Probiotics in the Management of Ulcerative Colitis

Chibbar, Richa; Dieleman, Levinus A.

doi:10.1097/mcg.0000000000000368

Cited by 53 publications

(29 citation statements)

References 24 publications

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“…Alterations in microbiota composition or aberrant responses to luminal bacteria or dietary components can result in increased intestinal permeability, which may lead to the development of such pathologies. In this context, many studies have been conducted to investigate the therapeutic potential of certain commensal and probiotic strains to ameliorate inflammatory bowel diseases in clinical trials (reviewed by Chibbar and Dieleman, 2015; Wasilewski et al, 2015) or in animal models of colitis (Ewaschuk et al, 2008; Arribas et al, 2009; Shen et al, 2012; Kang et al, 2013; Martin et al, 2014; Souza et al, 2016). In mice colitis models, beneficial bacteria reduce inflammatory cytokines, normalize gut permeability, and reinforce the epithelial barrier.…”

Section: Introductionmentioning

confidence: 99%

“…Escherichia coli Nissle 1917 (EcN) is a Gram-negative probiotic used to treat intestinal disorders, and particularly in maintaining remission of ulcerative colitis (Kruis et al, 2004; Chibbar and Dieleman, 2015). The strain, which was originally isolated from a soldier who survived a severe outbreak of diarrhea during the First World War, is a good colonizer of the human gut and positively affects gastrointestinal homeostasis and microbiota balance.…”

Section: Introductionmentioning

confidence: 99%

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Outer Membrane Vesicles and Soluble Factors Released by Probiotic Escherichia coli Nissle 1917 and Commensal ECOR63 Enhance Barrier Function by Regulating Expression of Tight Junction Proteins in Intestinal Epithelial Cells

et al. 2016

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The gastrointestinal epithelial layer forms a physical and biochemical barrier that maintains the segregation between host and intestinal microbiota. The integrity of this barrier is critical in maintaining homeostasis in the body and its dysfunction is linked to a variety of illnesses, especially inflammatory bowel disease. Gut microbes, and particularly probiotic bacteria, modulate the barrier integrity by reducing gut permeability and reinforcing tight junctions. Probiotic Escherichia coli Nissle 1917 (EcN) is a good colonizer of the human gut with proven therapeutic efficacy in the remission of ulcerative colitis in humans. EcN positively modulates the intestinal epithelial barrier through upregulation and redistribution of the tight junction proteins ZO-1, ZO-2 and claudin-14. Upregulation of claudin-14 has been attributed to the secreted protein TcpC. Whether regulation of ZO-1 and ZO-2 is mediated by EcN secreted factors remains unknown. The aim of this study was to explore whether outer membrane vesicles (OMVs) released by EcN strengthen the epithelial barrier. This study includes other E. coli strains of human intestinal origin that contain the tcpC gene, such as ECOR63. Cell-free supernatants collected from the wild-type strains and from the derived tcpC mutants were fractionated into isolated OMVs and soluble secreted factors. The impact of these extracellular fractions on the epithelial barrier was evaluated by measuring transepithelial resistance and expression of several tight junction proteins in T-84 and Caco-2 polarized monolayers. Our results show that the strengthening activity of EcN and ECOR63 does not exclusively depend on TcpC. Both OMVs and soluble factors secreted by these strains promote upregulation of ZO-1 and claudin-14, and down-regulation of claudin-2. The OMVs-mediated effects are TcpC-independent. Soluble secreted TcpC contributes to the upregulation of ZO-1 and claudin-14, but this protein has no effect on the transcriptional regulation of claudin-2. Thus, in addition to OMVs and TcpC, other active factors released by these microbiota strains contribute to the reinforcement of the epithelial barrier.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outer Membrane Vesicles and Soluble Factors Released by Probiotic Escherichia coli Nissle 1917 and Commensal ECOR63 Enhance Barrier Function by Regulating Expression of Tight Junction Proteins in Intestinal Epithelial Cells

et al. 2016

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“…A recent meta-analyses of Sand et al [17], Chibbar and Dieleman [18] and Derikx et al [19] confirmed the opinion on positive effects of administration of probiotics and stressing importance of Bifidobacterium component of the administered probiotic preparations. It is of interest that probiotics application was related to an increase of Enterobacteriaceae in our patients with acute UC.…”

