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Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy
OBJECTIVES: To examine the impact of serum-derived bovine immunoglobulin, an oral medical food known to neutralize bacterial antigen and reduce intestinal inflammation, on restoration of mucosal immunity and gastrointestinal function in individuals with HIV enteropathy. DESIGN: Open-label trial with...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3754419/ https://www.ncbi.nlm.nih.gov/pubmed/23660579 http://dx.doi.org/10.1097/QAD.0b013e328362e54c |
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author | Asmuth, David M. Ma, Zhong-Min Albanese, Anthony Sandler, Netanya G. Devaraj, Sridevi Knight, Thomas H. Flynn, Neil M. Yotter, Tammy Garcia, Juan-Carlos Tsuchida, Emily Wu, Tsung-Teh Douek, Daniel C. Miller, Christopher J. |
author_facet | Asmuth, David M. Ma, Zhong-Min Albanese, Anthony Sandler, Netanya G. Devaraj, Sridevi Knight, Thomas H. Flynn, Neil M. Yotter, Tammy Garcia, Juan-Carlos Tsuchida, Emily Wu, Tsung-Teh Douek, Daniel C. Miller, Christopher J. |
author_sort | Asmuth, David M. |
collection | PubMed |
description | OBJECTIVES: To examine the impact of serum-derived bovine immunoglobulin, an oral medical food known to neutralize bacterial antigen and reduce intestinal inflammation, on restoration of mucosal immunity and gastrointestinal function in individuals with HIV enteropathy. DESIGN: Open-label trial with intensive 8-week phase of bovine serum immunoglobulin (SBI) 2.5 g twice daily with a 4-week washout period and an optional 9-month extension study. METHODS: HIV enteropathy was defined as chronic gastrointestinal symptoms including frequent loose or watery stools despite no identifiable, reversible cause. Upper endoscopy for tissue immunofluorescent antibody assay and disaccharide gut permeability/absorption studies were performed before and after 8 weeks of SBI to test mucosal immunity and gastrointestinal function. Blood was collected for markers of microbial translocation, inflammation, and collagen kinetics. A validated gastrointestinal questionnaire assessed changes in symptoms. RESULTS: All eight participants experienced profound improvement in symptoms with reduced bowel movements/day (P = 0.008) and improvements in stool consistency (P = 0.008). Gut permeability was normal before and after the intervention, but d-xylose absorption increased in seven of eight participants. Mucosal CD4(+) lymphocyte densities increased by a median of 139.5 cells/mm(2) from 213 to 322 cells/mm(2) (P = 0.016). Intestinal-fatty acid binding protein (I-FABP), a marker of enterocyte damage, initially rose in seven of eight participants after 8 weeks (P = 0.039), and then fell below baseline in four of five who continued receiving SBI (P = 0.12). Baseline serum I-FABP levels were negatively correlated with subsequent rise in mucosal CD4(+) lymphocyte densities (r = −0.74, P = 0.046). CONCLUSION: SBI significantly increases intestinal mucosal CD4(+) lymphocyte counts, improves duodenal function, and showed evidence of promoting intestinal repair in the setting of HIV enteropathy. |
format | Online Article Text |
id | pubmed-3754419 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-37544192013-08-27 Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy Asmuth, David M. Ma, Zhong-Min Albanese, Anthony Sandler, Netanya G. Devaraj, Sridevi Knight, Thomas H. Flynn, Neil M. Yotter, Tammy Garcia, Juan-Carlos Tsuchida, Emily Wu, Tsung-Teh Douek, Daniel C. Miller, Christopher J. AIDS Clinical Science OBJECTIVES: To examine the impact of serum-derived bovine immunoglobulin, an oral medical food known to neutralize bacterial antigen and reduce intestinal inflammation, on restoration of mucosal immunity and gastrointestinal function in individuals with HIV enteropathy. DESIGN: Open-label trial with intensive 8-week phase of bovine serum immunoglobulin (SBI) 2.5 g twice daily with a 4-week washout period and an optional 9-month extension study. METHODS: HIV enteropathy was defined as chronic gastrointestinal symptoms including frequent loose or watery stools despite no identifiable, reversible cause. Upper endoscopy for tissue immunofluorescent antibody assay and disaccharide gut permeability/absorption studies were performed before and after 8 weeks of SBI to test mucosal immunity and gastrointestinal function. Blood was collected for markers of microbial translocation, inflammation, and collagen kinetics. A validated gastrointestinal questionnaire assessed changes in symptoms. RESULTS: All eight participants experienced profound improvement in symptoms with reduced bowel movements/day (P = 0.008) and improvements in stool consistency (P = 0.008). Gut permeability was normal before and after the intervention, but d-xylose absorption increased in seven of eight participants. Mucosal CD4(+) lymphocyte densities increased by a median of 139.5 cells/mm(2) from 213 to 322 cells/mm(2) (P = 0.016). Intestinal-fatty acid binding protein (I-FABP), a marker of enterocyte damage, initially rose in seven of eight participants after 8 weeks (P = 0.039), and then fell below baseline in four of five who continued receiving SBI (P = 0.12). Baseline serum I-FABP levels were negatively correlated with subsequent rise in mucosal CD4(+) lymphocyte densities (r = −0.74, P = 0.046). CONCLUSION: SBI significantly increases intestinal mucosal CD4(+) lymphocyte counts, improves duodenal function, and showed evidence of promoting intestinal repair in the setting of HIV enteropathy. Lippincott Williams & Wilkins 2013-09-10 2013-04-09 /pmc/articles/PMC3754419/ /pubmed/23660579 http://dx.doi.org/10.1097/QAD.0b013e328362e54c Text en © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nc-nd/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Clinical Science Asmuth, David M. Ma, Zhong-Min Albanese, Anthony Sandler, Netanya G. Devaraj, Sridevi Knight, Thomas H. Flynn, Neil M. Yotter, Tammy Garcia, Juan-Carlos Tsuchida, Emily Wu, Tsung-Teh Douek, Daniel C. Miller, Christopher J. Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy |
title | Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy |
title_full | Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy |
title_fullStr | Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy |
title_full_unstemmed | Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy |
title_short | Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy |
title_sort | oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with hiv enteropathy |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3754419/ https://www.ncbi.nlm.nih.gov/pubmed/23660579 http://dx.doi.org/10.1097/QAD.0b013e328362e54c |
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