Probiotics, prebiotics and symbiotics in inflammatory bowel diseases: state-of-the-art and new insights

Emanuele Sinagra, Mario Cottone, Vincenzo Davide Palumbo, Attilio Ignazio Lo Monte, Giuseppe Damiano, Giovanni Tomasello, Antonino Abbruzzo, Francesco Damiani, Francesco Cappello, Angelo Leone, Dario Raimondo, Maurizio Bellavia, Provvidenza Damiani, Zeenny, Emanuele Sinagra, Massimo Cocchi, Francesca Rossi, Tomasello, Facella, Tiziana FacellaJurjus, Cappello, Gabriele Spinelli

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


Inflammatory bowel disease (IBD) consists of two distinct clinical forms, ulcerative colitis (UC) and Crohn s disease (CD), with unknown aetiology, which nevertheless are considered to share almost identical pathophysiological backgrounds. Up to date, a full coherent mechanistic explanation for IBD is still lacking, but people start to realize that the pathogenesis of IBD involves four fundamental components: the environment, gut microbiota, the immune system and the genome. As a consequence, IBD development might be due to an altered immune response and a disrupted mechanism of host tolerance to the non-pathogenic resident microbiota, leading to an elevated inflammatory response. Considering the available data arising from the scientific literature, here reviewed, in CD, a benefit of probiotics remains unproven; in UC, a benefit of probiotics remains unproven, even if E. coli Nissle 1917seems promising in maintaining remission and it could be considered an alternative in patients intolerant or resistant to 5-ASA preparations; in pouchitis, small controlled trials suggest a benefit from VSL no. 3 in the primary and secondary prevention of pouchitis; in IBD-associated conditions, a benefit of probiotics remains unproven. However, well-designed randomized control clinical trials are necessary to understand the undoubted role of these agents in the management of gut physiology in health and disease.
Original languageEnglish
Pages (from-to)919-933
Number of pages15
Publication statusPublished - 2013

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Immunology and Allergy
  • Physiology
  • Immunology
  • Oncology
  • Endocrinology
  • Physiology (medical)
  • Cancer Research

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