Important role of the microbiome in intestinal diseases
1. kohgiloyeh & boyer ahmad - yasuj - yasuj - faculty of medical science
The vast majority of microbial species give rise to symbiotic host-bacterial interactions that are fundamental to human health. for example changes in the composition of the gut microbiota or dysbiosis may be associated with several clinical conditions, including obesity and metabolic diseases, autoimmune diseases and allergy, acute and chronic intestinal inflammation, irritable bowel syndrome, allergic gastroenteritis, and necrotizing enterocolitis.
for example, one recent quasi-experimental study was done which gave the mixture of l. acidophilus, l. casei and l. rhamnosus to all patients receiving antibiotics at two hospitals over time and found a significant reduction in the incidence of cdi cases and recurrences at these facilities. other papers, randomized, controlled trials of good quality will be pooled to assess probiotic strains for primary and secondary prevention of cdi.
stool transplant infusing donor stool into the intestine of the recipient to re-establish normal bacterial microbiota has shown promising results in preliminary studies. an association has been made between recurrent disease and intestinal dysbiosis, and an inability of certain individuals to re-establish their normal intestinal bacteria is thought to play a leading role in recurrence.
This search was performed to identify studies focused on evidence supporting by searching the biomedical electronic databases ovid medline, the cochrane library, ovid embase, google scholar, pubmed and international journal of probiotics. one reviewer identified studies and abstracted database on outcomes and relationship between the microbiota and the predisposition to disease as associative, correlative, or causal.
inclusion criteria included randomized controlled trials, blinded or open trials, in pediatric or adult populations, published in peer-reviewed journals or on clinical trial websites, or as meeting abstracts. exclusion criteria included pre-clinical studies, safety, kinetic studies, case reports or case series, duplicate reports, trials of unspecified types of probiotics, non-randomized trials, incomplete or outcomes reported, or if translation could not be obtained.
articles published in abstract form for missing significant data in full articles, further information was sought by contacting authors or by the company manufacturing the probiotic product. using a standardized data extraction form, the following data was systematically collected: authors, year of publication and journal, population data, study aims and outcomes by demographics, etc.
statistical analysis was performed using stata software version 12 to calculate pooled relative risks, univariate analysis results were analyzed using x2 test or fisher’s exact test for small cell sizes (<5) with a significance level of p < 0.05.
This review obtained which recently advances; modulation of gut microbiota with probiotics, prebiotics, or fermented dairy products has been suggested as a treatment of, or prevention for, different disorders such as ibs, infectious diarrhea, allergic disease, and necrotizing enterocolitis. mechanisms have been identified that suggest the microbiota may play a role in obesity development and propagation. evidence of studies showed that the microbiota in harvests energy, host gene functions, metabolic endotoxemia, aggravation of inflammatory mechanisms, and metabolic dysfunction.
among the pathogenic bacteria, clinical isolates have been studied, such as their role in prevention and treatment clostridium difficile infections. i would disagree with this hypothesis, as different probiotic strains can have different mechanisms-of-action and resulting degrees of efficacies.
The microbiome makes very important biochemical functions. disorders of the microbiome are associated with many human disease processes. the microbiome should be described by tools and observations used in the study of ecology. microbiome activities are essential for future strategies of healthcare and producing the drugs.
more well-done trials need to be done by testing the same types of probiotics. four different types of probiotics were found to be effective for primary prevention of cdi (s. boulardii, l. casei dn114001, the mixture of l. acidophilus and bifid. bifidum and the mixture of l. acidophilus, l. casei, and l. rhamnosus. more clinical experience with these four probiotics might be recommended to confirm if they are effective in larger populations of patients.
Microbiome, drugs, dysbiosis