Çölyakta Probiyotik ve Prebiyotikler
Yıl 2019,
Cilt: 28 Sayı: 3, 177 - 181, 30.12.2019
Nur Bengü Erdem
,
Aylin Açıkgöz
Öz
Çölyak hastalığının toplumdaki görülme sıklığı
yaklaşık olarak %1’dir. Hastalığın tek etkili tedavi yöntemi, yaşam boyu
sürdürülecek glutensiz diyettir. Günümüzde birçok ürünün gluten içermesi ve
glutensiz diyete uyumun zor olması, hastalığın tedavisinde alternatif tedavi
seçeneklerine ihtiyaç duyulmasına yol açmıştır. Çölyak; çevresel ve genetik
faktörlerin etkileşimi sonucunda oluşmaktadır. Gluten proteinleri hastalığın
oluşumunda esas çevresel etmen olmasına rağmen yapılan son çalışmalar bağırsak
mikrobiyotasındaki değişimlerin çölyak oluşumunu etkileyebileceğini
göstermektedir. Çölyak tanılı ve sağlıklı bireylerin mikrobiyota
kompozisyonlarının farklı olması hastalığın oluşumunda mikrobiyotanın etkisine
işaret etmektedir. Değişen bağırsak mikrobiyotasının çölyaktaki düzelmeyen
semptomlarla ilgili olduğu, ayrıca probiyotik ve/veya prebiyotik kullanımının
hastalığın tedavisinde faydalı olabileceği öne sürülmektedir. Bu yazının amacı;
probiyotik ve prebiyotiklerin çölyak hastalığı üzerine etkilerinin güncel literatür
ile derlenmesidir.
Kaynakça
- 1. de Sousa Moraes LF, Grzeskowiak LM, de Sales Teixeira TF, Peluzio MdCG. Intestinal microbiota and probiotics in celiac disease. Clin Microbiol Rev. 2014;27(3):482-9.
- 2. Schuppan D, Junker Y, Barisani D. Celiac disease: from pathogenesis to novel therapies. Gastroenterology. 2009;137(6):1912-33.
- 3. Tack GJ, Verbeek WH, Schreurs MW, Mulder CJ. The spectrum of celiac disease: epidemiology, clinical aspects and treatment. Nature Reviews Gastroenterology and Hepatology. 2010;7(4):204-13.
- 4. Makharia GK. Current and emerging therapy for celiac disease. Frontiers in medicine. 2014;1:6.
- 5. Bakshi A, Stephen S, Borum ML, Doman DB. Emerging therapeutic options for celiac disease: potential alternatives to a gluten-free diet. Gastroenterol Hepatol (N Y). 2012;8(9):582.
- 6. Cenit MC, Codoñer-Franch P, Sanz Y. Gut Microbiota and Risk of Developing Celiac Disease. J Clin Gastroenterol. 2016;50:S148-S52.
- 7. Cenit MC, Olivares M, Codoñer-Franch P, Sanz Y. Intestinal microbiota and celiac disease: cause, consequence or co-evolution? Nutrients. 2015;7(8):6900-23.
- 8. Roma E, Roubani A, Kolia E, et al.Dietary compliance and life style of children with coeliac disease. J Hum Nutr Diet. 2010;23(2):176-82.
- 9. Nylund L, Kaukinen K, Lindfors K. The microbiota as a component of the celiac disease and non-celiac gluten sensitivity. Clinical Nutrition Experimental. 2016;6:17-24.
- 10. Di Sabatino A, Corazza GR. Coeliac disease. The Lancet. 2009;373(9673):1480-93.
- 11. Di Cagno R, Rizzello CG, Gagliardi F, et al. Different fecal microbiotas and volatile organic compounds in treated and untreated children with celiac disease. Appl Environ Microbiol. 2009;75(12):3963-71.
- 12. Green PH, Lebwohl B, Greywoode R. Celiac disease. J Allergy Clin Immunol. 2015;135(5):1099-106.
- 13. Mustalahti K, Catassi C, Reunanen A, et al. The prevalence of celiac disease in Europe: results of a centralized, international mass screening project. Ann Med. 2010;42(8):587-95.
- 14. Accomando S, Cataldo F. The global village of celiac disease. Dig Liver Dis. 2004;36(7):492-8.
- 15. Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG clinical guidelines: diagnosis and management of celiac disease. The American journal of gastroenterology. 2013;108(5):656-76.
- 16. Sanz Y, Palma GD, Laparra M. Unraveling the ties between celiac disease and intestinal microbiota. Int Rev Immunol. 2011;30(4):207-18.
- 17. Dubois PC, Trynka G, Franke L, Hunt KA, Romanos J, Curtotti A, et al. Multiple common variants for celiac disease influencing immune gene expression. Nat Genet. 2010;42(4):295-302.
