Effects of Probiotics on Gut Microbiota in Patients with Inflammatory Bowel Disease: A Double-blind, Placebo-controlled Clinical Trial

Mahdi Shadnoush; Rahebeh Shaker Hosseini; Ahad Khalilnezhad; Lida Navai; Hossein Goudarzi; Maryam Vaezjalali

doi:10.4166/kjg.2015.65.4.215

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Shadnoush, Hosseini, Khalilnezhad, Navai, Goudarzi, and Vaezjalali: Effects of Probiotics on Gut Microbiota in Patients with Inflammatory Bowel Disease: A Double-blind, Placebo-controlled Clinical Trial

Original Article

Korean J Gastroenterol 2015;65(4):215-221.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.65.4.215

Effects of Probiotics on Gut Microbiota in Patients with Inflammatory Bowel Disease: A Double-blind, Placebo-controlled Clinical Trial

Mahdi Shadnoush, Rahebeh Shaker Hosseini, Ahad Khalilnezhad¹, Lida Navai², Hossein Goudarzi³, Maryam Vaezjalali³

National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Tehran, Iran

¹Department of Immunology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran

²Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Tehran, Iran

³Department of Microbiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence to: Mahdi Shadnoush, Shahid Beheshti University of Medical Sciences, Velenjak Street, Shahid Chamran High Way, Tehran 1985717443, Iran. Tel: +98-21-22401423, Fax: +98-21-22401423, E-mail: mshadnoush@gmail.com

Received 25 June 201418 February 2015 Accepted 2 March 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Several clinical trials have revealed various advantages for probiotics in inflammatory bowel disease (IBD). The aim of this study was to further investigate the effects of probiotic yogurt consumption on gut microbiota in patients with this disease.

Methods

A total of 305 participants were divided into three groups; group A (IBD patients receiving probiotic yogurt; n=105), group B (IBD patients receiving placebo; n=105), and control group (healthy individuals receiving probiotic yogurt; n=95). Stool samples were collected both before and after 8 weeks of intervention; and population of Lactobacillus, Bifidobacterium and Bacteroides in the stool specimens was measured by Taqman real-time PCR method.

Results

By the end of the intervention, no significant variations in the mean weight and body mass index were observed between three groups (p>0.05). However, the mean numbers of Lactobacillus, Bifidobacterium, and Bacteroides in group A were significantly increased compared to group B (p<0.001, p<0.001, and p<0.01, respectively). There were also significant differences in the mean numbers of either of three bacteria between group A and the healthy control group; however, these differences between two groups were observed both at baseline and the end of the intervention.

Conclusions

Consumption of probiotic yogurt by patients with IBD may help to improve intestinal function by increasing the number of probiotic bacteria in the intestine and colon. However, many more studies are required in order to prove the concept.

Keywords: Inflammatory bowel diseases, Microbiota, Probiotics

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Fig. 1.

Flow chart of the present experiment. Group A, inflammatory bowel disease (IBD) patients receiving probiotic yogurt; Group B, IBD patients receiving placebo; Control group, healthy individuals receiving probiotic yogurt.

Table 1.

Primers and Probes Used for Detection of Each Bacterium ^a

Bacteria	Type	Primer
Bifidobacterium	F_bif_IS	GGG ATG CTG GTG TGG AAG AGA
	R_bif_IS	TGC TCG CGT CCA CTA TCC AGT
	P_bif_IS	FAM-TCA AAC CAC CAC GCG CCA-BHQ1
Lactobacillus	F_lact	TGG ATG CCT TGG CAC TAG GA
	R_lact	AAA TCT CCG GAT CAA AGC TTA CTT AT
	P_lact	FAM-TAT TAG TTC CGT CCT TCA TC-BHQ1
Bacteroides	HuBacf	GGG TTT AAA GGG AGC GTA GG
	HuBacr	CTA CAC CAC GAA TTC CGC CT
	HuBac594Bhqf	FAM-TAA GTC AGT TGT GAA AGT TTG CGG CTC-BHQ1

^a Bifidobacterium, Lactobacillus, and Bacteroides load in stool of the participants by Taqman real-time PCR method.

