Randomized pilot trial of a synbiotic dietary supplement in chronic HIV-1 infection

BMC Complementary and Alternative Medicine

Research Article

Hiutung Chu¹  Timothy L Hayes¹  Marco Schunter¹  Charles L Bevins¹  Delandy McConnell¹  Sean S Crawford¹  J William Critchfield¹  Barbara L Shacklett²  Paul A Luciw³  David M Asmuth⁴  Jennifer Brown⁴  Stig Bengmark⁵ 

[1] Department of Medical Microbiology and Immunology, University of California, Davis, CA, USA;Department of Medical Microbiology and Immunology, University of California, Davis, CA, USA;Division of Infectious Diseases, Department of Internal Medicine, University of California, Davis, Sacramento, California, USA;Department of Pathology and Laboratory Medicine, Center for Comparative Medicine, University of California, Davis, California, USA;Division of Infectious Diseases, Department of Internal Medicine, University of California, Davis, Sacramento, California, USA;Institute of Hepatology, University College of London, London, UK;

关键词: Human immunodeficiency virus-1 (HIV-1);    synbiotics;    probiotics;    prebiotics;    microbial translocation;    immune activation;    highly active antiretroviral therapy (HAART);    combined antiretroviral therapy (CART);    complementary therapy.;   

DOI  :  10.1186/1472-6882-12-84

 received in 2012-03-07, accepted in 2012-06-29,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundInfection with HIV-1 results in marked immunologic insults and structural damage to the intestinal mucosa, including compromised barrier function. While the development of highly active antiretroviral therapy (HAART) has been a major advancement in the treatment of HIV-1 infection, the need for novel complementary interventions to help restore intestinal structural and functional integrity remains unmet. Known properties of pre-, pro-, and synbiotics suggest that they may be useful tools in achieving this goal.MethodsThis was a 4-week parallel, placebo-controlled, randomized pilot trial in HIV-infected women on antiretroviral therapy. A synbiotic formulation (Synbiotic 2000®) containing 4 strains of probiotic bacteria (1010 each) plus 4 nondigestible, fermentable dietary fibers (2.5 g each) was provided each day, versus a fiber-only placebo formulation. The primary outcome was bacterial translocation. Secondary outcomes included the levels of supplemented bacteria in stool, the activation phenotype of peripheral T-cells and monocytes, and plasma levels of C-reactive protein and soluble CD14.ResultsMicrobial translocation, as measured by plasma bacterial 16S ribosomal DNA concentration, was not altered by synbiotic treatment. In contrast, the synbiotic formulation resulted in significantly elevated levels of supplemented probiotic bacterial strains in stool, including L. plantarum and P. pentosaceus, with the colonization of these two species being positively correlated with each other. T-cell activation phenotype of peripheral blood lymphocytes showed modest changes in response to synbiotic exposure, with HLA-DR expression slightly elevated on a minor population of CD4+ T-cells which lack expression of HLA-DR or PD-1. In addition, CD38 expression on CD8+ T-cells was slightly lower in the fiber-only group. Plasma levels of soluble CD14 and C-reactive protein were unaffected by synbiotic treatment in this study.ConclusionsSynbiotic treatment for 4 weeks can successfully augment the levels of probiotic species in the gut during chronic HIV-1 infection. Associated changes in microbial translocation appear to be absent, and markers of systemic immune activation appear largely unchanged. These findings may help inform future studies aimed at testing pre- and probiotic approaches to improve gut function and mucosal immunity in chronic HIV-1 infection.Trial registrationClinical Trials.gov: NCT00688311

【 授权许可】

Unknown   
© Schunter et al.;licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.