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


OBJECTIVE
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-1beta; 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.


CONCLUSIONS
Synbiotic consumption was effective in improving clinical symptoms in patients with active Crohn's disease.
Steed
H
H
University of Dundee, UK.
Macfarlane
G T
GT
Blackett
K L
KL
Bahrami
B
B
Reynolds
N
N
Walsh
S V
SV
Cummings
J H
JH
Macfarlane
S
S
D000328:Adult; D000368:Aged; D001644:Bifidobacterium / Q000378:metabolism*; D015169:Colony Count, Microbial; D003424:Crohn Disease / Q000188:drug therapy* / Q000276:immunology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology / Q000382:microbiology*; D007779:Lactobacillus acidophilus / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009844:Oligosaccharides / Q000627:therapeutic use*; D056692:Prebiotics; D019936:Probiotics / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D009844:Oligosaccharides; D056692:Prebiotics