VSL#3 probiotic treatment reduces chemotherapy-induced diarrhoea and weight loss

Abstract

Background: One of the most common toxicities of cancer treatment is diarrhea. Probiotics have been shown effective at preventing diarrhea in inflammatory bowel disease and may prove useful in the oncology setting.Aim: The primary aim of this study was to investigate the probiotic mixture, VSL#3, for amelioration of chemotherapy-induced diarrhea (CID).Methods: This experiment was carried out in a clinically relevant model of CID. VSL#3 was administered to female DA rats in one of three schedules. Irinotecan was used to induce mucositis and diarrhea, with rats monitored for seven days to record incidence of weight-loss and diarrhea. At study completion, intestines were collected to investigate histological and proliferative changes, apoptosis levels and mucin composition.Results: VSL#3 reduced weight loss following irinotecan when administered before and after chemotherapy. Moderate and severe diarrhea was also prevented in these rats. This was associated with a significant increase in crypt proliferation combined with an inhibition of apoptosis in both the small and large intestines. VSL#3 also prevented irinotecan-induced increases in goblet cells within jejunal crypts.Conclusions: VSL#3 is effective at preventing severe diarrhea following chemotherapy with irinotecan and therefore has potential to be used clinically by cancer patients.

Review: Chemotherapy-induced diarrhea: pathophysiology, frequency and guideline-based management

“…Increased levels of EGFR are found in inflamed mucosa, particulary in goblet cells, which seem to play a role in CID [Threadgill et al 1995]. However, there was no increase in toxicity of head and neck radiation by addition of cetuximab in a phase III trial despite a possible correlation between EGFR targeting and maturation of squamous eptithelium of the tongue and nasal cavity [Bonner et al 2006;Keefe and Gibson, 2007]. The high expression of Kit in the interstitial cells of Cajal, which function as pacemaker cells of the intestinal motility, might be a potential mechanism for diarrhea induced by imatinib or sunitinib [Deininger et al 2003].…”

“…Usually it is a dose-related adverse effect and may be associated with other features of toxicity. CID appears to be a multifactorial process whereby acute damage to the intestinal mucosa (including loss of intestinal epithelium, superficial necrosis and inflammation of the bowel wall) causes an imbalance between absorption and secretion in the small bowel [Keefe et al 2000;Keefe, 2007;Gibson and Stringer, 2009].…”

Nutritional Management of Esophageal Cancer Patients

“…These fatty acids are an important energy source of enterocytes, maintain intestinal environment acidity and intestinal motility. Synbiotics also maintain the number of beneficial bacteria and inhibit the overgrowth of possible diarrheal pathogens, thus reducing the incidence of diarrhea [109].…”

Oral ingestion ofStreptococcus thermophilusdoes not affect mucositis severity or tumor progression in the tumor-bearing rat

“…Prior to the initial MTX injection, manual measurement of tumor size and weight using digital calipers showed no significant differences among the four treatment reduced. 23 Moreover, proliferation in the colonic epithelium was increased whilst apoptosis was decreased. We have previously demonstrated that a commercially available (sheep's milk) yogurt containing Lactobacillus bulgaricus and Streptococcus thermophilus, enhanced digestive and barrier function in rats with Methotrexate (MTX)-induced intestinal damage.…”