Probiotics in functional gastrointestinal disorders: what are the facts?

Current Opinion in Pharmacology

Volumn 8, Issue 6, 2008, Pages 704-708

  Quigley, Eamonn MM ^a  

^a UNIVERSITY COLLEGE CORK   (Ireland)

Author keywords

[No Author keywords available]

Indexed keywords

PLACEBO; PROBIOTIC AGENT;

ANTIINFLAMMATORY ACTIVITY; BACTERIAL OVERGROWTH; BIFIDOBACTERIUM ANIMALIS; BIFIDOBACTERIUM LONGUM INFANTIS; BLOATING; CLINICAL TRIAL; DIGESTIVE SYSTEM FUNCTION DISORDER; DISEASE PREDISPOSITION; DRUG EFFICACY; DRUG SAFETY; DRUG TREATMENT FAILURE; FLATULENCE; HUMAN; IMMUNOMODULATION; IMMUNOPATHOGENESIS; INFLAMMATION; INTESTINE FLORA; IRRITABLE COLON; LACTOBACILLUS ACIDOPHILUS; MAST CELL DEGRANULATION; MUCOSAL IMMUNITY; NONHUMAN; PRIORITY JOURNAL; REVIEW;

ANIMALS; BIFIDOBACTERIUM; GASTROINTESTINAL DISEASES; HUMANS; IRRITABLE BOWEL SYNDROME; LACTOBACILLUS ACIDOPHILUS; PROBIOTICS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 55649091833     PISSN: 14714892     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.coph.2008.08.007     Document Type: Review

References (32)

