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Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome: a randomized trial.
Eur J Gastroenterol Hepatol 2014; 26(6):630-9EJ

Abstract

INTRODUCTION

This preliminary study aimed to investigate the effects of the probiotic Saccharomyces boulardii on proinflammatory and anti-inflammatory cytokines in patients with diarrhea-dominant irritable bowel syndrome (IBS-D). The other objectives were to document any clinical improvement as judged by symptoms, quality of life, and histology.

PATIENTS AND METHODS

This was a randomized, double blind, placebo-controlled trial in which S. boulardii, 750 mg/day, or placebo was administered for 6 weeks in IBS-D patients, in addition to ispaghula husk standard treatment.

RESULTS

Thirty-seven patients received S. boulardii and 35 patients received the placebo. As compared with placebo, the S. boulardii group showed a significant decrease in blood and tissue levels of proinflammatory cytokines interleukin-8 (IL-8) and tumor necrosis factor-α (P<0.001) and an increase in anti-inflammatory IL-10 levels, as well as an increase in the tissue IL-10/IL-12 ratio (P<0.001). No significant change in the blood and tissue levels of cytokines was found in the placebo group. Bowel-related IBS-D symptoms reported in the patients' daily diary improved in both groups. However, overall improvement in the quality of life was more marked in the S. boulardii group. Although baseline histological findings were mild, an improvement was observed in the probiotic group in the lymphocyte and neutrophil infiltrates (P=0.017 and 0.018), epithelial mitosis (P=0.003), and intraepithelial lymphocytes (P=0.024). No serious adverse events were found in either group.

CONCLUSION

S. boulardii with ispaghula husk was superior to placebo with ispaghula husk in improving the cytokine profile, histology, and quality of life of patients with IBS-D. These preliminary results need to be confirmed in a well-powered trial.

Authors+Show Affiliations

Departments of aMedicine bPathology cCommunity Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24722560

Citation

Abbas, Zaigham, et al. "Cytokine and Clinical Response to Saccharomyces Boulardii Therapy in Diarrhea-dominant Irritable Bowel Syndrome: a Randomized Trial." European Journal of Gastroenterology & Hepatology, vol. 26, no. 6, 2014, pp. 630-9.
Abbas Z, Yakoob J, Jafri W, et al. Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome: a randomized trial. Eur J Gastroenterol Hepatol. 2014;26(6):630-9.
Abbas, Z., Yakoob, J., Jafri, W., Ahmad, Z., Azam, Z., Usman, M. W., ... Islam, M. (2014). Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome: a randomized trial. European Journal of Gastroenterology & Hepatology, 26(6), pp. 630-9. doi:10.1097/MEG.0000000000000094.
Abbas Z, et al. Cytokine and Clinical Response to Saccharomyces Boulardii Therapy in Diarrhea-dominant Irritable Bowel Syndrome: a Randomized Trial. Eur J Gastroenterol Hepatol. 2014;26(6):630-9. PubMed PMID: 24722560.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome: a randomized trial. AU - Abbas,Zaigham, AU - Yakoob,Javed, AU - Jafri,Wasim, AU - Ahmad,Zubair, AU - Azam,Zahid, AU - Usman,Muhammad W, AU - Shamim,Sara, AU - Islam,Muhammad, PY - 2014/4/12/entrez PY - 2014/4/12/pubmed PY - 2015/1/13/medline SP - 630 EP - 9 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 26 IS - 6 N2 - INTRODUCTION: This preliminary study aimed to investigate the effects of the probiotic Saccharomyces boulardii on proinflammatory and anti-inflammatory cytokines in patients with diarrhea-dominant irritable bowel syndrome (IBS-D). The other objectives were to document any clinical improvement as judged by symptoms, quality of life, and histology. PATIENTS AND METHODS: This was a randomized, double blind, placebo-controlled trial in which S. boulardii, 750 mg/day, or placebo was administered for 6 weeks in IBS-D patients, in addition to ispaghula husk standard treatment. RESULTS: Thirty-seven patients received S. boulardii and 35 patients received the placebo. As compared with placebo, the S. boulardii group showed a significant decrease in blood and tissue levels of proinflammatory cytokines interleukin-8 (IL-8) and tumor necrosis factor-α (P<0.001) and an increase in anti-inflammatory IL-10 levels, as well as an increase in the tissue IL-10/IL-12 ratio (P<0.001). No significant change in the blood and tissue levels of cytokines was found in the placebo group. Bowel-related IBS-D symptoms reported in the patients' daily diary improved in both groups. However, overall improvement in the quality of life was more marked in the S. boulardii group. Although baseline histological findings were mild, an improvement was observed in the probiotic group in the lymphocyte and neutrophil infiltrates (P=0.017 and 0.018), epithelial mitosis (P=0.003), and intraepithelial lymphocytes (P=0.024). No serious adverse events were found in either group. CONCLUSION: S. boulardii with ispaghula husk was superior to placebo with ispaghula husk in improving the cytokine profile, histology, and quality of life of patients with IBS-D. These preliminary results need to be confirmed in a well-powered trial. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/24722560/Cytokine_and_clinical_response_to_Saccharomyces_boulardii_therapy_in_diarrhea_dominant_irritable_bowel_syndrome:_a_randomized_trial_ L2 - http://Insights.ovid.com/pubmed?pmid=24722560 DB - PRIME DP - Unbound Medicine ER -