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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 World+J+Gastroenterol
2016 ; 22
(23
): 5415-21
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Intestinal-borne dermatoses significantly improved by oral application of
Escherichia coli Nissle 1917
#MMPMID27340358
Manzhalii E
; Hornuss D
; Stremmel W
World J Gastroenterol
2016[Jun]; 22
(23
): 5415-21
PMID27340358
show ga
AIM: To evaluate the effect of oral Escherichia coli (E. coli) Nissle application
on the outcome of intestinal-borne dermatoses. METHODS: In a randomized,
controlled, non-blinded prospective clinical trial 82 patients with
intestinal-borne facial dermatoses characterized by an erythematous
papular-pustular rash were screened. At the initiation visit 37 patients entered
the experimental arm and 20 patients constituted the control arm. All 57 patients
were treated with a vegetarian diet and conventional topical therapy of the
dermatoses with ointments containing tetracycline, steroids and retinoids. In the
experimental arm patients received a one month therapy with oral E. coli Nissle
at a maintenance dose of 2 capsules daily. The experimental group was compared to
a non-treatment group only receiving the diet and topical therapy. The primary
outcome parameter was improvement of the dermatoses, secondary parameters
included life quality and adverse events. In addition the immunological reaction
profile (IgA, interleucin-8 and interferon-?) was determined. Furthermore the
changes of stool consistency and the microbiota composition over the time of
intervention were recorded. RESULTS: Eighty-nine percent of the patients with
acne, papular-pustular rosacea and seborrhoic dermatitis responded to E. coli
Nissle therapy with significant amelioration or complete recovery in contrast to
56% in the control arm (P < 0.01). Accordingly, in the E. coli Nissle treated
patients life quality improved significantly (P < 0.01), and adverse events were
not recorded. The clinical improvement was associated with a significant increase
of IgA levels to normal values in serum as well as suppression of the
proinflammatory cytokine IL-8 (P < 0.01 for both parameters). In the E. coli
Nissle treated group a shift towards a protective microbiota with predominance of
bifidobacteria and lactobacteria (> 10(7) CFU/g stool) was observed in 79% and
63% of the patients, respectively (P < 0.01), compared to no change in the
control group without E. coli Nissle. Moreover, the detection rate of a
pathogenic flora dropped from 73% to 14 % of the patients in the experimental arm
(P < 0.01) with no significant change in the control arm (accounting 80% before
and 70% after the observation period, P > 0.05). Accordingly, stool consistency,
color and smell normalized in the E. coli Nissle treated patients. CONCLUSION: E.
coli Nissle protects the mucus barrier by overgrowth of a favorable gut
microbiota with less immunoreactive potential which finally leads to clinical
improvement of intestinal borne dermatoses.