Section: Discussionmentioning

confidence: 82%

“…We have shown that, among others, the numbers of Bifidobacteria are low in children with early, acute UC [15]. Wang [16] concluded recently that Bifidobacteria and Lactobacilli are increased in patients with active IBD after application of probiotics.A recent meta-analyses of Sand et al [17], Chibbar and Dieleman [18] and Derikx et al [19] confirmed the opinion on positive effects of administration of probiotics and stressing importance of Bifidobacterium component of the administered probiotic preparations. It is of interest that probiotics application was related to an increase of Enterobacteriaceae in our patients with acute UC.…”

mentioning

confidence: 82%

Influence of Lactobacillus and Bifidobacterium Combination on the Gut Microbiota, Clinical Course, and Local Gut Inflammation in Patients with Ulcerative Colitis: A Preliminary, Single-center, Open-label Study

Zurek¹,

Wcisło²,

Mach³

et al. 2017

J Prob Health

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Background: Ulcerative colitis (UC) is one of the chronic, relapsing, inflammatory disorders of the gut and is characterized by inflammation limited in most cases to the colon. Since gut microbiota play a critical role in the development and perpetuation of intestinal inflammation, the addition of probiotics to this complex system may exert a positive influence on gut inflammatory reactions. Methods:A single center, open-label, intention-to-treat study involving patients with moderate-to-severe UC was performed to check whether a probiotic mixture containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium longum given together with a standard treatment could decrease clinical and histopathology indexes for UC evaluation. Results:The mixture given once a day for at least 2 months together with mesalazine and ciprofloxacin to patients in the acute phase of UC significantly reduced their Mayo Clinic Index values. Moreover, numbers of Lactobacilli isolated from patients feces were significantly increased, while those of Gram-negative rods decreased. The mixture given together with mesalazine to patients with UC in remission also caused a decrease of their clinical scores, but a more prominent and significant decrease of the histopathological index values in biopsy samples was observed. Conclusions:Supplementation of standard therapy with the probiotic mixture used in this study was efficacious in inducing and maintaining remission in UC, and this effect was related to modulation of dysbiosis in the gut microbiota. analyzed randomized clinical trials and found that selected probiotics were efficacious in inducing and maintaining remission in UC [8]. Another review reached nearly the same conclusions on the efficacy of probiotics in UC [9]. Influence of Lactobacillus and Bifidobacterium Combination on the Gut• The aim of this study was to investigate in a single center, openlabel, intention-to-treat study involving patients with moderateto-severe UC whether a probiotic mixture containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium longum given together with standard therapy could decrease clinical and histopathology indexes for UC. Materials and Methods PatientsAltogether, 51 patients (21 with UC in remission and 30 in the active phase of UC) of both sexes and between 18 and 72 years of age who were being treated in the Jagiellonian University Medical College Clinic of Gastroenterology in Cracow, Poland were enrolled. The study was conducted from 2008 to 2011 and was approved by the Jagiellonian University independent ethics committee (No KBET/5/B/2007). Written informed consent was obtained from all patients before enrollment.Inclusion criteria included an existing diagnosis of UC based on disease history, colonoscopy results, and histopathologic evaluation of biopsies from the colonic mucosa. The patients were not treated with antibiotics for three months before enrollment. Exclusion criteria were: diabetes, autoimmune diseases, severe systemic diseases, alcoho...

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“…We preferred cocktail VSL#3 as probiotic supplementation because VSL#3 is one of the most beneficial recommendations for ulcerative colitis therapy [23] and leads to a reduction in colonic expression of pro-inflammatory cytokines and mucosal damage and stimulates barrier integrity in different cases of colitis [24] or in common bile duct ligation induced inflammatory response [25] . We here show that 5-week moderate exercise and probiotic VSL#3 supplementation together led to reductions in some cytokine levels whereas only moderate exercise or probiotic VSL#3 supplementation does not, suggesting that usage ÜNSAL, ÜNSAL, ÜNER, KOÇ YILDIRIM EKİCİ, BALKAYA, BELGE of probiotic VSL#3 during moderate exercise improves immune system, at least in part with these experimental conditions.…”

Section: Discussionmentioning

confidence: 99%

Ratlarda Yüzdürme Egzersizi ve Probiyotik VSL#3’ün Zonulin ile Bazı Yangısal ve Oksidatif Değişkenlere Etkileri

