Role and mechanisms of action ofEscherichia coliNissle 1917 in the maintenance of remission in ulcerative colitis patients: An update

Abstract

Ulcerative colitis (UC) is a chronic inflammatory disease, whose etiology is still unclear. Its pathogenesis involves an interaction between genetic factors, immune response and the "forgotten organ", Gut Microbiota. Several studies have been conducted to assess the role of antibiotics and probiotics as additional or alternative therapies for Ulcerative Colitis. Escherichia coli Nissle (EcN) is a nonpathogenic Gram-negative strain isolated in 1917 by Alfred Nissle and it is the active component of microbial drug Mutaflor(®) (Ardeypharm GmbH, Herdecke, Germany and EcN, Cadigroup, In Italy) used in many gastrointestinal disorder including diarrhea, uncomplicated diverticular disease and UC. It is the only probiotic recommended in ECCO guidelines as effective alternative to mesalazine in maintenance of remission in UC patients. In this review we propose an update on the role of EcN 1917 in maintenance of remission in UC patients, including data about efficacy and safety. Further studies may be helpful for this subject to further the full use of potential of EcN.

Current and emerging therapeutic targets for IBD

“…Escherichia coli Nissle (EcN) is a nonpathogenic Gram negative strain that controls intestinal barrier function and induces anti inflammatory proteins 124,125 . EcN is an established clinical therapy for patients with ulcerative colitis and exhibits similar anti inflammatory effects com pared with 5 ASAs 125 .…”

“…EcN is an established clinical therapy for patients with ulcerative colitis and exhibits similar anti inflammatory effects com pared with 5 ASAs 125 . EcN has direct antimicrobial effects, controls biofilm formation, stimulates human β defensin production by intestinal epithelial cells, and strengthens tight junctions by upregulating zonula occludens proteins 125 . In addition to this probiotic strain, several other probiotic approaches as well as faecal transplantation have been considered for IBD therapy, although unequivocal results have been obtained 126,127 .…”

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

“…The probiotic EcN is a good intestinal colonizer that has been licensed for use in human medicine to treat several disorders of the gastrointestinal tract. Its therapeutic efficacy in the remission of ulcerative colitis has been proved through clinical trials (Kruis et al, 2004; reviewed by Scaldaferri et al, 2016). In addition, the effectiveness of this probiotic in the amelioration of induced experimental colitis in mice is well-documented (Grabig et al, 2006; Ukena et al, 2007; Garrido-Mesa et al, 2011; Olier et al, 2012; Souza et al, 2016).…”

Structure and Functional Analysis of ClbQ, an Unusual Intermediate-Releasing Thioesterase from the Colibactin Biosynthetic Pathway

“…6–8 Paradoxically, the clb cluster is found in the probiotic Nissle 1917, which is used in Europe for the treatment of gastrointestinal disorders. 9,10 The gene cluster encodes a hybrid nonribosomal peptide synthetase (NRPS)/ polyketide synthase (PKS) pathway along with accessory proteins (Figure 1 and Figure S1). 6,11,12 Modular NRPSs and PKSs are multidomain enzymes responsible for the generation of a wide range of structurally diverse natural products.…”