Abstract
Inflammatory bowel diseases (IBD), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic inflammatory diseases of the digestive tract with periods of remission and relapses. The etiopathogenesis of IBD is multifactorial and has not been fully understood. Hence, only symptomatic treatment of these diseases is possible. The current pharmacological treatment has variable efficacy and is associated with the risk of significant side effects. Therefore, there is a constant need to search for new types of therapies with a high safety profile. Considering that the qualitative and quantitative profile of the gastrointestinal microbiome is often different in patients with IBD than in healthy individuals, there is a need for looking for therapies aimed at restoring intestinal microbiome homeostasis. Thus, the use of strictly defined probiotics, prebiotics and synbiotics may become an alternative form of IBD therapy. There is evidence that treatment with certain probiotic strains, e.g., VSL#3 and Escherischia coli Nissle 1917, is an effective form of therapy to induce remission in patients with mild to moderate UC. So far, the effectiveness of the use of probiotics, prebiotics and synbiotics in inducing or maintaining remission in patients with CD has not been confirmed. There are also reports of possible beneficial effects of fecal microbiota transplantation (FMT) on the course of IBD, especially UC. Further, well-planned studies on a large group of patients are needed to determine the role of specific probiotic strains, prebiotics, synbiotics and FMT in the treatment of IBD in adults and in children.
Highlights
Inflammatory bowel diseases (IBD), including ulcerative colitis (UC), Crohn’s disease (CD) and unclassified inflammatory bowel disease (IBD-U), are characterized by chronic inflammation of the gut mucosa [1]
Well-planned studies on a large group of patients are needed to determine the role of specific probiotic strains, prebiotics, synbiotics and fecal microbiota transplantation (FMT) in the treatment of IBD in adults and in children
It has been shown that the use of antibiotics and the associated dysbiosis are risk factors for the development of CD, and that quantitative and qualitative changes in the microbiome may be present in humans with a documented genetic predisposition to develop IBD, but without clinical symptoms [5,7]
Summary
Inflammatory bowel diseases (IBD), including ulcerative colitis (UC), Crohn’s disease (CD) and unclassified inflammatory bowel disease (IBD-U), are characterized by chronic inflammation of the gut mucosa [1]. Chronic inflammation of the intestinal mucosa is likely the result of multidirectional interactions between environmental, microbiological, genetic and immunological factors [2,3]. This results in an imbalance of the immune system within the gastrointestinal mucosa and the dominance of proinflammatory over anti-inflammatory processes [4,5,6,7]. The quantitative or qualitative change in the composition of the gut microbiome is one of the most important factors regulating the intestinal immune system, and may influence the development and course of IBD [4,5,6]. Regardless of whether changes of the gut microbiome are primary or secondary to IBD, its modification through diet, the use of antibiotics or probiotics provides a strong theoretical basis for conducting further, well-planned research about the use of therapy restoring the microbial balance in the gut as another element of IBD therapy [4,13,14]
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