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CFS: bacterium probiotic modulates host inflammatory processes beyond the gut

Simon

Senior Member
Messages
3,789
Location
Monmouth, UK
The role of gut bacteria in illness and health is all the rage, and this new study suggests they may play a role in CFS.

Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut (2013, free full text)

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David Groeger, Liam O’Mahony, Eileen F. Murphy, John F. Bourke, Timothy G. Dinan, Barry Kiely, Fergus Shanahan, * Eamonn M.M. Quigley


Abstract:

Certain therapeutic microbes, including Bifidobacteria infantis (B. infantis) 35624 exert beneficial immunoregulatory effects by mimicking commensal-immune interactions; however, the value of these effects in patients with non-gastrointestinal inflammatory conditions remains unclear.

In this study, we assessed the impact of oral administration of B. infantis 35624, for 6‒8 weeks on inflammatory biomarker and plasma cytokine levels in patients with ulcerative colitis (UC) (n = 22), chronic fatigue syndrome (CFS) (n = 48) and psoriasis (n = 26) in three separate randomized, double-blind, placebo-controlled interventions. Additionally, the effect of B. infantis 35624 on immunological biomarkers in healthy subjects (n = 22) was assessed.

Results
At baseline, both gastrointestinal (UC) and non-gastrointestinal (CFS and psoriasis) patients had significantly increased plasma levels of C-reactive protein (CRP) and the pro-inflammatory cytokines tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) compared with healthy volunteers.

B. infantis 35624 feeding resulted in reduced plasma CRP levels in all three inflammatory disorders compared with placebo. Interestingly, plasma TNF-α was reduced in CFS and psoriasis while IL-6 was reduced in UC and CFS.

Furthermore, in healthy subjects, LPS-stimulated TNF-α and IL-6 secretion by peripheral blood mononuclear cells (PBMCs) was significantly reduced in the B. infantis 35624-treated groups compared with placebo following eight weeks of feeding.

Conclusion
These results demonstrate the ability of this microbe to reduce systemic pro-inflammatory biomarkers in both gastrointestinal and non-gastrointestinal conditions. In conclusion, these data show that the immunomodulatory effects of the microbiota in humans are not limited to the mucosal immune system but extend to the systemic immune system.


My comments
C-reactive protein is a very general marker of inflammation and doesn't seem to have been studied much in CFS (juding by a quick google). Eg this study found C-reactive protein was higher in CFS than healthy controls, and this study found the same, but also found no difference in C-reactive protein between CFS and chronically fatigued patients. Elsewhere, alex3619 has pointed out that the immune changes didn't correlate with symptom scores. Still, interesting stuff.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Good stuff, Simon - thanks. Just had a quick look at the full text and noticed that the CFS selection criteria included "neuropsychological symptomatology" but "the exclusion of associated medical and psychiatric conditions." I wonder what are considered "associated medical and psychiatric conditions." They also say "Each potentially eligible patient was evaluated by a full review of clinical history, physical examination, full blood count and routine biochemistry analysis. Subjects with any clinically significant abnormalities in any of these tests were excluded from the study." That would exclude quite a lot of us, perhaps.

It would have been good to follow the patients for longer to see if their symptoms improved and whether the inflammatory improvement persisted. I note that they say "In general, reduction in inflammatory markers, such as those seen in this study would be regarded as indicative of
clinical remission and of a lower risk of relapse."
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
There are conflicting interests involved in this study:
Disclosure of Potential Conflicts of Interest
D.G., E.M. and B.K. are employees of the university campus company Alimentary Health Ltd. L.O.M., T.D., F.S. and E.Q. are consultants to Alimentary Health Ltd. F.S. has received research grants from G.S.K. J.B. has no conflict of interest.

