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Digestive Diseases and Sciences

, Volume 52, Issue 3, pp 607–611 | Cite as

The Role of Probiotics in Inflammatory Bowel Disease

  • Jennifer L. Jones
  • Amy E. Foxx-Orenstein
Review Paper

Background

The human intestine contains 300–500 different bacterial species. Concentrations of living bacteria in the large intestine may reach 1011–1012 cells/g of luminal contents [1]. Some of these bacteria are protective, some neutral and others pathogenic [2]. This dynamic community of intestinal microflora plays a critical role in maintaining intestinal health. Metabolic and digestive functions include fermentation of nondigestible dietary residue and mucous, salvage of energy from this residue, production of vitamin K, and absorption of ions. Trophic functions include control of proliferation and differentiation of intestinal epithelial cells, and development and balance of the immune system. These bacteria also protect against pathogens and maintain the epithelial barrier [1]. Probiotics, originally derived from cultured foods and milk products, are viable microorganisms with beneficial physiologic or therapeutic properties [2]. Although the definition of a probiotic has...

Keywords

Probiotics Inflammatory bowel disease Crohn's disease Ulcerative colitis Review Bacteria 

References

  1. 1.
    Guarner F, Malagelada J (2003) Gut flora in health and disease.[see comment]. Lancet 361:512–519PubMedCrossRefGoogle Scholar
  2. 2.
    Sartor R (2004) Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics. Gastroenterology 126:1620–1633PubMedCrossRefGoogle Scholar
  3. 3.
    Guarner F, Shaafsma G (1998) Probiotics. Int J Food Microbiol 39:237–238PubMedCrossRefGoogle Scholar
  4. 4.
    Fioramonti J, Theodorou V, Bueno L (2003) Probiotics: what are they? What are their effects on gut physiology? Best Pract Res Clin Gastroenterol 17:711–724PubMedCrossRefGoogle Scholar
  5. 5.
    Sartor R (2005) Probiotic therapy of intestinal inflammation and infections. Curr Opin Gastroenterol 21:44–50PubMedGoogle Scholar
  6. 6.
    Donohue D, Salminen S, Marteau P (1998) Safety of probiotic bacteria. In: Salminen S, Von Wright A (eds) Lactic acid bacteria. New York, Marcel Decker, pp 369–384Google Scholar
  7. 7.
    Farina C, Arosio M, Mangia M, Moioli F (2001) Lactobacillus casei subsp. rhamnosus sepsis in a patient with ulcerative colitis. J Clin Gastroenterol 33:251–252PubMedCrossRefGoogle Scholar
  8. 8.
    Pletinex M, Legein J, Vandeplas Y (1995) Fungicemia with Saccharomyces boulardii in a 1- year old girl with protracted diarrhea. J Pediatr Gastroenterol Nutr 21:113–115CrossRefGoogle Scholar
  9. 9.
    Fedorak R, Madsen K (2004) Probiotics and the management of inflammatory bowel disease. Inflamm Bowel Dis 10:286–299PubMedCrossRefGoogle Scholar
  10. 10.
    Riquelme A, Calvo M, Guzman A, Depix M, Garcia P, Perez C, et al. (2003) Saccharomyses cerevaciae fungemia after Saccharomyses boulardii treatment in immunocompromised patients. J Clin Gastroenterol 36:41–43PubMedCrossRefGoogle Scholar
  11. 11.
    Rautio M, Jousimies-Somer H, Kauma H, Pietarinen I, Saxelin M, Tynkkynen S, et al. (1999) Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 28:1159–1160PubMedGoogle Scholar
  12. 12.
    Hennequin C, Kauffmann-Lacroix C, Jobert A, Viard J, Ricour C, Jacquemin J, et al. (2000) Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis 19:16–20PubMedCrossRefGoogle Scholar
  13. 13.
    Tamboli C, Caucheteux C, Cortot A, Colombel J, Desreumaux P (2003) Probiotics in inflammatory bowel disease: a critical review. Best Pract Res Clin Gastroenterol 17:805–820PubMedCrossRefGoogle Scholar
  14. 14.
    Salminen M, Tynkkynen S, Rautelin H, Saxelin M, Vaara M, Ruutu P, et al. (2002) Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland. Clin Infect Dis 35:1155–1160PubMedCrossRefGoogle Scholar
