VSL 3 probiotica
Na de zoveelste anti-biotica kuur
gecobineerd met een portie Ibruprofen waren mijn darmen compleet van slag. Ondanks mijn
gezonde eten was een flink deel van mijn darmflora beschadigd. Iemand tipte mij over een
levende probiotica die je in de koelkast moet bewaren. Per zakje 450 miljard bacteriŽn en
8 verschillende stammen.
Skeptisch als ik ben surfde ik naar de
Pubmed database waarin klinische studies te vinden zijn. Tot mijn verbazing waren er nogal
wat studies naar gedaan.
Ik promoot normaal geen merk produkten maar
gezien de waarde van deze onderzoeken wilde ik er toch even op wijzen.
De naam vh produkt = VSL #3 en is te koop
via de apotheek
Effects of probiotic bacteria on
gastrointestinal motility in guinea-pig isolated tissue.
Department of Pharma-ceutical Sciences, Via
Belmeloro 6, 40126 Bologna, Italy.
CONCLUSION: The results obtained in this
study suggest that the proximal
colon relaxation activity showed by the probiotic bacteria could be one of the
possible mechanisms of action by which probiotics exert their positive effects
in regulating intestinal motility.
World J Gastroenterol. 2006 Oct
The VSL#3 probiotic formula induces
mucin gene expression and secretion in
colonic epithelial cells.
Institute of Parasitology, McGill
University, Ste. Anne de Bellevue, Canada.
Several studies have stressed the
importance of the microbiota in the
maintenance of the gastrointestinal epithelium. Probiotic bacteria were
previously shown to diminish symptoms in patients suffering from inflammatory
bowel disease by possibility enhancing epithelial barrier functions at the
mucosal surface. In this study, we investigated whether the clinically tested
VSL#3 probiotic formula and/or its secreted components can augment the
protective mucus layer. For in vivo studies, Wistar rats were orally
administered the probiotic mixture VSL#3 on a daily basis for seven days. After
treatment, basal luminal mucin content increased by 60%. In addition, we exposed
isolated rat colonic loops to the VSL#3 probiotic formula, which significantly
stimulated colonic mucin secretion and MUC2 gene expression; however, MUC1 and
MUC3 gene expression were only slightly elevated. The effect of the VSL#3 mucin
secretagogue was also tested in vitro using LS 174T colonic epithelial cells. In
contrast to the animal studies, cultured cells incubated with VSL#3 bacteria did
not exhibit increased mucin secretion. However, the bacterial secreted products
contained in the conditioned media stimulated a remarkable mucin secretion
effect. Among the three bacterial groups (Lactobacilli, Bifidobacteria and
Streptococci) contained in VSL#3, the Lactobacillus species were the strongest
potentiator of mucin secretion in vitro. A preliminary characterization of the
putative mucin secretagogue suggested that it was a heat-resistant soluble
compound, which is not sensitive to protease and DNase treatment. These findings
contribute to a better understanding of the complex and beneficial interaction
between colonic epithelial cells and intestinal bacteria. Key words: probiotics,
intestinal mucosa, mucin secretion, mucin secretagogue.
Am J Physiol Gastrointest Liver Physiol.
2006 Sep 14
Probiotics in chronic inflammatory
Evangelisches Krankenhaus Kalk, Koln.
Current data show that probiotics are more
effective in preventing the
recrudescence of an inflammatory process than in suppressing active disease.This
is reflected in the solid evidence for the effect of E. coli Nissle 1917
(Mutaflor) in the maintenance of remission of ulcerative colitis, and of VSL#3
in preventing the recurrence of pouchitis. These indications have since been
incorporated in valid guidelines. Initial clinical studies have also provided
promising results regarding the efficacy of VSL#3 in preventing pouchitis
immediately following proctocolectomy.
Bacterial and fungal microbiota in
relation to probiotic therapy (VSL#3) in
Department of General Internal Medicine,
CONCLUSIONS: Probiotic therapy with VSL#3
increases the total
number of intestinal bacterial cells as well as the richness and diversity of
the bacterial microbiota, especially the anaerobic flora. The diversity of the
fungal flora is repressed. Restoration of the integrity of a "protective"
intestinal mucosa related microbiota could therefore be a potential mechanism of
probiotic bacteria in inflammatory barrier diseases of the lower
Randomized Controlled Trial
Gut. 2006 Jun;55(6):833-41. Epub 2006 Jan
Probiotics and irritable bowel
syndrome: rationale, putative mechanisms, and
evidence of clinical efficacy.
