Increased Bacterial Urease Activity in Faeces in Juvenile Chronic Arthritis: Evidence of Altered Intestinal Microflora?

Abstract

The intestinal microflora was indirectly evaluated in juvenile chronic arthritis (JCA) by analysing enzyme activities--urease, beta-glucosidase and beta-glucuronidase--in faeces. In 18 out of 26 JCA patients, the illness had been diagnosed during the past year. The control group was composed of eight age-matched control patients and 18 family members of JCA patients (3-36 yr). The mean [95% confidence interval (CI)] urease activity, but not the activities of beta-glucosidase and beta-glucuronidase, in faeces from the JCA group differed from that in the control group: 32.3 (26.6-38.1) nmol/min/mg protein vs 24.0 (16.8-31.6), P = 0.07. The difference was more marked in a comparison of JCA patients with family members (P = 0.03). In a subgroup of subjects, the effect of 10 days oral bacteriotherapy with Lactobacillus GG on faecal enzyme activities was then investigated (n = 8 JCA patients, n = 8 control patients). This short-term oral bacteriotherapy reduced the increased urease activity in faeces of JCA patients. Keeping in mind the small number of subjects, it may be inferred from the present results that the increased urease activity in JCA is specific for the disease, suggesting altered intestinal microflora in JCA.

Dietary therapy with Lactobacillus GG, bovine colostrum or bovine immune colostrum in patients with juvenile chronic arthritis: Evaluation of effect on gut defence mechanisms

“…The finding that Lactobacillus GG reduced faecal urease activity is in accordance with previous results. In our previous study, faecal urease activity was higher in JCA patients than in healthy controls and family members, and Lactobacillus GG reduced this increased urease activity [51]. In children with acute viral gastroenteritis, oral bacteriotherapy also decreased elevated urease activity in faeces [19,21].…”

“…We have suggested that increased faecal urease activity reflects imbalanced anaerobic microflora in JCA, and Lactobacillus GG proved able to counteract this alteration. The observation that increased IgA and IgM immune responses, as well as increased 13-glucosidase and decreased urease activities in faeces, were detectable mainly in patients without sulphasalazine therapy, raises the suspicion that sulphasalazine may interfere with the function of Lactobacillus GG in the intestine.We have previously found in an in-vitro study that Lactobacillus GG is resistant to various pharmaceutical agents, including sulphasalazine [51]. Since circumstances in the intestine are not comparable to those in vitro, the findings of in-vitro studies must always be interpreted with The 13-glucosidase-enhancing effect of Lactobacillus GG can be explained by the fact that Lactobacillus GG itself produces 13-glucosidase [52].…”

Effects of Probiotic Supplementation on Oxidative Stress Indices in Women with Rheumatoid Arthritis: A Randomized Double-Blind Clinical Trial

“…It has frequently been reported that the gut microbiota is altered in patients with RA [33][34][35][36] and the contributory effect of such alteration in initiation of the disease has been revealed by animal studies [37]. On the other hand, oxidative stress has been suggested to be implicated in the disease pathogenesis [4] and is reported to play a role in gut microbiota changes as well [38].…”

Formulation and Design of Probiotic Supplements for Rheumatoid Arthritis Patients

“…effect of gut microbiota changes in the development of RA. [7][8][9][10][11][12] Therefore, it has been attempted to alleviate the symptoms of the disease through normalizing the gut bacterial pattern of the patients; administering probiotic preparations is one possible way to achieve this goal. [13][14][15] Animal studies have shown that various strains of Lactobacillus casei (L. casei) can efficiently decrease inflammatory cytokines in RA.…”