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Erschienen in: Diseases of the Colon & Rectum 2/2006

01.02.2006

Effects of Exopolysaccharide-Producing Probiotic Strains on Experimental Colitis in Rats

verfasst von: Neriman Şengül, M.D., Belma Aslím, Ph.D., Gülberk Uçar, Ph.D., Nihal Yücel, Ph.D., Sevil Işık, M.D., Hatice Bozkurt, M.S., Zişan Sakaoğullarí, M.D., Fuat Atalay, M.D.

Erschienen in: Diseases of the Colon & Rectum | Ausgabe 2/2006

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Purpose

Inflammatory bowel disease is suggested to result from a dysregulated immune response toward intestinal microflora, which may be restored by probiotic therapy based on the concept of healthy microflora. Ideal probiotic bacteria may be beneficial in inflammatory bowel disease; however, the mechanism of action and the clinical efficacy of probiotic usage are still unclear. In the present study, the effect of exopolysaccharide producing probiotics was evaluated on an experimental colitis model in rats.

Methods

Colitis was induced by intracolonic administration of acetic acid. Then, rats were treated daily with two probiotic strains, Lactobacillus delbrueckii subsp. bulgaricus B3 strain (exopolysaccharide of 211 mg/l: high-EPS group) or Lactobacillus delbrueckii subsp. bulgaricus A13 strain (EPS of 27 mg/l: low-EPS group), which were given into the stomach. The non-colitis–fed control group was only treated with high-exopolysaccharide strain. The model-control and control groups were treated only with tap water. Rats were killed after a seven-day treatment period. Disease activity was quantified by use of histologic scores and colonic myeloperoxidase activity, which is a marker of neutrophil infiltration during inflammation.

Results

The enhanced inflammatory response was accompanied by a higher level of myeloperoxidase activity in the colitis group. Histologic scores of colonic damage and myeloperoxidase activity were lower in both probiotic-treated groups compared with those of the colitis control group (P < 0.001), although the mentioned scores improved significantly more in the high-EPS group than in the low-EPS group (P < 0.001).