Mayo Clinic College of Medicine, Mayo
Clinic, Rochester, MN 55905, USA.
The irritable bowel syndrome (IBS) follows
an acute, presumably infectious
diarrheal illness in approximately 15% of patients. There may be a persistent,
mild inflammatory state with changes in mucosal function or structure. Changes
in the colonic bacterial flora reported in IBS seem related to predominant
bowel. Colonic bacteria normally metabolize nutrients with the formation of gas
and short chain fatty acids. The latter may induce propulsive contractions and
accelerate colonic transit or they may enhance fluid and sodium absorption in
the colon. This review addresses the mechanisms, rationale and current evidence
for the efficacy of probiotics, including Lactobacilli, Bifidobacteria, and
VSL#3, in the treatment of IBS. The mechanisms influenced by probiotics include
immune function, motility, and the intraluminal milieu. Probiotics may suppress
the low-grade inflammation associated with IBS or restore normal local immune
function. Lactobacilli and Bifidobacteria subspecies are able to deconjugate and
absorb bile acids, potentially reducing the colonic mucosal secretion of mucin
and fluids that may contribute to functional diarrhea or IBS with diarrhea.
Therapeutic trials show the potential benefit of Bifidobacteria or Lactobacilli
species alone or in the specific probiotic combination, VSL#3, on symptoms in
IBS. Colonic transit was retarded in IBS patients treated with VSL#3 without
induction of significant changes in bowel function. In summary, probiotics are
promising therapies in IBS.
13: J Clin Gastroenterol. 2006
Probiotics for women's health.
Department of Pathology Brigham and Women's
Hospital, Harvard Medical School,
Boston, MA, USA. firstname.lastname@example.org
GOALS: The goals of this research were
2-fold: (1) to determine whether a
commercially available probiotic mixture (VSL-3) could survive and grow in a
continuous culture system simulating the vaginal environment and (2) to
determine whether the probiotic mixture was capable of suppressing the growth of
a known vaginal vault pathogen, Gardnerella vaginalis.
STUDY: A well-documented continuous culture
system has been used to determine whether VSL-3 can survive and grow in conditions
simulating a vaginal environment. In addition, the ability of VSL-3 to inhibit the growth
of a known vaginal vault pathogen, G. vaginalis, has been determined.
RESULTS: The probiotic mixture was shown to
survive and maintain itself within
the fermentation vessel of the continuous culture system over an extended period
of time. This mixture, when challenged with a known pathogen, was also shown to
suppress the growth of G. vaginalis.
CONCLUSIONS: It may be feasible to use
probiotics as interventional therapy to suppress the growth of pathogens within
the vaginal vault associated with BV.
J Clin Gastroenterol. 2006 Mar;40(3):256-9.
The VSL# 3 probiotic mixture
modifies microflora but does not heal chronic
dextran-sodium sulfate-induced colitis or reinforce the mucus barrier in mice.
Gaudier E, Michel C, Segain JP, Cherbut C,
Human Nutrition and Gut Function
Department, INRA, Nantes, France.
The mucus layer covering the epithelium is
one of the main lines of defense of
the colonic barrier. Both mucus gel and mucin expressions are altered during
colonic inflammation and could be involved in epithelial repair. We postulated
that modulating colonic mucus and mucins by probiotic supplementation could
contribute to healing inflammatory mucosa. Our aim in this study was to
determine whether probiotics could repair dextran-sodium sulfate (DSS)-induced
chronic colitis in mice, and whether modifications of the colonic mucins could
be involved. For that purpose, the VSL#3 probiotic mixture of 8 lactic acid
bacteria probiotic strains was administered daily for 2 wk to mice with a mucosa
impaired by a mild DSS treatment, and to mice with a normal mucosa. Probiotic
strains survived in the gastrointestinal tract, increased the cecal
concentrations of bifidobacteria, and modified cecal microflora metabolic
activity in both DSS-treated and healthy mice. However, probiotic
supplementation did not reverse the inflammation induced by DSS at either the
macroscopic or histological level. Concurrently, probiotics did not modify the
colonic mucus barrier, in terms of either mucin gene expression or adherent
mucus layer thickness. In conclusion, the modification of microflora by
supplementation with the VSL#3 probiotic mixture did not help to repair the
colonic barrier breakdown caused by DSS treatment. The potential healing roles
of mucins were neither confirmed nor invalidated by this study.
