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Li N, Quidgley MC, Kobeissy FH, Joseph J, Neu J. Microbial cell components induced tolerance to flagellin-stimulated inflammation through Toll-like receptor pathways in intestinal epithelial cells. Cytokine 2012; 60:806-11. [PMID: 22944462 PMCID: PMC3572906 DOI: 10.1016/j.cyto.2012.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 06/29/2012] [Accepted: 08/06/2012] [Indexed: 01/01/2023]
Abstract
In the intestine, bacterial components activate innate responses that protect the host. We hypothesize that bacterial components reduce Interleukin-8 (IL-8) production in intestinal epithelial cells stimulated by flagellin via the Toll-like receptor (TLR) signaling pathway. Caco-2 cells were pretreated with various doses of lipopolysaccharide (LPS), lipoteichoic acid (LTA), or low-dose flagellin (LDFL) for 24h. Cells were then treated with flagellin (FL) 500 ng/ml (HDFL) for another 48 h. IL-8 production was measured in the cell culture medium by ELISA. Eighty-four genes in the TLR pathway were evaluated by RT Profiler PCR Array. Pathway Studio 8.0 software was used for altered pathway analysis. HDFL induced IL-8 production by 19-fold (p<0.01). Pretreatment with LDFL at 20, 10 or 1 ng/ml reduced HDFL-induced IL-8 production by 61%, 52% and 40%, respectively (p<0.05). LPS at 50 μg/ml decreased HDFL-induced IL-8 production by 38% (p<0.05). HDFL up-regulated CXCL10, IL1B, IL-8, IRAK2, NF-κB1 and I-κB (all p<0.05). Pathway Studio analysis showed that HDFL induced cell processes including inflammation, cell death and apoptosis. Pretreatment with LDFL at 10 ng/ml down-regulated FADD, FOS, MAP4K4, MyD88, TLR2, TLR3 and TNFERSF1A compared to HDFL (all p<0.05). These down-regulated genes are integral for numerous cell functions including inflammatory response, cell death, apoptosis and infection. These results demonstrate that LPS and LDFL provoke tolerance to HDFL-induced IL-8 production. This tolerance effect was accompanied by a complex interaction of multiple genes related to inflammatory as well as other responses in the TLR pathway rather than a single gene alteration.
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Affiliation(s)
- Nan Li
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville FL, USA 32610
| | - Maria C. Quidgley
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville FL, USA 32610
| | - Firas H. Kobeissy
- Department of Psychiatry, University of Florida, 1600 SW Archer Road, Gainesville FL, USA 32610
| | - Jessica Joseph
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville FL, USA 32610
| | - Josef Neu
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville FL, USA 32610
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Kataria J, Li N, Wynn JL, Neu J. Probiotic microbes: do they need to be alive to be beneficial? Nutr Rev 2009; 67:546-50. [PMID: 19703261 DOI: 10.1111/j.1753-4887.2009.00226.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
An essential symbiotic relationship exists between intestinal cells and commensal bacteria within the human gastrointestinal tract. Alteration or absence of this interaction may play a role in the development of human disease. Use of probiotic organisms has yielded improvement of certain medical conditions, such as inflammatory and infectious gastrointestinal disease, although the mechanisms of benefit remain poorly defined. The administration of live organisms is not without risk, both potential and realized, particularly in certain populations. Therefore, it is of considerable interest to determine if the health benefits of probiotics can be attained without the risks associated with administration of a live organism. Reviewed here is the evidence that heat-killed, ultraviolet-inactivated, and even components of these agents may be just as effective and considerably safer for the host.
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Affiliation(s)
- Jasmeet Kataria
- Developmental Gastroenterology and Biochemical Nutrition Laboratory, Department of Pediatrics, Division of Neonatology, University of Florida, School of Medicine, Gainesville, FL 32608, USA
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Sharp RR, Achkar JP, Brinich MA, Farrell RM. Helping patients make informed choices about probiotics: a need for research. Am J Gastroenterol 2009; 104:809-13. [PMID: 19343022 PMCID: PMC2746707 DOI: 10.1038/ajg.2008.68] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Applications of probiotics in the treatment of gastrointestinal disorders are gaining acceptance among patients, despite evidence that probiotics can present substantial health risks, particularly for patients who are immunocompromised or seriously ill. Patients will likely formulate their attitudes and beliefs about probiotic therapies with reference to interpretive frameworks that compare probiotics with more familiar therapeutic modalities, including complementary and alternative medicines, pharmacological therapies, and gene-transfer technologies. Each of these frameworks highlights a different set of benefit-to-risk considerations regarding probiotic usage and reinforces extreme characterizations of both the therapeutic promise and peril of probiotics. Considerable effort may be required to help patients make informed choices about probiotic therapies.