Conclusions

Exopolysaccharide-producing probiotics significantly attenuate experimental colitis, which may be mediated by exopolysaccharide in a dose-dependent manner. Therefore, exopolysaccharide-producing probiotics may be a promising therapeutic role in inflammatory bowel disease.
Literatur
1.
Zurück zum Zitat Shanahan, F 2001Inflammatory bowel disease: immunodiagnostics, immunotherapeutics and ecotherapeuticsGastroenterology120622635CrossRefPubMed Shanahan, F 2001Inflammatory bowel disease: immunodiagnostics, immunotherapeutics and ecotherapeuticsGastroenterology120622635CrossRefPubMed
2.
Zurück zum Zitat Farrell, RJ, LaMont, JT 2002Microbial factors in inflammatory bowel diseaseGastroenterol Clin North Am314162CrossRefPubMed Farrell, RJ, LaMont, JT 2002Microbial factors in inflammatory bowel diseaseGastroenterol Clin North Am314162CrossRefPubMed
3.
Zurück zum Zitat Sartor, RB 1997Pathogenesis and immune mechanisms of chronic inflammatory bowel diseasesAm J Gastroenterol925S11SPubMed Sartor, RB 1997Pathogenesis and immune mechanisms of chronic inflammatory bowel diseasesAm J Gastroenterol925S11SPubMed
4.
Zurück zum Zitat Fuller, R 1989Probiotics in man animalsJ Appl Bacteriol66365378PubMed Fuller, R 1989Probiotics in man animalsJ Appl Bacteriol66365378PubMed
5.
Zurück zum Zitat Gionchetti, P, Amadini, C, Rizzello, F, et al. 2002Probiotics-role in inflammatory bowel diseaseDig Liver Dis34S58S62PubMedCrossRef Gionchetti, P, Amadini, C, Rizzello, F,  et al. 2002Probiotics-role in inflammatory bowel diseaseDig Liver Dis34S58S62PubMedCrossRef
6.
Zurück zum Zitat McNaught, CE, MacFie, J 2001Probiotics in clinical practice: a critical review of the evidenceNutr Res21343353CrossRef McNaught, CE, MacFie, J 2001Probiotics in clinical practice: a critical review of the evidenceNutr Res21343353CrossRef
7.
Zurück zum Zitat Fiocchi, C 1998Inflammatory bowel disease: etiology and pathogenesisGastroenterol115182205CrossRef Fiocchi, C 1998Inflammatory bowel disease: etiology and pathogenesisGastroenterol115182205CrossRef
8.
Zurück zum Zitat Tamboli, CP, Caucheteux, C, Cortot, A, Colombel, JF, Desreumaux, P 2003Probiotics in inflammatory bowel disease: a critical reviewBest Pract Res Clin Gastroenterol17805820CrossRefPubMed Tamboli, CP, Caucheteux, C, Cortot, A, Colombel, JF, Desreumaux, P 2003Probiotics in inflammatory bowel disease: a critical reviewBest Pract Res Clin Gastroenterol17805820CrossRefPubMed
9.
Zurück zum Zitat Marteau, P, Seksik, P, Shanahan, F 2003Manipulation of the bacterial flora in inflammatory bowel diseaseBest Pract Res Clin Gastroenterol174761PubMedCrossRef Marteau, P, Seksik, P, Shanahan, F 2003Manipulation of the bacterial flora in inflammatory bowel diseaseBest Pract Res Clin Gastroenterol174761PubMedCrossRef
11.
Zurück zum Zitat Shanahan, F 2000Probiotics in inflammatory bowel disease: is there a scientific rationale?Inflamm Bowel Dis6107115PubMed Shanahan, F 2000Probiotics in inflammatory bowel disease: is there a scientific rationale?Inflamm Bowel Dis6107115PubMed
12.
Zurück zum Zitat Vuyst, L, Degeest, B 1999Heteropolysaccharides from lactic acid bacteriaFEMS Microbiol Rev23153177PubMedCrossRef Vuyst, L, Degeest, B 1999Heteropolysaccharides from lactic acid bacteriaFEMS Microbiol Rev23153177PubMedCrossRef
13.
Zurück zum Zitat Laws, A, Gu, Y, Marshall, V 2001Biosynthesis, characterization, and design of bacterial exopolysaccharides from lactic acid bacteriaBiotechnol Adv19597625CrossRefPubMed Laws, A, Gu, Y, Marshall, V 2001Biosynthesis, characterization, and design of bacterial exopolysaccharides from lactic acid bacteriaBiotechnol Adv19597625CrossRefPubMed
14.
