Probiotics Reduce Inflammation in Antiretroviral Treated, HIV-Infected Individuals: Results of the “Probio-HIV” Clinical Trial

d’Ettorre, Gabriella; Ceccarelli, Giancarlo; Giustini, Noemi; Serafino, Sara; Calantone, Nina; Girolamo, Gabriella De; Bianchi, Luigi; Bellelli, Valeria; Bartoli, Tommaso Ascoli; Marcellini, Sonia; Turriziani, Ombretta; Brenchley, Jason M.; Vullo, Vincenzo

doi:10.1371/journal.pone.0137200

Cited by 129 publications

(100 citation statements)

References 33 publications

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“…In a recent study, intake of a probiotic containing several Lactobacillus, Bifidobacterium , and Streptococcus spp. significantly reduced CD4+ and CD8+ T cell activation and plasma concentrations of high-sensitivity C-reactive protein, a biomarker associated with cardiovascular disease risk, in ART treated HIV-infected adults [102**]. Interestingly, these patients also reported fewer episodes of diarrhea and constipation.…”

Section: Therapeutic Approaches To Improve Microbiome and Microbial Tmentioning

confidence: 99%

“…Interestingly, these patients also reported fewer episodes of diarrhea and constipation. However, plasma concentrations of sCD14, a biomarker of MT, did not decrease after sustained probiotic intake [102**]. Another study demonstrated that intake of a probiotic yeast, Saccharomyces boulardii , reduced plasma concentrations of LBP and IL-6 in ART-treated HIV-infected individuals [103*].…”

Section: Therapeutic Approaches To Improve Microbiome and Microbial Tmentioning

confidence: 99%

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Microbial translocation and microbiome dysbiosis in HIV-associated immune activation

Zevin

McKinnon

Burgener

et al. 2016

Current Opinion in HIV and AIDS

218

149

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Purpose of Review To describe the mechanisms and consequences of both microbial translocation and microbial dysbiosis in HIV infection. Recent Findings Microbes in HIV are likely playing a large role in contributing to HIV pathogenesis, morbidities and mortality. Two major disruptions to microbial systems in HIV infection include microbial translocation and microbiome dysbiosis. Microbial translocation occurs when the bacteria (or bacterial products) that should be in the lumen of the intestine translocate across the tight epithelial barrier into systemic circulation, where they contribute to inflammation and pathogenesis. This is associated with poorer health outcomes in HIV infected individuals. In addition, microbial populations in the GI tract are also altered after HIV infection, resulting in microbiome dysbiosis, which further exacerbates microbial translocation, epithelial barrier disruption, inflammation, and mucosal immune functioning. Summary Altered microbial regulation in HIV infection can lead to poor health outcomes, and understanding the mechanisms underlying microbial dysbiosis and translocation may result in novel pathways for therapeutic interventions.

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Section: Therapeutic Approaches To Improve Microbiome and Microbial Tmentioning

confidence: 99%

Section: Therapeutic Approaches To Improve Microbiome and Microbial Tmentioning

confidence: 99%

Microbial translocation and microbiome dysbiosis in HIV-associated immune activation

Zevin

McKinnon

Burgener

et al. 2016

Current Opinion in HIV and AIDS

218

149

View full text Add to dashboard Cite

show abstract

“…In HIV-infected individuals, probiotics have been shown to decrease inflammation and microbial translocation (17,18). Thus, replenishing the gut microbiome with beneficial commensals may improve immunity, decrease inflammation, and improve health in individuals with HIV infection.…”

mentioning

confidence: 99%

Effects of Fecal Microbial Transplantation on Microbiome and Immunity in Simian Immunodeficiency Virus-Infected Macaques

