Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease

H. Steed; G. T. Macfarlane; K. L. Blackett; B. Bahrami; N. Reynolds; S. V. Walsh; J. H. Cummings; S. Macfarlane

doi:10.1111/j.1365-2036.2010.04417.x

Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease

H. Steed, G. T. Macfarlane, K. L. Blackett, B. Bahrami, N. Reynolds, S. V. Walsh, J. H. Cummings, S. Macfarlane

Research output: Contribution to journal › Article › peer-review

213 Citations (Scopus)

Abstract

Background

Crohn's disease is an inflammatory illness in which the immune response against gut microorganisms is believed to drive an abnormal immune response. Consequently, modification of mucosal bacterial communities, and the immune effects they elicit, might be used to modify the disease state.

Aim

To investigate the effects of synbiotic consumption on disease processes in patients with Crohn's disease.

Methods

A randomized, double-blind placebo-controlled trial was conducted involving 35 patients with active Crohn's disease, using a synbiotic comprising Bifidobacterium longum and Synergy 1. Clinical status was scored and rectal biopsies were collected at the start, and at 3- and 6-month intervals. Transcription levels of immune markers and mucosal bacterial 16S rRNA gene copy numbers were quantified using real-time PCR.

Results

Significant improvements in clinical outcomes occurred with synbiotic consumption, with reductions in both Crohn's disease activity indices (P = 0.020) and histological scores (P = 0.018). The synbiotic had little effect on mucosal IL-18, INF-gamma and IL-1 beta; however, significant reductions occurred in TNF-alpha expression in synbiotic patients at 3 months (P = 0.041), although not at 6 months. Mucosal bifidobacteria proliferated in synbiotic patients.

Conclusion

Synbiotic consumption was effective in improving clinical symptoms in patients with active Crohn's disease.

Original language	English
Pages (from-to)	872-883
Number of pages	12
Journal	Alimentary Pharmacology & Therapeutics
Volume	32
Issue number	7
DOIs	https://doi.org/10.1111/j.1365-2036.2010.04417.x
Publication status	Published - 1 Oct 2010

Keywords

Inflammatory bowel disease
Polymerase chain reaction
Real time PCR
Fecal samples
Bacteria
Mucosal
Therapy
Colitis
Flora
Quantitation

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10.1111/j.1365-2036.2010.04417.x

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Steed, H., Macfarlane, G. T., Blackett, K. L., Bahrami, B., Reynolds, N., Walsh, S. V., Cummings, J. H., & Macfarlane, S. (2010). Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease. Alimentary Pharmacology & Therapeutics, 32(7), 872-883. https://doi.org/10.1111/j.1365-2036.2010.04417.x

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title = "Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease",

abstract = "Background Crohn's disease is an inflammatory illness in which the immune response against gut microorganisms is believed to drive an abnormal immune response. Consequently, modification of mucosal bacterial communities, and the immune effects they elicit, might be used to modify the disease state. Aim To investigate the effects of synbiotic consumption on disease processes in patients with Crohn's disease. Methods A randomized, double-blind placebo-controlled trial was conducted involving 35 patients with active Crohn's disease, using a synbiotic comprising Bifidobacterium longum and Synergy 1. Clinical status was scored and rectal biopsies were collected at the start, and at 3- and 6-month intervals. Transcription levels of immune markers and mucosal bacterial 16S rRNA gene copy numbers were quantified using real-time PCR. Results Significant improvements in clinical outcomes occurred with synbiotic consumption, with reductions in both Crohn's disease activity indices (P = 0.020) and histological scores (P = 0.018). The synbiotic had little effect on mucosal IL-18, INF-gamma and IL-1 beta; however, significant reductions occurred in TNF-alpha expression in synbiotic patients at 3 months (P = 0.041), although not at 6 months. Mucosal bifidobacteria proliferated in synbiotic patients. Conclusion Synbiotic consumption was effective in improving clinical symptoms in patients with active Crohn's disease.",

keywords = "Inflammatory bowel disease, Polymerase chain reaction, Real time PCR, Fecal samples, Bacteria, Mucosal, Therapy, Colitis, Flora, Quantitation",

author = "H. Steed and Macfarlane, {G. T.} and Blackett, {K. L.} and B. Bahrami and N. Reynolds and Walsh, {S. V.} and Cummings, {J. H.} and S. Macfarlane",