Zurück zum Zitat Knoshaug, EP, Ahlgrent, JA, Trempy, JE 2000Growth associated exopolysaccharide expression in Lactococcuc lactis subspecies cremoris Ropy352J Dairy Sci83633640PubMed Knoshaug, EP, Ahlgrent, JA, Trempy, JE 2000Growth associated exopolysaccharide expression in Lactococcuc lactis subspecies cremoris Ropy352J Dairy Sci83633640PubMed
15.
Zurück zum Zitat Looijesteijn, PJ, Trapet, L, Vries, E, Ebee, T, Hugenholtz, J 2001Physiological function of exopolysaccharides produced by Lactococcus lactis Int J Food Microbiol647180CrossRefPubMed Looijesteijn, PJ, Trapet, L, Vries, E, Ebee, T, Hugenholtz, J 2001Physiological function of exopolysaccharides produced by Lactococcus lactis Int J Food Microbiol647180CrossRefPubMed
16.
Zurück zum Zitat Ruas-Madiedo, P, Reyes-Gavilan, CG 2005Invited review: methods for the screening, isolation, and characterization of exopolysaccharides produced by lactic acid bacteriaJ Dairy Sci88843856PubMedCrossRef Ruas-Madiedo, P, Reyes-Gavilan, CG 2005Invited review: methods for the screening, isolation, and characterization of exopolysaccharides produced by lactic acid bacteriaJ Dairy Sci88843856PubMedCrossRef
17.
Zurück zum Zitat Wacher-Rodarte, C, Galvan, M, Farres, A, Gallardo, F, Marchall, VM, Garcia-Garibay, M 1993Yogurt production from reconstituted skim milk powders using different polymer and nonpolymer forming starter culturesJ Dairy Res60247254CrossRef Wacher-Rodarte, C, Galvan, M, Farres, A, Gallardo, F, Marchall, VM, Garcia-Garibay, M 1993Yogurt production from reconstituted skim milk powders using different polymer and nonpolymer forming starter culturesJ Dairy Res60247254CrossRef
18.
Zurück zum Zitat Dave, RI, Shah, NP 1997Effect of level of starter culture on viability of yogurt and probiotic bacteria in yogurtsFood Australia49164168 Dave, RI, Shah, NP 1997Effect of level of starter culture on viability of yogurt and probiotic bacteria in yogurtsFood Australia49164168
19.
Zurück zum Zitat Ruas Madiedo, P, Hugenholtz, J, Zoon, P 2002An overview of the functionality of exopolysaccharides produced by lactic acid bacteriaInt Dairy J12163171CrossRef Ruas Madiedo, P, Hugenholtz, J, Zoon, P 2002An overview of the functionality of exopolysaccharides produced by lactic acid bacteriaInt Dairy J12163171CrossRef
20.
Zurück zum Zitat Pigeon, RM, Cuesta, EP, Gililliand, SE 2002Binding of free bile acids by cells of yogurt starter culture bacteriaJ Dairy Sci8527052710PubMedCrossRef Pigeon, RM, Cuesta, EP, Gililliand, SE 2002Binding of free bile acids by cells of yogurt starter culture bacteriaJ Dairy Sci8527052710PubMedCrossRef
21.
Zurück zum Zitat Welman, AD, Maddox, IS 2003Exopolysaccharides from lactic acid bacteria: perspectives and challengesTrends Biotechnol21269274CrossRefPubMed Welman, AD, Maddox, IS 2003Exopolysaccharides from lactic acid bacteria: perspectives and challengesTrends Biotechnol21269274CrossRefPubMed
22.
Zurück zum Zitat Roy, D, Sirois, S, Vincent, D 2001Molecular discrimination of Lactobacilli used as starter and probiotic cultures by amplified ribosomal DNA restriction analysisCurr Microbiol42282289PubMed Roy, D, Sirois, S, Vincent, D 2001Molecular discrimination of Lactobacilli used as starter and probiotic cultures by amplified ribosomal DNA restriction analysisCurr Microbiol42282289PubMed
23.
Zurück zum Zitat Ventura, M, Casas, IA, Morelli, L, Callegari, M 2000Rapid amplified ribosomal DNA restriction analysis (ARDRA) identification of Lactobacillus spp. isolated from fecal and vaginal samplesSyst Appl Microbiol23504509PubMed Ventura, M, Casas, IA, Morelli, L, Callegari, M 2000Rapid amplified ribosomal DNA restriction analysis (ARDRA) identification of Lactobacillus spp. isolated from fecal and vaginal samplesSyst Appl Microbiol23504509PubMed
