Friendly bacteria the key to ulcerative colitis treatment

A type of ‘friendly bacteria’ has been the key for researchers at the University of Dundee who have just developed a treatment that offers the opportunity of new therapies for the management of one of the UK's most common forms of inflammatory bowel disease - ulcerative colitis.

Results from a four-week patient trial led by Professor George Macfarlane showed that many of the patients’ symptoms were dramatically reduced to near normal levels.

Affecting an estimated fifty thousand people in the UK, with a particularly high incidence rate in north east Scotland, ulcerative colitis is an acute and chronic disease that causes inflammation and sores, called ulcers, in the lining of the large bowel.

After studying the bowel wall of colitis patients and healthy volunteers, the team made an important discovery. The levels of a specific type of friendly bacteria were 30 times less in colitis patients than in healthy people. As well as stimulating the immune system and offering anti-cancer properties, many of these organisms have anti-inflammatory effects, and after noting that the particular types of this bacteria were also different in colitis patients, the researchers set about developing substitute organisms that could help colitis patients.

As a result, Professor Macfarlane and his team developed a probiotic, which together with a carbohydrate source forms a ‘synbiotic’ and was given to the colitis patients as a substitute for the anti-inflammatory effects that the naturally occurring ‘friendly bacteria’ offer to healthy people. In a four-week trial with active ulcerative colitis patients, the researchers monitored the effect of the synbiotic.

Ulcerative colitis patients commonly experience abdominal pain and diarrhoea but fatigue, weight loss, rectal bleeding, loss of appetite and loss of body fluids and nutrients can affect some patients. The trial results were dramatic showing that the synbiotic had a highly significant effect on inflammatory molecules in the bowel wall, largely reducing the pain and discomfort commonly experienced by ulcerative colitis patients. Molecular and clinical tests showed that many symptoms associated with colitis were reduced to near normal levels, and unlike many other treatments, there are no side effects.

Professor George Macfarlane said, “This is an important development in the search for an effective treatment for ulcerative colitis. The trial results show that participants receiving the synbiotic stopped experiencing pain, diarrhoea and other symptoms commonly associated with the disease. This meant that they could go about their daily lives without worrying about the symptoms that makes living with the disease a struggle.”

The work is ongoing and the research team is also investigating the effects that both diet and age have on the gut. A multidisciplinary team of ten have worked on the project that has seen laboratory based observations translated to the clinical environment - the patients. The project was funded by the Medical Research Council.

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