Document Detail


Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial.
MedLine Citation:
PMID:  15647189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Ulcerative colitis (UC) is an acute and chronic inflammatory disease of the large bowel with unknown aetiology. The immune response against normal commensal microorganisms is believed to drive inflammatory processes associated with UC. Therefore, modulation of bacterial communities on the gut mucosa, through the use of probiotics and prebiotics, may be used to modify the disease state.
METHODS: A synbiotic was developed for use in UC patients combining a probiotic, Bifidobacterium longum, isolated from healthy rectal epithelium, and a prebiotic (Synergy 1), a preferential inulin-oligofructose growth substrate for the probiotic strain. Treatment was employed in a double blinded randomised controlled trial using 18 patients with active UC for a period of one month. Clinical status was scored and rectal biopsies were collected before and after treatment, and transcription levels of epithelium related immune markers were measured.
RESULTS: Sigmoidoscopy scores (scale 0-6) were reduced in the test group (start 4.5 (1.4), end 3.1 (2.5)) compared with placebo (start 2.6 (2.1), end 3.2 (2.2)) (p=0.06). mRNA levels for human beta defensins 2, 3, and 4, which are strongly upregulated in active UC, were significantly reduced in the test group after treatment (p=0.016, 0.038, and 0.008, respectively). Tumour necrosis factor alpha and interleukin 1alpha, which are inflammatory cytokines that drive inflammation and induce defensin expression, were also significantly reduced after treatment (p=0.018 and 0.023, respectively). Biopsies in the test group had reduced inflammation and regeneration of epithelial tissue.
CONCLUSIONS: Short term synbiotic treatment of active UC resulted in improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy.
Authors:
E Furrie; S Macfarlane; A Kennedy; J H Cummings; S V Walsh; D A O'neil; G T Macfarlane
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  54     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-13     Completed Date:  2005-02-07     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  242-9     Citation Subset:  AIM; IM    
Affiliation:
Microbiology and Gut Biology Group, University of Dundee, Ninewells Hospital Medical School, Dundee DD1 9SY, UK. e.furrie@dundee.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bifidobacterium* / isolation & purification
Biopsy
C-Reactive Protein / metabolism
Colitis, Ulcerative / metabolism,  pathology,  therapy*
Cytokines / biosynthesis,  genetics
Double-Blind Method
Female
Gene Expression
Humans
Inflammation Mediators / metabolism
Intestinal Mucosa / microbiology,  pathology
Male
Middle Aged
Oligosaccharides / therapeutic use
Pilot Projects
Probiotics / therapeutic use*
RNA, Messenger / genetics
Rectum / pathology
Sigmoidoscopy
Treatment Outcome
beta-Defensins / biosynthesis,  genetics
Chemical
Reg. No./Substance:
0/Cytokines; 0/Inflammation Mediators; 0/Oligosaccharides; 0/RNA, Messenger; 0/beta-Defensins; 0/oligofructose; 9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
Gut. 2005 Sep;54(9):1346   [PMID:  16099808 ]
Gut. 2006 Dec;55(12):1692-3   [PMID:  17124152 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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