24.
Zurück zum Zitat Tilsala-Timisjarvi, A, Alatossava, T 1993Enzymatic amplification of 16 s rRNA gene sequences from dairy Lactobacillus speciesMilchwissenschaft48123125 Tilsala-Timisjarvi, A, Alatossava, T 1993Enzymatic amplification of 16 s rRNA gene sequences from dairy Lactobacillus speciesMilchwissenschaft48123125
25.
Zurück zum Zitat Frengova, GI, Simova, ED, Beshkova, DM, Simov, ZI 2000Production and monomer composition of exopolysaccharides by yogurt starter culturesCan J Microbiol46123127CrossRef Frengova, GI, Simova, ED, Beshkova, DM, Simov, ZI 2000Production and monomer composition of exopolysaccharides by yogurt starter culturesCan J Microbiol46123127CrossRef
26.
Zurück zum Zitat Dubois, M, Gilles, KA, Hamilton, JK, Peters, PA, Smith, F 1956Colorimetric method for determination of sugars and related substancesAnal Chem28350356CrossRef Dubois, M, Gilles, KA, Hamilton, JK, Peters, PA, Smith, F 1956Colorimetric method for determination of sugars and related substancesAnal Chem28350356CrossRef
27.
Zurück zum Zitat Torino, MI, Taranto, MP, Sesma, F, Font de Valdez, G 2001Heterofermentative pattern and exopolysaccharide production by Lactobacillus helveticus 15807 in response to environmental pHJ Appl Microbiol91846852CrossRefPubMed Torino, MI, Taranto, MP, Sesma, F, Font de Valdez, G 2001Heterofermentative pattern and exopolysaccharide production by Lactobacillus helveticus 15807 in response to environmental pHJ Appl Microbiol91846852CrossRefPubMed
28.
Zurück zum Zitat Kihara, N, Fuente, SG, Fujino, K, Takahashi, T, Pappas, TN, Mantyh, CR 2003Vanilloid receptor-1 containing primary sensory neurones mediate dextran sulphate sodium induced colitis in ratsGut52713719CrossRefPubMed Kihara, N, Fuente, SG, Fujino, K, Takahashi, T, Pappas, TN, Mantyh, CR 2003Vanilloid receptor-1 containing primary sensory neurones mediate dextran sulphate sodium induced colitis in ratsGut52713719CrossRefPubMed
29.
Zurück zum Zitat Fioramonti, J, Theodorou, V, Bueno, L 2003Probiotics: what are they? What are their effects on gut physiology?Best Pract Res Clin Gastroenterol17711724CrossRefPubMed Fioramonti, J, Theodorou, V, Bueno, L 2003Probiotics: what are they? What are their effects on gut physiology?Best Pract Res Clin Gastroenterol17711724CrossRefPubMed
30.
Zurück zum Zitat Marteau, P, Seksik, P, Shanahan, F 2003Manipulation of the bacterial flora in inflammatory bowel diseaseBest Pract Res Clin Gastroenterol174761PubMedCrossRef Marteau, P, Seksik, P, Shanahan, F 2003Manipulation of the bacterial flora in inflammatory bowel diseaseBest Pract Res Clin Gastroenterol174761PubMedCrossRef
31.
Zurück zum Zitat McCarthy, J, O'Mahony, L, O'Callaghan, L, et al. 2003Double blind, placebo controlled trial of two probiotic strains in interleukin 10 knockout mice and mechanistic link with cytokine balanceGut52975980CrossRefPubMed McCarthy, J, O'Mahony, L, O'Callaghan, L,  et al. 2003Double blind, placebo controlled trial of two probiotic strains in interleukin 10 knockout mice and mechanistic link with cytokine balanceGut52975980CrossRefPubMed
32.
Zurück zum Zitat Shibolet, O, Karmeli, F, Eliakim, R, et al. 2002Variable response to probiotics in two models of experimental colitis in ratsInflamm Bowel Dis8399406PubMedCrossRef Shibolet, O, Karmeli, F, Eliakim, R,  et al. 2002Variable response to probiotics in two models of experimental colitis in ratsInflamm Bowel Dis8399406PubMedCrossRef
33.
Zurück zum Zitat Rembacken, BJ, Snelling, AM, Hawkey, PM, Chalmers, DM, Axon, AT 1999Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trialLancet354635639PubMedCrossRef Rembacken, BJ, Snelling, AM, Hawkey, PM, Chalmers, DM, Axon, AT 1999Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trialLancet354635639PubMedCrossRef
