairly high rate of clinical remission [8,9], reiterated or long-term administration of the aforementioned medications should be carefully weighed in light of their benefits and side effects In this regard, numerous reports have disclosed the negative impact of antibiotics towards the gut microbiota, leading to significant drops in microbial diversity, evenness and species richness, i.e., dysbiosis [10–12]. In this perspective, nonpharmacological interventions such as bacteriotherapy, cell therapy and the administration of nutraceuticals have garnered increasing attention over the last decade for their potential applications in companion animal gastroenterology. The purpose of the current review is to critically appraise the state of the art regarding the main complementary and alternative therapies that show promise in the treatment of CIE, with special emphasis on those ones that manipulate the host’s intestinal microbiota, as well as providing an outlook for the near future
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