Mechanisms and therapeutic effectiveness of lactobacilli.
Mechanisms and therapeutic effectiveness of lactobacilli.
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DOI：
10.1136/jclinpath-2015-202976
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发表时间：
2016-03
影响因子：
3.4
通讯作者：
Iannitti T
中科院分区：
文献类型：
--
作者：
Di Cerbo A;Palmieri B;Aponte M;Morales-Medina JC;Iannitti T
肠道微生物组不是一个沉默的生态系统，而是发挥多种生理和免疫功能。几十年来，乳酸杆菌已被用作治疗几种病理状况的有效疗法，显示出总体积极的安全性特征。本文综述了乳酸杆菌的作用机制和临床证据。我们使用关键词“乳酸杆菌”检索Pubmed/Medline。从1950年到2015年的选定论文是根据其内容选择的。已纳入使用乳酸杆菌作为治疗剂的相关临床和实验文章。乳酸杆菌的应用包括肾功能不全的肾脏支持、胰腺健康、代谢失衡的管理以及癌症的治疗和预防。体外和体内研究表明，长时间的乳酸杆菌给药诱导人胃肠道微生物生态系统的定性和定量改变，在抵消病理相关的生理和免疫变化方面具有令人鼓舞的前景。很少有研究强调了益生菌给药后易位伴随后败血症和菌血症的风险，但仍然缺乏对这些化合物剂量效应的研究。因此，在选择合适的乳酸菌菌种、其遗传稳定性和易位风险时需要非常小心，主要与炎症性疾病诱导的肠道粘膜通透性增强有关。最后，我们需要确定要输送的足够数量的细菌，以达到最佳的临床疗效，降低副作用的风险。
The gut microbiome is not a silent ecosystem but exerts several physiological and immunological functions. For many decades, lactobacilli have been used as an effective therapy for treatment of several pathological conditions displaying an overall positive safety profile. This review summarises the mechanisms and clinical evidence supporting therapeutic efficacy of lactobacilli. We searched Pubmed/Medline using the keyword ‘Lactobacillus’. Selected papers from 1950 to 2015 were chosen on the basis of their content. Relevant clinical and experimental articles using lactobacilli as therapeutic agents have been included. Applications of lactobacilli include kidney support for renal insufficiency, pancreas health, management of metabolic imbalance, and cancer treatment and prevention. In vitro and in vivo investigations have shown that prolonged lactobacilli administration induces qualitative and quantitative modifications in the human gastrointestinal microbial ecosystem with encouraging perspectives in counteracting pathology-associated physiological and immunological changes. Few studies have highlighted the risk of translocation with subsequent sepsis and bacteraemia following probiotic administration but there is still a lack of investigations on the dose effect of these compounds. Great care is thus required in the choice of the proper Lactobacillus species, their genetic stability and the translocation risk, mainly related to inflammatory disease-induced gut mucosa enhanced permeability. Finally, we need to determine the adequate amount of bacteria to be delivered in order to achieve the best clinical efficacy decreasing the risk of side effects.