34.
Zurück zum Zitat Gionchetti, P, Rizzello, F, Helwig, U, et al. 2003Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trialGastroenterology12412021209CrossRefPubMed Gionchetti, P, Rizzello, F, Helwig, U,  et al. 2003Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trialGastroenterology12412021209CrossRefPubMed
35.
Zurück zum Zitat Kennedy, RJ, Hoper, M, Deodhar, K, Kirk, SJ, Gardiner, KR 2000Probiotic therapy fails to improve gut permeability in a hapten model of colitisScand J Gastroenterol3512661271PubMedCrossRef Kennedy, RJ, Hoper, M, Deodhar, K, Kirk, SJ, Gardiner, KR 2000Probiotic therapy fails to improve gut permeability in a hapten model of colitisScand J Gastroenterol3512661271PubMedCrossRef
36.
Zurück zum Zitat Temmerman, R, Pot, B, Huys, G, Swings, J 2003Identification and antibiotic susceptibility of bacterial isolates from probiotic productsInt J Food Microbiol81110CrossRefPubMed Temmerman, R, Pot, B, Huys, G, Swings, J 2003Identification and antibiotic susceptibility of bacterial isolates from probiotic productsInt J Food Microbiol81110CrossRefPubMed
37.
Zurück zum Zitat Guo, X, Wang, WP, Ko, JK 1990Involvement of neutrophils and free radicals in the potentiating effects of passive cigarette smoking on inflammatory bowel disease in ratsGastroenterology117884892CrossRef Guo, X, Wang, WP, Ko, JK 1990Involvement of neutrophils and free radicals in the potentiating effects of passive cigarette smoking on inflammatory bowel disease in ratsGastroenterology117884892CrossRef
38.
Zurück zum Zitat Burner, U, Jantschko, W, Obinger, C 1999Kinetics of oxidation of aliphatic and aromatic thiols by myeloperoxidase compounds I and IIFEBS Lett443290296CrossRefPubMed Burner, U, Jantschko, W, Obinger, C 1999Kinetics of oxidation of aliphatic and aromatic thiols by myeloperoxidase compounds I and IIFEBS Lett443290296CrossRefPubMed
39.
Zurück zum Zitat Kettle, AJ, Winterbourn, CC 1991Mechanism of inhibition of myeloperoxidase by anti-inflammatory drugsBiochem Pharmacol4114851492CrossRefPubMed Kettle, AJ, Winterbourn, CC 1991Mechanism of inhibition of myeloperoxidase by anti-inflammatory drugsBiochem Pharmacol4114851492CrossRefPubMed
40.
Zurück zum Zitat Grisham, MB, Beniot, JN, Granger, DN 1990Assessment of leukocyte involvement during ischemia and reperfusion on the intestinePacker, LGlazer, AE eds. Methods enzymol oxygen radicals in biological systemsAcademic PressSan Diego729741 Grisham, MB, Beniot, JN, Granger, DN 1990Assessment of leukocyte involvement during ischemia and reperfusion on the intestinePacker, LGlazer, AE eds. Methods enzymol oxygen radicals in biological systemsAcademic PressSan Diego729741
41.
Zurück zum Zitat Servin, AL, Coconnier, MH 2003Adhesion of probiotic strains to the intestinal mucosa and interaction with pathogensBest Pract Res Clin Gastroenterol17741754CrossRefPubMed Servin, AL, Coconnier, MH 2003Adhesion of probiotic strains to the intestinal mucosa and interaction with pathogensBest Pract Res Clin Gastroenterol17741754CrossRefPubMed
42.
Zurück zum Zitat Gill, HS 2003Probiotics to enhance anti-infective defenses in the gastrointestinal tractBest Pract Res Clin Gastroenterol17755773CrossRefPubMed Gill, HS 2003Probiotics to enhance anti-infective defenses in the gastrointestinal tractBest Pract Res Clin Gastroenterol17755773CrossRefPubMed
43.
Zurück zum Zitat Neurath, MF, Becker, C, Barbulescu, K 1998Role of NF-kappaB in immune and inflammatory responses in the gutGut43856860PubMedCrossRef Neurath, MF, Becker, C, Barbulescu, K 1998Role of NF-kappaB in immune and inflammatory responses in the gutGut43856860PubMedCrossRef
