VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis

被引:533
作者
Bibiloni, R
Fedorak, RN
Tannock, GW
Madsen, KL
Gionchetti, P
Campieri, M
De Simone, C
Sartor, RB
机构
[1] Univ Alberta, Div Gastroenterol, Edmonton, AB T6G 2C8, Canada
[2] Univ Alberta, Dept Agr Food & Nutr Sci, Edmonton, AB T6G 2C8, Canada
[3] Univ Bologna, Div Gastroenterol, Bologna, Italy
[4] Univ Aquila, I-67100 Laquila, Italy
[5] Univ N Carolina, Div Gastroenterol, Chapel Hill, NC USA
[6] Univ N Carolina, Div Hepatol, Chapel Hill, NC USA
基金
加拿大健康研究院;
关键词
D O I
10.1111/j.1572-0241.2005.41794.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND AND AIMS: Intestinal bacteria have been implicated in the initiation and perpetuation of IBD; in contrast, "probiotic bacteria" have properties possibly effective in treating and preventing relapse of IBD. We evaluated the safety and efficacy of VSL#3 and the components, and the composition of the biopsy-associated microbiota in patients with active mild to moderate ulcerative colitis (UC). METHODS: Thirty-four ambulatory patients with active UC received open label VSL#3, 3,600 billion bacteria daily in two divided doses for 6 wk. The presence of biopsy-associated bacteria was detected using a nucleic acid-based method and the presence of VSL#3 species confirmed by DNA sequencing of 16S rRNA. RESULTS: Thirty-two patients completed 6 wk of VSL#3 treatment and 2 patients did not have the final endoscopic assessment. Intent to treat analysis demonstrated remission (UCDAI <= 2) in 53% (n = 18); response (decrease in UCDAI >= 3, but final score >= 3) in 24% (n = 8); no response in 9% (n = 3); worsening in 9% (n = 3); and failure to complete the final sigmoidoscopy assessment in 5% (n = 2). There were no biochemical or clinical adverse events related to VSL#3. Two of the components of VSL#3 were detected by PCR/DGGE in biopsies collected from 3 patients in remission. CONCLUSION: Treatment of patients with mild to moderate UC, not responding to conventional therapy, with VSL#3 resulted in a combined induction of remission/response rate of 77% with no adverse events. At least some of the bacterial species incorporated in the probiotic product reached the target site in amounts that could be detected.
引用
收藏
页码:1539 / 1546
页数:8
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