J Nutr. 2005 Dec;135(12):2753-61.
PMID: 16317116 [PubMed - indexed for
Effects of probiotic bacteria
(VSL#3) on the polyamine biosynthesis and cell
proliferation of normal colonic mucosa of rats.
Linsalata M, Russo F, Berloco P, Valentini
AM, Caruso ML, De Simone C, Barone M,
Polimeno L, Di Leo A.
Laboratory of Biochemistry, National
Institute for Digestive Diseases IRCCS
"Saverio de Bellis", Castellana G., Bari, University of Bari, Italy.
BACKGROUND: Probiotics seem to possess
tumour inhibitory properties, but few
studies have investigated their actions on the cell proliferation of normal
colonic mucosa. The effects of a probiotic mixture (VSL#3) on polyamine
biosynthesis, Ki-67 levels and apoptosis in the normal colon of rats were
studied. MATERIALS AND METHODS: For a 4-week period, 20 rats were fed a VSL#3
solution and 20 rats a saline solution. Samples from the colonic mucosa were
collected at the end of treatment. Polyamines were detected by HPLC, ornithine
decarboxylase activity by a radiometric technique, and apoptosis and Ki-67 by
histochemical and immunohistochemical methods. RESULTS: VSL#3 caused a
significant decrease in colonic polyamine levels, ornithine decarboxylase
activity and Ki-67 compared to controls. A significant increase in the apoptotic
index was also observed. CONCLUSION: Probiotics could also reduce proliferation
rates in a condition not affected by hyperproliferative or neoplastic growth,
when the normal control mechanisms are still completely effective.
In Vivo. 2005 Nov-Dec;19(6):989-95.
PMID: 16277012 [PubMed - indexed for
A randomized controlled trial of a
probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating.
Kim HJ, Vazquez Roque MI, Camilleri M,
Stephens D, Burton DD, Baxter K,
Thomforde G, Zinsmeister AR.
Clinical Enteric Neuroscience Translational
and Epidemiological Research
(CENTER) Group, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
AIM: To evaluate the effects of a
combination probiotic on symptoms and colonic
transit in patients with irritable bowel syndrome (IBS) and significant
bloating. METHODS: Forty-eight patients with Rome II IBS were randomized in a
parallel group, double-blind design to placebo or VSL# 3 twice daily (31
patients received 4 weeks and 17 patients 8 weeks of treatment). Pre- and
post-treatment colonic transit measurements were performed using scintigraphy
with (111)In charcoal. Symptoms were summarized as an average daily score for
the entire period of treatment and separately for the first 4 weeks of
treatment. Weekly satisfactory relief of abdominal bloating was assessed.
RESULTS: Treatment with VSL# 3 was associated with reduced flatulence over the
entire treatment period (placebo 39.5 +/- 2.6 vs VSL# 3 29.7 +/- 2.6, P =
0.011); similarly, during the first 4 weeks of treatment, flatulence scores were
reduced (placebo 40.1 +/- 2.5 vs VSL# 3 30.8 +/- 2.5, P = 0.014). Proportions of
responders for satisfactory relief of bloating, stool-related symptoms,
abdominal pain and bloating scores were not different. Colonic transit was
retarded with VSL# 3 relative to placebo (colon geometric center 2.27 +/- 0.20
vs 2.83 +/- 0.19, P = 0.05 respectively). CONCLUSION: VSL# 3 reduces flatulence
scores and retards colonic transit without altering bowel function in patients
with IBS and bloating.
Neurogastroenterol Motil. 2005
Randomized Controlled Trial
VSL#3 probiotic-mixture induces
remission in patients with active ulcerative
Bibiloni R, Fedorak RN, Tannock GW, Madsen
KL, Gionchetti P, Campieri M, De
Simone C, Sartor RB.
