A pilot study on the effects of probiotic supplementation on neuropsychological performance and micro<scp>RNA</scp>‐29a‐c levels in antiretroviral‐treated <scp>HIV</scp>‐1‐infected patients

Ceccarelli, Giancarlo; Fratino, Mariangela; Selvaggi, Carla; Giustini, Noemi; Serafino, Sara; Schietroma, Ivan; Scheri, Giuseppe Corano; Pavone, Paolo; Passavanti, G.; Fegatelli, Danilo Alunni; Mezzaroma, Ivano; Antonelli, Guido; Vullo, Vincenzo; Scagnolari, Carolina; d’Ettorre, Gabriella

doi:10.1002/brb3.756

Cited by 50 publications

(41 citation statements)

References 31 publications

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“…Experimental evidence has shown that lipopolysaccharides can alter the blood-brain barrier permeability [ 16 ], possibly leading to leakage of the serum pro-inflammatory milieu into the CSF, precipitating local inflammation. In this sense, several studies have shown that the gut microbiota and its products play central regulatory roles in this bidirectional relationship between the enteric and the central nervous system and on gut-brain axis [ 17 , 18 , 19 , 20 , 21 , 22 ]. The administration of probiotics to correct dysbiosis reduces microbial translocation, systemic inflammation and, possibly, the subsequent blood-brain barrier permeability, thus exerting an ameliorative effect on intrathecal immune activation and cognitive function.…”

Section: Discussionmentioning

confidence: 99%

Impact of High-Dose Multi-Strain Probiotic Supplementation on Neurocognitive Performance and Central Nervous System Immune Activation of HIV-1 Infected Individuals

et al. 2017

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Background: Gut microbiota has metabolic activity which influences mucosal homeostasis, local and systemic immune responses, and other anatomical systems (i.e., brain). The effects of dysbiosis are still poorly studied in Human Immunodeficiency Virus-1 (HIV-1) positive subjects and insufficient data are available on the impairment of the gut-brain axis, despite neurocognitive disorders being commonly diagnosed in these patients. This study evaluated the impact of a probiotic supplementation strategy on intrathecal immune activation and cognitive performance in combined antiretroviral therapy (cART) treated HIV-1 infected subjects. Methods: Thirty-five HIV-1 infected individuals were included in this study. At baseline (T0) a battery of tests was administered, to evaluate neurocognitive function and a lumbar puncture was performed to determine neopterin concentration in cerebrospinal fluid (CSF), as a marker of Central Nervous System (CNS) immune activation. Subsequently, a subgroup of participants underwent a 6-month course of multi-strain probiotics supplementation; this intervention group was evaluated, after probiotic treatment, with a second lumbar puncture and with repeated neurocognitive tests. Results: At T0, all participants showed impaired results in at least one neurocognitive test and elevated neopterin concentrations in CSF. After supplementation with probiotics (T6), the interventional group presented a significant decrease in neopterin concentration and a significant improvement in several neurocognitive tests. In contrast, no significant modifications were observed in the neurocognitive performance of controls between T0 and T6. The CNS Penetration Effectiveness Score of antiretroviral therapy did not show an influence from any of the investigated variables. Conclusions: Multi-strain probiotic supplementation seems to exert a positive effect on neuroinflammation and neurocognitive impairment in HIV-1 infected subjects, but large trials are needed to support the concept that modulation of the gut microbiota can provide specific neurological benefits in these patients.

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Section: Discussionmentioning

confidence: 99%

Impact of High-Dose Multi-Strain Probiotic Supplementation on Neurocognitive Performance and Central Nervous System Immune Activation of HIV-1 Infected Individuals

et al. 2017

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“…Finally, a relatively new field of research is the investigation of the role of endocrinological and nutritional factors in episodic memory impairment in HIV infection. For instance, it has been shown that, in patients with HIV infection, both verbal and visual episodic memory performance, tested with RAVLT and the Rey‐Osterrieth Complex Figure Test (ROCFT), respectively, can be modulated by regulation of the gut microbiota through nutritional supplementation .…”

Section: Resultsmentioning

confidence: 99%

“… reported an association of memory performance, but not of psychomotor speed, with the presence of detectable HIV RNA in plasma. Interestingly, in patients with long‐term virological suppression (< 50 copies/mL) and CD4 counts > 400 cells/μL, a regulatory effect of the gut microbiota (modulated with nutritional supplementation) was found on both verbal and visual episodic memory performance .…”

Section: Resultsmentioning

confidence: 99%

The association of memory disorders and chronic HIV disease in the antiretroviral therapy era: a systematic literature review

