The new trial, published in the Journal of Clinical Investigation, suggests that supplementation with prebiotics and probiotics (PP) may be beneficial for antiretroviral (ARV)-treated HIV patients after research in an animal model of the disease showed promising results.
Led by Jason Brenchley from the US National Institute of Allergy and Infectious Disease, the research team noted that while ARV drugs are the first line therapy for patients with HIV; people treated with ARVs still have a higher mortality rate than uninfected individuals. They also noted that HIV infection results in gastrointestinal (GI) tract damage, microbial translocation, and immune activation, which are not completely ameliorated with ARV therapy.
“We demonstrate that symbiotic probiotics/prebiotics supplementation of ARV treatment enhanced gastrointestinal immune function,” said Brenchley and his colleagues.
The team suggested that pre- and probiotics provide an ‘exciting adjunctive therapeutic approach for HIV infection’ that is well tolerated and inexpensive.
“Our data suggest that PP treatment may be a useful approach to supplementing ARV therapy in HIV-infected individuals to mitigate residual GI inflammation and damage, thereby potentially having a beneficial impact on morbidity and mortality,” they said.
Writing in an accompanying article on the research, Judith Aberg and colleagues at New York University School of Medicine, USA, suggest that the findings are ‘intriguing’ and “expand our perspective on the potential impact of probiotics in HIV infection.”
Brenchley and colleagues treated SIV-infected macaques (a model of human HIV-infection) with either ARV alone or ARV in combination with a symbiotic mixture of probiotics and prebiotics.
In the trial seven chronically SIV-infected pigtail macaques received the symbiotic mixture of prebiotic inulin (Culturelle; prebiotic inulin) and a probiotic (VSL#3) for 60 days.
The team found that macaques given the PP mixture had enhanced gastrointestinal immune function and decreased inflammation compared to macaques treated with ARV alone.
“This synbiotic treatment resulted in increased frequency and functionality of GI tract APCs, enhanced reconstitution and functionality of CD4+ T cells, and reduced fibrosis of lymphoid follicles in the colon,” said Brenchley and his colleagues.
“Thus, ARV synbiotic supplementation in HIV-infected individuals may improve GI tract immunity and thereby mitigate inflammatory sequelae, ultimately improving prognosis.”
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Source: Journal of Clinical Investigation
Published online ahead of print, doi: 10.1172/JCI66227
“Probiotic/prebiotic supplementation of antiretrovirals improves gastrointestinal immunity in SIV-infected macaques”
Authors: Nichole R. Klatt, Lauren A. Canary, Xiaoyong Sun, Carol L. Vinton, et al