Department of Agricultural, Food and
Nutritional Science, University of Alberta,
Edmonton, Alberta, Canada.
BACKGROUND AND AIMS: Intestinal bacteria
have been implicated in the initiation
and perpetuation of IBD; in contrast, "probiotic bacteria" have properties
possibly effective in treating and preventing relapse of IBD. We evaluated the
safety and efficacy of VSL#3 and the components, and the composition of the
biopsy-associated microbiota in patients with active mild to moderate ulcerative
colitis (UC). METHODS: Thirty-four ambulatory patients with active UC received
open label VSL#3, 3,600 billion bacteria daily in two divided doses for 6 wk.
The presence of biopsy-associated bacteria was detected using a nucleic
acid-based method and the presence of VSL#3 species confirmed by DNA sequencing
of 16S rRNA. RESULTS: Thirty-two patients completed 6 wk of VSL#3 treatment and
2 patients did not have the final endoscopic assessment. Intent to treat
analysis demonstrated remission (UCDAI < or = 2) in 53% (n = 18); response
(decrease in UCDAI > or = 3, but final score > or =3) in 24% (n = 8); no
response in 9% (n = 3); worsening in 9% (n = 3); and failure to complete the
final sigmoidoscopy assessment in 5% (n = 2). There were no biochemical or
clinical adverse events related to VSL#3. Two of the components of VSL#3 were
detected by PCR/DGGE in biopsies collected from 3 patients in remission.
CONCLUSION: Treatment of patients with mild to moderate UC, not responding to
conventional therapy, with VSL#3 resulted in a combined induction of
remission/response rate of 77% with no adverse events. At least some of the
bacterial species incorporated in the probiotic product reached the target site
in amounts that could be detected.
Randomized Controlled Trial
Am J Gastroenterol. 2005
PMID: 15984978 [PubMed - indexed for
Probiotics (VSL#3) in arthralgia in
patients with ulcerative colitis and Crohn's
disease: a pilot study.
Karimi O, Pena AS, van Bodegraven AA.
Laboratory of Immunogenetics, VUmc,
Amsterdam, the Netherlands.
Arthralgia is a common extraintestinal
manifestation of inflammatory bowel
disease (IBD). Alterations of the immunologic regulation in the gut may
contribute to the pathogenesis of arthralgia. Probiotics (VSL#3) have proven
effective in the treatment of pouchitis in patients with ileal pouch anal
anastomosis after panproctocolectomy for ulcerative colitis both in maintaining
remission and in preventing a flare-up without side effects. The aim of this
study was to determine the safety and efficacy of VSL#3 in patients with
quiescent IBD who suffered from arthralgia for more than two weeks. An
open-label trial was conducted using VSL#3. Pre- and post-treatment joint pain
intensity were measured on the Ritchie Articular Index and visual analog scale.
Disease activity of the bowel was assessed by the Truelove-Witts and the
Harvey-Bradshaw scores. Sixteen of 29 patients completed the trial; in 10 of the
16 patients a statistically significant improvement was documented by the
Ritchie Articular Index. No one of the patients had a relapse of intestinal
disease while on probiotics. These preliminary results suggest that the
probiotic mixture VSL#3 may be an alternative treatment for arthralgia in
patients with IBD without inducing exacerbation of the disease. Because
probiotics may be effective in the treatment of IBD as well, our results suggest
that patients with active disease and arthralgia may also derive benefit from
this treatment. Proper randomized controlled studies are indicated.
Drugs Today (Barc). 2005 Jul;41(7):453-9.
PMID: 16193098 [PubMed - indexed for
Beneficial effects of a probiotic
VSL#3 on parameters of liver dysfunction in
chronic liver diseases.
Loguercio C, Federico A, Tuccillo C,
Terracciano F, D'Auria MV, De Simone C, Del
Vecchio Blanco C.
Department of Internistica Clinica e
Sperimentale F. Magrassi e A. Lanzara,
Inter-University Research Center on Foods, Nutrition, and Gastrointestinal Tract
(CIRANAD), Second University of Naples, Naples, Italy.
