Probiotic Mix VSL#3 Is Effective Adjunctive Therapy for Mild to Moderately Active Ulcerative Colitis

Mardini, Houssam; Grigorian, Alla

doi:10.1097/mib.0000000000000084

Cited by 112 publications

(61 citation statements)

References 14 publications

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“…Probiotics are defined as live microorganisms that confer a health benefit to the host when administered in adequate amounts (Sanders, 2008). VSL#3 (also called VSL3) is a combinatorial probiotic that is used for human intestinal disorders, such as inflammatory bowel disease and ulcerative colitis (Bibiloni et al, 2005;Penner and Fedorak, 2005;Lee et al, 2012;Mardini and Grigorian, 2014). VSL3 contains eight live bacterial strains that are considered beneficial for the host, including Bifidobacterium breve, Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei, Lactobacillus bulgaricus, and Streptococcus thermophilus.…”

Section: Introductionmentioning

confidence: 99%

Regulation of Hepatic Drug-Metabolizing Enzymes in Germ-Free Mice by Conventionalization and Probiotics

Selwyn

Cheng

Klaassen

et al. 2015

Drug Metabolism and Disposition

107

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Little is known regarding the effect of intestinal microbiota modifiers, such as probiotics and conventionalization with exogenous bacteria, on host hepatic drug metabolism. Therefore, the goal of this study was to determine the effect of these modifiers on the expression of various drug-metabolizing enzymes of the host liver. VSL3 is a probiotic that contains eight live strains of bacteria. Five groups of mice were used: 1) conventional mice (CV), 2) conventional mice treated with VSL3 in drinking water, 3) germ-free (GF) mice, 4) GF mice treated with VSL3, and 5) GF mice exposed to the conventional environment for 2 months. All mice were 3 months old at tissue collection. GF conditions markedly downregulated the cytochrome P450 (P450) 3a gene cluster, but upregulated the Cyp4a cluster, whereas conventionalization normalized their expression to conventional levels [reverse-transcription quantitative polymerase chain reaction (qPCR) and western blot]. Changes in the Cyp3a and 4a gene expression correlated with alterations in the pregnane X receptor and peroxisome proliferator-activated receptor a-DNA binding, respectively (chromatin immunoprecipitation-qPCR). VSL3 increased each bacterial component in the large intestinal content of the CV mice, and increased these bacteria even more in GF mice, likely due to less competition for growth in the GF environment. VSL3 given to conventional mice increased the mRNAs of Cyp4v3, alcohol dehydrogenase 1, and carboxyesterase 2a, but decreased the mRNAs of multiple phase II glutathione-S-transferases. VSL3 given to germ-free mice decreased the mRNAs of UDPglucuronosyltransferases 1a9 and 2a3. In conclusion, conventionalization and VSL3 alter the expression of many drug-metabolizing enzyme s in the liver, suggesting the importance of considering "bacteria-drug" interactions for various adverse drug reactions in patients.

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Section: Introductionmentioning

confidence: 99%

Regulation of Hepatic Drug-Metabolizing Enzymes in Germ-Free Mice by Conventionalization and Probiotics

Selwyn

Cheng

Klaassen

et al. 2015

Drug Metabolism and Disposition

107

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“…VSL#3 has been evaluated in five studies in patients with ulcerative colitis. A meta-analysis of these studies reported a response rate of 53 % and a remission rate of 44 % in VSL#3-treated patients compared to 29 and 25 % of placebo-treated patients [ 2 ]. Outcomes for data on the use of probiotics in CD are less impressive.…”

Section: Prebiotics and Probiotics In Ibdmentioning

confidence: 97%

“…Conversely, data are weak to support the use of aloe vera, dietary fish oil, or Boswellia as IBD therapy. There is good evidence that probiotics, specifically VSL#3, prevent the first and recurrent episodes of pouchitis and treat active pouchitis and ulcerative colitis [ 2 ].…”

Section: Brief Review Of Literaturementioning

confidence: 99%

What About Alternative Therapies I Can Try? Dietary Supplements, Probiotics, Prebiotics, and Alternative Therapies in IBD

Quezada

Cross

2015

Inflammatory Bowel Disease

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“…[86][87][88] One of the most promising probiotic supplements, VSL#3, is a set of 8 bacterial strains that significantly reduces disease severity and induces remission in patients with UC compared to the placebo. 89,90 Additionally, VSL#3 can prevent pouchitis following total proctocolectomy and J-pouch formation. 91 However, engraftment of probiotics is often poor as demonstrated by lack of detectable probiotic strains 2 weeks following cessation of intake.…”

Section: Clinical Use Of Fmt For Ibdmentioning

confidence: 99%

Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease

2017

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Inflammatory bowel disease (IBD) is a complex set of diseases that lead to chronic inflammation in the gastrointestinal tract. Although the etiology of IBD is not fully understood, it is well-known that the intestinal microbiota is associated with the development and maintenance of IBD. Manipulation of the gut microbiota, therefore, may represent a target for IBD therapy. Fecal microbiota transplantation (FMT), where fecal microbiota from a healthy donor is transplanted into a patient's GI tract, is already a successful therapy for Clostridium difficile infection. FMT is currently being explored as a potential therapy for IBD as well. In this review, the associations between the gut microbiota and IBD and the emerging data on FMT for IBD will be discussed.

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Probiotic Mix VSL#3 Is Effective Adjunctive Therapy for Mild to Moderately Active Ulcerative Colitis

Abstract: VSL#3, when added to conventional therapy at a daily dose of 3.6 × 10 CFU/d, is safe and more effective than conventional therapy alone in achieving higher response and remission rates in mild to moderately active ulcerative colitis.

Cited by 112 publications

References 14 publications

Regulation of Hepatic Drug-Metabolizing Enzymes in Germ-Free Mice by Conventionalization and Probiotics

Regulation of Hepatic Drug-Metabolizing Enzymes in Germ-Free Mice by Conventionalization and Probiotics

What About Alternative Therapies I Can Try? Dietary Supplements, Probiotics, Prebiotics, and Alternative Therapies in IBD

Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease

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