Birgitte Stiksrud1, Piotr Nowak, Felix C Nwosu, Dag Kvale, Anders Thalme, Anders Sonnerborg, Per M Ueland, Kristian Holm, Stein-Erik Birkeland, Anders E A Dahm, Per M Sandset, Knut Rudi, Johannes R Hov, Anne M Dyrhol-Riise, Marius Trøseid. 1. *Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; †Department of Infectious Diseases, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; ‡Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; §Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences; ‖K.G. Jebsen Center for Inflammation Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; ¶Department of Clinical Science, University of Bergen, Bergen, Norway; #Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway; **Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway; ††TINE SA, TINE R&D, Oslo, Norway; ‡‡Department of Haematology, Akershus University Hospital, Nordbyhagen, Norway; §§Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway; ‖‖Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway; and ¶¶Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway.
Abstract
BACKGROUND: Microbial translocation and chronic inflammation may contribute to non-AIDS morbidity in patients with HIV. This study assessed the impact of probiotic intervention on microbial translocation and inflammation in patients on antiretroviral therapy with viral suppression and subnormal CD4 count. METHODS:Thirty-two patients receiving antiretroviral therapy (CD4 <500 cells/μL) were randomized in a double-blind fashion to multistrain daily probiotics (n = 15), placebo (n = 9), or controls (n = 8) for 8 weeks. Soluble inflammation markers, D-dimer, lipopolysaccharide (LPS), sCD14, T-cell activation, tryptophan metabolites, and gut microbiota composition were analyzed at baseline and end of study. Nonparametric statistics were applied. RESULTS:Twenty-four participants completed the study and were included in as-treated analyses. In patients receiving probiotics, there was a significant reduction in D-dimer levels (median change 33%, P = 0.03) and a tendency to reduced levels of C-reactive protein (CRP) (P = 0.05) and interleukin (IL)-6 (P = 0.06). The changes in CRP and IL-6 were highly correlated (r = 0.95, P < 0.01), whereas changes in D-dimer did not correlate with changes in CRP or IL-6. Increases in Bifidobacteria (P = 0.04) and Lactobacilli (P = 0.06) were observed in the probiotic group, whereas the relative abundance of Bacteroides decreased (P ≤ 0.01). No significant changes were seen in markers of microbial translocation or T-cell activation. However, the expansion of Bifidobacteria correlated negatively with differences in LPS (r = -0.77, P = 0.01), whereas the reduction in Bacteroides correlated positively with changes in LPS during the study period (r = 0.72, P = 0.02). CONCLUSIONS:Probiotic intervention seemed to reduce markers of coagulation and inflammation without overt changes in microbial translocation. These findings warrant further studies in larger cohorts with long-term follow-up.
RCT Entities:
BACKGROUND: Microbial translocation and chronic inflammation may contribute to non-AIDS morbidity in patients with HIV. This study assessed the impact of probiotic intervention on microbial translocation and inflammation in patients on antiretroviral therapy with viral suppression and subnormal CD4 count. METHODS: Thirty-two patients receiving antiretroviral therapy (CD4 <500 cells/μL) were randomized in a double-blind fashion to multistrain daily probiotics (n = 15), placebo (n = 9), or controls (n = 8) for 8 weeks. Soluble inflammation markers, D-dimer, lipopolysaccharide (LPS), sCD14, T-cell activation, tryptophan metabolites, and gut microbiota composition were analyzed at baseline and end of study. Nonparametric statistics were applied. RESULTS: Twenty-four participants completed the study and were included in as-treated analyses. In patients receiving probiotics, there was a significant reduction in D-dimer levels (median change 33%, P = 0.03) and a tendency to reduced levels of C-reactive protein (CRP) (P = 0.05) and interleukin (IL)-6 (P = 0.06). The changes in CRP and IL-6 were highly correlated (r = 0.95, P < 0.01), whereas changes in D-dimer did not correlate with changes in CRP or IL-6. Increases in Bifidobacteria (P = 0.04) and Lactobacilli (P = 0.06) were observed in the probiotic group, whereas the relative abundance of Bacteroides decreased (P ≤ 0.01). No significant changes were seen in markers of microbial translocation or T-cell activation. However, the expansion of Bifidobacteria correlated negatively with differences in LPS (r = -0.77, P = 0.01), whereas the reduction in Bacteroides correlated positively with changes in LPS during the study period (r = 0.72, P = 0.02). CONCLUSIONS: Probiotic intervention seemed to reduce markers of coagulation and inflammation without overt changes in microbial translocation. These findings warrant further studies in larger cohorts with long-term follow-up.
Authors: Susan A Tuddenham; Wei Li A Koay; Ni Zhao; James R White; Khalil G Ghanem; Cynthia L Sears Journal: Clin Infect Dis Date: 2020-02-03 Impact factor: 9.079
Authors: S Serrano-Villar; J F Vázquez-Castellanos; A Vallejo; A Latorre; T Sainz; S Ferrando-Martínez; D Rojo; J Martínez-Botas; J Del Romero; N Madrid; M Leal; J I Mosele; M J Motilva; C Barbas; M Ferrer; A Moya; S Moreno; M J Gosalbes; V Estrada Journal: Mucosal Immunol Date: 2016-12-21 Impact factor: 7.313
Authors: Gabriella d'Ettorre; Giancarlo Ceccarelli; Paolo Pavone; Pietro Vittozzi; Gabriella De Girolamo; Ivan Schietroma; Sara Serafino; Noemi Giustini; Vincenzo Vullo Journal: AIDS Res Ther Date: 2016-04-27 Impact factor: 2.250