Cited by 766Inflammatory Bowel DiseaseProbiotics and Fermented FoodsMicrobial Metabolites in Food Biotechnology

Synbiotic therapy ( Bifidobacterium longum /Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial

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Furrie, E, Macfarlane, S, Kennedy, A, Cummings, J H, Walsh, S V, O’Neil, D A, Macfarlane, G T·2005·Gut

Abstract

Background and aims: Ulcerative colitis (UC) is an acute and chronic inflammatory disease of the large bowel with unknown aetiology. The immune response against normal commensal microorganisms is believed to drive inflammatory processes associated with UC. Therefore, modulation of bacterial communities on the gut mucosa, through the use of probiotics and prebiotics, may be used to modify the disease state. Methods: A synbiotic was developed for use in UC patients combining a probiotic, Bifidobacterium longum , isolated from healthy rectal epithelium, and a prebiotic (Synergy 1), a preferential inulin-oligofructose growth substrate for the probiotic strain. Treatment was employed in a double blinded randomised controlled trial using 18 patients with active UC for a period of one month. Clinical status was scored and rectal biopsies were collected before and after treatment, and transcription levels of epithelium related immune markers were measured. Results: Sigmoidoscopy scores (scale 0–6) were reduced in the test group (start 4.5 (1.4), end 3.1 (2.5)) compared with placebo (start 2.6 (2.1), end 3.2 (2.2)) (p = 0.06). mRNA levels for human beta defensins 2, 3, and 4, which are strongly upregulated in active UC, were significantly reduced in the test group after treatment (p = 0.016, 0.038, and 0.008, respectively). Tumour necrosis factor α and interleukin 1α, which are inflammatory cytokines that drive inflammation and induce defensin expression, were also significantly reduced after treatment (p = 0.018 and 0.023, respectively). Biopsies in the test group had reduced inflammation and regeneration of epithelial tissue. Conclusions: Short term synbiotic treatment of active UC resulted in improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy.

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  1. Furrie, Macfarlane, Kennedy, et al www.gutjnl.com on August 21, 2023 by guest. Protected by copyright. http://gut.bmj.com/ Gut: first published as 10.1136/gut.2004.044834 on 11 January 2005. Downloaded from

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Authors
Furrie, E., Macfarlane, S., Kennedy, A., Cummings, J. H., Walsh, S. V., O’Neil, D. A., & Macfarlane, G. T.
Affiliations
  • University of Dundee (GB)
  • Ninewells Hospital (GB)
  • University of Aberdeen (GB)
Corresponding author
Furrie, E
Venue
Gut
Publisher
BMJ
Published
2005-01-11
Volume
54
Issue
2
Pages
242-249
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
OpenAlex
W2131691027
Cited by
766
References
44
Citations by year
2026: 17 · 2025: 33 · 2024: 32 · 2023: 32 · 2022: 34 · 2021: 43 · 2020: 35 · 2019: 33 · 2018: 27 · 2017: 29 · 2016: 31 · 2015: 30 · 2014: 37 · 2013: 28 · 2012: 41
FWCI
25.52
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Medical Research Council
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
Keywords
ulcerative colitis, Bifidobacterium longum, probiotics, prebiotics, gut microbiota, inflammation resolution, human beta-defensins, TNF-α, interleukin-1 alpha, rectal mucosa, epithelial regeneration, commensal bacteria
MeSH terms
Adult, Aged, Bifidobacterium, Biopsy, C-Reactive Protein, Colitis, Ulcerative, Double-Blind Method, Female, Humans, Intestinal Mucosa, Male, Middle Aged, Oligosaccharides, Pilot Projects, Rectum, RNA, Messenger, Sigmoidoscopy, Gene Expression, Cytokines, Treatment Outcome, Inflammation Mediators, Probiotics, beta-Defensins

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