Table 2.

Demographic and Clinical Features of the Patients with Inflammatory Bowel Disease (IBD)

Variable	Group A	Group B	Control group	p-value
Age (yr)	36.63±9.07	37.67±8.02	38.67±10.32	0.082
Sex (men : women)	54±32 (62.8±37.2)	50±40 (55.6±44.4)	28±56 (66.7±33.3)	0.068
Height (m)	1.70±0.07	1.69±0.07	1.70±0.09	0.073
Diagnosis age (yr)	26.00±7.63	25.00±8.13	–	–
Disease duration (yr)	10.63±5.81	11.56±5.10	–	–
Ulcerative colitis	80 (93.0)	81 (90.0)	–	–
Crohn's disease	6 (7.0)	9 (10.0)	–	–

Values are presented as mean±SD or n (%).

Group A, IBD patients receiving probiotic yogurt; Group B, IBD patients receiving placebo; Control group, healthy individuals receiving probiotic yogurt.

Table 3.

Weight of the Participants before and after the Intervention

Variable	Baseline	End	p-value
Weight (kg)
Group A	70.31±12.38	70.27±12.39	0.083
Group B	69.55±10.49	69.47±10.58	0.079
Control group	70.54±9.74	70.57±9.27	0.085
p-value	0.068	0.063	–
BMI (kg/m²)
Group A	24.06±2.80	24.04±2.72	0.071
Group B	24.25±2.70	24.22±2.73	0.079
Control group	24.20±2.78	24.23±2.66	0.075
p-value	0.070	0.072	–

Values are presented as mean±SD.

Group A, inflammatory bowel disease (IBD) patients receiving probiotic yogurt; Group B, IBD patients receiving placebo; Control group, healthy individuals receiving probiotic yogurt.

Table 4.

Stool Concentrations of Lactobacillus, Bifidobacterium and Bacteriodes in Group A and Group B before and after the Intervention

Variable	Baseline	End	p-value
Lactobacillus (CFU/g)
Group A	6.1±0.4	8.3±0.4	<0.001
Group B	5.9±0.3	6.1±0.5	>0.05
p-value	0.079	<0.001	–
Bifidobacterium (CFU/g)
Group A	7.3±0.3	10.5±0.5	<0.001
Group B	7.1±0.3	6.8±0.4	>0.05
p-value	0.099	<0.001	–
Bacteriodes (CFU/g)
Group A	1.7±0.1	1.1±0.2	0.034
Group B	1.9±0.1	2.2±0.2	>0.05
p-value	0.079	0.005	–

Values are presented as mean±SD.

Group A, inflammatory bowel disease (IBD) patients receiving probiotic yogurt; Group B, IBD patients receiving placebo; CFU, colony-forming unit.

Table 5.

Stool Concentrations of Lactobacillus, Bifidobacterium and Bacteriodes in Group A and Control Group before and after the Intervention

Variable	Baseline	End	p-value
Lactobacillus (CFU/g)
Group A	6.1±0.4	8.3±0.4	<0.001
Control group	6.8±0.4	7.9±0.3	0.009
p-value	0.033	0.021	–
Bifidobacterium (CFU/g)
Group A	7.3±0.3	10.5±0.5	<0.001
Control group	8.2±0.2	9.1±0.2	0.009
p-value	<0.01	<0.01	–
Bacteriodes (CFU/g)
Group A	1.7±0.1	1.1±0.2	0.034
Control group	3.1±0.2	3.9±0.3	0.037
p-value	<0.001	<0.001	–

Values are presented as mean±SD.

Group A, inflammatory bowel disease patients receiving probiotic yogurt; Control group, healthy individuals receiving probiotic yogurt; CFU, colony-forming unit.

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