The long-term effects of probiotics in the therapy of ulcerative colitis: A clinical study

Abstract

Aim.Intestinal dysbiosis seems to be the leading cause of inflammatory bowel diseases, and probiotics seems to represent the proper support against their occurrence. Actually, probiotic blends and anti-inflammatory drugs represent a weapon against inflammatory bowel diseases. The present study evaluates the long-term (2 years) effects of combination therapy (mesalazine plus a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4) on ulcerative colitis activity. Method. Sixty patients with moderate-to-severe ulcerative colitis were enrolled: 30 of them were treated with a single daily oral administration of mesalazine 1200 mg; 30 patients received a single daily oral administration of mesalazine 1200 mg and a double daily administration of a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4. The treatment was carried out for two years and the clinical response evaluated according to the Modified Mayo Disease Activity Index. Results. All patients treated with combination therapy showed better improvement compared to the controls. In particular, the beneficial effects of probiotics were evident even after two years of treatment. Conclusions. A long-term treatment modality of anti-inflammatory drugs and probiotics is viable and could be an alternative to corticosteroids in mild-to moderate ulcerative colitis.

The Effectiveness of Probiotics in the Treatment of Inflammatory Bowel Disease (IBD)—A Critical Review

“…Treatment with probiotics together with commonly used anti-inflammatory drugs seems to be a more effective solution in comparison to treatment with probiotics alone. Palumbo and co-workers [ 95 ] demonstrated the positive effect of mesalazine use (Mesavancol ® 1200 mg CPR, Giuliani spa, Milan, Italy) with the probiotic mix ( Lactobacillus salivarius, Lactobacillus acidophilus, and Bifidobacterium bifidum strain BGN4; Acronelle ® , Bromatech SRL, Milan, Italy) among UC patients. The group with the double treatment showed reduced recovery time, weaker activity of the disease, and they presented a better endoscopic picture.…”

The New Proactive Approach and Precision Medicine in Crohn’s Disease

“…Thus, probiotics have been proposed to alter the gut microbiota with the goal of decreasing stimulation of the intestinal immune system, preventing epithelial dysfunction, and reducing permeability of the gut mucosa. A long-term UC study comparing daily oral mesalazine 1200 mg monotherapy to daily oral mesalazine 1200 mg in combination with bidaily probiotics (blend of Lactobacillus salivarius , Lactobacillus acidophilus , and Bifidobacterium bifidus strain BGN4) found significant disease improvement based on the Modified Mayo Disease Activity Index (MMDAI) after 18 months of treatment with combination therapy compared to monotherapy [ 85 ]. Other studies found that probiotics, specifically VSL#3, were as effective as mesalazine in preventing UC relapse and were an effective treatment for pouchitis [ 86 , 87 ].…”

A New Proposal for the Pathogenic Mechanism of Non-Coeliac/Non-Allergic Gluten/Wheat Sensitivity: Piecing Together the Puzzle of Recent Scientific Evidence

“…In particular, Bifidobacterium bifidum BGN 4 seems to reduce the production of pro-inflammatory cytokines, thanks to the chiro-inositol present in its cell membrane [ 154 ]. According to a recent study [ 155 ], the administration of a specific probiotic blend containing Bifidobacterium bifidum BGN 4, Lactobacillus salivarius and Lactobacillus acidophilus (Acronelle ® , Bromatech srl, Milan, Italy) decreases inflammation in patients with IBD, in combination with mesalazine treatment.…”