MOAMEN ABDELFADIL ISMAIL, MAJD M. JAMJOOM, WALLA ABUELGASIM OSMAN, HASSAN HUSSAIN ALJASSEM, GHAZI WAIL ALANZI, HEBA EZZAT HASHEM ,KHADIJAH ABDULRAHMAN SALEH ALRAJHI, MOHAMMED AHMED ALHELALI, DIMA HISHAM AL-QURAISH, MOHAMED OBAID MOHAMED HASSAN, MAKKI AYMAN ALAMOUDI
DOI: https://doi.org/Background: Gut microbiota dysbiosis has been strongly implicated in the pathogenesis and progression of inflammatory bowel disease (IBD). Microbiota-targeted therapies, including probiotics, synbiotics, and nutraceuticals, have emerged as promising adjunctive approaches.
Objective: This systematic review synthesized evidence on the clinical efficacy of microbiota modulation in ulcerative colitis and Crohn’s disease.
Methods: Following PRISMA 2020 guidelines, peer-reviewed clinical trials and observational studies were analyzed. Eligible studies included adults and children with IBD who received probiotic, synbiotic, or nutraceutical interventions, with outcomes assessing disease activity, microbial composition, inflammatory biomarkers, and remission rates.
Results: Across 27 included studies, interventions such as VSL#3, Lactocare®, Bifidobacterium breve fermented milk, and natural compounds (e.g., mastiha, balsalazide-probiotic combinations) demonstrated significant improvements in microbial balance, cytokine modulation, and clinical remission. However, variability in strain efficacy, trial design, and patient populations resulted in inconsistent outcomes. Systematic reviews confirmed a strong association between microbiota dysbiosis, therapeutic response, and disease activity.
Conclusion: Microbiota-targeted therapies show substantial promise in improving outcomes for IBD patients. Personalized approaches considering individual microbiome profiles and multi-kingdom dysbiosis are essential for optimizing therapeutic efficacy. Larger, standardized, and long-term studies are required to establish microbiota-based therapies as integral components of IBD management.
