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Abstract(s)
Introdução: A Doença Inflamatória Intestinal tem aumentado em incidência, prevalência e severidade em vários países. Com evidência recente que aponta para a disrupção do balanço da microbióta intestinal, os probióticos tornam-se uma possibilidade terapêutica com forte suporte teórico, quer usados isoladamente, quer em associação com a terapêutica clássica desta patologia. Este trabalho pretende fazer uma revisão sistemática com base em publicações científicas sobre o tratamento da doença inflamatória intestinal com probióticos.
Métodos: Foram pesquisadas publicações indexadas na base de dados da Pubmed, na biblioteca electrónica da Faculdade de Ciências da Saúde da Universidade da Beira Interior. Utilizaram-se as seguintes “MeSH words”: Probiotics, Ulcerative Colitis e Crohn Disease. Foram selecionadas 49 publicações para análise.
Resultados: Apesar de alguns trabalhos demostrarem uma melhoria com o uso de probióticos, a evidência para o tratamento da Doença de Crohn (DC) com probióticos permanece insuficiente. No entanto, quando falamos de Colite Ulcerosa (CU), os estudos são mais numerosos e animadores. Dos 10 estudos analisados no âmbito da indução da remissão de CU ligeira e moderada, 7 deles mostraram resultados positivos com o uso de probióticos. Quanto à terapia de manutenção na remissão da CU, todos os estudos analisados mostraram a não inferioridade dos probióticos, quando comparados à terapia standard. Foram analisados ainda estudos com probióticos na profilaxia pós-operatória de bolsite e no tratamento da bolsite ativa e refractária a antibióticos, com resultados positivos. Estes resultados fizeram com que o uso de VSL#3 fosse recomendado pela Organização Mundial de Gastroenterologia para a prevenção pós-operatória bem como para a prevenção de recaída após remissão da bolsite.
Conclusão: Apesar da mistura probiótica VSL#3 ser aprovada pela organização mundial de Gastroenterologia tanto na prevenção de manutenção de remissão de bolsite como na manutenção da remissão da CU, a grande maioria dos trabalhos não mostram uma melhoria relevante com o tratamento probiótico. De relevar que a grande maioria dos estudos analisados possuía numerosas limitações, sendo os seus resultados muito divergentes entre os autores. Desde modo, mais estudos são necessários para um maior esclarecimento do papel dos probióticos no tratamento da Doença Inflamatória Intestinal.
Introduction: The Inflammatory Bowl Disease is a chronic inflammatory condition that is increasing in incidence, prevalence and severity, in many countries. As recent findings leads us to the disruption of microbiota balance, probiotics become a therapeutic possibility associated with a strong theoretical support. That is true when the probiotic is used is isolated and when it is associated with classic inflammatory bowl disease therapy. The present dissertation intends to perform a systematic revision based on scientific publication related to treatment of inflammatory bowl disease with probiotics therapy. Methods: Indexed publications were researched in the PubMed’s database, in the “Faculdade de Ciências da Saúde” of Universidade da Beira Interior electronic library. The following terms were used: Probiotics, Ulcerative Colitis e Crohn Disease. 49 publications were selected for analysis. Results: Although some studies can demonstrate an improvement with the use of probiotics, the evidence for the treatment of Crohn's disease (DC) with probiotics remains inadequate. As regards ulcerative colitis (CU) studies are now more numerous and with brighter future. Of the 10 studies analysed in the induction of remission of mild to moderate ulcerative colitis, 7 of them showed positive results with the use of probiotics. As for the maintenance of remission of UC therapy all studies analysed showed non-inferiority of probiotics compared to standard therapy. Also, were analysed studies of probiotic therapy not only in prophylaxis of postoperative Pouchitis, but also in the treatment of active and refractory to antibiotics Pouchitis, with positive outcome. These results have led to the recommendation by the World Organization of Gastroenterology for the use of VSL#3 regarding the postoperative prevention and prevention of relapse after remission of pouchitis. Conclusion: Although the probiotic mixture VSL#3 is already been approved by the World Organization of Gastroenterology in the maintenance of remission of pouchitis, as well as in the maintenance of remission of UC, the great majority of the analysed works did not show a relevant improvement with probiotic treatment. It is important to underline that most of the studies had major limitations, and that the authors were not unanimous when it came to the outcome of their experiences. Therefore, more studies are needed for a better understanding of the roll of probiotics in the treatment of inflammatory bowel disease.
Introduction: The Inflammatory Bowl Disease is a chronic inflammatory condition that is increasing in incidence, prevalence and severity, in many countries. As recent findings leads us to the disruption of microbiota balance, probiotics become a therapeutic possibility associated with a strong theoretical support. That is true when the probiotic is used is isolated and when it is associated with classic inflammatory bowl disease therapy. The present dissertation intends to perform a systematic revision based on scientific publication related to treatment of inflammatory bowl disease with probiotics therapy. Methods: Indexed publications were researched in the PubMed’s database, in the “Faculdade de Ciências da Saúde” of Universidade da Beira Interior electronic library. The following terms were used: Probiotics, Ulcerative Colitis e Crohn Disease. 49 publications were selected for analysis. Results: Although some studies can demonstrate an improvement with the use of probiotics, the evidence for the treatment of Crohn's disease (DC) with probiotics remains inadequate. As regards ulcerative colitis (CU) studies are now more numerous and with brighter future. Of the 10 studies analysed in the induction of remission of mild to moderate ulcerative colitis, 7 of them showed positive results with the use of probiotics. As for the maintenance of remission of UC therapy all studies analysed showed non-inferiority of probiotics compared to standard therapy. Also, were analysed studies of probiotic therapy not only in prophylaxis of postoperative Pouchitis, but also in the treatment of active and refractory to antibiotics Pouchitis, with positive outcome. These results have led to the recommendation by the World Organization of Gastroenterology for the use of VSL#3 regarding the postoperative prevention and prevention of relapse after remission of pouchitis. Conclusion: Although the probiotic mixture VSL#3 is already been approved by the World Organization of Gastroenterology in the maintenance of remission of pouchitis, as well as in the maintenance of remission of UC, the great majority of the analysed works did not show a relevant improvement with probiotic treatment. It is important to underline that most of the studies had major limitations, and that the authors were not unanimous when it came to the outcome of their experiences. Therefore, more studies are needed for a better understanding of the roll of probiotics in the treatment of inflammatory bowel disease.
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Keywords
Probiotics Ulcerative Colitis e Crohn Disease