Background: We have previously shown a reduction of gastrointestinal symptoms after the oral administration of Bifidobacterium infantis Natren Life Start super strain (NLS-SS) in untreated celiac disease (CD) patients. The symptomatic improvement was not associated with changes in intestinal permeability or serum levels of cytokines, chemokines, or growth factors. Therefore, we hypothesized that the beneficial symptomatic effect observed previously in patients with CD treated with B. infantis may be related to the modulation of innate immunity.
Goals: To investigate the potential mechanisms of a probiotic B. infantis Natren Life Start super strain on the mucosal expression of innate immune markers in adult patients with active untreated CD compared with those treated with B. infantis×6 weeks and after 1 year of gluten-free diet (GFD).
Methods: Numbers of macrophages and Paneth cells and α-defensin-5 expression were assessed by immunohistochemistry in duodenal biopsies.
Results: We showed that GFD decreases duodenal macrophage counts in CD patients more effectively than B. infantis. In contrast, B. infantis decreases Paneth cell counts and expression of α-defensin-5 in CD (P<0.001).
Conclusions: The results identify differential innate immune effects of treatment with B. infantis compared with 1 year of GFD. Further studies are needed to investigate synergistic effects of GFD and B. infantis supplementation in CD.
*Medicine Department, Farcombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
†Small Intestinal Section, Department of Medicine
‡Department of Alimentation, Dr. C. Bonorino Udaondo, Gastroenterology Hospital
§Research Institute, Universidad del Salvador, Buenos Aires, Argentina
Supported by CIHR MOP-142773 to EFV, who also holds a CRC. M.I.P.-S. received a CIHR-FHP Health Professional Award Fellowship.
The authors declare that they have nothing to disclose.
M.I.P.-S.: acquisition, analysis, and interpretation of data, statistical analysis, and drafting of the manuscript. E.C.: study design, patient recruitment and assessment, acquisition of data, and critical revision of the manuscript. G.L., M.L.M., R.M., and E.S.: lab tests, serology, and critical revision of the manuscript. A.G.: acquisition of data and dietary supervision. X.H.: technical process and analysis of immunohistochemistry and critical revision of the manuscript. A.C.: histopathological diagnosis. S.N. and H.V.: acquisition of data and critical revision of the manuscript. P.B.: critical revision of the manuscript for important intellectual content. E.F.V. and J.C.B.: study concept and design, acquisition, analyses, and interpretation of data, critical revision of the manuscript for intellectual content and study direction.
Address correspondence to: Julio C. Bai, MD, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Av. Caseros 2061, Buenos Aires, Argentina (e-mail: email@example.com).
Received May 10, 2016
Accepted July 25, 2016