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Vol. 27, No. 3, 2009
Issue release date: September 2009
Section title: Are We Approaching Solutions for Unresolved Problems?
Dig Dis 2009;27:412–417
(DOI:10.1159/000228582)

Prebiotics, Probiotics and Helminths: The ‘Natural’ Solution?

Guarner F.
Digestive System Research Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University Hospital Vall d’Hebron, Barcelona, Spain

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Article / Publication Details

First-Page Preview
Abstract of Are We Approaching Solutions for Unresolved Problems?

Published online: 9/24/2009

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 0

ISSN: 0257-2753 (Print)
eISSN: 1421-9875 (Online)

For additional information: http://www.karger.com/DDI

Abstract

Background: The pathophysiological mechanisms that generate chronic inflammatory lesions in inflammatory bowel disease (IBD) have, at least in part, been unveiled. Abnormal communication between gut microbial communities and the mucosal immune system is being incriminated as the core defect leading to intestinal injury in genetically susceptible individuals. The therapeutic manipulation of gut microecology has attracted high expectation as a strategic area for the control and prevention of IBD. Method: Literature review. Results: The gut is the major site for induction of regulatory T cells, which secrete immunoregulatory cytokines such as IL-10 and TGF-β and can regulate both Th1 and Th2 responses. Recent findings suggest that some gut commensals, including lactobacilli, bifidobacteria and helminths, play a major role in the induction of regulatory T cells in gut lymphoid follicles. Such T cell-mediated regulatory pathways are essential homeostatic mechanisms by which the host can tolerate the massive burden of innocuous antigens within the gut without responding through inflammation. In clinical practice, the evidence for the use of probiotics or prebiotics is strongest in the case of pouchitis. In addition, one probiotic strain appears to be equivalent to mesalazine in maintaining remission of ulcerative colitis. However, studies of probiotics in Crohn’s disease have been disappointing. Conclusions: Further research is needed to optimize the use of probiotics, prebiotics or helminths for these indications.


  

Author Contacts

Francisco Guarner
Digestive System Research Unit, CIBEREHD
University Hospital Vall d’Hebron, Passeig Vall d’Hebron, 119–129
ES–08035 Barcelona (Spain)
E-Mail fguarner@vhebron.net

  

Article Information

Published online: September 24, 2009
Number of Print Pages : 6
Number of Figures : 3, Number of Tables : 0, Number of References : 34

  

Publication Details

Digestive Diseases (Clinical Reviews)

Vol. 27, No. 3, Year 2009 (Cover Date: September 2009)

Journal Editor: Malfertheiner P. (Magdeburg)
ISSN: 0257-2753 (Print), eISSN: 1421-9875 (Online)

For additional information: http://www.karger.com/DDI


Article / Publication Details

First-Page Preview
Abstract of Are We Approaching Solutions for Unresolved Problems?

Published online: 9/24/2009

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 0

ISSN: 0257-2753 (Print)
eISSN: 1421-9875 (Online)

For additional information: http://www.karger.com/DDI


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