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document
Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome : a randomized trial . INTRODUCTION This preliminary study aimed to investigate the effects of the probiotic Saccharomyces boulardii on proinflammatory and anti-inflammatory cytokines in patients with diarrhea-dominant irritable bowel syndrome ( IBS-D ) . The other objectives were to document any clinical improvement as judged by symptoms , quality of life , and histology . PATIENTS AND METHODS This was a randomized , double blind , placebo-controlled trial in which S. boulardii , 750 mg/day , or placebo was administered for 6 weeks in IBS-D patients , in addition to ispaghula husk standard treatment . RESULTS Thirty-seven patients received S. boulardii and 35 patients received the placebo . As compared with placebo , the S. boulardii group showed a significant decrease in blood and tissue levels of proinflammatory cytokines interleukin-8 ( IL-8 ) and tumor necrosis factor-α ( P < 0.001 ) and an increase in anti-inflammatory IL-10 levels , as well as an increase in the tissue IL-10/IL-12 ratio ( P < 0.001 ) . No significant change in the blood and tissue levels of cytokines was found in the placebo group . Bowel-related IBS-D symptoms reported in the patients ' daily diary improved in both groups . However , overall improvement in the quality of life was more marked in the S. boulardii group . Although baseline histological findings were mild , an improvement was observed in the probiotic group in the lymphocyte and neutrophil infiltrates ( P=0.017 and 0.018 ) , epithelial mitosis ( P=0.003 ) , and intraepithelial lymphocytes ( P=0.024 ) . No serious adverse events were found in either group . CONCLUSION S. boulardii with ispaghula husk was superior to placebo with ispaghula husk in improving the cytokine profile , histology , and quality of life of patients with IBS-D . These preliminary results need to be confirmed in a well-powered trial .
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Intervention_Pharmacological
Cytokine
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Intervention_Pharmacological
Saccharomyces boulardii therapy
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Intervention_Pharmacological
probiotic Saccharomyces boulardii
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
boulardii
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Intervention_Control
placebo
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Intervention_Pharmacological
boulardii
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Intervention_Control
placebo
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Intervention_Control
placebo
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Intervention_Pharmacological
boulardii
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Outcome_Physical
blood and tissue levels of proinflammatory cytokines interleukin-8 ( IL-8 )
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Outcome_Physical
tumor necrosis factor-α
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Outcome_Physical
anti-inflammatory IL-10 levels
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Outcome_Physical
tissue IL-10/IL-12 ratio
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Outcome_Physical
blood and tissue levels of cytokines
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Outcome_Physical
Bowel-related IBS-D symptoms
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Outcome_Other
quality of life
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Participant_Condition
with diarrhea-dominant irritable bowel syndrome ( IBS-D )
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Participant_Sample-size
Thirty-seven
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Participant_Sample-size
35