Influence of Lactobacillus and Bifidobacterium Combination on the Gut Microbiota, Clinical Course, and Local Gut Inflammation in Patients with Ulcerative Colitis: A Preliminary, Single-center, Open-label Study

Abstract

Background: Ulcerative colitis (UC) is one of the chronic, relapsing, inflammatory disorders of the gut and is characterized by inflammation limited in most cases to the colon. Since gut microbiota play a critical role in the development and perpetuation of intestinal inflammation, the addition of probiotics to this complex system may exert a positive influence on gut inflammatory reactions. Methods:A single center, open-label, intention-to-treat study involving patients with moderate-to-severe UC was performed to check whether a probiotic mixture containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium longum given together with a standard treatment could decrease clinical and histopathology indexes for UC evaluation. Results:The mixture given once a day for at least 2 months together with mesalazine and ciprofloxacin to patients in the acute phase of UC significantly reduced their Mayo Clinic Index values. Moreover, numbers of Lactobacilli isolated from patients feces were significantly increased, while those of Gram-negative rods decreased. The mixture given together with mesalazine to patients with UC in remission also caused a decrease of their clinical scores, but a more prominent and significant decrease of the histopathological index values in biopsy samples was observed. Conclusions:Supplementation of standard therapy with the probiotic mixture used in this study was efficacious in inducing and maintaining remission in UC, and this effect was related to modulation of dysbiosis in the gut microbiota. analyzed randomized clinical trials and found that selected probiotics were efficacious in inducing and maintaining remission in UC [8]. Another review reached nearly the same conclusions on the efficacy of probiotics in UC [9]. Influence of Lactobacillus and Bifidobacterium Combination on the Gut• The aim of this study was to investigate in a single center, openlabel, intention-to-treat study involving patients with moderateto-severe UC whether a probiotic mixture containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium longum given together with standard therapy could decrease clinical and histopathology indexes for UC. Materials and Methods PatientsAltogether, 51 patients (21 with UC in remission and 30 in the active phase of UC) of both sexes and between 18 and 72 years of age who were being treated in the Jagiellonian University Medical College Clinic of Gastroenterology in Cracow, Poland were enrolled. The study was conducted from 2008 to 2011 and was approved by the Jagiellonian University independent ethics committee (No KBET/5/B/2007). Written informed consent was obtained from all patients before enrollment.Inclusion criteria included an existing diagnosis of UC based on disease history, colonoscopy results, and histopathologic evaluation of biopsies from the colonic mucosa. The patients were not treated with antibiotics for three months before enrollment. Exclusion criteria were: diabetes, autoimmune diseases, severe systemic diseases, alcoho...

Obesity as a risk factor for COVID-19: an overview

“…Xu et al demonstrated that some patients with COVID-19 presented microbial dysbiosis with decreased Lactobacillus and Bifidobacterium in fecal samples (Xu et al 2020). These bacteria play an important role in gut homeostasis and neurological function (Ni et al 2019), and supplementation with these bacteria can improve gut inflammation in ulcerative colitis patients (Pilarczyk Zurek et al 2017).…”

Gut microbiota in pathophysiology, diagnosis, and therapeutics of inflammatory bowel disease

“…Chen et al [ 312 ] reported that the probiotic mixture of B. infantis , L. acidophilus , and Enterococcus faecalis with or without Bacillus cereus could restore the relative abundance of Lactobacillus , Bifidobacterium , Bacteroides , and Akkermansia in a mouse model of DSS-induced chronic colitis. In UC patients, a mixture of Lactobacillus and Bifidobacterium significantly increases the population of Proteobacteria and reduces Gramnegative rods [ 313 ].…”

Efficacy of Probiotics-Based Interventions as Therapy for Inflammatory Bowel Disease: A Recent Update

“…In patients of UC, consumption of a mixture of Lactobacillus and Bifidobacteria reported a significant increase in the population of genera of Proteobacteria and reduction in Gram-negative rods. Supplementation of the probiotic mixture had a significant effect on the alteration of the gastrointestinal microbiome ( Pilarczyk-Żurek et al, 2017 ). Similarly, several other studies also reported that consumption of probiotics successfully restores and modulates a healthy microbial ecosystem as a treatment for IBD in patients ( Liu et al, 2020a , Liu et al, 2020b , Xia et al, 2020 ).…”

“…Pathogenesis of IBD might be engendered by the rising of abnormal microflora in the gut. Oral administration of probiotics is widely practiced for various health improvements, including as therapies for gut-related disorders ( Altun et al, 2019 , Pilarczyk-Żurek et al, 2017 , van der Waal et al, 2019 ). Studies conducted to evaluate the efficiency of probiotics in the IBD, that demonstrated in animal models are summarized in Table 1 and the clinical intervention are summarized in Table 2 .…”

“…Meanwhile, the population of pathogenic Klebsiella genus and Streptococcus genus before treatment were found to decrease significantly after FMT (Tian et al, 2019). Reduction in the abundance of Prevotella with enriching the proportion of Klebsiella and Streptococcus were important factors to the onset of UC ( Pilarczyk-Żurek et al, 2017 ). Another study also evaluated the remission of active UC linked to several microflorae such as Clostridium cluster IV and XVIII; Barnesiella spp.…”