Probiotics: progress toward novel therapies for intestinal diseases.

PURPOSE OF REVIEW: As the beneficial effects of probiotics on health and disease prevention and treatment have been well recognized, the demand for probiotics in clinical applications and as functional foods has significantly increased in spite of limited understanding of the mechanisms. This review focuses on the most recent advances in probiotic research from genetics to biological consequences regulated by probiotics and probiotic-derived factors. RECENT FINDINGS: Genomic and proteomic studies reveal genes and proteins involved in probiotic adaptation in the host and while exerting their beneficial effects. Recent studies in cell culture and in animal models emphasize probiotic functions in intestinal development, nutrition, host microbial balance, cytoprotection, barrier function, innate immunity, and inflammation. Most importantly, several novel and known probiotic-derived factors have been characterized, which regulate host-signaling pathways and mediate probiotic function. SUMMARY: Progress in understanding probiotic mechanisms of action will increase our basic understanding of biological crosstalk and provide the rationale to support the development of new hypothesis-driven studies to define the clinical efficacy of probiotics for intestinal disorders.

Challenges in IBD Research: Novel Technologies.

Novel technologies is part of five focus areas of the Challenges in IBD research document, which also includes preclinical human IBD mechanisms, environmental triggers, precision medicine and pragmatic clinical research. The Challenges in IBD research document provides a comprehensive overview of current gaps in inflammatory bowel diseases (IBD) research and delivers actionable approaches to address them. It is the result of a multidisciplinary input from scientists, clinicians, patients, and funders, and represents a valuable resource for patient centric research prioritization. In particular, the novel technologies section is focused on prioritizing unmet clinical needs in IBD that will benefit from novel technologies applied to: 1) non-invasive detection and monitoring of active inflammation and assessment of treatment response; 2) mucosal targeted drug delivery systems; and 3) prevention of post-operative septic complications and treatment of fistulizing complications. Proposed approaches include development of multiparametric imaging modalities and biosensors, to enable non invasive or minimally invasive detection of pro-inflammatory signals to monitor disease activity and treatment responses. Additionally, technologies for local drug delivery to control unremitting disease and increase treatment efficacy while decreasing systemic exposure are also proposed. Finally, research on biopolymers and other sealant technologies to promote post-surgical healing; and devices to control anastomotic leakage and prevent post-surgical complications and recurrences are also needed.