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Review

Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance

by
Andrea Piccioni
1,*,
Laura Franza
2,
Mattia Brigida
3,
Christian Zanza
2,
Enrico Torelli
2,
Martina Petrucci
2,
Rebecca Nicolò
2,
Marcello Covino
1,
Marcello Candelli
1,
Angela Saviano
2,
Veronica Ojetti
1,2 and
Francesco Franceschi
1,2
1
Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 1-00168 Rome, Italy
2
Università Cattolica del Sacro Cuore, 1-00168 Rome, Italy
3
Unit of Gastroenterology, Department of Systems Medicine, Tor Vergata University, 2-00133 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Pers. Med. 2021, 11(4), 298; https://doi.org/10.3390/jpm11040298
Submission received: 20 February 2021 / Revised: 5 April 2021 / Accepted: 11 April 2021 / Published: 14 April 2021
(This article belongs to the Special Issue Targeting the Microbiome for Disease Diagnosis and Therapy: New Frontiers for Personalized Medicine)
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Abstract

How can the knowledge of probiotics and their mechanisms of action be translated into clinical practice when treating patients with diverticular disease and acute diverticulitis? Changes in microbiota composition have been observed in patients who were developing acute diverticulitis, with a reduction of taxa with anti-inflammatory activity, such as Clostridium cluster IV, Lactobacilli and Bacteroides. Recent observations supported that a dysbiosis characterised by decreased presence of anti-inflammatory bacterial species might be linked to mucosal inflammation, and a vicious cycle results from a mucosal inflammation driving dysbiosis at the same time. An alteration in gut microbiota can lead to an altered activation of nerve fibres, and subsequent neuronal and muscular dysfunction, thus favoring abdominal symptoms’ development. The possible role of dysbiosis and mucosal inflammation in leading to dysmotility is linked, in turn, to bacterial translocation from the lumen of the diverticulum to perivisceral area. There, a possible activation of Toll-like receptors has been described, with a subsequent inflammatory reaction at the level of the perivisceral tissues. Being aware that bacterial colonisation of diverticula is involved in the pathogenesis of acute diverticulitis, the rationale for the potential role of probiotics in the treatment of this disease becomes clearer. For this review, articles were identified using the electronic PubMed database through a comprehensive search conducted by combining key terms such as “gut microbiota”, “probiotics and gut disease”, “probiotics and acute diverticulitis”, “probiotics and diverticular disease”, “probiotics mechanism of action”. However, the amount of data present on this matter is not sufficient to draw robust conclusions on the efficacy of probiotics for symptoms’ management in diverticular disease.
Keywords: gut microbiota; probiotics and gut disease; probiotics and acute diverticulitis; probiotics and diverticular disease; probiotics mechanism of action gut microbiota; probiotics and gut disease; probiotics and acute diverticulitis; probiotics and diverticular disease; probiotics mechanism of action

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MDPI and ACS Style

Piccioni, A.; Franza, L.; Brigida, M.; Zanza, C.; Torelli, E.; Petrucci, M.; Nicolò, R.; Covino, M.; Candelli, M.; Saviano, A.; et al. Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance. J. Pers. Med. 2021, 11, 298. https://doi.org/10.3390/jpm11040298

AMA Style

Piccioni A, Franza L, Brigida M, Zanza C, Torelli E, Petrucci M, Nicolò R, Covino M, Candelli M, Saviano A, et al. Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance. Journal of Personalized Medicine. 2021; 11(4):298. https://doi.org/10.3390/jpm11040298

Chicago/Turabian Style

Piccioni, Andrea, Laura Franza, Mattia Brigida, Christian Zanza, Enrico Torelli, Martina Petrucci, Rebecca Nicolò, Marcello Covino, Marcello Candelli, Angela Saviano, and et al. 2021. "Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance" Journal of Personalized Medicine 11, no. 4: 298. https://doi.org/10.3390/jpm11040298

APA Style

Piccioni, A., Franza, L., Brigida, M., Zanza, C., Torelli, E., Petrucci, M., Nicolò, R., Covino, M., Candelli, M., Saviano, A., Ojetti, V., & Franceschi, F. (2021). Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance. Journal of Personalized Medicine, 11(4), 298. https://doi.org/10.3390/jpm11040298

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