Probiotics and prebiotics in chronic inflammatory bowel diseases

Table 1 Clinical studies of probiotics in IBD

Author	Design	Group (Dose/d) (n)		Results
		Probiotic	Comparator
Induction of remission of ulcerative colitis
Kato 2004 [87]	DB, R, C	Bifidobacterium fermented milk (100 mL) (10)	Placebo (10)	Reduced UCDAI (P < 0.05)
Rembacken 1999 [85]	DB, R, C	E. coli Nissle 1917 (1 × 1011 cfu) (57)	Mesalamine (59)	As effective as mesalamine at attaining remission
Bibiloni 2005 [88]	Open-label	VSL#3 (3.6 × 109 cfu) (32)	None	77% remission or response rate
Ishikawa 2003 [86]	R, C	Lactobacillus and Bifidobacterium-fermented milk (100 mL) (11)	Placebo (10)	Reduced exacerbation of symptoms (P < 0.01)
Borody 2003 [90]	Case reports	Fecal enema (6)	None	100% remission
Maintenance of remission of ulcerative colitis
Kruis 2004 [82]	DB, R, C	E. coli Nissle 1917(2.5-25 × 109 cfu) (162)	Mesalamine (165)	As effective as mesalamine at maintaining remission (P = 0.003)
Zocco 2006 [83]	Open-label	Lactobacillus GG (1.8 × 1010 cfu) (65)	Mesalamine (60) Mesalamine + LGG (62)	No difference in relapse rates at 12 mo. LGG more effective than mesalamine at prolonging relapse-free time (P < 0.05)
Shanahan 2006 [117]	DB, R, C	Lactobacillus salivarius or Bifidobacterium infantus (1 × 109 cfu) (52/group)	Placebo (53)	No improvement of time to relapse
Venturi 1999 [84]	Open-label	VSL#3 (1 × 1012 cfu) (20)	None	75% maintained clinical and endoscopic remission
Induction of remission of Crohn’s disease
Schultz 2004 [97]	DB, R, C	Lactobacillus GG (2 × 109 cfu) (5)	Placebo (6)	No difference in remission rates
McCarthy 2001 [118]	Open-label	Lactobacillus salivarius (1 × 1010 cfu) (25)	None	Reduced disease activity compared with baseline
Gupta 2000 [119]	Open-label	Lactobacillus GG (2 × 1010 cfu) (4)	None	Improvement in CDAI scores compared with baseline (P < 0.05)
Maintenance of remission of Crohn’s disease
Prantera 2002 [95]	DB, R, C	Lactobacillus GG (1.2 × 1010 cfu) (23)	Placebo (22)	No significant difference in remission
Campieri 2000 [120]	R, C	VSL#3 (3 × 1011 cfu) (20)	Mesalamine (20)	Equivalent to mesalamine in preventing recurrence
Marteau 2006 [94]	DB, R, C	Lactobacillus johnsonii LA1(2 × 109 cfu) (48)	Placebo (50)	No difference in endoscopic recurrence
Malchow 1997 [93]	DB, R, C	E. coli Nissle 1917 (5 × 1010 cfu) (16)	Placebo (12)	No difference in remission rates
Bousvaros 2005 [96]	DB, R, C	Lactobacillus GG (2 × 1010 cfu) (39)	Placebo (36)	No difference in time to relapse
Guslandi 2000 [91]	R, C 6 mo	Saccharomyces boulardii (1 g/d) + mesalamine (2g) (16)	Mesalamine (16)	Significant prolongation of remission (P < 0.05)
Induction of remission of pouchitis
Kuisma 2003 [80]	DB, R, C	Lactobacillus GG (1 × 1010 cfu) (10)	Placebo (10)	No difference in PDAI
Laake 2004 [121]	Open-label	Lactobacillus acidophilus and Bifidobacterium lactis-fermented milk (500 mL) (51)	None	Improved PDAI, no difference in histology
Gionchetti 2000 [78]	DB, R, C	VSL#3 (6 g) (20)	Placebo (20)	Increased remission time (P < 0.001)
Mimura 2004 [122]	DB, R, C	VSL#3 (6 g) (20 )	Placebo (16)	Increased remission time (P < 0.0001)
Gionchetti 2003 [79]	DB, R, C	VSL#3 (1 × 1011) (20)	Placebo (20)	Increased remission time (P < 0.05)

DB: Double-blind; R: Randomized; C: Controlled; UCDAI: Ulcerative colitis disease activity index; CDAI: Crohn’s disease activity index; LGG: Lactobacillus GG; PDAI: Pouchitis disease activity index.