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Steed, H, Macfarlane, GT, Blackett, KL, Bahrami, B, Reynolds, N, Walsh, SV, Cummings, JH & Macfarlane, S 2010, 'Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease', Alimentary Pharmacology & Therapeutics, vol. 32, no. 7, pp. 872-883. https://doi.org/10.1111/j.1365-2036.2010.04417.x

Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease. / Steed, H.; Macfarlane, G. T.; Blackett, K. L. et al.
In: Alimentary Pharmacology & Therapeutics, Vol. 32, No. 7, 01.10.2010, p. 872-883.

Research output: Contribution to journal › Article › peer-review

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T2 - the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease

AU - Steed, H.

AU - Macfarlane, G. T.

AU - Blackett, K. L.

AU - Bahrami, B.

AU - Reynolds, N.

AU - Walsh, S. V.

AU - Cummings, J. H.

AU - Macfarlane, S.

PY - 2010/10/1

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N2 - Background Crohn's disease is an inflammatory illness in which the immune response against gut microorganisms is believed to drive an abnormal immune response. Consequently, modification of mucosal bacterial communities, and the immune effects they elicit, might be used to modify the disease state. Aim To investigate the effects of synbiotic consumption on disease processes in patients with Crohn's disease. Methods A randomized, double-blind placebo-controlled trial was conducted involving 35 patients with active Crohn's disease, using a synbiotic comprising Bifidobacterium longum and Synergy 1. Clinical status was scored and rectal biopsies were collected at the start, and at 3- and 6-month intervals. Transcription levels of immune markers and mucosal bacterial 16S rRNA gene copy numbers were quantified using real-time PCR. Results Significant improvements in clinical outcomes occurred with synbiotic consumption, with reductions in both Crohn's disease activity indices (P = 0.020) and histological scores (P = 0.018). The synbiotic had little effect on mucosal IL-18, INF-gamma and IL-1 beta; however, significant reductions occurred in TNF-alpha expression in synbiotic patients at 3 months (P = 0.041), although not at 6 months. Mucosal bifidobacteria proliferated in synbiotic patients. Conclusion Synbiotic consumption was effective in improving clinical symptoms in patients with active Crohn's disease.

AB - Background Crohn's disease is an inflammatory illness in which the immune response against gut microorganisms is believed to drive an abnormal immune response. Consequently, modification of mucosal bacterial communities, and the immune effects they elicit, might be used to modify the disease state. Aim To investigate the effects of synbiotic consumption on disease processes in patients with Crohn's disease. Methods A randomized, double-blind placebo-controlled trial was conducted involving 35 patients with active Crohn's disease, using a synbiotic comprising Bifidobacterium longum and Synergy 1. Clinical status was scored and rectal biopsies were collected at the start, and at 3- and 6-month intervals. Transcription levels of immune markers and mucosal bacterial 16S rRNA gene copy numbers were quantified using real-time PCR. Results Significant improvements in clinical outcomes occurred with synbiotic consumption, with reductions in both Crohn's disease activity indices (P = 0.020) and histological scores (P = 0.018). The synbiotic had little effect on mucosal IL-18, INF-gamma and IL-1 beta; however, significant reductions occurred in TNF-alpha expression in synbiotic patients at 3 months (P = 0.041), although not at 6 months. Mucosal bifidobacteria proliferated in synbiotic patients. Conclusion Synbiotic consumption was effective in improving clinical symptoms in patients with active Crohn's disease.

KW - Inflammatory bowel disease

KW - Polymerase chain reaction

KW - Real time PCR

KW - Fecal samples

KW - Bacteria

KW - Mucosal

KW - Therapy

KW - Colitis

KW - Flora

KW - Quantitation

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DO - 10.1111/j.1365-2036.2010.04417.x

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C2 - 20735782

SN - 0269-2813

VL - 32

SP - 872

EP - 883

JO - Alimentary Pharmacology & Therapeutics

JF - Alimentary Pharmacology & Therapeutics

IS - 7

ER -

Clinical trial: the microbiological and immunological effects of synbiotic consumption - a randomized double-blind placebo-controlled study in active Crohn's disease

Abstract

Keywords

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