K M Lammers, Policlinico S. Orsola, University of Bologna, Bologna, Italy; A Vergopoulos, N Babel, Institute of Medical Immunology, University Hospital Charite, Berlin Humboldt University, Berlin, Germany; F Rizzello, Policlinico S. Orsola, University of Bologna, Bologna, Italy; E Caramelli, Institute of Histology and General Embryology, University of Bologna, Bologna, Italy; H-D Volk, Institute of Medical Immunology, University Hospital Charite, Berlin Humboldt University, Berlin, Germany; P Gionchetti, M Campieri, Policlinico S. Orsola, University of Bologna, Bologna, Italy
Recently we have obtained favorable results with a highly concentrated probiotic preparation VSL#3 (VSL Pharmaceuticals, Ft. Lauderdale, USA) containing of 300 billions/g viable lyophilized bacteria of eight different strains, e.g. three strains of bifidobacteria, four strains of lactobacilli and one strain of Streptococcus salivarius subsp.
Thermophilus, in maintenance treatment of chronic pouchitis and in the prevention of onset of pouchitis. The mechanism of action however is unclear. Tissue level mRNA expression of a panel of immunological parameters was evaluated using real time quantitative PCR approach in sixteen patients with ulcerative colitis who underwent pouch surgery and received either probiotics or placebo immediately after protective ileostomy closure of the pouch, during the first year after surgery.
None of the patients studied developed pouchitis during the study as was assessed clinically, endoscopically and histologically according to PDAI. The significant findings (expressed as a unitless value through the formula 2.-dCT) of this study include a decrease in interleukin 1 beta, interleukin 8 and interferon gamma gene expression in the probiotic treated group versus placebo group, 0.01 vs. 0.05 (p<0.02), 0.004 vs. 0.02, p<0.05) and 0.0009 vs. 0.003 (p<0.05), respectively.
No significant changes were found in the proinflammatory cytokines tumor necrosis factor alpha, interleukin 6, interleukin 12, the antiinflammatory cytokines interleukin 10 and transforming growth factor beta, and in CD3, CTLA-4 and heme oxygenase-1.
Therefore, the early immunomodulatory effects of probiotics may be in downregulation of the inflammatory response by means of a decrease in interleukin 1 beta and interferon gamma, and by preventing interleukin 8-induced neutrophil infiltration and subsequent activation.
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