VSL#3 Probiotic Induces Remission in Active Ulcerative Colitis

BACKGROUND AND AIMS:
Intestinal bacteria have been implicated in the initiation and perpetuation of IBD; in contrast, "probiotic bacteria" have properties possibly effective in treating and preventing relapse of IBD. We evaluated the safety and efficacy of VSL#3 and the components, and the composition of the biopsy-associated microbiota in patients with active mild to moderate ulcerative colitis (UC).

METHODS:


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Thirty-four ambulatory patients with active UC received open label VSL#3, 3,600 billion bacteria daily in two divided doses for 6 wk. The presence of biopsy-associated bacteria was detected using a nucleic acid-based method and the presence of VSL#3 species confirmed by DNA sequencing of 16S rRNA.

RESULTS:
Thirty-two patients completed 6 wk of VSL#3 treatment and 2 patients did not have the final endoscopic assessment. Intent to treat analysis demonstrated remission (UCDAI 2) in 53% (n = 18); response (decrease in UCDAI 3, but final score 3) in 24% (n = 8); no response in 9% (n = 3); worsening in 9% (n = 3); and failure to complete the final sigmoidoscopy assessment in 5% (n = 2). There were no biochemical or clinical adverse events related to VSL#3. Two of the components of VSL#3 were detected by PCR/DGGE in biopsies collected from 3 patients in remission.

CONCLUSION:
Treatment of patients with mild to moderate UC, not responding to conventional therapy, with VSL#3 resulted in a combined induction of remission/response rate of 77% with no adverse events. At least some of the bacterial species incorporated in the probiotic product reached the target site in amounts that could be detected.

Source:
The American Journal of Gastroenterology (2005) 100, 1539–1546; doi:10.1111/j.1572-0241.2005.41794.x
Rodrigo Bibiloni PhD1, Richard N Fedorak MD2, Gerald W Tannock PhD1, Karen L Madsen PhD2, Paolo Gionchetti MD3, Massimo Campieri MD3, Claudio De Simone PhD4 and R Balfour Sartor MD5

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