- 18. Ghosh S. Advances in our understanding of the pathogenesis of celiac disease. Canadian Journal of Gastroenterology and Hepatology. 2011;25(4):186-.
- 19. Lerner A. New therapeutic strategies for celiac disease. Autoimmun Rev. 2010;9(3):144-7.
- 20. Marasco G, Di Biase AR, Schiumerini R, et al. Gut microbiota and celiac disease. Dig Dis Sci. 2016;61(6):1461-72.
- 21. Belkaid Y, Hand TW. Role of the microbiota in immunity and inflammation. Cell. 2014;157(1):121-41.
- 22. Collado MC, Donat E, Ribes-Koninckx C, Calabuig M, Sanz Y. Imbalances in faecal and duodenal Bifidobacterium species composition in active and non-active coeliac disease. BMC Microbiol. 2008;8(1):232.
- 23. Collado MC, Donat E, Ribes-Koninckx C, Calabuig M, Sanz Y. Specific duodenal and faecal bacterial groups associated with paediatric coeliac disease. J Clin Pathol. 2009;62(3):264-9.
- 24. Di Cagno R, De Angelis M, De Pasquale I, et al. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization. BMC Microbiol. 2011;11(1):219.
- 25. Harnett J, Myers SP, Rolfe M. Probiotics and the microbiome in celiac disease: a randomised controlled trial. Evid Based Complement Alternat Med. 2016;2016.
- 26. Lionetti E, Catassi C. New clues in celiac disease epidemiology, pathogenesis, clinical manifestations, and treatment. Int Rev Immunol. 2011;30(4):219-31.
- 27. Golfetto L, Senna FDd, Hermes J,et al. Lower bifidobacteria counts in adult patients with celiac disease on a gluten-free diet. Arq Gastroenterol. 2014;51(2):139-43.
- 28. Sánchez E, Donat E, Ribes-Koninckx C, Fernández-Murga ML, Sanz Y. Duodenal-mucosal bacteria associated with celiac disease in children. Appl Environ Microbiol. 2013;79(18):5472-9.
- 29. Wacklin P, Laurikka P, Lindfors K, et al. Altered duodenal microbiota composition in celiac disease patients suffering from persistent symptoms on a long-term gluten-free diet. The American journal of gastroenterology. 2014;109(12):1933-41.
- 30. De Palma G, Nadal I, Collado MC, Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. Br J Nutr. 2009;102(8):1154-60.
- 31. Allen LH, De Benoist B, Dary O, Hurrell R, Organization WH. Guidelines on food fortification with micronutrients. 2006.
- 32. Vanderpool C, Yan F, Polk DB. Mechanisms of probiotic action: Implications for therapeutic applications in inflammatory bowel diseases. Inflamm Bowel Dis. 2008;14(11):1585-96.
- 33. De Angelis M, Rizzello CG, Fasano A, et al. VSL# 3 probiotic preparation has the capacity to hydrolyze gliadin polypeptides responsible for celiac sprue probiotics and gluten intolerance. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2006;1762(1):80-93.
- 34. Yoo JY, Kim SS. Probiotics and prebiotics: Present status and future perspectives on metabolic disorders. Nutrients. 2016;8(3):173.
- 35. Krupa-Kozak U, Drabińska N, Jarocka-Cyrta E. The effect of oligofructose-enriched inulin supplementation on gut microbiota, nutritional status and gastrointestinal symptoms in paediatric coeliac disease patients on a gluten-free diet: study protocol for a pilot randomized controlled trial. Nutr J. 2017;16(1):47.
- 36. Kim Y, Keogh J, Clifton P. Probiotics, prebiotics, synbiotics and insulin sensitivity. Nutr Res Rev. 2017:1-17.
- 37. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998;158(17):1855-67.
- 38. Smecuol E, Hwang HJ, Sugai E, et al. Exploratory, randomized, double-blind, placebo-controlled study on the effects of Bifidobacterium infantis natren life start strain super strain in active celiac disease. J Clin Gastroenterol. 2013;47(2):139-47.
- 39. Martinello F, Roman CF, Souza PAd. Effects of probiotic intake on intestinal bifidobacteria of celiac patients. Arq Gastroenterol. 2017;54(2):85-90.
- 40. Olivares M, Castillejo G, Varea V, Sanz Y. Double-blind, randomised, placebo-controlled intervention trial to evaluate the effects of Bifidobacterium longum CECT 7347 in children with newly diagnosed coeliac disease. Br J Nutr. 2014;112(1):30-40.
- 41. Quagliariello A, Aloisio I, Bozzi Cionci N, et al. Effect of Bifidobacterium breve on the Intestinal Microbiota of Coeliac Children on a Gluten Free Diet: A Pilot Study. Nutrients. 2016;8(10):660.