Are probiotics effective in the treatment of fungal colonization of the gastrointestinal tract? Experimental and clinical studies.

J Physiol Pharmacol. 2006 Nov;57 Suppl 9:35-49.

Are probiotics effective in the treatment of fungal colonization of
the gastrointestinal tract? Experimental and clinical studies.

Zwolinska-Wcislo M, Brzozowski T, Mach T, Budak A, Trojanowska D,
Konturek PC, Pajdo R, Drozdowicz D, Kwiecien S.

Dept. of Gastroenterology, Hepatology and Infectious Diseases,
Jagiellonian University Medical College, Cracow, Poland.
mzwcislo@@@@su.krakow.pl

The influence of fungal colonization and probiotic treatment on the
course of gastric ulcer (GU) and ulcerative colitis (UC) was not
explored. Our studies included: 1) clinical investigation of 293
patients with dyspeptic and ulcer complaints and 72 patients with
lower gastrointestinal (GI) tract: 60 patients with UC, 12 with
irritable bowel syndrome (IBS) - the control group. Significant fungal
colonization (SFC), over 10(5) CFU/ml was evaluated. Mycological
investigation was performed, including qualitative and quantitative
examination, according to Muller method, 2) experimental studies in
rats included estimation of the influence of inoculation of Candida
isolated from human GI tract on the healing process of GU, induced by
acetic acid with or without probiotic Lactobacillus acidophilus (10(6)
CFU/ml) introduced intragastrically (i.g.). At 0, 4, 15 and 25 day
after ulcer induction. Weight, damage area, gastric blood flow (GBF)
(H2 clearance), expression of mRNA for cytokines IL-beta, TNF-alpha
(ELISA) were evaluated. Mycology: qualitative and quantitative
examination was performed. MPO serum activity was measured. Results of
clinical studies: 1) SFC was more frequent in patients with GU: 54.2%
of cases and patients with over 5 years history of UC: 33.3% cases. 2)
SFC delayed GU healing and influenced the maintenance of clinical
symptoms in both diseases. Results of animal studies: 3) In Candida
inoculated rats, the GBF was significantly lower than in the vehicle
controls (saline administered group). Upregulation of TNF-alpha,
IL-1beta was recorded. The GUs were still present till 25 day in all
rats inoculated with Candida, in contrast to vehicle group (reduction
of ulcer in 92% at day 25). Conclusions: 1) Fungal colonization delays
process of ulcer and inflammation healing of GI tract mucosa. That
effect was attenuated by probiotic therapy. 2) Probiotic therapy seems
to be effective in treatment of fungal colonization of GI tract. 3)
Lactobacillus acidophilus therapy shortens the duration of fungal
colonization of mucosa (enhanced Candida clearance is associated with
IL-4, INF-gamma response).

PMID: 17242486 [PubMed - in process]

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