- Fecal Incontinence
|Inflammatory bowel disease therapeutic strategies through the modulation of the microbiota: how and when to introduce pre-, pro-, syn- or postbiotics?
Am J Physiol Gastrointest Liver Physiol. 2022 Sep 27. doi: 10.1152/ajpgi.00002.2022.Online ahead of print.
1Nantes Université, Inserm, The Enteric Nervous System in Gut and Brain Disorders, IMAD, Nantes, France.
2UMR STLO, Agrocampus Ouest, Institut Agro, INRAE, Rennes, France.
3UR1268 BIA, INRAE Pays de la Loire, Nantes, France.
Inflammatory bowel diseases (IBD), a heterogeneous group of inflammatory conditions that encompass both ulcerative colitis and Crohn's disease, represent a major public health concern. The etiology of IBD is not yet fully understood and no cure is available, with current treatments only showing long-term effectiveness in a minority of patients. A need to increase our knowledge on IBD pathophysiology is growing, in order to define preventive measures, to improve disease outcome, and to develop new effective and lasting treatments. IBD pathogenesis is sustained by aberrant immune responses, associated with alterations of the intestinal epithelial barrier (IEB), modifications of the enteric nervous system and changes in microbiota composition. Currently, most of the treatments target the inflammation and the immune system, but holistic approaches targeting lifestyle and diet improvements are emerging. As dysbiosis is involved in IBD pathogenesis, pre-, pro-, syn- and postbiotics are used/tested to reduce the inflammation or strengthen the IEB. The present review will resume these works, pointing out the stage of life, the duration and the environmental conditions that should go along with microbiota or microbiota-derived treatments.