Probiotics Reduce Inflammation in Antiretroviral Treated, HIV-Infected Individuals: Results of the "Probio-HIV" Clinical Trial

• Published in: PloS one 2015-09, Vol.10 (9), p.e0137200-e0137200
• Main Authors: d'Ettorre, Gabriella, Ceccarelli, Giancarlo, Giustini, Noemi, Serafino, Sara, Calantone, Nina, De Girolamo, Gabriella, Bianchi, Luigi, Bellelli, Valeria, Ascoli-Bartoli, Tommaso, Marcellini, Sonia, Turriziani, Ombretta, Brenchley, Jason M, Vullo, Vincenzo
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; Aged; Aging - drug effects; Aging - immunology; AIDS; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Attorneys; C-reactive protein; CD38 antigen; CD4 antigen; CD4-Positive T-Lymphocytes - drug effects; CD4-Positive T-Lymphocytes - immunology; CD8 antigen; Cell activation; Clinical trials; Combined Modality Therapy; Complications; Dietary supplements; Dosage and administration; Drug therapy; Dysbiosis - complications; Enumeration; Female; Gastrointestinal Microbiome - drug effects; Gastrointestinal tract; Histocompatibility antigen HLA; HIV; HIV Infections - complications; HIV Infections - diet therapy; HIV Infections - immunology; HIV Infections - microbiology; Human immunodeficiency virus; Humans; Immune response; Immunity; Immunology; Inflammation; Inflammation - complications; Inflammation - diet therapy; Interleukin 6; Life assessment; Lipopolysaccharides; Longitudinal Studies; Lymphocytes; Lymphocytes T; Male; Markers; Microorganisms; Middle Aged; Morbidity; Patient outcomes; Patients; Peripheral blood; Plasma levels; Probiotics; Probiotics - pharmacology; Probiotics - therapeutic use; Protein binding; Ribonucleic acid; RNA; Statistical analysis; Supplementation; Translocation
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0137200

HIV infection results in damage to the gastrointestinal (GI) tract, microbial translocation and immune activation. These are not completely normalized with combined antiretroviral therapy (cART). Moreover, increate morbidity and mortality of cART-treated HIV-infected individuals is associated with inflammation. In order to enhance GI tract immunity, we recruited and treated 20 HIV-infected humans with cART supplemented with probiotics and followed inflammation and immunological parameters (clinical trial number NCT02164344). 11 HIV seronegative subjects were included as control group. The enumeration of CD4+, CD8+, CD38+ and HLA-DR+ lymphocytes were evaluated on peripheral blood; HIV-RNA levels, sCD14, d-dimer, C-reactive protein (CRP) high sensitivity C-reactive protein (hsCRP), IL-6 and Lipopolysaccharide Binding Protein (LBP) were assayed on plasma. We observe that cART does not normalize the levels of immune activation in HIV positive patients anyway inflammation and markers of microbial translocation were significantly reduced with probiotic supplementation. Patients show a clear and statistically significant reduction in the levels of immune activation on CD4 T-lymphocytes, for both markers CD38 and HLA-DR and their simultaneous expression, LBP and hsCRP plasma levels after probiotic diet supplementation settling to values comparable to controls. Supplementing cART with probiotics in HIV-infected individuals may improve GI tract immunity and there by mitigate inflammatory sequelae, ultimately improving prognosis. ClinicalTrials.gov NCT02164344.