Efficacy and risk assessment of possible fungemia of treatment with saccharomyces boulardii in a rat model of ulcerative colitis

SUMMARYEfficacy and Risk Assessment of Possible Fungemia of Treatment withSaccharomyces boulardii in a Rat Model of Ulcerative ColitisSaygılı, Saba Mukaddes MD.Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi ç Hastalıkları A.D.Correspondence: DEUTF ç Hastalıkları A.D. Balçova/ ZM Re-mail: sacarbay@yahoo.comIntroduction: There are studies suggesting the efficacy of probiotics in UlcerativeColitis and Crohn?s Disease. The risk of fungemia is the most important problemrestricting the use of Saccharomyces boulardii, a probiotic, during the active period ofthese diseases.Aim: We aimed to investigate the efficacy of Saccharomyces boulardii (S.boulardii), aprobiotic, in the trinitrobenzene sulphonic acid (TNBS) induced experimental colitismodel of the rats and also to assess the risk of fungemia which is an unfavourable sideeffect of this therapy.Material and Method: Thirty two Wistar Albino female rat were seperated into fivegroups after the approval of the local animal ethics commitee of Dokuz Eylül UniversityFaculty of Medicine. 50 mg of TNBS was applied to the rectum of the rats via a catheter,except the ones in group 1, in order to induce colitis on the first day of the study.Consequential 14 days the rats received oral saline in group 1 and 2, 1 mg per kg ofS.boulardii dissolved in their daily drinking water in group 3, 1 mg per kg of methylprednisolon in group 4 and combination of same doses of both S.boulardii and methylprednisolon via the same route. Loss of weight, the form of the stool, occurence of overtrectal bleeding and occult blood in the stool were monitored during the study and clinicalscores for colitis were reported. After 14 days the intestines of the rats were examinedand the specimens underwent macroscopic and microscopic scoring. TNF-α ve NO levelswere examined from serum and tissue samples. Fungemia was investigated by using theliver and spleen samples of the rats.Group 1 Group 2 Group 3 Group 4 Group 5AverageClinical 1 4,3 4,1 3,8 4ScoreSerumTNF-α 7,5 pg/ml 12,4 pg/ml 16,4 pg/ml 9,6 pg/ml 12,6 pg/ml(pg/ml)TissueTNF-α 21 pg/ml 28,9 pg/ml 18,1 pg/ml 23,1 pg/ml 20,5 pg/ml(pg/ml)Serum NO4,7 ppb 3,7 ppb 2,9 ppb 4,9 ppb 7,7 ppbppbTissue NO6,2 ppb 29,7 ppb 16,6 ppb 14,7 ppb 11,9 ppb(ppb)Group 4 and group 5 showed significantly lower average clinical scores compared toother groups. The tissue levels of NO were significantly lower in groups 3, 4 and 5.However the difference between macroscopic and microscopic scoring, serum and tissuelevels of TNF-α and serum NO levels of groups 3, 4 and 5 when compared to group 2revealed no significance.Result: Single application of S.boulardii in a model of TNBS induced colitis was foundto be inefficient when compared to the standard therapy, methyl prednisolon, by means ofaverage clinical scoring, macroscopic and microscopic scoring, serum and tissue levels ofTNF-α and serum levels of NO. There was not any case of fungemia due to S.boulardii.Key Words: Rat, Experimental colitis, TNBS, Saccharomyces boulardii, Fungemia