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dc.contributor.authorShanahan, Fergus
dc.date.accessioned2012-02-03T15:10:12Z
dc.date.available2012-02-03T15:10:12Z
dc.date.issued2012-02-03T15:10:12Z
dc.identifier.citationBr J Nutr. 2002 Sep;88 Suppl 1:S5-9.en_GB
dc.identifier.issn0007-1145 (Print)en_GB
dc.identifier.issn0007-1145 (Linking)en_GB
dc.identifier.pmid12215176en_GB
dc.identifier.doi10.1079/BJN2002624en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209024
dc.description.abstractProbiotic therapy is attracting the renewed interest of clinicians and basic investigators from a variety of traditional research disciplines. While the theoretical rationale for modifying the commensal flora of the gastrointestinal tract in specific circumstances appears sound and requires scientific pursuit, the field of probiotics has been clouded by exaggerated claims from some quarters. In general, many of the claims for therapeutic efficacy have not been well substantiated, but the field is now poised for evaluation within the realm of evidence-based medicine. Alterations in commensal bacterial flora within the gastrointestinal tract are associated with susceptibility to pathogens such as Clostridium difficile and there is persuasive evidence that the normal flora may participate in the pathogenesis of inflammatory bowel disease and other chronic diseases in genetically susceptible individuals. This has prompted various strategies to fortify or otherwise modify the enteric flora by dietary supplements containing probiotic formulations. Detailed comparisons of probiotic performance amongst different bacterial strains have not been performed in vivo in man or under clinical trial conditions, and the level of scientific characterisation of individual organisms has been variable. In addition, it cannot be assumed that the same probiotic is equally suitable for all individuals. Moreover, the heterogeneity of clinical disorders such as Crohn's disease and ulcerative colitis implies that strain-specific properties may be required for subset-specific categories of patients. While cocktails of probiotics offer convenience, therapeutic progress may require clarification of the mechanism of probiotic action and may be delayed until individual bacterial components have been rigorously studied. More importantly, the full potential of therapeutic manipulation of the enteric flora with probiotics or other strategies may not be optimally realised until the composition and metabolic activities of the normal flora are better understood.
dc.language.isoengen_GB
dc.subject.meshDigestive System/microbiologyen_GB
dc.subject.meshEvidence-Based Medicineen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInflammatory Bowel Diseases/*diet therapy/microbiologyen_GB
dc.subject.meshProbiotics/*therapeutic useen_GB
dc.subject.meshSymbiosisen_GB
dc.titleProbiotics and inflammatory bowel disease: from fads and fantasy to facts and future.en_GB
dc.contributor.departmentDepartment of Medicine, Clinical Sciences Building, Cork University Hospital,, Wilton, Ireland. F.Shanahan@ucc.ieen_GB
dc.identifier.journalThe British journal of nutritionen_GB
dc.description.provinceMunster
html.description.abstractProbiotic therapy is attracting the renewed interest of clinicians and basic investigators from a variety of traditional research disciplines. While the theoretical rationale for modifying the commensal flora of the gastrointestinal tract in specific circumstances appears sound and requires scientific pursuit, the field of probiotics has been clouded by exaggerated claims from some quarters. In general, many of the claims for therapeutic efficacy have not been well substantiated, but the field is now poised for evaluation within the realm of evidence-based medicine. Alterations in commensal bacterial flora within the gastrointestinal tract are associated with susceptibility to pathogens such as Clostridium difficile and there is persuasive evidence that the normal flora may participate in the pathogenesis of inflammatory bowel disease and other chronic diseases in genetically susceptible individuals. This has prompted various strategies to fortify or otherwise modify the enteric flora by dietary supplements containing probiotic formulations. Detailed comparisons of probiotic performance amongst different bacterial strains have not been performed in vivo in man or under clinical trial conditions, and the level of scientific characterisation of individual organisms has been variable. In addition, it cannot be assumed that the same probiotic is equally suitable for all individuals. Moreover, the heterogeneity of clinical disorders such as Crohn's disease and ulcerative colitis implies that strain-specific properties may be required for subset-specific categories of patients. While cocktails of probiotics offer convenience, therapeutic progress may require clarification of the mechanism of probiotic action and may be delayed until individual bacterial components have been rigorously studied. More importantly, the full potential of therapeutic manipulation of the enteric flora with probiotics or other strategies may not be optimally realised until the composition and metabolic activities of the normal flora are better understood.


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