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Mitsuyama et al (2008) Beneficial effects of Lactobacillus casei in ulcerative colitis: a pilot study

Mitsuyama et al (2008) Beneficial effects of Lactobacillus casei in ulcerative colitis: a pilot study


Mitsuyama K, Matsumoto S, Yamasaki H, Masuda J, Kuwaki K, Takedatsu H, Nagaoka M, Andoh A, Tsuruta O and Sata M (2008) Beneficial effects of Lactobacillus casei in ulcerative colitis: a pilot study. Journal of Clinical Biochemistry and Nutrition 43 (Suppl 1): 78-81.


To investigate the therapeutic effects of Lactobacillus casei Shirota (LcS) on patients with ulcerative colitis (UC).


In an open-label trial, ten patients with mild to moderately active UC (determined by the Truelove & Witts criteria) consumed a daily probiotic milk drink containing LcS (8 x 1010) for eight weeks in conjunction with conventional therapy (aminosalicylates and/or prednisolone). Changes in the clinical status of patients were measured by a clinical activity index score at baseline and at two week intervals, which measured several aspects of disease (episodes of diarrhoea, nocturnal diarrhoea, visible faecal blood, abdominal pain or cramping, general wellbeing, abdominal tenderness, need for anti-diarrhoeal medication). The physicians taking these measurements were blinded to the treatment regime of the patients.

The control group consisted of nine previously treated patients with active UC whose baseline characteristics were similar to the study group and had previously received conventional therapy but not a probiotic.

In addition, the effect of heat-treated LcS on IL-6 production was assessed in vitro in samples of lipopolysaccharide stimulated peripheral blood mononuclear cells (PBMC) from patients with active UC.


Compared to the control group, probiotic consumption was associated with significantly improved clinical activity index scores after four weeks (P = 0.033), six weeks (P = 0.026) and eight weeks (P = 0.012). When compared to pre-treatment clinical activity index scores, a trend for improved clinical status was observed in the probiotic group but not in the control group at six weeks (P = 0.010) and eight weeks (P = 0.035). The probiotic was well tolerated and no adverse effects were reported.

In vitro tests showed that LcS inhibited IL-6 production in PBMC of UC patients.


The data indicate that supplementing conventional UC therapy with Lactobacillus casei Shirota is safe and more effective in achieving clinical improvement of active UC compared to conventional treatment alone.

The probiotic mechanism of activity may involve inhibition of IL-6 signalling since this cytokine is thought to promote intestinal inflammation.

These findings need to be confirmed in a larger, randomised controlled trial.

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