Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2013
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
_version_ 1782281907563659264
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
work_keys_str_mv AT asmuthdavidm oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT mazhongmin oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT albaneseanthony oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT sandlernetanyag oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT devarajsridevi oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT knightthomash oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT flynnneilm oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT yottertammy oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT garciajuancarlos oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT tsuchidaemily oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT wutsungteh oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT douekdanielc oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy
AT millerchristopherj oralserumderivedbovineimmunoglobulinimprovesduodenalimmunereconstitutionandabsorptionfunctioninpatientswithhiventeropathy