Abstract
Studies of probiotics, fructan-type prebiotics, and synbiotics in patients with ulcerative colitis (UC) show significant heterogeneity in methodology and results. Here, we study the efficacy of such interventions and the reasons for the heterogeneity of their results. Eligible random controlled trials were collected from the PUBMED and SCOPUS databases. A total of 18 placebo-controlled and active treatment-controlled (i.e., mesalazine) studies were selected with a Jadad score ≥ 3, including 1491 patients with UC. Data for prebiotics and synbiotics were sparse and consequently these studies were excluded from the meta-analysis. The UC remission efficacy of probiotics was measured in terms of relative risk (RR) and odds ratio (OR). Significant effects were observed in patients with active UC whenever probiotics containing bifidobacteria were used, or when adopting the US Food and Drug Administration (FDA)-recommended scales (UC Disease Activity Index and Disease Activity Index). By the FDA recommended scales, the RR was 1.55 (CI95%: 1.13–2.15, p-value = 0.007, I2 = 29%); for bifidobacteria-containing probiotics, the RR was 1.73 (CI95%: 1.23–2.43, p-value = 0.002, I2 = 35%). No significant effects were observed on the maintenance of remission for placebo-controlled or mesalazine-controlled studies. We conclude that a validated scale is necessary to determine the state of patients with UC. However, probiotics containing bifidobacteria are promising for the treatment of active UC.
Highlights
The worldwide incidence and prevalence of inflammatory bowel diseases (IBDs) have been increasing over the last few decades [1]
Because different probiotics were used to induce remission in active ulcerative colitis (UC) patients (Table 1), we studied the efficacy of Mutaflor, VSL#3, and other probiotics that included Bifidobacterium strains, separately (Figure 3)
Six studies (424 patients) that used bifidobacteria-containing probiotics were analyzed, and the results suggested that such probiotics were effective in inducing remission in active
Summary
The worldwide incidence and prevalence of inflammatory bowel diseases (IBDs) have been increasing over the last few decades [1]. Along with Crohn’s disease (CD), ulcerative colitis (UC) is one of the two major types of IBDs. Unlike CD, which can affect any part of the gastrointestinal tract, from the mouth to the anus, UC characteristically only affects the inner lining of the large bowel [2]. The etiology of UC is still unclear, one of the main hypotheses is that it is caused by an excessive immune response to endogenous bacteria in genetically predisposed individuals [3,4]. Manipulation of the mucosal microbiota to reduce the inflammatory potential of colonizing bacteria is an attractive therapeutic option for UC. Most conventional UC therapies, including the use of compounds containing 5-aminosalicylic acid (5-ASA), corticosteroids, immunosuppressant agents, and anti-tumor necrosis factor (TNF) monoclonal antibodies, suppress intestinal inflammation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