Ünsal¹,

Ünsal²,

Üner³

et al. 2016

Kafkas Univ Vet Fak Derg

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Moderate exercise stimulates immune system whereas intensive exercise may display immune-suppressive effect associated with the disruption of intestinal barrier. With this study, we tested the effects of moderate and intensive swimming exercises on some cytokines and oxidant variables and zonulin, an intestinal barrier marker, in rats. We also tested possible ameliorative effects of probiotic VSL#3 in both moderate and intensive exercise regimens. Twenty eight rats were randomly divided into 4 equal groups: Control-C, Probiotic-P, Exercise-E, Probiotic+Exercise-PE. The rats in group E and PE underwent moderate swimming exercise for 5 weeks. Following this period, intensive swimming exercise was performed for 5 days. The rats in group C and group P were sedentary. Probiotic VSL#3 was given to group P and PE in the water. At the end of the experiments, serum zonulin, TNF-α, IL-6, IL-10, TGF-β, MDA, and protein carbonyl levels were determined. Evidences obtained from present study indicate that moderate swimming exercise improves barrier integrity of intestine and decreases oxidative stress. During the moderate swimming experiment, probiotic VSL#3 supplementation may also improve inflammatory response. On the other hand, intensive exercise does not led changes in the inflammatory response and oxidative stress, but beneficial responses of moderate exercise on the selected parameters probably disappear due to the intense exercise-induced mild stress. Keywords: Cytokine, Oxidative parameters, Probiotic, Rat, Swimming exercise, Zonulin Ratlarda Yüzdürme Egzersizi ve Probiyotik VSL#3'ün Zonulin İle Bazı Yangısal ve Oksidatif Değişkenlere Etkileri ÖzetYoğun egzersizler intestinal bariyerin bozulmasıyla ilişkili olarak immun-supresif etki oluşturabilirken, ılımlı egzersizler immun sistemi stimule eder. Bu çalışma ile ratlarda ılımlı ve yoğun yüzdürme egzersizlerinin bazı sitokinlere, oksidan değişkenlere ve intestinal bariyer belirteci zonuline etkilerini değerlendirdik. Ayrıca probiyotik VSL#3'ün hem ılımlı hem de yoğun yüzdürme periyodundaki olası iyileştirici etkilerini test ettik. Yirmi sekiz rat, rasgele 4 eşit gruba ayrıldı: Kontrol-C, Probiyotik-P, Egzersiz-E, Probiyotik+Egzersiz-PE. E ve PE grubundaki ratlara 5 hafta süreyle ılımlı yüzdürme egzersizi ve ılımlı yüzdürme periyodunu takiben 5 gün süreyle yoğun yüzdürme egzersizi yaptırıldı. C ve P grupları ise sedanter grupları oluşturdu. P ve PE gruplarına içme suyu ile probiyotik VSL#3 verildi. Deneylerin sonunda serumda zonulin, TNF-α, IL-6, IL-10, TGF-β, MDA ve protein karbonil düzeyleri belirlendi. Sonuçlar ılımlı yüzdürme egzersizinin bağırsak bariyer bütünlüğünü koruduğunu ve oksidatif stresi azalttığını göstermektedir. Ilımlı egzersiz sürecinde probiyotik VSL#3 alınması yangısal yanıtı da olumlu etkileyebilir. Diğer taraftan yoğun egzersiz herhangi bir yangısal yanıta ve oksidatif strese neden olmamıştır. Fakat ılımlı egzersizin ortaya çıkardığı faydalı yanıtlar muhtemelen yoğun egzersizin oluşturduğu hafif şiddetteki stres nedeniyle ortadan kalkmıştır.

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Probiotics in the Management of Ulcerative Colitis

Cited by 53 publications

References 24 publications

Outer Membrane Vesicles and Soluble Factors Released by Probiotic Escherichia coli Nissle 1917 and Commensal ECOR63 Enhance Barrier Function by Regulating Expression of Tight Junction Proteins in Intestinal Epithelial Cells

Outer Membrane Vesicles and Soluble Factors Released by Probiotic Escherichia coli Nissle 1917 and Commensal ECOR63 Enhance Barrier Function by Regulating Expression of Tight Junction Proteins in Intestinal Epithelial Cells

Influence of Lactobacillus and Bifidobacterium Combination on the Gut Microbiota, Clinical Course, and Local Gut Inflammation in Patients with Ulcerative Colitis: A Preliminary, Single-center, Open-label Study

Ratlarda Yüzdürme Egzersizi ve Probiyotik VSL#3’ün Zonulin ile Bazı Yangısal ve Oksidatif Değişkenlere Etkileri

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