P0583 The Effects of a Dual-Strain Probiotic Versus Placebo on Cytokine Levels in Patients with Ulcerative Colitis

Abstract Background Ulcerative colitis (UC) is a form of Inflammatory Bowel Disease (IBD) characterised by chronic mucosal inflammation of the colon. It has been shown that fatigue in patients with ulcerative colitis is a particularly burdensome symptom[1]. Studies have shown that patients with IBD have higher fatigue scores than non-IBD control groups[1]. In UC, activation and dysregulation of the adaptive immune response at the epithelial level results in the abnormal response to antigens leading to an inflammatory cascade resulting in a production of multiple different pro-inflammatory cytokines including IL10, IL23 and TNF-α amongst others[2]. The aim of this study therefore is to evaluate the effects of a dual-strain probiotic versus placebo on cytokines in relation to UC and fatigue. Methods This is a single centre double-blind randomised placebo-controlled trial in Tallaght University Hospital, Dublin. Participants are between the ages of 18 to 65 and have a confirmed diagnosis of ulcerative colitis. After randomisation, participants were enrolled on either a 3 month probiotic or placebo arm. Participants had blood tests and a faecal calprotectin at baseline and at conclusion of the study. The probiotic is a dual strain Bifidobacterium longum 35624® combined with B. longum 1714®. Results 10 controls and 59 participants meeting eligibility criteria were successfully recruited. After double-blind randomisation, 30 participants were on the active dual-probiotic arm with 29 participants on the placebo arm (table 1). In our cytokine analysis the mean concentrations for IFN-α, IFN-γ, IL-10, IL-12p70, IL-6, IL-8, IP-10 and MCP-1 increased post the probiotic. SAA and IL-17A remained relatively unchanged post the probiotic, and an improvement was seen in IL-1β and TNF-α. Contrasted with the placebo arm of the study where mean concentrations in IFN-γ, IL-17A, IL-6, IP-10 and MCP-1 increased post the placebo. SAA and IL-8 remained relatively unchanged post the placebo. There was an improvement seen in IFN-α, IL-10, IL-12p70, IL-1β and TNF-α (table 2). Results could be due to low detection rates. Conclusion This study found probiotics may not always be beneficial for patients with UC and may worsen some pro-inflammatory cytokine levels. References 1.Römkens TEH, van Vugt-van Pinxteren MWJ, Nagengast FM, van Oijen MGH, de Jong DJ. High prevalence of fatigue in inflammatory bowel disease: A case control study. Journal of Crohn's and Colitis. 2011;5(4):332-7. 2.Ordás I, Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. 2012 Nov 3;380(9853):1606-19.