Bacillus coagulans: a viable adjunct therapy for relieving symptoms of rheumatoid arthritis according to a randomized, controlled trial

BackgroundLactic acid-producing bacteria (LAB) probiotics demonstrate immunomodulating and anti-inflammatory effects and the ability to lessen the symptoms of arthritis in both animals and humans. This randomized, double-blind, placebo-controlled, parallel-design, clinical pilot trial was conducted to evaluate the effects of the LAB probiotic preparation, Bacillus coagulans GBI-30, 6086, on symptoms and measures of functional capacity in patients with rheumatoid arthritis (RA) in combination with pharmacological anti-arthritic medications.MethodsForty-five adult men and women with symptoms of RA were randomly assigned to receive Bacillus coagulans GBI-30, 6086 or placebo once a day in a double-blind fashion for 60 days in addition to their standard anti-arthritic medications. Arthritis activity was evaluated by clinical examination, the American College of Rheumatology (ACR) criteria, the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI), and laboratory tests for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).ResultsSubjects who received Bacillus coagulans GBI-30, 6086 experienced borderline statistically significant improvement in the Patient Pain Assessment score (P = .052) and statistically significant improvement in Pain Scale (P = .046) vs placebo. Compared with placebo, Bacillus coagulans GBI-30, 6086 treatment resulted in greater improvement in patient global assessment and self-assessed disability; reduction in CRP; as well as the ability to walk 2 miles, reach, and participate in daily activities. There were no treatment-related adverse events reported throughout this study.ConclusionsResults of this pilot study suggest that adjunctive treatment with Bacillus coagulans GBI-30, 6086 LAB probiotic appeared to be a safe and effective for patients suffering from RA. Because of the low study population size, larger trials are needed to verify these results.Trial registrationACTRN12609000435280

[1]  N. Mehra,et al.  Probiotics, immunomodulation and health benefits , 2009 .

[2]  W. Arend,et al.  Physiology of cytokine pathways in rheumatoid arthritis. , 2001, Arthritis and rheumatism.

[3]  S. Kaminogawa,et al.  Oral intake of Lactobacillus delbrueckii subsp. bulgaricus OLL1073R-1 prevents collagen-induced arthritis in mice. , 2002, Journal of food protection.

[4]  A. Deschamps,et al.  Acid and bile tolerance of spore-forming lactic acid bacteria. , 2000, International journal of food microbiology.

[5]  R. Sartor,et al.  Review article: Role of the enteric microflora in the pathogenesis of intestinal inflammation and arthritis , 1997, Alimentary pharmacology & therapeutics.

[6]  S. Gabriel,et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. , 2008, Arthritis and rheumatism.

[7]  S. Cutting,et al.  Bacillus Probiotics: Spore Germination in the Gastrointestinal Tract , 2002, Applied and Environmental Microbiology.

[8]  H. Gill,et al.  Systemic Immunity-Enhancing Effects in Healthy Subjects Following Dietary Consumption of the Lactic Acid Bacterium Lactobacillus rhamnosus HN001 , 2001, Journal of the American College of Nutrition.

[9]  O. Vaarala Immunological effects of probiotics with special reference to lactobacilli , 2003, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[10]  J. Koopman,et al.  Gut flora induces and maintains resistance against streptococcal cell wall‐induced arthritis in F344 rats , 1992, Clinical and experimental immunology.

[11]  J F Fries,et al.  The Health Assessment Questionnaire (HAQ). , 2005, Clinical and experimental rheumatology.

[12]  T. Yokokura,et al.  Suppressive effects of the oral administration of Lactobacillus casei on type II collagen-induced arthritis in DBA/1 mice. , 1998, Life sciences.

[13]  R. Korpela,et al.  Effects of probiotic therapy on the activity and activation of mild rheumatoid arthritis – a pilot study , 2003, Scandinavian journal of rheumatology.

[14]  M. Urdaci,et al.  Coagulin, a bacteriocin‐like inhibitory substance produced by Bacillus coagulans I4 , 1998, Journal of applied microbiology.

[15]  K. Zimmermann,et al.  Immunomodulatory consequences of oral administration of Lactobacillus rhamnosus strain GG in healthy volunteers , 2003, Journal of Dairy Research.

[16]  M. Homma [ACR preliminary definition, of improvement in rheumatoid arthritis]. , 1996, Ryumachi. [Rheumatism].

[17]  B. Cukrowska,et al.  Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases. , 2004, Immunology letters.

[18]  J. O'dell,et al.  Therapeutic strategies for rheumatoid arthritis. , 2004, The New England journal of medicine.

[19]  M. Kleerebezem,et al.  Towards understanding molecular modes of probiotic action. , 2006, Current opinion in biotechnology.

[20]  K. Ambatipudi,et al.  In search of neutrophil granule proteins of the tammar wallaby (Macropus eugenii). , 2008, Molecular immunology.

[21]  F. Shanahan,et al.  Is the mucosal route of administration essential for probiotic function? Subcutaneous administration is associated with attenuation of murine colitis and arthritis , 2004, Gut.

[22]  S. Salminen,et al.  Dietary therapy with Lactobacillus GG, bovine colostrum or bovine immune colostrum in patients with juvenile chronic arthritis: Evaluation of effect on gut defence mechanisms , 1997, InflammoPharmacology.

[23]  F. Mor,et al.  Lactobacillus GG bacteria ameliorate arthritis in Lewis rats. , 2004, The Journal of nutrition.

[24]  Atlanta,et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. , 2008, Arthritis and rheumatism.

[25]  S. Im,et al.  Lactobacillus casei suppresses experimental arthritis by down-regulating T helper 1 effector functions. , 2008, Molecular immunology.

[26]  J J Anderson,et al.  American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[27]  C. Bingham,et al.  Remission in rheumatoid arthritis: wishful thinking or clinical reality? , 2005, Seminars in arthritis and rheumatism.

[28]  L. Drago,et al.  Lactobacillus sporogenes or Bacillus coagulans: misidentification or Mislabelling? , 2006 .

[29]  B. Goldin,et al.  Clinical indications for probiotics: an overview. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  S. Salminen,et al.  Quality assurance criteria for probiotic bacteria. , 2001, The American journal of clinical nutrition.