Conservative Approach Recommended for Irritable Bowel Syndrome
A recent study has shed light on the importance of a cautious approach when it comes to the use of probiotics in treating irritable bowel syndrome (IBD). While the microbiome hypothesis, which suggests that an imbalance of intestinal microbes can lead to various diseases, has garnered significant attention, researchers have found limited evidence supporting the efficacy of probiotics typically used for alleviating IBD symptoms, such as Lactobacillus and Bifidobacterium strains.
Published in the Journal of the American Society of Gastroenterology (ACG), the study conducted by researchers, including Vivek C. Goodoory from Leeds Gastroenterology Research Institute at Saint James University Hospital in England, analyzed the impact of probiotics on IBD patients (DOI: https://doi.org/10.1053/j.gastro.2023.07.018). The findings revealed that the effects of lactic acid bacteria on irritable bowel syndrome remain unclear.
The microbiome refers to the collection of microorganisms thriving within our bodies. As research increasingly demonstrates that the equilibrium of the intestinal microbial ecosystem not only influences overall health but also contributes to disease development, scientists worldwide are zealously pursuing new drug developments rooted in the microbiome hypothesis.
Presently, clinical trials investigating various indications, including the treatment of recurrent Clostridium difficile infection (CDI), psoriasis, and immune skin diseases, are underway. In the realm of IBD, domestic company Kobiolab is collaborating with Celltrion to identify potential candidate substances. Additionally, CJ Bioscience has announced its plan to push forward with clinical trials by securing new microbiome drug candidates for IBD.
Although it seemed logical to assume that supplementing IBD patients with Lactobacillus and Bifidobacterium strains would yield favorable outcomes, these strains were actually found to be reduced in IBD patients. This prompted the research team to concentrate on the uncertainties surrounding the effectiveness of various strains and preferred strains.
Conducting a comprehensive analysis of randomized controlled trials comparing probiotics to placebos in IBD patients, the researchers identified 24 trials out of 82 with low risk of bias. These trials shed light on the relationship between different strains and their effects on general symptoms, abdominal pain, and abdominal distension.
The analysis revealed moderate certainty regarding the efficacy of the Eshrichia strain, whereas the widely recognized Lactobacillus strain and the patented Lactobacillus plantarum 299V strain exhibited low certainty. Additionally, the combination of probiotics LacClean Gold S, Duolac 7s, and Bacillus strain, as well as Saccharomyces cerevisae I-3856 and Bifidobacterium strains, showed very low certainty in terms of combating abdominal pain.
Furthermore, in more than 55 trials involving over 7000 patients, the relative risk of experiencing adverse events in the probiotic group was not significantly higher.
Concluding their research, the scientists noted, “Certain combinations of probiotics or strains may exhibit beneficial effects on IBS. However, in studies that met clinical criteria, the certainty of the evidence for efficacy was consistently low to very low.”
Although the microbiome hypothesis, which states that an imbalance of intestinal microbes causes various diseases, is attracting attention, a study has found that a conservative approach should be taken in irritable bowel syndrome (IBD).
It is difficult to trust that the level of evidence for the effectiveness of various probiotics, including Lactobacillus bacteria, which are generally known to be effective in relieving the symptoms of IBD, as well as Bifidobacterium bacteria and representative patent strains, is generally low.
The results of a study on the effect of probiotics on IBD patients conducted by researchers including Vivek C. Goodoory, Leeds Gastroenterology Research Institute, Saint James University Hospital, England, were published in the Journal of the American Society of Gastroenterology (ACG) on the 2nd (DOI: https://doi.org/10.1053/j.gastro.2023.07.018).
As a result of the meta-analysis, it was concluded that the effect of lactic acid bacteria on irritable bowel syndrome is unclear.
The microbiome refers to the ecosystem of microorganisms in the body. The development of new drugs based on the microbiome hypothesis is being fueled worldwide as it has been found that the balance of the intestinal microbial ecosystem affects not only health but also the development of diseases.
Currently, clinical trials are underway for various indications such as the treatment of recurrent Clostridium difficile infection (CDI), psoriasis, immune skin disease, etc. In the field of IBD, Kobiolab, a domestic company, is conducting joint research with Celltrion to discover candidate substances. , CJ Bioscience has announced that it will advance clinical trials by securing new microbiome drug candidates for IBD.
Given that Lactobacillus and Bifidobacterium strains were reduced in IBD patients, it was common sense to predict that adding the strains would be effective in improving symptoms.
The research team focused on the fact that although some probiotics may be useful for IBD, the effect of differences in strain and preferred strain is unclear, and a comprehensive analysis of randomized controlled trials comparing probiotics and placebo in IBD patients he did.
Among 82 RCT clinical trials involving a total of 10,332 patients, 24 RCTs with low risk of bias were selected and the relationship between each stressor on general symptoms, abdominal pain, and abdominal distention was identified.
The analysis showed moderate certainty in the evidence in favor of the Eshrichia strain, but low certainty for the well-known Lactobacillus and the patented strain, Lactobacillus plantarum 299V.
In addition, there was very low certainty for the combination of probiotics, LacClean Gold S, Duolac 7s and Bacillus strain, and the results were similar for the benefit of Saccharomyces cerevisae I-3856 and Bifidobacterium strains for abdominal pain.
In 55 trials involving more than 7000 patients, the relative risk of experiencing adverse events was not significantly higher in the probiotic group.
“Certain combinations of probiotics or strains may be beneficial in IBS,” the researchers concluded. “However, in studies that met clinical criteria, the certainty of the evidence for efficacy was low to very low in almost all analyses.”
#Cold #water #microbiome #drug #development #benefits #stress #unclear #IBD
