Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials
Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials
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DOI：
10.1017/s0029665107005563
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发表时间：
2007-08-01
影响因子：
7
通讯作者：
Lindsay, James O.
中科院分区：
文献类型：
--
作者：
Hedin, Charlotte;Whelani, Kevin;Lindsay, James O.
人类受试者和他们的肠道微生物群一起进化，达到一种相互容忍的状态。来自动物模型和人类研究的越来越多的证据表明，炎症性肠病（1131）代表了这种关系的失调。因此，肠道微生态是一个有吸引力的治疗靶点，副作用很少。益生菌和益生元已经在临床试验中作为IBD的治疗方法进行了研究，结果相互矛盾。使用益生菌治疗袋炎的证据是有说服力的，一些研究表明它们在溃疡性结肠炎中的有效性。益生菌和益生元治疗克罗恩病的试验不那么令人信服。然而，方法差异很大，益生菌、益生元和组合（合成）治疗的范围已经在各种患者群体中进行了测试，并有各种各样的终点。因此，关于某一特定患者群体的任何一种治疗的结论只能从相对少数患者的证据中得出。本文综述了肠道微生物群在IBD发病机制中的作用，并阐述了使用益生菌、益生元和合成菌治疗IBD的肠道微生物群的临床证据。
Human subjects and their enteric microbiota have evolved together to reach a state of mutual tolerance. Mounting evidence from both animal models and human studies suggests that inflammatory bowel disease (1131)) represents a malfunction of this relationship. The enteric microecology therefore represents an attractive therapeutic target with few side effects. Probiotics and prebiotics have been investigated in clinical trials as treatments for IBD, with conflicting results. The evidence for the use of probiotics in the management of pouchitis is persuasive and several studies indicate their effectiveness in ulcerative colitis. Trials of probiotics and prebiotics in Crohn's disease are less convincing. However, methodologies vary widely and a range of probiotic, prebiotic and combination (synbiotic) treatments have been tested in a variety of patient groups with an assortment of end points. Conclusions about any one treatment in a specific patient group can therefore only be drawn on evidence from relatively small numbers of patients. The present article reviews the role of the intestinal microbiota in the pathogenesis of IBD and addresses the clinical evidence for the therapeutic manipulation of bowel microbiota using probiotics, prebiotics and synbiotics in IBD.