Effect of probiotics on pro-inflammatory cytokines and NF-kappaB activation in ulcerative colitis.
OBJECTIVE
To demonstrate the therapeutic effect of probiotics in patients with ulcerative colitis (UC), and their effect on inflammatory mediators and nuclear factor (NF)-kappaB activation in these patients.


METHODS
Thirty patients with mild to moderate UC were randomly classified into two groups: sulfasalazine group, who received sulfasalazine 2400 mg/d; and probiotic group, who received sulfasalazine 2400 mg/d with probiotic. The patients were investigated before and after 8 wk of treatment with probiotic (Lactobacillus delbruekii and Lactobacillus fermentum). Colonic activity of myeloperoxidase (MPO) was assayed with UV spectrophotometry, the colonic content of interleukin (IL)-6 was determined by enzyme-linked immunosorbent assay (ELISA), fecal calprotectin was determined by ELISA, and expression of NF-kappaB p65 and tumor necrosis factor (TNF)-alpha proteins in colonic tissue was identified by immunohistochemistry and reverse transcription polymerase chain reaction, respectively.


RESULTS
At the start of the study, colonic mucosal injury and inflammation were demonstrated in UC patients by hematoxylin and eosin staining, and an increase in colonic MPO activity, fecal calprotectin, and expression of colonic TNF-alpha and NF-kappaB p65 proteins. The use of probiotic for 8 wk significantly ameliorated the inflammation by decreasing the colonic concentration of IL-6, expression of TNF-alpha and NF-kappaB p65, leukocyte recruitment, as demonstrated by a decrease in colonic MPO activity, and the level of fecal calprotectin compared to sulfasalazine group and the control group (P < 0.05).


CONCLUSIONS
Oral supplementation with probiotics could be helpful in maintaining remission and preventing relapse of UC.
Hegazy
Sahar K
SK
Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta 8130, Egypt. saharhegazy96@yahoo.co.uk
El-Bedewy
Mohamed M
MM
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000378:metabolism*; D005243:Feces; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000187:drug effects / Q000378:metabolism; D048668:Lactobacillus delbrueckii / Q000502:physiology; D052197:Limosilactobacillus fermentum / Q000502:physiology; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism*; D009195:Peroxidase / Q000378:metabolism; D019936:Probiotics / Q000494:pharmacology* / Q000627:therapeutic use; D012460:Sulfasalazine / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015850:Interleukin-6; D039841:Leukocyte L1 Antigen Complex; D016328:NF-kappa B; D014409:Tumor Necrosis Factor-alpha; D012460:Sulfasalazine; D009195:Peroxidase
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