Ripamonti

Clerici

2019

HIV Medicine

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Objectives Despite recent pharmacological progress, memory impairment is still frequently reported in people living with HIV. We aimed to conduct a systematic literature review investigating the presence of impairment of (sub)components of memory function in patients prescribed highly active antiretroviral therapy (ART). Methods We adopted a cognitive neuropsychological model of memory function as the theoretical framework, distinguishing between a short‐term working memory component and a long‐term component of memory, along with their specific (sub)components. We systematically searched for the presence of impairment of each (sub)component in the selected papers. Careful consideration was given to study design and methods and control of covariates. Results Only the central executive component of working memory has been consistently reported to be impaired in HIV infection. The other two (sub)components, namely the phonological loop and the visuospatial sketchpad, were unimpaired. Discordant results have been obtained as to verbal and visual episodic memory, as some authors reported an association with HIV infection, whereas others did not. There is little evidence for semantic memory deficit in HIV infection, while there are suggestions that the neural substrate of implicit memory may be damaged by the effects of HIV infection and inflammation. Most studies in this area have been conducted in small samples and with poor control for covariates. Thus, conclusions regarding the association of memory dysfunction with HIV infection are hampered by methodological issues such as selection bias and unmeasured confounding. Conclusions The task remains for future research to ascertain the impact of HIV infection on memory function.

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“…About 20 mL of whole blood was collected by venipuncture in Vacutainer tubes containing EDTA (BD Biosciences, San Jose, CA, USA) at each study visit. Peripheral blood mononuclear cells were separated by Ficoll gradient centrifugation (Lympholyte; Cedarlane Labs, Hornby, ON, Canada) and washed twice in phosphate-buffered saline solution (Ceccarelli et al 2017b). Freshly isolated PBMCs were used immediately for immune phenotyping and activation staining.…”

Section: Specimen Processingmentioning

confidence: 99%

Cognitive impairment and CSF proteome modification after oral bacteriotherapy in HIV patients

et al. 2019

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Objective: To investigate whether a probiotic supplementation to cART patients modifies the cerebrospinal fluid (CSF) proteome and improves neurocognitive impairment. Methods: 26 CSF samples from 13 HIV-positive patients [six patients living with HIV (PLHIV) and seven patients with a history of AIDS (PHAIDS)] were analyzed. All patients underwent to neurocognitive evaluation and blood sampling at baseline and after 6 months of oral bacteriotherapy. Immune phenotyping and activation markers (CD38 and HLA-DR) were evaluated on peripheral blood mononuclear cells (PBMC). Plasma levels of IL-6, sCD14, and MIP-1β were detected, by enzyme-linked immunosorbent assay (ELISA). Functional proteomic analysis of CSF sample was conducted by two-dimensional electrophoresis; a multivariate analysis was performed by principal component analysis (PCA) and data were enriched by STRING software. Results: Oral bacteriotherapy leads to an improvement on several cognitive test and neurocognitive performance in both groups of HIV-positive subjects. A reduction in the percentage of CD4 + CD38 + HLA-DR + T cells was also observed at peripheral level after the probiotic intake (p = 0.008). In addition, the probiotic supplementation to cART significantly modifies protein species composition and abundance at the CSF level, especially those related to inflammation (β2-microglobulin p = 0.03; haptoglobin p = 0.06; albumin p = 0.003; hemoglobin p = 0.003; immunoglobulin heavy chains constant region p = 0.02, transthyretin p = 0.02) in PLHIV and PHAIDS. Conclusions: Our results suggest that oral bacteriotherapy as a supplement to cART could exert a role in the amelioration of inflammation state at peripheral and CNS level.

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A pilot study on the effects of probiotic supplementation on neuropsychological performance and microRNA‐29a‐c levels in antiretroviral‐treated HIV‐1‐infected patients

Abstract: Introduction: The gut microbiota is involved in the regulation of cognition, mood, anxi-

Cited by 50 publications

References 31 publications

Impact of High-Dose Multi-Strain Probiotic Supplementation on Neurocognitive Performance and Central Nervous System Immune Activation of HIV-1 Infected Individuals

Impact of High-Dose Multi-Strain Probiotic Supplementation on Neurocognitive Performance and Central Nervous System Immune Activation of HIV-1 Infected Individuals

The association of memory disorders and chronic HIV disease in the antiretroviral therapy era: a systematic literature review

Cognitive impairment and CSF proteome modification after oral bacteriotherapy in HIV patients

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