Tu1976 Clostridium Butyricum Regulates IL-10 Production in Normal and Inflammatory Conditions Through Different Target Cells

Abstract

Background: A shift in composition of intestinal microbiota is regarded to be important for the symptoms and complications of short bowel syndrome (SBS). However, attempts to normalize the colonic microbiota in SBS have not been formally studied. We investigated whether two weeks' treatment with Saccharomyces boulardii influences colonic microbiota and has an impact on the lactate levels in SBS patients. Methods: Symptoms and colonic microbiota were investigated in 14 SBS adult patients on long-term parenteral nutrition who were treated with Saccharomyces boulardii (Sb). A 250 mg capsule Sb was given twice daily for two weeks. Microbiota were investigated using structure functional fluorescence in situ hybridization (FISH) analysis of Carnoy fixated stool cylinders. Altogether 82 FISH probes representing different groups of microbiota were used. Stool samples were collected at days 0, 7, 14, as related to the start of Sb therapy. 10 healthy untreated persons were used as controls. Results: The patients had an apparently SBS-specific increase in the prevalence of Lactobacilli. Bacteroides (Bac303), Roseburia (EREC) groups increased, and Bifidobacteriaceae (Bac 164) and Enterobacteriaceae (Ebac) groups decreased significantly with Sb therapy in SBS. These changes all represented an alteration towards the distribution seen in the normal controls. The changes in all other microbial groups were not consistent, and the median values did not change significantly. The SBS-specific increase in Lactobacilli demonstrated a tendency to decrease, which was however statistically non-significant. However, probiotic treatment decreased levels of lactic acid from 30, 72 mg/dL to 18, 64 mg/dL, so to the reference value. Conclusions: The composition of colonic microbiota in patients with SBS on long term parenteral nutrition differs significantly from that in healthy persons. Saccharomyces boulardii treatment made the microbiota more similar to healthy controls. Especially strong effects are observed with regard to Bacteroides, Roseburia, Bifidobacteriaceae and Enterobacteriaceae groups. None of these bacterial groups showed complete normalization when compared to healthy controls however. The concentration of plasma lactate fell to reference values after Sb treatment. It is possible that the two-week treatment was insufficient to unravel specific shifts in other bacterial groups or to normalize the main fermentative groups. Longer-term therapeutic studies are necessary for what appears a promising strategy.