Probiotics and their derivatives as treatments for inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic relapsing disorder that is increasing in prevalence in Western society and has been linked to the development of colorectal cancer. There remains no definitive treatment for IBD, hence recent investigations have focused on the development of new therapeutics, including probiotics, which can reduce intestinal inflammation and restore balance to the gastrointestinal microbiota. Probiotics are currently being studied in greater detail, albeit predominantly in animal models of IBD. Clinical studies have yielded promising findings and justify further investiga- tion. Furthermore, the use of inactivated probiotics as well as the solu- ble products produced by these bacteria has demonstrated therapeutic potential, and may in fact be more suitable, as there is no risk of sepsis associated with their administration and they can be manufactured with greater quality control. Further research is essential to define the mechanism and source of probiotic action, and to identify more effica- cious strains, while future clinical trials must focus on determining whether the bacterial and genetic profiles of IBD patients influence the effectiveness of treatment. (Inflamm Bowel Dis 2009;15:1906-1914)