  15. 15.
    Hamilton-Miller J, Shah S, Winkler J (1999) Public health issues arising from microbiological and labelling quality foods and supplements containing probiotic organisms. Public Health Nutr 2:223–229PubMedCrossRefGoogle Scholar
  16. 16.
    Katz J, Pirovano F, Matteuzzi DEA (2002) Commercially available probiotic preparations: are you getting what you pay for? Gastroenterology 122:A459Google Scholar
  17. 17.
    Duchmann R, Kaiser I, Hermann E, Mayet W, Ewe K, zum Meyer Buschenfelde K (1995) Tolerance exists towards resident intestinal flora but is broken in active inflammatory bowel disease (IBD) [see comment]. Clin Exp Immunol 102:448–455PubMedCrossRefGoogle Scholar
  18. 18.
    Macpherson A, Khoo U, Forgacs I, Philpott-Howard J, Bjarnason I (1996) Mucosal antibodies in inflammatory bowel disease are directed against intestinal bacteria. Gut 38:365–375PubMedGoogle Scholar
  19. 19.
    Sartor R (2003) Microbial influences in inflammatory bowel disease: role in pathogenesis and clinical implications. In: Sartor R, Sandborn W, eds. Kirsner's Inflammatory Bowel Diseases. 6 ed. Edinburgh, Elsevier, pp 138–162Google Scholar
  20. 20.
    Neut C, Bulois P, Desreumaux P, Membre J, Lederman E, Gambiez L, et al. (2002) Changes in the bacterial flora of the neoterminal ileum after ileocolonic resection for Crohn's disease. Am J Gastroenterol 97:939–946PubMedCrossRefGoogle Scholar
  21. 21.
    Swidsinski A, Ladhoff A, Pernthaler A, Swidsinski S, Loening-Baucke V, Ortner M, et al. (2002) Mucosal flora in inflammatory bowel disease. Gastroenterology 122:44–54PubMedCrossRefGoogle Scholar
  22. 22.
    Cartun R, Van Kruiningen H, Pedersen C, Berman M (1993) An immunocytochemical search for infectious agents in Crohn's disease. Modern Pathol 6:212–219Google Scholar
  23. 23.
    Shanahan F (2000) Probiotics and inflammatory bowel disease: Is there a scientific rationale? Inflamm Bowel Dis 6:107–115PubMedCrossRefGoogle Scholar
  24. 24.
    D’Haens G, Geboes K, Peeters M, Baert F, Penninckx F, Rutgeerts P (1998) Early lesions of recurrent Crohn's disease caused by infusion of intestinal contents in excluded ileum. Gastroenterology 114:262–267PubMedCrossRefGoogle Scholar
  25. 25.
    Rutgeerts P, Van Assche G, Vermeire S, D’Haens G, Baert F, Noman M, et al. (2005) Ornidazole for prophylaxis of postoperative Crohn's disease recurrence: a randomized, double-blind, placebo-controlled trial. Gastroenterology 128:856–861PubMedCrossRefGoogle Scholar
  26. 26.
    Cario E (2005) Bacterial interactions with cells of the intestinal mucosa: Toll-like receptors and NOD2. Gut 54:1182–1193PubMedCrossRefGoogle Scholar
  27. 27.
    Buning C, Genschel J, Buhner S, Kruger S, Kling K, Dignass A, et al. (2004) Mutations in the NOD2/CARD15 gene in Crohn's disease are associated with ileocecal resection and are a risk factor for reoperation. Aliment Pharmacol Ther 19:1073–1078PubMedCrossRefGoogle Scholar
  28. 28.
    Cobrin G, Abreu M (2005) Defects in mucosal immunity leading to Crohn's disease. Immunol Rev 206:277–295PubMedCrossRefGoogle Scholar
  29. 29.
    Steidler L, Hans W, Schotte L, Neirynck S, Obermeier F, Falk W, et al. (2000) Treatment of murine colitis by Lactococcus lactis secreting interleukin-10. Science 289:1352–1355PubMedCrossRefGoogle Scholar
  30. 30.
    Prantera C, Scribano M, Falasco G, Andreoli A, Luzi C (2002) Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease: a randomised controlled trial with Lactobacillus GG. Gut 51:405–409PubMedCrossRefGoogle Scholar
  31. 31.
    Malchow H (1997) Crohn's disease and Escherichia coli. A new approach in therapy to maintain remission of colonic Crohn's disease? J Clin Gastroenterol 25:653–658Google Scholar
  32. 32.
