Korean J Gastroenterol.  2012 Aug;60(2):94-101. 10.4166/kjg.2012.60.2.94.

Effect of a Probiotic Preparation (VSL#3) in Patients with Mild to Moderate Ulcerative Colitis

• Lee JH
• Moon G
• Kwon HJ
• Jung WJ
• Seo PJ
• Baec TY
• Lee JH
• Kim HS

• KMID: 1387337
• DOI: http://doi.org/10.4166/kjg.2012.60.2.94

Abstract

BACKGROUND/AIMS
Ulcerative colitis (UC) is a chronic disease that characteristically has a relapsing and remitting course. Probiotics might possibly induce remission in the treatment of active UC. Aims of our study were to assess the efficacy of VSL#3 on clinical response and colonic tissue cytokine concentration changes in patients with active UC.
METHODS
Twenty-four eligible patients with mild to moderate UC received open-label VSL#3 4 sachets daily in 2 divided doses for 8 weeks. The disease activity pre- and post-VSL#3 therapy was assessed by ulcerative colitis disease activity score and colonic tissue cytokine profiling done at baseline and at week 8.
RESULTS
Twenty-four patients (mean age, 43.7 years; range, 20-70 years; male/female, 15/9) were enrolled and 2 patients did not have the final endoscopic assessment. A total of 22 patients were analyzed. Intent to treat analysis demonstrated remission in 45.8% of subjects (n=11); partial response in 20.8% (n=5); no change or worse in 25.0% (n=6) of subjects. The mean ulcerative colitis disease activity index (UCDAI) scores decreased from 7.09+/-1.81 to 1.45+/-1.29 in patients with a remission (p<0.001). The mean endoscopic scores had also significantly decreased from 1.91+/-0.54 to 0.63+/-0.50 in patients with a remission (p<0.001). The concentrations of colonic cytokines did not change significantly during treatment in patients with a remission.
CONCLUSIONS
Our study demonstrated that VSL#3 is effective in achieving clinical responses and remissions in patients with mild-to moderately active UC, further supporting the potential role in UC therapy.

Keyword

Probiotics; Ulcerative colitis; Cytokines

MeSH Terms

Adult
Aged
Colitis, Ulcerative/*therapy
Cytokines/metabolism
Drug Administration Schedule
Humans
Male
Middle Aged
Probiotics/*therapeutic use
Severity of Illness Index

Figure

• 

  Fig. 1 Bar diagrams showing (A) ulcerative colitis disease activity index (UCDAI) scores and (B) endoscopic scores before and after administration of VSL#3 for each responding group (*p<0.001, **p=0.011). Two patients did not complete the final endoscopic assessment.

• 

  Fig. 2 Bar diagrams showing the colonic cytokine profile before and after administration of VSL#3 for each responding group in (A) tumor necrosis factor (TNF)-α, (B) interferon (IFN)-γ, (C) interleukin (IL)-12, and (D) IL-10. *p<0.05. Two patients did not complete the final colonic tissue sampling.

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