probiotics in inflammatory bowel diseases and associated conditions益生菌在炎症性肠道疾病和相关条件.pdfVIP

Nutrients 2011, 3, 245-264; doi:10.3390/nu3020245 OPEN ACCESS nutrients ISSN 2072-6643 /journal/nutrients Review Probiotics in Inflammatory Bowel Diseases and Associated Conditions David R. Mack Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada; E-Mail: dmack@cheo.on.ca; Tel.: +1-613-737-7600 (ext.) 2516; Fax: +1-613-738-4854 Received: 1 January 2011; in revised form: 17 January 2011 / Accepted: 15 February 2011 / Published: 17 February 2011 Abstract: A complex set of interactions between the human genes encoding innate protective functions and immune defenses and the environment of the intestinal mucosa with its microbiota is currently considered key to the pathogenesis of the chronic inflammatory bowel diseases (IBD). Probiotics offer a method to potentially alter the intestinal microbiome exogenously or may provide an option to deliver microbial metabolic products to alter the chronicity of intestinal mucosal inflammation characterizing IBD. At present, there is little evidence for the benefit of currently used probiotic microbes in Crohn’s disease or associated conditions affecting extra-intestinal organs. However, clinical practice guidelines are now including a probiotic as an option for recurrent and relapsing antibiotic sensitive pouchitis and the use of probiotics in mild ulcerative colitis is provocative and suggests potential f