An imbalance in gut microbiota seems to contribute to the development of chronic inﬂammatory disorders of the gastrointestinal tract, such as ulcerative colitis (UC).
Although it has been suggested that probiotic supplementation is an eﬀective approach to colitis, its eﬀects on intestinal ﬂora and on mucosal cytokine balance have never been explored.
To evaluate the eﬀect of Lactobacillus casei (L. casei) DG, a probiotic strain, on colonic-associated microbiota, mucosal cytokine balance, and toll-like receptor (TLR) expression.
Twenty-six patients with mild left-sided UC were randomly allocated to one of three groups for an 8-week treatment period: the ﬁrst group of 7 patients received oral 5aminosalicylic acid (5-ASA) alone, the second group of 8 patients received oral 5-ASA plus oral L. casei DG, and the third group of 11 patients received oral 5-ASA and rectal L. casei DG.
Biopsies were collected from the sigmoid region to culture mucosal-associated microbes and to assess cytokine and TLR messenger RNA (mRNA) levels by quantitative real-time polymerase chain reaction (RT-PCR).
5-ASA alone or together with oral L. casei DG failed to aﬀect colonic ﬂora and TLR expression in a signiﬁcant manner, but when coupled with rectally administered L. casei DG, it modiﬁed colonic microbiota by increasing Lactobacillus spp. and reducing Enterobacteriaceae. It also signiﬁcantly reduced TLR-4 and interleukin (IL)-1β mRNA levels and signiﬁcantly increased mucosal IL-10.
Manipulation of mucosal microbiota by L. casei DG and its eﬀects on the mucosal immune system seem to be required to mediate the beneﬁcial activities of probiotics in UC patients.
D'Incà R, Barollo M, Scarpa M, Grillo AR, Brun P, Vettorato MG, Castagliuolo I, Sturniolo GC
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