| کلمات کلیدی | Keywords: Crohn’s disease, probiotics, prebiotics, gut microbiome, inflammation, systematic review, dysbiosis, immune modulation. |
| خلاصه مقاله | Background: Crohn’s disease (CD), a chronic inflammatory bowel disease, is characterized by dysbiosis of the gut microbiome and an abnormal immune response. Probiotics and prebiotics have emerged as potential therapeutic strategies for modulating gut microbiota composition and inflammatory pathways in CD. This systematic review aims to evaluate the current evidence on the role of probiotics and prebiotics in modulating the gut microbiome and inflammatory responses in patients with Crohn's disease.
Methods: A systematic search was conducted in PubMed, Scopus, and Cochrane Library for studies published between 2000 and 2024. Inclusion criteria were randomized controlled trials, cohort studies, and clinical trials assessing the impact of probiotics or prebiotics on gut microbiome diversity, inflammatory markers (e.g., C-reactive protein, TNF-α), and disease outcomes in CD patients. Studies focusing on both adult and pediatric populations were included.
Results: Out of 420 studies identified, 21 met the inclusion criteria. The evidence suggests that probiotics, particularly strains of Lactobacillus and Bifidobacterium, have modest but significant effects in restoring gut microbiota balance, reducing intestinal permeability, and alleviating inflammatory responses. Prebiotics, including inulin and fructooligosaccharides, were shown to promote beneficial microbiota growth and enhance the production of short-chain fatty acids (SCFAs), which play a key role in gut barrier function and immune modulation. While both probiotics and prebiotics were beneficial in reducing disease symptoms and markers of inflammation, the effects were more pronounced when combined therapies were used. Notably, the impact of these interventions was variable depending on the severity of the disease and the individual’s baseline microbiome composition.
Conclusion: Probiotics and prebiotics appear to offer promising adjunctive treatments for modulating the gut microbiome and inflammatory responses in Crohn’s disease. This review supports the potential of these interventions in managing disease symptoms and improving gut health. However, due to variability in treatment outcomes, future large-scale, long-term clinical trials are necessary to determine the optimal strains, doses, and duration of these therapies in Crohn's disease. |