1. O'Hara A.M., and Shanahan F. Gut microbiota: mining for therapeutic potential. Clin Gastroenterol Hepatol 5 (2007) 274-284. An up-to-date, crucial and thorough review of the potential for commensal bacteria, their products and components as well as host-flora interactions in IBS.
2. Isolauri E., Kalliomaki M., Laitinen K., and Salminen S. Modulation of the maturing gut barrier and microbiota: a novel target in allergic disease. Curr Pharm Des 14 (2008) 1368-1375
3. Rachmilewitz D., Kayatura, Karmeli F., Hayashi T., Reinus C., Rudensky B., Akira S., Takeda K., Lee J., Takabayashi K., et al. Toll-like receptor 9 signaling mediates the anti-inflammatory effects of probiotics in murine experimental colitis. Gastroenterology 126 (2004) 520-528
4. Jijon H., Backer J., Diaz H., Yeung H., Thiel D., McKaigney C., De Simone C., and Madsen K. DNA from probiotic bacteria modulates murine and human epithelial and immune function. Gastroenterology 126 (2004) 1358-1373
5. Quigley E.M. Bacterial flora in irritable bowel syndrome: role in pathophysiology, implications for management. J Dig Dis 8 (2007) 2-7
6. Thabane M., Kottachchi D.T., and Marshall J.K. Systematic review and meta-analysis: the incidence and prognosis of post-infectious irritable bowel syndrome. Aliment Pharmacol Ther 26 (2007) 535-544. A comprehensive review of post-infectious IBS. Defines the prevalence and risk factors for this uncommon but instructive variety of IBS.
7. Marshall J.K., Thabane M., Borgaonkar M.R., and James C. Postinfectious irritable bowel syndrome after a food-borne outbreak of acute gastroenteritis attributed to a viral pathogen. Clin Gastroenterol Hepatol 5 (2007) 457-460
8. Quigley E.M.M. Bacteria: a new player in gastrointestinal motility disorders-infections, bacterial overgrowth and probiotics. Gastroenterol Clin N Am 36 (2007) 735-748
9. Chadwick V., Chen W., Shu D., Paulus B., Bethwaite P., Tie A., and Wilson I. Activation of the mucosal immune system in irritable bowel syndrome. Gastroenterology 122 (2002) 1778-1783
10. Barbara G., Wang B., Stanghellini V., de Giorgio R., Cremon C., Di Nardo G., Trevisani M., Campi B., Geppetti P., Tonini M., et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology 132 (2007) 26-37. Demonstrates the ability of mast cells derived from human subjects with IBS to stimulate nociceptive neurons in an animal model.
11. Barbara G., Stanghellini V., De Giorgio R., Cremon C., Cottrell G.S., Santini D., Pasquinelli G., Morselli-Labate A.M., Grady E.F., Bunnett N.W., et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology 126 (2004) 693-702. Reveals increased mast cell numbers and more degranulating mast cells among IBS subjects and, most strikingly, records a correlation between the proximity of mast cells to neural elements in the colonic mucosa and pain severity.
12. Cenac N., Andrews C.N., Holzhausen M., Chapman K., Cottrell G., Andrade-Gordon P., Steinhoff M., Barbara G., Beck P., Bummett N.W., et al. Role for protease activity in visceral pain in irritable bowel syndrome. J Clin Invest 117 (2007) 636-647. This detailed study illustrates how far IBS research has shifted towards an emphasis on the role of the intestinal immune responses and provides convincing evidence for proteases, presumably derived from mast cells, in the genesis of neuronal events that are thought to play a role in the pathogenesis of IBS.
13. Aerssens J., Camilleri M., Talloen W., Thielemans L., Göhlmann H.W., Van Den Wyngaert I., Thielemans T., De Hoogt R., Andrews C.N., Bharucha A.E., et al. Alterations in mucosal immunity identified in the colon of patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 6 (2008) 194-205
14. Holmén N., Isaksson S., Simrén M., Sjövall H., and Ohman L. CD4+CD25+ regulatory T cells in irritable bowel syndrome patients. Neurogastroenterol Motil 19 (2007) 119-125
15. MacSharry J., O'Mahony L., Fanning A., Bairead E., Sherlock G., Tiesman J., Fulmer A., Kiely B., Dinan T.G., Shanahan F., and Quigley E.M.M. Mucosal cytokine imbalance in irritable bowel syndrome (IBS). Scand J Gastroenterol 27 (2008) 1-10 [Epub ahead of print]
16. O'Mahony L., McCarthy J., Kelly P., Hurley G., Luo F.Y., O'Sullivan G.C., Kiely B., Collins J.K., Shanahan F., and Quigley E.M.M. A randomized, placebo-controlled, double-blind comparison of the probiotic bacteria lactobacillus and Bifidobacterium in irritable bowel syndrome (IBS): symptom responses and relationship to cytokine profiles. Gastroenterology 128 (2005) 541-551
17. Liebregts T., Adam B., Bredack C., Roth A., Heinzel S., Lester S., Downie-Doyle S., Smith E., Drew P., Talley N.J., and Holtmann G. Immune activation in patients with irritable bowel syndrome. Gastroenterology 132 (2007) 913-920
18. Dinan T.G., Quigley E.M., Ahmed S.M., Scully P., O'Brien S., O'Mahony L., O'Mahony S., Shanahan F., and Keeling P.W. Hypothalamic-pituitary-gut axis dysregulation in irritable bowel syndrome: plasma cytokines as a potential biomarker?. Gastroenterology 130 (2006) 304-311. Identifies elevated levels of IL-6 and IL-8 in serum among IBS patients and correlates these cytokine levels with an exaggerated Hypothalamic-Pituitary-Adrenal axis response.
19. Kassinen A., Krogius-Kurikka L., Mäkivuokko H., Rinttilä T., Paulin L., Corander J., Malinen E., Apajalahti J., and Palva A. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology 133 (2007) 24-33. The most definitive study to date of the microbiology of the fecal flora in IBS and one that uses modern molecular methods. Describes significant changes in IBS.
20. Shanahan F. Irritable bowel syndrome: shifting the focus toward the gut microbiota. Gastroenterology 133 (2007) 340-342
21. Quigley E.M.M. A 51-year-old with IBS. Test or treat for bacterial overgrowth?. Clin Gastroenterol Hepatol 5 (2007) 1140-1143
22. Posserud I., Stotzer P.O., Bjornsson E., Abrahamsson H., and Simren M. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut 56 (2007) 802-808
23. Bratten J.R., Spanier J., and Jones M.P. Lactulose breath testing does not discriminate patients with irritable bowel syndrome from healthy controls. Am J Gastroenterol 103 (2008) 958-963
24. Parkes G.C., Brostoff J., Whelan K., and Sanderson J.D. Gastrointestinal microbiota in irritable bowel syndrome: their role in its pathogenesis and treatment. Am J Gastroenterol 103 (2008) 1557-1567
25. Quigley E.M.M., and Flourie B. Probiotics in irritable bowel syndrome: a rationale for their use and an assessment of the evidence to date. Neurogastroenterol Motil 19 (2007) 166-172
26. McFarland L.V., and Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol 14 (2008) 2650-2661
27. Wilhelm S.M., Brubaker C.M., Varcak E.A., and Kale-Pradhan P.B. Effectiveness of probiotics in the treatment of irritable bowel syndrome. Pharmacotherapy 28 (2008) 496-505
28. Nikfar S., Rahimi R., Rahimi F., Derakhshani S., and Abdollahi M. Efficacy of probiotics in irritable bowel syndrome: a meta-analysis of randomized, controlled trials. Dis Colon Rectum (May 9 2008) [Epub ahead of print]
29. Whorwell P.J., Altringer L., Morel J., Bond Y., Charbonneau D., O'Mahony L., Kiely B., Shanahan B., and Quigley E.M. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol 101 (2006) 326-333. The largest and only dose-ranging study of a probiotic in IBS, which demonstrates a significant benefit for one dose of the bifidobacterium in terms of the primary symptoms and global response in IBS.
30. Bueno L., de Ponti F., Fried M., Kullak-Ublick G.A., Kwiatek M.A., Pohl D., Quigley E.M., Tack J., and Talley N.J. Serotonergic and non-serotonergic targets in the pharmacotherapy of visceral hypersensitivity. Neurogastroenterol Motil 19 1 Suppl. (2007) 89-119. Includes a detailed discussion of the experimental basis for the use of probiotics in IBS.
31. Rousseaux C., Thuru X., Gelot A., Barnich N., Neut C., Dubuquoy L., Dubuquoy C., Merour E., Geboes K., Chamaillard M., et al. Lactobacillus acidophilus modulates intestinal pain and induces opioid and cannabinoid receptors. Nat Med 13 (2007) 35-37
32. Duncker S.C., Wang L., Hols P., and Bienenstock J. The D-alanine content of lipoteichoic acid is crucial for Lactobacillus plantarum-mediated protection from visceral pain perception in a rat colorectal distension model. Neurogastroenterol Motil 20 (2008) 843-850