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Abstract

Two Lactobacillus strains have proven anti-inflammatory properties by reducing pro-inflammatory responses to antigens. This randomized double-blind placebo-controlled trial tested the hypothesis that L. plantarum HEAL9 and L. paracasei 8700:2 suppress ongoing celiac disease autoimmunity in genetically at risk children on a gluten-containing diet in a longitudinally screening study for celiac disease. Seventy-eight children with celiac disease autoimmunity participated of whom 40 received 1010 CFU/day of L. plantarum HEAL9 and L. paracasei 8700:2 (probiotic group) and 38 children maltodextrin (placebo group) for six months. Blood samples were drawn at zero, three and six months and phenotyping of peripheral blood lymphocytes and IgA and IgG autoantibodies against tissue transglutaminase (tTG) were measured. In the placebo group, naïve CD45RA+ Th cells decreased (p = 0.002) whereas effector and memory CD45RO+ Th cells increased (p = 0.003). In contrast, populations of cells expressing CD4+CD25highCD45RO+CCR4+ increased in the placebo group (p = 0.001). Changes between the groups were observed for NK cells (p = 0.038) and NKT cells (p = 0.008). Median levels of IgA-tTG decreased more significantly over time in the probiotic (p = 0.013) than in the placebo (p = 0.043) group whereas the opposite was true for IgG-tTG (p = 0.062 respective p = 0.008). In conclusion, daily oral administration of L. plantarum HEAL9 and L. paracasei 8700:2 modulate the peripheral immune response in children with celiac disease autoimmunity.

Keywords: autoimmunity; celiac disease; immune function; probiotic.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus paracasei DSM 13434Increased Regulatory T Cell PopulationsHarmful
Moderate
Lactobacillus paracasei DSM 13434Modulated Immune ResponseBeneficial
Moderate
Lactobacillus paracasei DSM 13434Reduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarumIncreased Regulatory T Cell PopulationsHarmful
Moderate
Lactobacillus plantarumModulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarumReduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarum DSM 6595Modulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarum DSM 6595Reduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarum DSM 6596Decreased Naïve CD45RA+ T Helper CellsNeutral
Small
Lactobacillus plantarum DSM 6596Elevated IgG-tTG LevelsHarmful
Small
Lactobacillus plantarum DSM 6596Increased Natural Killer Cell ProportionBeneficial
Small
Lactobacillus plantarum DSM 6596Increased Natural Killer T CellsBeneficial
Moderate
Lactobacillus plantarum DSM 6596Modulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarum DSM 6596Reduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarum HEAL9Modulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarum HEAL9Reduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarum LP09Change in Immunoglobulin G Tissue Transglutaminase LevelsNeutral
Small
Lactobacillus plantarum LP09Increased NK Cell CountNeutral
Small
Lactobacillus plantarum LP09Modulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarum LP09Reduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarum LP09Reduced Naïve CD45RA+ Th Cell CountBeneficial
Moderate
Lactobacillus plantarum SD-5209Increased Regulatory T Cell PopulationsHarmful
Moderate
Lactobacillus plantarum SD-5209Modulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarum SD-5209No Change in IgG-tTG LevelsNeutral
Small
Lactobacillus plantarum SD-5209Reduced Median Levels of IgA-tTGBeneficial
Moderate
Lactobacillus plantarum UALp-05MModulated Peripheral Immune ResponseBeneficial
Moderate
Lactobacillus plantarum UALp-05MReduced Median Levels of IgA-tTGBeneficial
Moderate

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