OBJECTIVES: To evaluate whether chronic
therapy with probiotics affects plasma
levels of cytokines and oxidative/nitrosative stress parameters, as well as
liver damage, in patients with various types of chronic liver disease. PATIENTS
AND METHODS: A total of 22 nonalcoholic fatty liver disease (NAFLD) and 20
alcoholic liver cirrhosis (AC) patients were enrolled in the study and compared
with 36 HCV-positive patients with chronic hepatitis without (20, CH) or with
(16, CC) liver cirrhosis. All patients were treated with the probiotic VSL#3.
Routine liver tests, plasma levels of tumor necrosis factor alpha (TNF-alpha),
interleukin (IL)-6 and -10, malondialdehyde (MDA), and 4-hydroxynonenal (4-HNE),
S-nitrosothiols (S-NO), were evaluated on days -30, 0, 90, and 120. RESULTS:
Treatment with VSL#3 exerted different effects in the various groups of
patients: in NAFLD and AC groups, it significantly improved plasma levels of MDA
and 4-HNE, whereas cytokines (TNF-alpha, IL-6, and IL-10) improved only in AC
patients. No such effects were observed in HCV patients. Routine liver damage
tests and plasma S-NO levels were improved at the end of treatment in all
groups. CONCLUSIONS: Results of the study suggest that manipulation of
intestinal flora should be taken into consideration as possible adjunctive
therapy in some types of chronic liver disease.
J Clin Gastroenterol. 2005 Jul;39(6):540-3.
Nutritional and metabolic issues in
inflammatory bowel disease.
Cabre E, Gassull MA.
Department of Gastroenterology. Germans
Trias i Pujol University Hospital,
Badalona, Catalonia, Spain.
PURPOSE OF REVIEW: This article describes
the clinical papers published in 2002
and early 2003 on nutritional and metabolic derangement in inflammatory bowel
disease. RECENT FINDINGS: Insulin-like growth factor 1 and Insulin-like growth
factor binding protein 3 are decreased in inflammatory bowel disease, and
disease therapy hardly reverses this situation. There are promising data on
recombinant human growth hormone therapy in paediatric inflammatory bowel
disease. Several papers have added some fuel to the debate on the prevalence and
pathogenesis of metabolic bone disease in inflammatory bowel disease. Articles
have been published investigating the role of dietary fat in the therapeutic
action of enteral feeding in Crohn's disease. Low-fat diets are particularly
useful, and adding medium-chain triglycerides does not impair the effectiveness
of these diets. Balanced amounts of saturated, monounsaturated and
polyunsaturated fat should probably be used. Relevant contributions on the
usefulness of probiotic preparations (VSL#3) in the treatment and prevention of
pouchitis have been published. Other papers deal with the effects of medical and
surgical therapy on body composition and metabolism in the inflammatory bowel
disease, the treatment of oxidative stress of these patients, and the possible
role of some vitamin deficiencies on thrombotic risk in the condition. SUMMARY:
Inflammatory bowel disease therapy hardly reverses growth hormone-insulin-like
growth factor 1 disturbances of patients. The role of inflammation and steroid
therapy of metabolic bone disease in inflammatory bowel disease is still
controversial. Low-fat diets, with added amounts of medium-chain triglycerides,
are useful in decreasing gut inflammation in the condition. The search for the
optimal dietary fatty acid composition deserves further investigations. The use
of probiotics and prebiotics opens new therapeutic perspectives for the disease.
Curr Opin Clin Nutr Metab Care. 2003
A randomized controlled trial of a
probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel
Kim HJ, Camilleri M, McKinzie S, Lempke MB,
Burton DD, Thomforde GM, Zinsmeister
Clinical Enteric Neuroscience Translational
& Epidemiological Research Program,
Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
AIM: To investigate the effects of a
probiotic formulation, VSL#3, on
gastrointestinal transit and symptoms of patients with Rome II irritable bowel
syndrome with predominant diarrhoea. METHODS: Twenty-five patients with
diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive
VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice
daily for 8 weeks after a 2-week run-in period. Pre- and post-treatment
gastrointestinal transit measurements were performed in all patients. Patients
recorded their bowel function and symptoms daily in a diary during the 10-week
study, which was powered to detect a 50% change in the primary colonic transit
end-point. RESULTS: There were no significant differences in mean
gastrointestinal transit measurements, bowel function scores or satisfactory
global symptom relief between the two treatment groups, pre- or post-therapy.
