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Blood, 1 June 2004, Vol. 103, No. 11, pp. 4365-4367.
Prepublished online as a Blood First Edition Paper on February 12, 2004; DOI 10.1182/blood-2003-11-3769.
Submitted November 4, 2003
Accepted February 4, 2004
Probiotic Effects on Experimental Graft-Versus-Host-Disease: Let Them Eat Yoghurt
Armin Gerbitz*, Michael Schultz, Andrea Wilke, Hans-Joerg Linde, Juergen Schoelmerich, Reinhard Andreesen, and Ernst Holler
Hematology/Oncology, University of Regensburg, Regensburg, Bavaria, Germany; Hematology/Oncology, University of Munich, Munich, Bavaria, Germany
Internal Medicine, University of Regensburg, Regensburg, Bavaria, Germany
Hematology/Oncology, University of Regensburg, Regensburg, Bavaria, Germany
Institute of Medical Microbiology and Hygene, University of Regensburg, University of Regensburg, Regensburg, Bavaria, Germany
* Corresponding author; email: armin.gerbitz{at}med3.med.uni-muenchen.de.
Acute graft versus host disease (aGvHD) often limits feasibility and outcome of allogeneic bone marrow transplantation. Current pathophysiological concepts of aGvHD involve conditioning regimens, donor derived T cells, proinflammatory cytokines and bacterial lipopolysaccharide (LPS) as a major trigger for aGvHD. LPS derives mostly from gram-negative bacteria, and can enter circulation through the impaired mucosal barrier after the conditioning regimen. Probiotic microorganisms have been shown to alter the composition of the intestinal microflora and thereby mediate anti-inflammatory effects. We hypothesized that modifying the enteric flora using the probiotic microorganism Lactobacillus rhamnosus GG, would ameliorate aGvHD. Here we show, that oral administration of Lactobacillus rhamnosus GG before and after transplantation results in improved survival and reduced aGvHD. Furthermore, subculturing of mesenteric lymph node tissue revealed a reduced translocation of enteric bacteria. Our findings suggest, that alteration of the intestinal microflora plays an important role in the initiation of experimental aGvHD.
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