    Guslandi M, Mezzi G, Sorghi M, Testoni P (2000) Saccharomyces boulardii in maintenance treatment of Crohn's disease. Dig Dis Sci 45:1462–1464PubMedCrossRefGoogle Scholar
  33. 33.
    Ingrassia I, Leplingard A, Darfeuille-Michaud A (2005) Lactobacillus casei DN-114 001 inhibits the ability of adherent-invasive Escherichia coli isolated from Crohn's disease to and to invade intestinal epithelial cells. Appl Environ Microbiol 71:2880–2887PubMedCrossRefGoogle Scholar
  34. 34.
    Braat H, van den Brande J, van Tol E, Hommes D, Peppelenbosch M, van Deventer S (2004) Lactobacillus rhamnosus induces peripheral hyporesponsiveness in stimulated CD4+ T cells via modulation of dendritic cell function. Am J Clin Nutr 80:1618–1625PubMedGoogle Scholar
  35. 35.
    Venturi A, Gionchetti P, Rizzello F, Johansson R, Zucconi E, Brigidi P, et al. (1999) Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 13:1103–1108PubMedCrossRefGoogle Scholar
  36. 36.
    Rembacken B, Snelling A, Hawkey P, Chalmers D, Axon A (1999) Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet 354(9179):635–639PubMedCrossRefGoogle Scholar
  37. 37.
    Kruis W, Kalk E, Fric P, et al. (2001) Maintenance of remission in ulcerative colitis is equally effective with Escherichia coli Nissle 1917 and with standard mesalamine. Gastroenterology 120:A127CrossRefGoogle Scholar
  38. 38.
    Schroeder K, Tremaine W, Ilstrup DM (1987) Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis-a randomized study. N Engl J Med 317:1625–1629PubMedCrossRefGoogle Scholar
  39. 39.
    Baron J, Connell A, Lennard-Jones J (1964) Variation in observers in describing mucosal appearances in proctocolitis. BMJ i:89–92CrossRefGoogle Scholar
  40. 40.
    Fedorak R, Gionchetti P, Campieri M (2003) VSL3 probiotic mixture induces remission in patients with active ulcerative colitis (abstr). Gastroenterology 124:A377CrossRefGoogle Scholar
  41. 41.
    Guslandi M, Giollo P, Testoni P (2003) A pilot trial of saccharomyces boulardii in ulcerative colitis. Eur J Gastroenterol Hepatol 15:697–698PubMedCrossRefGoogle Scholar
  42. 42.
    Gionchetti P, Rizzello F, Venturi A, Brigidi P, Matteuzzi D, Bazzocchi G, et al. (2000) Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 119:305–309PubMedCrossRefGoogle Scholar
  43. 43.
    Mimura T, Rizzello F, Schreiber S, et al. (2002) Once daily high dose probiotic therapy maintains remission and improved quality of life in patients with recurrent or refractory pouchitis: a randomized, placebo-controlled, double-blind trial. Gastroenterology 122:A81Google Scholar
  44. 44.
    Sandborn W, Tremaine W, Batts K, Pemberton J, Phillips S (1994) Pouchitis after ileal pouch-anal anastomosis: a Pouchitis Disease Activity Index. Mayo Clin Proc 69:409–415PubMedGoogle Scholar
  45. 45.
    Gionchetti P, Rizzello F, Helwig U, Venturi A, Lammers K, Brigidi P, et al. (2003) Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology 124:1202–1209PubMedCrossRefGoogle Scholar
  46. 46.
    Shen B, Fazio V, Remzi F, et al. (2005) An open-labeled trial of probiotic as a maintenance therapy in patients with antibiotic-dependent pouchitis. Gastroenterology 124:A586Google Scholar
  47. 47.
    Heuschen U, Autschbach F, Allemeyer E, Zollinger A, Heuschen G, Uehlein T, et al. (2001) Long-term follow-up after ileoanal pouch procedure: algorithm for diagnosis, classification, and management of pouchitis. Dis Colon Rectum 44:487–499PubMedCrossRefGoogle Scholar
  48. 48.
    Shen B, Achkar J, Lashner B, Ormsby A, Remzi F, Bevins C, et al. (2001) Endoscopic and histologic evaluation together with symptom assessment are required to diagnose pouchitis. Gastroenterology 121:261–267PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyRochesterUSA

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