Probiotic therapy of intestinal inflammation and infections

摘要

Probiotics offer promise for physiologic, nontoxic treatment of pouch itis, ulcerative colitis, and acute : infectious diarrhea, but larger, controlled clinical studies must be performed to clarify optimal agents; doses; ''o combinations of various probiotics, prebiotics, and antibiotics; and therapeutic conditions.The distal ileum and colon are colonized by a complex group of commensal facultative or obligate anaerobic bacterial and fungal species whose composition and metabolic activity are poorly characterized, whereas the esophagus, stomach, and proximal intestines are exposed to swallowed dietary and oral microbiota. These micro-bial agents and their secreted products are intimately associated with the gastrointestinal mucosa and influence epithelial growth, differentiation, and function, as well as development and trafficking of mucosal immune cells. The gastrointestinal track has developed redundant mechanisms to coexist with its autochthonous (resident) microbiota, yet rapidly respond to invading pathogens and then return to homeostasis with its commensals after the pathogenic infection is cleared.