Ulcerative colitis (UC) is an idiopathic inflammatory disorder of the gastrointestinal tract. Although the causes of UC remain incompletely understood, many experimental and clinical observations have suggested involvement of intestinal microflora in its pathogenesis.
In genetically susceptible individuals, tissue damage can result from failure of normal regulatory constraints on the mucosal immune responsiveness to intestinal bacteria. Therefore, restoring the microbial balance may represent a plausible therapeutic approach in the treatment of UC.
Experimental studies have shown that luminal antigens are involved in chronic intestinal inflammatory disorders. Bifidogenic growth stimulator (BGS) is a prebiotic preparation produced by Propionibacterium freudenreichii isolated from Swiss cheese. Previously BGS was shown to act in the colon as a growth stimulator of Bifidobacteria.
A recent study, to be published in Nutrition (Available online 12 October 2005), was designed with the aim to determine the potential therapeutic efficacy and safety of BGS in patients with active UC.
Researchers at the Kurume University, Fukuoka, Japan administered BGS orally (4.5 g daily) for 4 wk to twelve patients with mildly to moderately active ulcerative colitis in an open-label treatment protocol while the baseline anti-inflammatory therapy was continued. The response to treatment was evaluated clinically and endoscopically. Concentrations of short-chain fatty acids and the composition of commensal bacteria, including Bifidobacteria, Enterobacteria and Bacteroides species, were studied in stool samples.
Results from the study indicate that oral BGS resulted in clinical and endoscopic improvements in patients with UC. Treatment with BGS is safe and well tolerated and does not require dietary restrictions.
Thus, oral BGS therapy may represent a non-toxic way to treat ulcerative colitis. However, the authors warn that controlled studies are needed to demonstrate its efficacy in the treatment of this disorder.