Improvement of intestinal mucosa after probiotic supplementation in HIV-1 patients

Objectives: We evaluated the inflammatory infiltration and the damages of the gut epithelial in intestinal biopsies collected before and after 6 months of probiotics treatment (Vivomixx in EU;Visbiome in USA), focusing on intraepithelial lymphocytes(IELs) count, enterocytes apoptosis, and HSP60 protein in patients infected with HIV-1 on c-ART. Methodology: Ten HIV-infected subjects were underwent endoscopic procedures prior to initiation of probiotics supplementation and after 6 months. All samples were evaluated with histological score analysis, Immunohistochemical evaluation and T.U.N.E.L. for apoptosis evaluation. Results: After 6 months of probiotics supplementation, the number of IELs significantly decreased in the ileum, cecum, transverse and descending colon (p=0.049, p=0.027, p=0.004, p=0.002 respectively). The HSP60 median values were higher in all intestinal tracts before supplementations, and significantly decreased after treatment in ascending, transverse and descending colon (p= 0.01; p= 0.037; p= 0.04 respectively). The decline of IELs infiltrating the intestinal epithelium after treatment was strictly associated to a statistically significant decrease in the levels of enterocytes apoptosis index both in epithelium and intestinal crypts (p=0.04). Conclusion: probiotics supplementation for 6 months in HIV-1+ patients under ART is associated with a marked decrease in IELs and HSP60 protein, recovery of the gut epithelial integrity, and improved mitochondrial morphology.