## 3 Health Benefits
### Prebiotic and Anti-Inflammatory Effect  
The anti-inflammatory and gastrointestinal-disease-modulating effects of artichoke have been extensively studied in recent decades. Numerous studies report the therapeutic properties of artichoke against inflammatory bowel disease (IBF) [139, 140, 141], a condition characterized by chronic relapses and remissions of inflammation in the gastrointestinal tract. IBD results from immune disorders arising from complex interactions between genetic and environmental factors such as diet, stress, insufficient sleep, alcohol and microbial composition [142].  
[PERSON] et al. [139] measured the prebiotic effect of artichoke by-products after in vitro fermentation by human fecal microbiota, observing an increase in the production of total acetate, propionate and SCFA by the gut microbiota. Another study reported the benefits of artichoke head after short-term colonic fermentation using an in vitro intestinal model; the results showed an increase in total SCFA production and an increase in the bacterial genus _Lactobacillus_ spp. [100]. [PERSON] et al. [102] observed the effects of gluten-free bread enriched with artichoke leaf extract on Caco-2 cells exposed to LPS after in vitro digestion and colonic fermentations. The extracts produced a decrease in cellular expression of the inflammatory markers TNF-\(\alpha\) and IL-1\(\beta\) as well as an increase in the total antioxidant capacity.  
Many of the beneficial properties of artichoke are attributed to the large amount of phenolic compounds present in the leaves; however, the head and stems of artichoke are the parts most commonly used to treat digestive disorders. The anti-inflammatory and prebiotic properties are due to the high fiber content of these sections, particularly the presence of inulin and pectins. Inulin has been reported to positively alter the gut microbiota by being fermented in the large intestine and colon by beneficial bacteria such as _Bifidobacteria_ and _Lactobacillus_, increasing the levels of these species. The functional attributes of these bacteria are known to contribute directly or indirectly to various health benefits, including protection against oxidative stress, pathogenic microbes, hypertension, inflammation and diabetes [143]. [PERSON] et al. [105] observed that the application of very-long-chain inulin extracted from artichoke in healthy adults for 3 weeks was able to modify the composition of the intestinal microbiota, increasing the levels of _Bifidobacteria_, _Lactobacillus_ and _Bacteroides-Prevotella_. As mentioned previously, inulin is also capable of triggering the production of SCFAs (acetate, propionate and butyrate) through bacterial fermentation in the colon [50]. These three compounds present remarkable beneficial health functions; acetate is a substrate for cholesterol and fatty acid synthesis, and propionate is a precursor for the synthesis of glucose in the liver [144]. Butyrate provides an anticancer activity, as it is the main substrate for colonic epithelial cells and plays an important role in cell differentiation and regulation [145]. Pectins present in artichoke also play an important role in its anti-inflammatory effect. One study showed that artichoke pectins reduced the expression of inflammatory markers such as TNF-\(\alpha\), ICAM-I, IL-1\(\beta\) and IL-6 in C57 BL/6 mice with colitis [104]. In addition, pectin from artichoke increased the expression of the intestinal barrier genes Ocludin and MUC-1. Toll-like receptor (TLR) signaling has been shown to be suppressed by MUC-1, so artichoke pectins increase MUC-1 expression, leading to decreased TLR-4 levels and, thus, a low expression of pro-inflammatory cytokines [146].