Probiotics, Prebiotics and Other Dietary Supplements for Gut Microbiota Modulation in Celiac Disease Patients.

2020-09-02
Nutrients 12(9)
- Giovanni Marasco
- Giovanna Grazia Cirota
- Benedetta Rossini
- Lisa Lungaro
- Anna Rita Di Biase
- Antonio Colecchia
- Umberto Volta
- Roberto De Giorgio
- Davide Festi
- Giacomo Caio

PubMed: 32887325
DOI: 10.3390/nu12092674

Study Design

Type: Review
Population: celiac disease (CD) patients

Rigorous Journal

To date, the only available treatment for celiac disease (CD) patients is a life-lasting gluten-free diet (GFD). Lack of adherence to the GFD leads to a significant risk of adverse health consequences. Food cross-contamination, nutritional imbalances, and persistent gastrointestinal symptoms are the main concerns related to GFD. Moreover, despite rigid compliance to GFD, patients struggle in achieving a full restoring of the gut microbiota, which plays a role in the nutritive compounds processing, and absorption. Pivotal studies on the supplementation of GFD with probiotics, such as Bifidobacterium and Lactobacilli, reported a potential to restore gut microbiota composition and to pre-digest gluten in the intestinal lumen, reducing the inflammation associated with gluten intake, the intestinal permeability, and the cytokine and antibody production. These findings could explain an improvement in symptoms and quality of life in patients treated with GFD and probiotics. On the other hand, the inclusion of prebiotics in GFD could also be easy to administer and cost-effective as an adjunctive treatment for CD, having the power to stimulate the growth of potentially health-promoting bacteria strains. However, evidence regarding the use of prebiotics and probiotics in patients with CD is still insufficient to justify their use in clinical practice.

Research Insights

Bifidobacterium→Improved Quality of Life
These findings could explain an improvement in symptoms and quality of life in patients treated with GFD and probiotics.
Effect
Beneficial
Effect size
Small
Bifidobacterium→Improved Symptoms
These findings could explain an improvement in symptoms and quality of life in patients treated with GFD and probiotics.
Effect
Beneficial
Effect size
Small
Bifidobacterium→Reduced Antibody Production
Pivotal studies on the supplementation of GFD with probiotics, such as Bifidobacterium and Lactobacilli, reported a potential to restore gut microbiota composition and to pre-digest gluten in the intestinal lumen, reducing the inflammation associated with gluten intake, the intestinal permeability, and the cytokine and antibody production.
Effect
Beneficial
Effect size
Small
Bifidobacterium→Reduced Inflammation
Pivotal studies on the supplementation of GFD with probiotics, such as Bifidobacterium and Lactobacilli, reported a potential to restore gut microbiota composition and to pre-digest gluten in the intestinal lumen, reducing the inflammation associated with gluten intake, the intestinal permeability, and the cytokine and antibody production.
Effect
Beneficial
Effect size
Small
Bifidobacterium→Reduced Intestinal Permeability
Pivotal studies on the supplementation of GFD with probiotics, such as Bifidobacterium and Lactobacilli, reported a potential to restore gut microbiota composition and to pre-digest gluten in the intestinal lumen, reducing the inflammation associated with gluten intake, the intestinal permeability, and the cytokine and antibody production.
Effect
Beneficial
Effect size
Small
Bifidobacterium→Reduced Th2 Cytokine Production
Pivotal studies on the supplementation of GFD with probiotics, such as Bifidobacterium and Lactobacilli, reported a potential to restore gut microbiota composition and to pre-digest gluten in the intestinal lumen, reducing the inflammation associated with gluten intake, the intestinal permeability, and the cytokine and antibody production.
Effect
Beneficial
Effect size
Small