Hensley-McBain

Zevin

Manuzak

et al. 2016

J Virol

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An altered intestinal microbiome during chronic human immunodeficiency virus (HIV) infection is associated with mucosal dysfunction, inflammation, and disease progression. We performed a preclinical evaluation of the safety and efficacy of fecal microbiota transplantation (FMT) as a potential therapeutic in HIV-infected individuals. Antiretroviral-treated, chronically simian immunodeficiency virus (SIV)-infected rhesus macaques received antibiotics followed by FMT. The greatest microbiota shift was observed after antibiotic treatment. The bacterial community composition at 2 weeks post-FMT resembled the pre-FMT community structure, although differences in the abundances of minor bacterial populations remained. Immunologically, we observed significant increases in the number of peripheral Th17 and Th22 cells and reduced CD4؉ T cell activation in gastrointestinal tissues post-FMT. Importantly, the transplant was well tolerated with no negative clinical side effects. Although this pilot study did not control for the differential contributions of antibiotic treatment and FMT to the observed results, the data suggest that FMT may have beneficial effects that should be further evaluated in larger studies. IMPORTANCE Due to the immunodeficiency and chronic inflammation that occurs during HIV infection, determination of the safety of FMT is crucial to prevent deleterious consequences if it is to be used as a treatment in the future. Here we used the macaque model of HIV infection and performed FMT on six chronically SIV-infected rhesus macaques on antiretroviral treatment. In addition toproviding a preclinical demonstration of the safety of FMT in primates infected with a lentivirus, this study provided a unique opportunity to examine the relationships between alterations to the microbiome and immunological parameters. In this study, we found increased numbers of Th17 and Th22 cells as well as decreased activation of CD4 ؉ T cells post-FMT, and these changes correlated most strongly across all sampling time points with lower-abundance taxonomic groups and other taxonomic groups in the colon. Overall, these data provide evidence that changes in the microbiome, particularly in terms of diversity and changes in minor populations, can enhance immunity and do not have adverse consequences.A ntiretroviral treatment (ART) has substantially decreased the progression to AIDS in human immunodeficiency virus (HIV)-infected individuals. However, despite the ability to suppress viremia, HIV-infected individuals in whom the infection is suppressed by ART have increased rates of morbidity and mortality compared to those of uninfected individuals (1). One mechanism underlying the increased mortality is dysfunction of the gastrointestinal (GI) tract, which is associated with inflammation during HIV infection. Several lines of evidence support the role of GI dysfunction in HIV-related disease, including (i) a consistent association between mortality in HIV-infected individuals and markers of microbial translocation and gut epithe...

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“…These results are in accordance with a study carried out by d'Ettorre et al in 2015, where HIV infected patients on ART have been supplemented with probiotics for 48 weeks. In the treatment group, it has been observed a significant reduction in the levels of immune activation on CD4 + and CD8 + T lymphocytes for both markers CD38 and HLA-DR, and of their simultaneous expression, and lower microbial products, LPS and C-reactive protein plasma levels, with values comparable to control group (HIV seronegative subjects) [23]. Thus, in HIV infected subjects, the Lactobacillus casei Shirota would be beneficial immunologically, virologically, and bacteriologically.…”

Section: Probiotics As a New Therapeutic Approach That Might Improve mentioning

confidence: 93%

Microbiome and Probiotics inHealth and HIV Infection

D’Angelo¹,

Reale²,

Costantini³

2017

Preprint

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Microbiota plays a key role in various body functions, as well as in physiological, metabolic and immunological processes, through different mechanisms, such as the regulation of the development and/or functions of different types of immune cells in the intestines. Several evidences indicate that alteration in the gut microbiota can influence infectious and non-infectious diseases. Bacteria that resides on the mucosal surface or within the mucus layer interact with the host immune system, thus a healthy gut microbiota is essential for the development of mucosal immunity. The immunomodulatory activity of probiotics has been proposed in several bowel disorders or in aging-related dysfunctions. In HIV infected patients, the intestinal immune system is affected and inflammation persists during ART therapy, too. Several studies are in progress to investigate the ability of probiotics to modulate epithelial barrier functions, microbiota composition and microbial translocation in HIV infection. This mini-review aims to suggest how the use of probiotics is beneficial not only in maintaining a healthy status but also in improving HIV subjects conditions.

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Probiotics Reduce Inflammation in Antiretroviral Treated, HIV-Infected Individuals: Results of the “Probio-HIV” Clinical Trial

Cited by 129 publications

References 33 publications

Microbial translocation and microbiome dysbiosis in HIV-associated immune activation

Microbial translocation and microbiome dysbiosis in HIV-associated immune activation

Effects of Fecal Microbial Transplantation on Microbiome and Immunity in Simian Immunodeficiency Virus-Infected Macaques

Microbiome and Probiotics inHealth and HIV Infection

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