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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2018; 24(1): 5-14
Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.5
Relationship between intestinal microbiota and ulcerative colitis: Mechanisms and clinical application of probiotics and fecal microbiota transplantation
Zhao-Hua Shen, Chang-Xin Zhu, Yong-Sheng Quan, Zhen-Yu Yang, Shuai Wu, Wei-Wei Luo, Bei Tan, Xiao-Yan Wang
Zhao-Hua Shen, Chang-Xin Zhu, Yong-Sheng Quan, Zhen-Yu Yang, Shuai Wu, Wei-Wei Luo, Bei Tan, Xiao-Yan Wang, Department of Gastroenterology, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China
Zhao-Hua Shen, Chang-Xin Zhu, Yong-Sheng Quan, Zhen-Yu Yang, Shuai Wu, Wei-Wei Luo, Bei Tan, Xiao-Yan Wang, Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha 410008, Hunan Province, China
Author contributions: Shen ZH wrote the manuscript; Wang XY contributed to the manuscript critical revision; all authors approved the final version of the article.
Supported by the National Natural Science Foundation of China, No. 81670504 and No. 81472287; and the New Xiangya Talent Project of the Third Xiangya Hospital of Central South University, No. 20150308.
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Yan Wang, MD, PhD, Professor, Department of Gastroenterology, Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan Province, China. wangxiaoyan2913@126.com
Telephone: +86-13974889301 Fax: +86-731-88618457
Received: October 1, 2017
Peer-review started: October 3, 2017
First decision: October 18, 2017
Revised: November 7, 2017
Accepted: November 21, 2017
Article in press: November 21, 2017
Published online: January 7, 2018
Processing time: 97 Days and 8.5 Hours
Abstract

Ulcerative colitis (UC) is an inflammatory disease that mainly affects the colon and rectum. It is believed that genetic factors, host immune system disorders, intestinal microbiota dysbiosis, and environmental factors contribute to the pathogenesis of UC. However, studies on the role of intestinal microbiota in the pathogenesis of UC have been inconclusive. Studies have shown that probiotics improve intestinal mucosa barrier function and immune system function and promote secretion of anti-inflammatory factors, thereby inhibiting the growth of harmful bacteria in the intestine. Fecal microbiota transplantation (FMT) can reduce bowel permeability and thus the severity of disease by increasing the production of short-chain fatty acids, especially butyrate, which help maintain the integrity of the epithelial barrier. FMT can also restore immune dysbiosis by inhibiting Th1 differentiation, activity of T cells, leukocyte adhesion, and production of inflammatory factors. Probiotics and FMT are being increasingly used to treat UC, but their use is controversial because of uncertain efficacy. Here, we briefly review the role of intestinal microbiota in the pathogenesis and treatment of UC.

Keywords: Fecal microbiota transplantation; Intestinal microbiota; Ulcerative colitis; Probiotics; Mechanism; Clinical application

Core tip: As we all know, genetic factors, host immune system disorders, intestinal microbiota dysbiosis, and environmental factors contribute to the pathogenesis of ulcerative colitis (UC). In this review, we explore the mechanism and clinical application of intestinal microbiota such as probiotics and fecal microbiota transplantation in UC so that we can use these tools to cure more diseases. Enteric microbiota leads to new therapeutic strategies for UC.