High-Dose Probiotics for the Treatment of Active Pouchitis

Abstract

High doses of the probiotic VSL#3 are effective in the treatment of mild pouchitis. Further controlled studies are warranted.

Randomised clinical trial: the effectiveness of Lactobacillus reuteri ATCC 55730 rectal enema in children with active distal ulcerative colitis

“…Thirty-one patients accomplished the trial (17 males, median age 13 year, range [7][8][9][10][11][12][13][14][15][16][17][18]. Mayo score (including clinical and endoscopic features) decreased significantly in the L. reuteri group (3.2 AE 1.3 vs. 8.6 AE 0.8, P < 0.01) compared with placebo (7.1 AE 1.1 vs. 8.7 AE 0.7, NS); furthermore, histological score significantly decrease only in the L. reuteri group (0.6 AE 0.5 vs. 4.5 AE 0.6, P < 0.01) (placebo: 2.9 AE 0.8 vs. 4.6 AE 0.6, NS).…”

“…11,12 Probiotics are live microorganisms that in adequate amount confer a healthy benefit to the host. 13 15,17,18 Use of probiotics in CD has produced less convincing results than in UC. 19 This study was performed in children with distal active UC to assess the effectiveness of rectal administration of Lactobacillus (L) reuteri ATCC 55730 (Reuflor Ò Italchimici SpA, Italy), on rectal mucosa inflammation as well as on mucosal expression levels of some cytokines, known to be involved in the inflammatory mechanisms of UC.…”

“…39 However, the studies on the use of probiotics in IBD are heterogeneous for the microorganism species or strains given as well as for methodology and patient populations. 15,16 It should be also considered that benefits described with one species are not necessarily attributed to others. On the other hand, probiotics used in complex disorders such as IBD, with the aim to modulate the complex interactions between intestinal mucosa and gut microbiota, should possess some critical properties, such as the ability to adhere to the intestinal mucosa and to interact with immunological cells harbouring the gut wall.…”

Inocuidad, prevención y riesgos de los probióticos

“…There is consensus about the mechanisms through which probiotics induce there effects work and it is accepted that while some stimulate local immunity and the effectiveness of immune responses, others exert anti-inflammatory or anti-allergic activities or induce and stimulate immune tolerance processes 18,19 . In experimental models of colitis, VSL#3 induced the proliferation of regulatory T lymphocytes that synthesize TGF (Transforming Growth Factor)-beta, which acts as a proliferation and tissue repair factor.…”

“…For this reason, it is logical to argue that its administration should be beneficial for patients whose seriously ill or at risk of becoming so. In these cases, their resident intestinal microbiota is affected by the use of broad-spectrum antibiotics, modifications of their diet, placement of tubes in to digestive tract, changes into in blood pH, arterial irrigation and the presence of anoxia along with alterations of motility and the development of of stress reactions with increases of proinflammatory peptides and catecholamines [19][20][21][22] . The synergistic effects of these alterations may lead to conditions that favor the translocation of bacteria from the intestinal lumen, the oral mucosa or the vaginal canal to the bloodstream and increase the risk of a systemic inflammatory response syndrome 25,26 .…”