40 research outputs found
Prospects for the development of probiotics and prebiotics for oral applications
There has been a paradigm shift towards an ecological and microbial community-based approach to understanding oral diseases. This has significant implications for approaches to therapy and has raised the possibility of developing novel strategies through manipulation of the resident oral microbiota and modulation of host immune responses. The increased popularity of using probiotic bacteria and/or prebiotic supplements to improve gastrointestinal health has prompted interest in the utility of this approach for oral applications. Evidence now suggests that probiotics may function not only by direct inhibition of, or enhanced competition with, pathogenic micro-organisms, but also by more subtle mechanisms including modulation of the mucosal immune system. Similarly, prebiotics could promote the growth of beneficial micro-organisms that comprise part of the resident microbiota. The evidence for the use of pro or prebiotics for the prevention of caries or periodontal diseases is reviewed, and issues that could arise from their use, as well as questions that still need to be answered, are raised. A complete understanding of the broad ecological changes induced in the mouth by probiotics or prebiotics will be essential to assess their long-term consequences for oral health and disease
Oral vancomycin and gentamicin for treatment of very early onset inflammatory bowel disease
Background: The pathogenesis of inflammatory bowel disease (IBD) is complex and involves the contribution of genetic and environmental factors. Many patients with very early onset IBD are difficult to treat. The current antibiotic medication that targets gram-negative and anaerobic bacteria provides only moderate efficacy in subsets of patients with IBD. Methods: We report a case series of 5 children with a mean age of 1.6 years (range 6 months to 2.7 years) during IBD onset, who were previously refractory to standard treatments and who received oral vancomycin with or without gentamicin. Results: Four out of 5 children demonstrated substantial therapeutic effect, and the effect was sustained in 3 children over a follow-up period of 12-33 months. Conclusion: Our findings are consistent with model systems and suggest that randomized trials are required to establish whether a change in therapeutic paradigm, that is, targeting gram-positive bacteria with nonabsorbable antibiotics, may have therapeutic benefits
Oral vancomycin and gentamicin for treatment of very early onset inflammatory bowel disease
Background: The pathogenesis of inflammatory bowel disease (IBD) is complex and involves the contribution of genetic and environmental factors. Many patients with very early onset IBD are difficult to treat. The current antibiotic medication that targets gram-negative and anaerobic bacteria provides only moderate efficacy in subsets of patients with IBD. Methods: We report a case series of 5 children with a mean age of 1.6 years (range 6 months to 2.7 years) during IBD onset, who were previously refractory to standard treatments and who received oral vancomycin with or without gentamicin. Results: Four out of 5 children demonstrated substantial therapeutic effect, and the effect was sustained in 3 children over a follow-up period of 12-33 months. Conclusion: Our findings are consistent with model systems and suggest that randomized trials are required to establish whether a change in therapeutic paradigm, that is, targeting gram-positive bacteria with nonabsorbable antibiotics, may have therapeutic benefits
Supplementary Material for: Oral Vancomycin and Gentamicin for Treatment of Very Early Onset Inflammatory Bowel Disease
<p><b><i>Background:</i></b> The pathogenesis of inflammatory bowel
disease (IBD) is complex and involves the contribution of genetic and
environmental factors. Many patients with very early onset IBD are
difficult to treat. The current antibiotic medication that targets
gram-negative and anaerobic bacteria provides only moderate efficacy in
subsets of patients with IBD. <b><i>Methods:</i></b> We report a case
series of 5 children with a mean age of 1.6 years (range 6 months to 2.7
years) during IBD onset, who were previously refractory to standard
treatments and who received oral vancomycin with or without gentamicin. <b><i>Results:</i></b>
Four out of 5 children demonstrated substantial therapeutic effect, and
the effect was sustained in 3 children over a follow-up period of 12-33
months. <b><i>Conclusion:</i></b> Our findings are consistent with
model systems and suggest that randomized trials are required to
establish whether a change in therapeutic paradigm, that is, targeting
gram-positive bacteria with nonabsorbable antibiotics, may have
therapeutic benefits.</p