Maintenance of intestinal epithelial barrier integrity by a combination of probiotics, herbal extract, and vitamins.

BACKGROUND: Irritable bowel syndrome (IBS) and Inflammatory bowel disease (IBD) are pathological conditions that severely hamper the quality of life of patients. Especially in pediatric and adolescent patients, the use of Complementary and alternative medicine is an appealing approach as an adjuvant for the management of symptoms, limiting the detrimental effect of the conventional therapy. In this work, we tested the effect of Enterokind Junior (EntJ), a mix of two probiotic strains Lactobacillus reuteri DSM 25175 and Lactobacillus acidophilus DSM 24936, Matricaria Chamomilla, and vitamins, in in vitro model of intestinal inflammation. Caco-2 cells were subjected to LPS treatment or THP-1 cells stimulated with LPS treatment, as paradigms of inflammatory conditions. METHODS: The effect of the probiotic formulation was evaluated by measuring Caco-2 monolayer's Transepithelial Electrical resistance (TEER) and paracellular permeability alterations, tight junction proteins expression and localization by confocal microscopy, and release of pro-inflammatory cytokines (TNF-α and IL-8) by ELISA assay. RESULTS: Results demonstrated that upon impairment of intestinal parameters induced by inflammatory stimuli, the combination of probiotic was able to prevent TEER decrease and paracellular permeability alterations and to maintain the tight junction expression and localization. Moreover, the release of proinflammatory cytokines induced by inflammation was reduced by EntJ treatment. CONCLUSIONS: This work, in line with previous observations, supports a protective role of Lactobacillus reuteri DSM 25175, Lactobacillus acidophilus DSM 24936 and the other components in the maintenance of a healthy gut, holding up the use of this combination as an adjuvant for irritable bowel syndrome-related symptoms management.

Anti-inflammatory activity of a fixed combination of probiotics and herbal extract in an in-vitro model of intestinal inflammation by stimulating Caco-2 cells with LPS-conditioned THP-1 cells medium.

BACKGROUND: Inflammatory bowel disease (IBD) is an inflammatory condition of the gastrointestinal tract, characterized by chronic and relapsing immune system activation, often diagnosed in adolescence, with a rising incidence in pediatric populations. IBD results from altered interactions between gut microbes and the intestinal immune system which induce an aberrant immune response, thus anti-inflammatory or immunosuppressive therapies are generally used. Recent interest has been given to the identification of integrative and complementary approaches that could be able to restore and preserve the intestinal barrier function. METHODS: In this work, we tested the effect of a fixed combination of probiotics and herbal extract (Colikind Gocce® [CKG], Schwabe Pharma, Egna-Neumarkt, Bolzano, Italy) in an in-vitro model of intestinal inflammation. Caco-2 cells stimulated with LPS-conditioned monocytes culture medium was used as a paradigm of intestinal inflammation. The possible effect of CKG in maintaining the homeostasis of the intestinal epithelial barrier was investigated by measurement of the trans-epithelial electrical resistance, the paracellular permeability, and the release of inflammatory cytokines (TNF-α, IL-8, and IL-10). RESULTS: Results obtained in this work demonstrated that CKG is able to prevent the impairment of intestinal barrier function induced by inflammation, ameliorating the transepithelial electrical resistance and the paracellular permeability of the Caco-2 monolayer; moreover, CKG is able to counteract the increased release of TNF-a and IL-8 induced by inflammatory stimulus, thus reducing the intestinal inflammation. CONCLUSIONS: This work underlines the protective effect of CKG on intestinal barrier, reducing the damages induced by inflammatory stimulus. This suggests CKG as an interesting product in the management of intestinal inflammatory conditions.

Efficacy and safety of the syrup "KalobaTUSS®" as a treatment for cough in children: a randomized, double blind, placebo-controlled clinical trial.

BACKGROUND: Acute cough in children often causes discomfort to children and parents, reducing their quality of life. Despite the extensive utilization of over-the-counter remedies for cough, the efficacy of most of these treatments in children has not been confirmed. METHODS: We conducted a randomized, double blind, placebo-controlled clinical trial of 106 children with acute cough to evaluate the efficacy and safety of KalobaTUSS®, a paediatric cough syrup based on acacia honey and on Malva sylvestris extract, Inula helenium extract, Plantago major extract, and Helichrysum stoechas extract by using a validated 6 points Likert scale. RESULTS: Children were orally treated with KalobaTUSS® or placebo for 8 days. Children receiving KalobaTUSS® showed an early and significant reduction in night-time and day-time cough scores measured using a specific scale and a shorter duration of cough than children treated with the placebo. CONCLUSIONS: KalobaTUSS® is well tolerated and produces positive effects by reducing the severity and shortening the duration of cough in children. TRIAL REGISTRATION: Clinicaltrials.gov no. NCT04073251 . Retrospectively registered.

