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Aim: Intestinal dysbiosis seems to be the leading cause of inflammatory bowel diseases, and probiotics seems to represent the proper support against their occurrence. Actually, probiotic blends and anti-inflammatory drugs represent a weapon against inflammatory bowel diseases. The present study evaluates the long-term (2 years) effects of combination therapy (mesalazine plus a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4) on ulcerative colitis activity., Method: Sixty patients with moderate-to-severe ulcerative colitis were enrolled: 30 of them were treated with a single daily oral administration of mesalazine 1200 mg; 30 patients received a single daily oral administration of mesalazine 1200 mg and a double daily administration of a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4. The treatment was carried out for two years and the clinical response evaluated according to the Modified Mayo Disease Activity Index., Results: All patients treated with combination therapy showed better improvement compared to the controls. In particular, the beneficial effects of probiotics were evident even after two years of treatment., Conclusions: A long-term treatment modality of anti-inflammatory drugs and probiotics is viable and could be an alternative to corticosteroids in mild-to moderate ulcerative colitis.

In this work, we propose that for further studies of the physiopathology and treatment for inflammatory bowel diseases, an integral view of the conditions, including the triad of microbiota-heat shock proteins (HSPs)-probiotics, ought to be considered. Microbiota is the complex microbial flora that resides in the gut, affecting not only gut functions but also the health status of the whole body. Alteration in the microbiota's composition has been implicated in a variety of pathological conditions (e.g., ulcerative colitis, UC), involving both gut and extra-intestinal tissues and organs. Some of these pathologies are also associated with an altered expression of HSPs (chaperones) and this is the reason why they may be considered chaperonopathies. Probiotics, which are live microorganisms able to restore the correct, healthy equilibrium of microbiota composition, can ameliorate symptoms in patients suffering from UC and modulate expression levels of HSPs. However, currently probiotic therapy follows ex-adiuvantibus criteria, i.e., treatments with beneficial effects but whose mechanism of action is unknown, which should be changed so the probiotics needed in each case are predetermined on the basis of the patient's microbiota. Consequently, efforts are necessary to develop diagnostic tools for elucidating levels and distribution of HSPs and the microbiota composition (microbiota fingerprint) of each subject and, thus, guide specific probiotic therapy, tailored to meet the needs of the patient. Microbiota fingerprinting ought to include molecular biology techniques for sequencing highly conserved DNA, e.g., genes encoding 16S RNA, for species identification and, in addition, quantification of each relevant microbe.

The intestinal inflammatory bowel disease (IBD) are a group of inflammatory pathologies of the digestive line with chronicity and recurrent characteristics. The IBDs mostly recognized are the ulcerative colitis and Crohn's disease; they are more frequent in the industrialized countries and among the caucasian populations that among those africans or oriental. The secondary artropaties to IBD recognize a multifactorial genesis in subjects predisposed as a result genetically of environmental factors; a fundamental role of the intestinal dysbiosis they are hypothesized. [ABSTRACT FROM AUTHOR]

The gut of a healthy adult harbours a myriad of different microbial species (approximately 1014 colony forming units). In healthy adults, the main control of intestinal bacterial colonization occurs through the gastric acidity. Moreover, other factors can influence the intestinal microenvironment, as pH, temperature, competition among different bacterial strains, peristalsis, drugs, radiotherapy, and much more. It was found that, when you have an impaired microbial homeostasis, the intestinal microsystem becomes unstable, so that leads to an alteration of the permeability of tissues, together with the activation of the intestinal immune system (MALT). These microenvironmental changes thus provide the substrate for the etiopathogenetic outbreak of numerous pathologies of gastro-intestinal tract, together with a miscellany of extraintestinal disorders. From the foregoing, we understand the real importance of maintaining a correct homeostasis of the intestinal microenvironment, in order to prevent the onset of specific disease of the digestive system. [ABSTRACT FROM AUTHOR]