Role of the gut microbiota in inflammatory bowel disease pathogenesis: What have we learnt in the past 10 years?

Table 2 Probiotics and prebiotics in inflammatory bowel disease

Active component	Study	Design	n	Duration	Intervention	Result	Reference
Lactobacillus	CD remission	RCT	98	6 mo	Lactobacillus johnsonii LA1 4 × 109 cfu/d	No difference	[184]
	IBD		40	1 mo	Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 supplemented yogurt	Anti-inflammatory effects	[185]
Bifidobacterium	Active UC	RCT	20	12 wk	Bifido-fermented milk [B. breve, B. bifidum and acidophilus] (1 × 1010) or placebo	Decreased clinical activity (P < 0.05) decreased endoscopic/histological scores (P < 0.01)	[186]
	Active UC	Open label	12	4 wk	BGS 4.5 g/d	Decrease in clinical activity index (P < 0.01) and endoscopic scores (P < 0.05)	[187]
	C57BL/6 mice	Experimental	16	3 d	B. bifidum S17	Decrease in microscopic inflammation and reduction in inflammatory cytokines	[188]
E. coli Nissle 1917	UC remission		327	12 mo	200 mg E. coli Nissle 1917 or 1500 mg mesalazine/d	E. coli Nissle 1917 was equivalent to mesalazine in maintaining remission	[189]
VSL#3	UC remission	Open label	34	6 wk	VSL#3, 3.6 × 1012, bacteria/d	ITT analysis demonstrated remission in 18/34 and response in 8/34	[190]
	Active UC	RCT	29	12 mo	VSL#3 450-1800 billion bacteria/d	Remission was achieved in 13/14 VSL#3 and 4/15 placebo (P < 0.001)	[191]
						Relapses within 1 yr of followup occurred in 3/14 VSL#3 and 11/15 placebo
						Endoscopic and histological score were significantly lower in VSL#3 vs placebo (P < 0.05)
Inulin	Active UC	RCT	19	2 wk	3 g/d mesalazine and either 12 g/d oligofructose-enriched inulin or placebo	Dyspeptic symptoms scale decreased significantly and an early reduction of calprotectin was observed in oligofructose-enriched inulin group	[202]
	Pouchitis	RCT	20	3 wk	24 g/d inulin or placebo	Reduction in inflammation, increase butyrate conc and decreased inflammation associated factors	[203]
Inulin and FOS	HLA-B27 rat model IBD			12 wk	8 g/kg body weight inulin or FOS	FOS increased Bifidobacterium spp. FOS and inulin reduced Clostridium cluster XI and C. difficile toxin gene expression correlating with a reduction of chronic intestinal inflammation	[204]
FOS	Active CD	RCT	103	4 wk	15 g/d FOS or placebo	No clinical benefit, despite impacting on DC function	[205]
	Active CD	Open label	10	3 wk	15 g/d	Significant reduction in Harvey Bradshaw index (P < 0.01) significant increase in faecal bifidobacteria conc. (P < 0.001) and modifies DC function	[206]

CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; RCT: Randomized control trial; FOS: Fructooligosaccharides; E. coli: Escherichia coli.