Alimentary Health appears to be linked to the probiotic Align which is involved in a controversy about false claims: P&G Gets Probiotic False Ad Action Pared - Law360

This doesn't of course mean Align won't do what they say it will, however it pays to be aware of who pays the bills for the research. Unless full data is available, then the results of this study must be considered under caution..
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
There are conflicting interests involved in this study:


Alimentary Health appears to be linked to the probiotic Align which is involved in a controversy about false claims: P&G Gets Probiotic False Ad Action Pared - Law360

This doesn't of course mean Align won't do what they say it will, however it pays to be aware of who pays the bills for the research. Unless full data is available, then the results of this study must be considered under caution..

Well spotted, RustyJ. After checking out your link I wondered what the relationship was between Alimentary Health and P&G so did a quick search and found this:

http://www.norgine.com/downloads/pr_archive/Norgine and AH Corporate Press Release 240811.pdf
 

Dolphin

Senior Member
Messages
17,567
Good stuff, Simon - thanks. Just had a quick look at the full text and noticed that the CFS selection criteria included "neuropsychological symptomatology" but "the exclusion of associated medical and psychiatric conditions." I wonder what are considered "associated medical and psychiatric conditions." They also say "Each potentially eligible patient was evaluated by a full review of clinical history, physical examination, full blood count and routine biochemistry analysis. Subjects with any clinically significant abnormalities in any of these tests were excluded from the study." That would exclude quite a lot of us, perhaps.

Here's the full extract:
Chronic fatigue syndrome patients. Patients with chronic fatigue syndrome (CFS) meeting the criteria outlined by the Centers for Disease Control (CDC) were recruited from gastroenterology and rheumatology clinics at Cork University Hospital. A total of 48 female patients between 18 and 65 y of age were selected. Those who had other diseases of the gastrointestinal tract, including inflammatory bowel disease (IBD) and clinically significant systemic diseases, individuals diagnosed with lactose intolerance or immunodeficiency, individuals who had undergone any abdominal surgery (with the exception of hernia repair and appendectomy), and those with a psychiatric illness were excluded. The diagnosis of CFS was made using the 1994 Centers for Disease Control and CFS International Study Group diagnostic criteria.54 The international criteria are based on the fulfillment of two major criteria: CFS causing incapacity, lasting more than 6 mo, and the exclusion of associated medical and psychiatric conditions, as well as the concurrence of a series of symptom-based criteria, particularly rheumatologic and neuropsychological symptomatology.

54. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A; International Chronic Fatigue Syndrome
Study Group. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med 1994; 121:953-9; PMID:7978722; http://dx.doi.org/10.7326/0003-4819-121-12-199412150-00009

Sounds like a reasonably standard way that the Fukuda et al. (1994) criteria are used.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Here's the full extract:


Sounds like a reasonably standard way that the Fukuda et al. (1994) criteria are used.

I don't think that Fukuda is very well-regarded by ME patients in the know. Also, do a lot of us not have "clinically significant abnormalities" in "full blood count and routine biochemistry analysis"?
 

Dolphin

Senior Member
Messages
17,567
I don't think that Fukuda is very well-regarded by ME patients in the know. Also, do a lot of us not have "clinically significant abnormalities" in "full blood count and routine biochemistry analysis"?

My point wasn't to recommend it but to clarify which criteria were used, which wasn't clear from your post it seemed to me. Maybe 90% of the research in the field has used it in the last 15-18 years (with a lot of the rest using the Oxford criteria).
 

Waverunner

Senior Member
Messages
1,079
Align was the only probiotic that helped me in the past and you can read my old posts about it. I tried it the first time in 2010 and I really don't care what many alternative sites claim. P&G developed it and I'm thankful. The other companies always use the same old strains, mix them together, so that even pro inflammatory probiotics are contained and sell them as great probiotic without even providing one single study.
 

Dolphin

Senior Member
Messages
17,567
Also, do a lot of us not have "clinically significant abnormalities" in "full blood count and routine biochemistry analysis"?

I'm not sure that we do (although I'm not saying some people aren't unnecessarily removed)? Which tests are you thinking about? What they are thinking of are the sort of bog-standard tests GPs run.