دانلود رایگان مقاله انگلیسی رژیم غذایی، میکروبیوتا و بیماری التهابی روده: بررسی - امرالد 2017

ABSTRACT

Propose: Verify the possible associations between dietary components and the intestinal microbiota in clinical parameters of inflammatory bowel disease. Methodology: In this review, a search in PubMed and Bireme databases was performed. We included randomized clinical trials published between 2005 and 2017, only in adult humans with CD or UC. Findings: Six articles were included by the end of the search. The most widely used intervention was the use of prebiotics, including fructooligosaccharides or fructooligosaccharides with inulin, followed by probiotics. The main findings regarding the microbiota were the increase in the total amount of bacteria and variability (phyla). Clinically there was improvement in inflammation, seen in parameters such as Creactive protein, interleukins and tumor necrosis factor alpha. Originality: Dietary interventions, especially from symbiotics, can modulate the microbiota, mainly in relation to time, when compared pre and post supplementation, and this positively interferes with clinical parameters of IBDs. However, the studies were quite heterogeneous in population, methodology, intervention, mycobiota analysis and inflammatory markers.

DISCUSSION

In the last decade, we have observed the beginning of publications about the influence of dietary components on the microbiota’s modulation in patients with IBD. The present review of the literature allowed recognizing the main dietary interventions used to improve clinical outcomes associated with signs and symptoms of IBDs. Most of the studies used prebiotics for treatment, and observed positive effects on inflammation, usually associated with disease activity indexes and inflammatory markers. Despite the heterogeneity of the intestinal flora analyses, there was a prevalence of investigation in the phyla Actinobacteria and Firmicutes, which are generally associated with IBDs. The most effective intervention included in this review, was done with symbiotics, (B longum of 2 x 10¹¹ and 12 g of oligofructose and inulin) over a period of 4 weeks, in patients of both sexes with active UC (Furrie et al., 2005).

Several studies using symbiotics as an intervention in patients with IBD have shown evidence that these dietary components can potentially be developed in therapies for acute or active disease (Saez-Lara et al., 2015). Treatment with TPN and ED was also effective, with decreased inflammation (CRP) and clinical remission in 88.23% of patients (CDAI <150). NPT treatment in active DC is used to contribute to intestinal rest of the inflamed tissue, less antigenic stimulation and stimulation of protein synthesis, which may aid in cell renewal and in healing wounds in the intestinal mucosa. In addition, the rate of remission after 3 months of onset of intervention ranges from 20 to 79% depending on population characteristics and administration. Enteral nutrition has also shown efficacy in the treatment of active CD, mainly related to antiinflammatory mechanisms and has remission rates between 20 and 84.2% (Altmore et al., 2015).