title: Probiotics, prebiotics and symbiotics in inflammatory bowel diseases: state-of-the-art and new insights.
abstract: Inflammatory bowel disease (IBD) consists of two distinct clinical forms, ulcerative colitis (UC) and Crohn's disease (CD), with unknown aetiology, which nevertheless are considered to share almost identical pathophysiological backgrounds. Up to date, a full coherent mechanistic explanation for IBD is still lacking, but people start to realize that the pathogenesis of IBD involves four fundamental components: the environment, gut microbiota, the immune system and the genome. As a consequence, IBD development might be due to an altered immune response and a disrupted mechanism of host tolerance to the non-pathogenic resident microbiota, leading to an elevated inflammatory response. Considering the available data arising from the scientific literature, here reviewed, in CD, a benefit of probiotics remains unproven; in UC, a benefit of probiotics remains unproven, even if E. coli Nissle 1917 seems promising in maintaining remission and it could be considered an alternative in patients intolerant or resistant to 5-ASA preparations; in pouchitis, small controlled trials suggest a benefit from VSL no. 3 in the primary and secondary prevention of pouchitis; in IBD-associated conditions, a benefit of probiotics remains unproven. However, well-designed randomized control clinical trials are necessary to understand the undoubted role of these agents in the management of gut physiology in health and disease.
authors.affiliation: PhD Course in Surgical Biotechnology and Regenerative Medicine, University of Palermo, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Sinagra
authors.affiliation: Department DICHIRONS, University of Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tomasello
authors.affiliation: Euro-Mediterranean Institute of Science and Technology, Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cappello
authors.affiliation: Department BIONEC, University of Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Leone
authors.affiliation: Department DIBIMIS, University of Palermo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cottone
authors.affiliation: Euro-Mediterranean Institute of Science and Technology, Palermo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bellavia
authors.affiliation: Fondazione Istituto S. Raffaele- G. Giglio, Gastroenterology and Endoscopy Unit, Cefalu', Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rossi
authors.affiliation: Fondazione Istituto S. Raffaele- G. Giglio, Gastroenterology and Endoscopy Unit, Cefalu', Italy.
authors.forename: T
authors.initials: T
authors.lastname: Facella
authors.affiliation: Policlinico Paolo Giaccone, Hospital, Unit of Geriatry, Palermo, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Damiani
authors.affiliation: Department BIONEC, University of Palermo, Italy.
authors.forename: M N
authors.initials: MN
authors.lastname: Zeenny
authors.affiliation: PhD Course in Surgical Biotechnology and Regenerative Medicine, University of Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Damiani
authors.affiliation: PhD Course in Surgical Biotechnology and Regenerative Medicine, University of Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Abruzzo
authors.affiliation: Department DICHIRONS, University of Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Damiano
authors.affiliation: Department DICHIRONS, University of Palermo, Italy.
authors.forename: V D
authors.initials: VD
authors.lastname: Palumbo
authors.affiliation: Institute Paolo Sotgiu for Research in Quantitative and Quantum Psychiatry and Cardiology, LUdeS University, Lugano, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Cocchi
authors.affiliation: Department of Morphology, American University of Beirut, Beirut, Lebanon.
authors.forename: A
authors.initials: A
authors.lastname: Jurjus
authors.affiliation: Department DICHIRONS, University of Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Spinelli
authors.affiliation: PhD Course in Surgical Biotechnology and Regenerative Medicine, University of Palermo, Italy.
authors.forename: A I
authors.initials: AI
authors.lastname: Lo Monte
authors.affiliation: Fondazione Istituto S. Raffaele- G. Giglio, Gastroenterology and Endoscopy Unit, Cefalu', Italy.
authors.forename: D
authors.initials: D
authors.lastname: Raimondo
mesh_terms: D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D064307:Microbiota; D056692:Prebiotics; D019936:Probiotics / Q000627:therapeutic use*
chemical_list: D056692:Prebiotics