44.
Zurück zum Zitat Neish, AS, Gewirtz, AT, Zeng, H, et al. 2001Prokaryotic regulation of epithelial responses by inhibition of IkappaB-alpha ubiquitinationScience28915601563CrossRef Neish, AS, Gewirtz, AT, Zeng, H,  et al. 2001Prokaryotic regulation of epithelial responses by inhibition of IkappaB-alpha ubiquitinationScience28915601563CrossRef
45.
Zurück zum Zitat Reid, G, Howard, J, Gan, BS 2001Can bacterial interference prevent infection?Trends Microbiol9424428CrossRefPubMed Reid, G, Howard, J, Gan, BS 2001Can bacterial interference prevent infection?Trends Microbiol9424428CrossRefPubMed
46.
Zurück zum Zitat Sutherland, IW 2001Microbial polysaccharides from gram-negative bacteriaInt Dairy J11663674CrossRef Sutherland, IW 2001Microbial polysaccharides from gram-negative bacteriaInt Dairy J11663674CrossRef
47.
Zurück zum Zitat Jolly, L, Stingele, F 2001Molecular organization and functionality of exopolysaccharide gene clusters in lactic acid bacteriaInt Dairy J11733745CrossRef Jolly, L, Stingele, F 2001Molecular organization and functionality of exopolysaccharide gene clusters in lactic acid bacteriaInt Dairy J11733745CrossRef
48.
Zurück zum Zitat Videla, S, Vilaseca, J, Antolin, M, et al. 2001Dietary inulin improves distal colitis induced by dextran sodium sulfate in the ratAm J Gastroenterol9614861493CrossRefPubMed Videla, S, Vilaseca, J, Antolin, M,  et al. 2001Dietary inulin improves distal colitis induced by dextran sodium sulfate in the ratAm J Gastroenterol9614861493CrossRefPubMed
49.
Zurück zum Zitat Walker, WA, Duffy, LC 1998Diet and bacterial colonization: role of probiotics and prebioticsJ Nutr Biochem9668675CrossRef Walker, WA, Duffy, LC 1998Diet and bacterial colonization: role of probiotics and prebioticsJ Nutr Biochem9668675CrossRef
50.
Zurück zum Zitat Tuohy, KM, Probert, HM, Smejkal, CW, Gibson, GR 2003Using probiotics and prebiotics to improve gut healthDrug Discov Today8692700CrossRefPubMed Tuohy, KM, Probert, HM, Smejkal, CW, Gibson, GR 2003Using probiotics and prebiotics to improve gut healthDrug Discov Today8692700CrossRefPubMed
51.
Zurück zum Zitat Tamime, AY 2002Fermented milks: a historical food with modern applications—a reviewEur J Clin Nutr56S2S15PubMedCrossRef Tamime, AY 2002Fermented milks: a historical food with modern applications—a reviewEur J Clin Nutr56S2S15PubMedCrossRef
52.
Zurück zum Zitat Marteau, P, Shanahan, F 2003Basic aspects and pharmacology of probiotics: an overview of pharmacokinetics, mechanisms of action and side-effectsBest Pract Res Clin Gastroenterol17725740PubMedCrossRef Marteau, P, Shanahan, F 2003Basic aspects and pharmacology of probiotics: an overview of pharmacokinetics, mechanisms of action and side-effectsBest Pract Res Clin Gastroenterol17725740PubMedCrossRef
53.
Zurück zum Zitat Jurjus, AR, Khoury, NN, Reimund, JM 2004Animal models of inflammatory bowel diseaseJ Pharmacol Toxicol Methods508192CrossRefPubMed Jurjus, AR, Khoury, NN, Reimund, JM 2004Animal models of inflammatory bowel diseaseJ Pharmacol Toxicol Methods508192CrossRefPubMed
Metadaten
Titel
Effects of Exopolysaccharide-Producing Probiotic Strains on Experimental Colitis in Rats
verfasst von
Neriman Şengül, M.D.
Belma Aslím, Ph.D.
Gülberk Uçar, Ph.D.
Nihal Yücel, Ph.D.
Sevil Işık, M.D.
Hatice Bozkurt, M.S.
Zişan Sakaoğullarí, M.D.
Fuat Atalay, M.D.
Publikationsdatum
01.02.2006
Erschienen in
Diseases of the Colon & Rectum / Ausgabe 2/2006
Print ISSN: 0012-3706
Elektronische ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-005-0267-6

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