Alimentos funcionais atenuam indicadores de doenças inflamatórias intestinais

Abstract

Inflammatory bowel diseases (IBDs) are chronic and relapsing diseases, with global incidence and accelerated growth in newly industrialized countries. Among IBD, ulcerative colitis (UC) affects the colon and compromises quality and life expectancy of patients. Studies in animal and human models suggest that in UC there is an increase in the expression of proinflammatory cytokines due to pathogenic intestinal microbiota, and this situation plays a fundamental role in the development and maintenance of the disease. Functional, prebiotic and symbiotic foods are potential therapeutic alternatives or complementary to the current treatments for IBD, since they provide survival, implantation and beneficial balance of microbiota intestinal. This systematic review with meta-analysis examined preclinical trials to elucidate the effects of prebiotic foods on induced IBD and the results of randomized clinical trials to raise evidence about the safety and efficacy of symbiotics as treatment of UA. The articles were obtained between January 2017 and March 2019 in the Pub Med, ScienceDirect and Scielo databases using the colitis, symbiotic and prebiotic keywords. A total of 1779 complete studies, abstracts or chapters of books were found and listed the keywords used in the literature search. At the end of the selection process, five papers met the inclusion criteria for meta-analysis of randomized experimental trials, and three were included for the meta-analysis of clinical trials in humans. When comparing the data, a significant increase of Lactobacillus and Bifidobacterium in the colon of the animals of the groups supplemented with prebiotics was observed, and a significant decrease in the macroscopic damages scores in the colon. In addition, the results demonstrated significant endoscopic or histological improvement of the clinical activity index and C-reactive protein, microbiota, BHI, mRNAs, TNFα, IL-1α, IL-10, MPO. The data found strongly demonstrated the ability of prebiotics to increase the amount of beneficial bacteria, decrease macroscopic damage scores, increase short chain fatty acid concentration (CCFA) and improve the indicators of inflammation and oxidative stress in the colon of the animals studied , and also that symbiotics increase probiotic microorganisms, modulate the reduces proinflammatory colonic cytokines and elevates the anti-inflammatory. This fact reduces inflammatory indicators of the colon of the patients. We reinforce the evidence that functional foods have therapeutic potential for patients with UC. Studies are needed to investigate the long-term effects / doses to be used in active UC.