Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate.
Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, PubMed was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation. More than three hundred articles published up to 2015 were selected and reviewed. Randomized placebo-controlled trials and meta-analysis were firstly included, mainly for probiotics. A meta-analysis was not performed because of the heterogeneity of these studies. Most of relevant data derived from studies on probiotics, reporting some efficacy in ulcerative colitis and in pouchitis, while disappointing results are available for Crohn's disease. Probiotic supplementation may significantly reduce rates of rotavirus diarrhea. Efficacy of probiotics in NSAID enteropathy and irritable bowel syndrome is still controversial. Finally, FMT has been recently recognized as an efficacious treatment for recurrent Clostridium difficile infection. Modulation of intestinal flora represents a very interesting therapeutic target, although it still deserves some doubts and limitations. Future studies should be encouraged to provide new understanding about its therapeutical role.
Antonella Gallo, Giovanna Passaro, Raffaele Landolfi, Massimo Montalto, Institute of Internal Medicine, Fondazione Policlinico "Agostino Gemelli", Catholic University of Sacred Heart, 00168 Rome, Italy.
Antonella
A
Gallo
Antonella Gallo, Giovanna Passaro, Raffaele Landolfi, Massimo Montalto, Institute of Internal Medicine, Fondazione Policlinico "Agostino Gemelli", Catholic University of Sacred Heart, 00168 Rome, Italy.
Giovanna
G
Passaro
Antonella Gallo, Giovanna Passaro, Raffaele Landolfi, Massimo Montalto, Institute of Internal Medicine, Fondazione Policlinico "Agostino Gemelli", Catholic University of Sacred Heart, 00168 Rome, Italy.
Antonio
A
Gasbarrini
Antonella Gallo, Giovanna Passaro, Raffaele Landolfi, Massimo Montalto, Institute of Internal Medicine, Fondazione Policlinico "Agostino Gemelli", Catholic University of Sacred Heart, 00168 Rome, Italy.
Raffaele
R
Landolfi
Antonella Gallo, Giovanna Passaro, Raffaele Landolfi, Massimo Montalto, Institute of Internal Medicine, Fondazione Policlinico "Agostino Gemelli", Catholic University of Sacred Heart, 00168 Rome, Italy.
Massimo
M
Montalto
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D003967:Diarrhea / Q000209:etiology / Q000628:therapy; D000069467:Fecal Microbiota Transplantation; D000069196:Gastrointestinal Microbiome; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000382:microbiology* / Q000628:therapy*; D043183:Irritable Bowel Syndrome / Q000382:microbiology / Q000628:therapy; D056692:Prebiotics / Q000008:administration & dosage; D019936:Probiotics / Q000627:therapeutic use; D012400:Rotavirus Infections / Q000628:therapy
D000900:Anti-Bacterial Agents; D056692:Prebiotics
Gut; Inflammation; Microbiota; Prebiotic; Probiotic