Serenoa repens and Urtica dioica Fixed Combination: In-Vitro Validation of a Therapy for Benign Prostatic Hyperplasia (BPH).

Benign prostatic hyperplasia (BPH) is an age-related chronic disorder, characterized by the hyperproliferation of prostatic epithelial and stromal cells, which drives prostate enlargement. Since BPH aetiology and progression have been associated with the persistence of an inflammatory stimulus, induced both by Nuclear Factor-kappa B (NF-κB) activation and reactive oxygen species (ROS) production, the inhibition of these pathways could result in a good tool for its clinical treatment. This study aimed to evaluate the antioxidant and anti-inflammatory activity of a combined formulation of Serenoa repens and Urtica dioica (SR/UD) in an in vitro human model of BPH. The results confirmed both the antioxidant and the anti-inflammatory effects of SR/UD. In fact, SR/UD simultaneously reduced ROS production, NF-κB translocation inside the nucleus, and, consequently, interleukin 6 (IL-6) and interleukin 8 (IL-8) production. Furthermore, the effect of SR/UD was also tested in a human androgen-independent prostate cell model, PC3. SR/UD did not show any significant antioxidant and anti-inflammatory effect, but was able to reduce NF-κB translocation. Taken together, these results suggested a promising role of SR/UD in BPH and BPH-linked disorder prevention.

A Fixed Combination of Probiotics and Herbal Extracts Attenuates Intestinal Barrier Dysfunction from Inflammatory Stress in an In vitro Model Using Caco-2 Cells.

BACKGROUND: Inflammatory Bowel Diseases (IBD), are considered a growing global disease, with about ten million people being affected worldwide. Maintenance of intestinal barrier integrity is crucial for preventing IBD onset and exacerbations. Some recent patents regarding oily formulations containing probiotics (WO2010122107A1 and WO2010103374A9) and the use of probiotics for gastrointestinal complaints (US20110110905A1 and US9057112B2) exist, or are pending application. OBJECTIVE: In this work, we studied the effect of a fixed combination of registered Lactobacillus reuteri and Lactobacillus acidophilus strains and herbal extracts in an in vitro inflammation experimental model. METHODS: Caco-2 cell monolayer was exposed to INF-γ+TNF-α or to LPS; Trans Epithelial Electrical Resistance (TEER) and paracellular permeability were investigated. ZO-1 and occludin Tight Junctions (TJs) were also investigated by mean of immunofluorescence. RESULTS: Pre-treatment with the fixed combination of probiotics and herbal extracts prevented the inflammation-induced TEER decrease, paracellular permeability increase and TJs translocation. CONCLUSIONS: In summary, the fixed combination of probiotics and herbal extracts investigated in this research was found to be an interesting candidate for targeting the re-establishment of intestinal barrier function in IBD conditions.

The role of natural galactagogues during breast feeding: focus on a Galega officinalis based food supplement.

Maternal milk is the optimal food for newborns. To this end, a number of interventions are used to enhance milk production. However, pharmacological interventions may be associated with a perceived risk of adverse effects and therefore many mothers prefer to rely on natural herbal remedies. Several herbal remedies have been traditionally used to this purpose. However, the level of evidence supporting their use is mixed. Among different currently-employed natural remedies, Galega officinalis has emerged to be one of those sustained by the strongest evidence. In this paper, we comment on a galega-based product. It is a standardized food supplement used to support breastfeeding mothers and to promote milk production containing Galega officinalis and other substances, including vitamins and magnesium, with potential effect on mother's well-being. In a recent product evaluation on a large sample of Italian women, the wide majority of mothers have declared to be satisfied with this product, and two third of them reported that the milk production was improved with the use of this product. Noteworthy, this galega-based food supplement was also reported to promote psychological benefit. The evidence of a perceived psychological benefit associated with this product is of particular importance, given the high degree of distress often experienced by mothers during the post-partum period. Last, a high level of safety was perceived by the participants. This galega-based food supplement does have a role in supporting breastfeeding mothers and enhance milk production during lactation. Further clinical trials could provide further evidence on the effectiveness of the product.