ISSN (Print): 1574-8847
ISSN (Online): 2212-3938
Volume 16, 4 Issues, 2021
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ISSN (Print): 1574-8847
ISSN (Online): 2212-3938
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The gut microbiota and their metabolites play a central role in modulating gut health and disease in all age groups. The
administration of beneficial microbes (probiotics) confer several health benefits on the host. The administration of some
indigestible dietary fibre/carbohydrate (prebiotics) alone or in combination with probiotics (symbiotics) can also alter the
composition and/or activity of the intestinal microbiota and bring possible benefits to the individual’s health. The use of
prebiotics, probiotics, and symbiotics formulations has been appreciated for health benefits in "topping up your good bacteria"
or indeed in an attempt to normalise the dysbiotic microbiota associated with several disorders. Prebiotics, probiotics and
symbiotics are widely used to mantain a proper gut immune function and promote healthy digestive system and treat several
gastro-intestinal disorders however, new therapeutic uses are emerging in several disorders and pathologies not only affecting
the digestive system but also other organs and systems. The thematic issue is intended to provide updated reviews about clinical
y preclinical evidence of uses of prebiotics, probiotics, and synbiotics. We hope that this special issue will help attract the
interest of different medical specialties, nursing care and other communities, such as public, health-related academics and
industry, on this group of bioactive compounds. This issue of Current Clinical Pharmacology, ‘‘New effects of prebiotics,
probiotics, and symbiotics” reflects the interplay between different health sciences at the leading edge of this growing research
field which intensively suggest new opportunities for improving the care or to prevent adverse outcomes in several disorders.
Roselli and Finamore  reviewed the use of synbiotics in the treatment of ulcerative colitis, a chronic inflammation of the
colon caused by a dysregulated immune response to host intestinal microbiota in genetically susceptible subjects. The
mechanism of actions of synbiotics appears to be mediated by the modulation of the inflammatory response through cytokine
expression and immune cell modulation induced by probiotic bacteria, and stimulating on production of certain short-chain
fatty acid by prebiotics. Jayanama and Theou  review the benificial effects of probiotics and prebiotics on frailty and ageing
because in older people the inappropriate intake of prebiotics and probiotics, sarcopenia, physical inactivity, polypharmacy, and
social vulnerability can lead to a gut dysbiosis. The use of probiotics and prebiotics may improve the homeostasis of gut
microflora and prevent frailty and unhealthy aging, although their effects vary based on the features of individual populations.
Chronic wounds are commonly associated with polymicrobial biofilm infections. In the previous years, the extensive use of
antibiotics has generated several antibiotic-resistant variants. To overcome this issue, alternative natural treatments have been
proposed, including the use of microorganisms like probiotics. Brognara et al.  reviewed the scientific evidence for the use
of probiotics in the treatment of infected chronic wounds. Lactobacillus plantarum currently represents the most studied strain,
showing a positive application in burns compared to guideline treatments, and an additional mean in chronic wound infections.
Naseer et al.  reviewed the available literature on the utility of different commercially available prebiotics in patients with
functional and chronic idiopathic constipation, a highly prevalent functional gastrointestinal disorder that may significantly
affect the quality of life and health care costs. The authors conclude after the analysis of clinical trials that the administration of
prebiotics is an effective treatment for chronic idiopathic constipation as it improves the stool consistency, number of bowel
moments and bloating. Naseer et al.  reviewed the use of prebiotics and probiotic in inflammatory bowel diseases. They
found most of the studies evaluating the effects of probiotics used administration of lactobacillus, VSL#3 or Escherichia coli
nissle 1917 and there is also evidence supporting these agents for induction and maintenance of remission in ulcerative colitis
and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and
Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited.
In contrast, the results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative
relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and
have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long
duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be
more beneficial and effective in patients with inflammatory bowel disease. Vlachoud et al.  in their systematic review
evaluated randomized controlled trials and experimental studies assessing the effect of probiotic supplements on diabetic
nephropathy. Most of the microorganisms used in the studies belonged to the Lactobacillus and Bifidobacterium genus
although they did not follow a specific dosage. The majority of the studies demonstrated the benefits of probiotic
supplementation on the reduction of inflammation, oxidative stress and on the amelioration of renal function biomarkers in
subjects with diabetic nephropathy .
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