Intestinal-borne dermatoses significantly improved by oral application of Escherichia coli Nissle 1917

被引:27
作者
Manzhalii, Elina [1 ]
Hornuss, Daniel [2 ]
Stremmel, Wolfgang [2 ]
机构
[1] Bogomolets Natl Med Univ, Dept Propedeut Internal Med 2, UA-02097 City Kiev, Ukraine
[2] Univ Heidelberg Hosp, Dept Gastroenterol, D-69120 Heidelberg, Germany
关键词
Intestinal-borne dermatoses; Escherichia coli Nissle 1917; Immunological response; IgA; Interleukin-8; Interferon-alpha; Gut microbiota; INFLAMMATORY-BOWEL-DISEASE; EPITHELIAL-CELLS; GUT MICROBIOTA; STRAIN NISSLE-1917; PROBIOTIC BACTERIUM; HUMAN HEALTH; PATHOGENS; INVASION; LINKING;
D O I
10.3748/wjg.v22.i23.5415
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To evaluate the effect of oral Escherichia coli (E. coli) Nissle application on the outcome of intestinal-borne dermatoses. METHODS: In a randomized, controlled, non-blinded prospective clinical trial 82 patients with intestinal-borne facial dermatoses characterized by an erythematous papular-pustular rash were screened. At the initiation visit 37 patients entered the experimental arm and 20 patients constituted the control arm. All 57 patients were treated with a vegetarian diet and conventional topical therapy of the dermatoses with ointments containing tetracycline, steroids and retinoids. In the experimental arm patients received a one month therapy with oral E. coli Nissle at a maintenance dose of 2 capsules daily. The experimental group was compared to a non-treatment group only receiving the diet and topical therapy. The primary outcome parameter was improvement of the dermatoses, secondary parameters included life quality and adverse events. In addition the immunological reaction profile (IgA, interleucin-8 and interferon-alpha) was determined. Furthermore the changes of stool consistency and the microbiota composition over the time of intervention were recorded. RESULTS: Eighty-nine percent of the patients with acne, papular-pustular rosacea and seborrhoic dermatitis responded to E. coli Nissle therapy with significant amelioration or complete recovery in contrast to 56% in the control arm (P < 0.01). Accordingly, in the E. coli Nissle treated patients life quality improved significantly (P < 0.01), and adverse events were not recorded. The clinical improvement was associated with a significant increase of IgA levels to normal values in serum as well as suppression of the proinflammatory cytokine IL-8 (P < 0.01 for both parameters). In the E. coli Nissle treated group a shift towards a protective microbiota with predominance of bifidobacteria and lactobacteria (> 10(7) CFU/g stool) was observed in 79% and 63% of the patients, respectively (P < 0.01), compared to no change in the control group without E. coli Nissle. Moreover, the detection rate of a pathogenic flora dropped from 73% to 14 % of the patients in the experimental arm (P < 0.01) with no significant change in the control arm (accounting 80% before and 70% after the observation period, P > 0.05). Accordingly, stool consistency, color and smell normalized in the E. coli Nissle treated patients. CONCLUSION: E. coli Nissle protects the mucus barrier by overgrowth of a favorable gut microbiota with less immunoreactive potential which finally leads to clinical improvement of intestinal borne dermatoses.
引用
收藏
页码:5415 / 5421
页数:7
相关论文
共 27 条
[11]   Probiotics in the Treatment and Prevention of Atopic Dermatitis [J].
Foelster-Holst, R. .
ANNALS OF NUTRITION AND METABOLISM, 2010, 57 :16-19
[12]  
Fujimura KE, 2010, EXPERT REV ANTI-INFE, V8, P435, DOI [10.1586/eri.10.14, 10.1586/ERI.10.14]
[13]   Probiotic Escherichia coli strain Nissle 1917 outcompetes intestinal pathogens during biofilm formation [J].
Hancock, Viktoria ;
Dahl, Malin ;
Klemm, Per .
JOURNAL OF MEDICAL MICROBIOLOGY, 2010, 59 (04) :392-399
[14]   Escherichia coli Nissle 1917 (Mutaflor): New Insights into an Old Probiotic Bacterium [J].
Jacobi, Christoph A. ;
Malfertheiner, Peter .
DIGESTIVE DISEASES, 2011, 29 (06) :600-607
[15]   Nonpathogenic Escherichia coli strain Nissle 1917 inhibits signal transduction in intestinal epithelial cells [J].
Kamada, Nobuhiko ;
Maeda, Kenichi ;
Inoue, Nagamu ;
Hisamatsu, Tadakazu ;
Okamoto, Susumu ;
Hong, Kyong Su ;
Yamada, Takaya ;
Watanabe, Noriaki ;
Tsuchimoto, Kanji ;
Ogata, Haruhiko ;
Hibi, Toshifumi .
INFECTION AND IMMUNITY, 2008, 76 (01) :214-220
[16]   The 'hygiene hypothesis' for autoimmune and allergic diseases: an update [J].
Okada, H. ;
Kuhn, C. ;
Feillet, H. ;
Bach, J. -F. .
CLINICAL AND EXPERIMENTAL IMMUNOLOGY, 2010, 160 (01) :1-9
[17]   Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study [J].
Penders, John ;
Thijs, Carel ;
van den Brandt, Piet A. ;
Kummeling, Ischa ;
Snijders, Bianca ;
Stelma, Foekje ;
Adams, Hanne ;
van Ree, Ronald ;
Stobberingh, Ellen E. .
GUT, 2007, 56 (05) :661-667
[18]   The first 1000 cultured species of the human gastrointestinal microbiota [J].
Rajilic-Stojanovic, Mirjana ;
de Vos, Willem M. .
FEMS MICROBIOLOGY REVIEWS, 2014, 38 (05) :996-1047
[19]   Linking the gut microbiota to human health [J].
Robles Alonso, Virginia ;
Guarner, Francisco .
BRITISH JOURNAL OF NUTRITION, 2013, 109 :S21-S26
[20]   IMMUNOREGULATORY ROLE OF INTERLEUKIN-10 IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE [J].
SCHREIBER, S ;
HEINIG, T ;
THIELE, HG ;
RAEDLER, A .
GASTROENTEROLOGY, 1995, 108 (05) :1434-1444