Differences in abdominal bloating scores between treatments were borderline
significant (P = 0.09, analysis of covariance). Further analysis revealed that
abdominal bloating was reduced (P = 0.046) with VSL#3 [mean post- minus
pre-treatment score, - 13.7; 95% confidence interval (CI), - 2.5 to - 24.9], but
not with placebo (P = 0.54) (mean post- minus pre-treatment score, - 1.7; 95%
CI, 7.1 to - 10.4). With the exception of changes in abdominal bloating, VSL#3
had no effect on other individual symptoms: abdominal pain, gas and urgency. All
patients tolerated VSL#3 well. CONCLUSION: VSL#3 appears to be promising in the
relief of abdominal bloating in patients with diarrhoea-predominant irritable
bowel syndrome. This is unrelated to an alteration in gastrointestinal or
Randomized Controlled Trial
Aliment Pharmacol Ther. 2003 Apr
Prophylaxis of diarrhoea in
patients submitted to radiotherapeutic treatment on
pelvic district: personal experience.
Delia P, Sansotta G, Donato V, Messina G,
Frosina P, Pergolizzi S, De Renzis C.
Radiologic Science Institute, Oncologic
Radiotherapy Unit, University Hospital,
Diarrhoea is a severe side-effect of
radiotherapy on the pelvic area. It is due
to acute enteric damage. We aimed at determining the ability of a highly
concentrated freeze-dried living bacteria compound (VSL/3) to reduce these
side-effects in 190 patients receiving radio therapy on the pelvic area. A total
of 95 patients received radiotherapy alone and 95 were also administered VSL/3
bags, at doses of one bag three times a day beginning on the first day of the
radiotherapy treatment. The same diet was indicated for both groups. All
patients were irradiated for 6 to 7 weeks, with Linac X-6 MV or 15 MV through a
box multiportal technique with the lower limit of the fields below the obturator
foramina, upper limit at L5-S1, lateral limit 1.5 cm beyond the innominate hip.
The total radiated dose ranged from 60 to70 Gy for a daily dose of 180 cGy.
Gastroenteric toxicity was rated in WHO degrees. Two patients receiving
radiotherapy alone had to discontinue the treatment due to acute enteritis.
Toxicity was found in 52 (50.6%) patients with radiotherapy alone vs 36 (30.5%)
patients receiving VSL/3. None of them had to discontinue radiotherapy. Toxicity
of degrees 3 or 4 was found in 28 patients receiving radiotherapy alone vs 7
with VSL/3. These preliminary data suggest the effectiveness of VSL/3 in
preventing the occurrence of diarrhoea in patients submitted to radiotherapy
with a direct and indirect improvement of their quality of life and a good
Dig Liver Dis. 2002 Sep;34 Suppl 2:S84-6.
Effects of probiotic administration
upon the composition and enzymatic activity
of human fecal microbiota in patients with irritable bowel syndrome or
Brigidi P, Vitali B, Swennen E, Bazzocchi
G, Matteuzzi D.
Dipartimento di Scienze Farmaceutiche,
Universita di Bologna, Italy.
In a clinical trial, 10 patients suffering
from irritable bowel syndrome or
functional diarrhea were administered the probiotic preparation VSL-3.
Preliminary results indicated that administration of VSL-3 improved the clinical
picture and changed the composition and biochemistry of fecal microbiota. Titer
variations of intestinal bacterial groups were evaluated by culture and PCR
techniques. A significant increase in lactobacilli, bifidobacteria and
Streptococcus thermophilus was observed as a consequence of probiotic treatment,
while enterococci, coliforms, Bacteroides and Clostridium perfringens did not
change significantly. The strains Bifidobacterium infantis Y1 and
Bifidobacterium breve Y8, included in VSL-3, were specifically detected in feces
of patients treated with the probiotic by using strain-specific PCR primers. In
addition, fecal beta-galactosidase increased and urease activities decreased as
a result of changes in the intestinal microbiota induced by VSL-3
Res Microbiol. 2001 Oct;152(8):735-41.