Commentary on Prebiotic Utility in Colitis: Will Inflammasomics Hold the Key?,

Inflammatory bowel disease (IBD) remains an idiopathic and incurable condition despite considerable advances in our understanding of its pathogenesis. Known contributors include a genetic predisposition, dysregulation of the mucosal immune system, and reduced epithelial barrier function, confounded by a range of other environmental and epigenetic factors. Indeed, an infective causative agent has yet to be definitively eliminated. Importantly, an imbalance (dysbiosis) between commensal organisms (comprising both bacterial and fungal elements) and pathogens is currently being pursued as a critical factor in IBD pathogenesis and, possibly, its etiology (1). The composition of the enteric microflora and the dynamic state of its microbial ecology are increasingly being associated with an expanding number of seemingly disparate disorders, ranging from the spectrum of infective enteritides to more covert conditions such as chemotherapy-induced mucositis, nonalcoholic steatohepatitis, and even obesity (2). It is perhaps no coincidence that these disorders are characterized variably by degrees of inflammation. Restoring a healthy bowel microbiota through external dietary intervention is perceived as a logical strategy. Gopalakrishnan et al. (3), in the current issue, explore the potential utility of the milk-derived prebiotic galacto-oligosaccharide (GOS) in a mouse model of the ulcerative colitis variant of IBD. Prebiotics are broadly defined as nondigestible dietary compounds, usually oligosaccharides, capable of restoring bowel homeostasis through selective fermentation by certain commensal organisms. Unlike single probiotics (health-promoting bacteria; usually lactobacilli and bifidobacteria), prebiotics have the potential to induce major shifts in bacterial communities and hence the overall composition of the intestinal microflora. Moreover, certain prebiotics, including GOS, have the potential to directly affect the mucosal immune system, and it is in this context that Gopalakrishnan et al. (3)