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Affiliation(s)
- Richard R Sharp
- Department of Bioethics, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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Besselink MG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM, Nieuwenhuijs VB, Bollen TL, van Ramshorst B, Witteman BJ, Rosman C, Ploeg RJ, Brink MA, Schaapherder AF, Dejong CH, Wahab PJ, van Laarhoven CJ, van der Harst E, van Eijck CH, Cuesta MA, Akkermans LM, Gooszen HG. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008; 371:651-659. [PMID: 18279948 DOI: 10.1016/s0140-6736(08)60207-x] [Citation(s) in RCA: 832] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Infectious complications and associated mortality are a major concern in acute pancreatitis. Enteral administration of probiotics could prevent infectious complications, but convincing evidence is scarce. Our aim was to assess the effects of probiotic prophylaxis in patients with predicted severe acute pancreatitis. METHODS In this multicentre randomised, double-blind, placebo-controlled trial, 298 patients with predicted severe acute pancreatitis (Acute Physiology and Chronic Health Evaluation [APACHE II] score > or =8, Imrie score > or =3, or C-reactive protein >150 mg/L) were randomly assigned within 72 h of onset of symptoms to receive a multispecies probiotic preparation (n=153) or placebo (n=145), administered enterally twice daily for 28 days. The primary endpoint was the composite of infectious complications--ie, infected pancreatic necrosis, bacteraemia, pneumonia, urosepsis, or infected ascites--during admission and 90-day follow-up. Analyses were by intention to treat. This study is registered, number ISRCTN38327949. FINDINGS One person in each group was excluded from analyses because of incorrect diagnoses of pancreatitis; thus, 152 individuals in the probiotics group and 144 in the placebo group were analysed. Groups were much the same at baseline in terms of patients' characteristics and disease severity. Infectious complications occurred in 46 (30%) patients in the probiotics group and 41 (28%) of those in the placebo group (relative risk 1.06, 95% CI 0.75-1.51). 24 (16%) patients in the probiotics group died, compared with nine (6%) in the placebo group (relative risk 2.53, 95% CI 1.22-5.25). Nine patients in the probiotics group developed bowel ischaemia (eight with fatal outcome), compared with none in the placebo group (p=0.004). INTERPRETATION In patients with predicted severe acute pancreatitis, probiotic prophylaxis with this combination of probiotic strains did not reduce the risk of infectious complications and was associated with an increased risk of mortality. Probiotic prophylaxis should therefore not be administered in this category of patients.
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Affiliation(s)
- Marc Gh Besselink
- Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Erik Buskens
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Department of Epidemiology, University Medical Center Groningen, Groningen, Netherlands
| | | | - Harry van Goor
- Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Harro M Timmerman
- Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Thomas L Bollen
- Department of Radiology, St Antonius Hospital, Nieuwegein, Netherlands
| | | | - Ben Jm Witteman
- Department of Gastroenterology, Gelderse Vallei Hospital, Ede, Netherlands
| | - Camiel Rosman
- Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Rutger J Ploeg
- Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
| | - Menno A Brink
- Department of Gastroenterology, Meander Medical Center, Amersfoort, Netherlands
| | | | - Cornelis Hc Dejong
- Department of Surgery and NUTRIM, University Hospital Maastricht, Maastricht, Netherlands
| | - Peter J Wahab
- Department of Gastroenterology, Rijnstate Hospital, Arnhem, Netherlands
| | | | | | | | - Miguel A Cuesta
- Department of Surgery, Vrije Universiteit Medical Center, Amsterdam, Netherlands
| | - Louis Ma Akkermans
- Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Hein G Gooszen
- Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
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