Skip to main content
SpringerLink
Log in

Spotlight on VSL#3 Probiotic Mixture in Chronic Inflammatory Bowel Diseases

  • Adis Spotlight
  • Published:
BioDrugs Aims and scope Submit manuscript

Abstract

VSL#3 (VSL#3®) is a high-concentration probiotic preparation of eight live freeze-dried bacterial species that are normal components of the human gastrointestinal microflora, including four strains of lactobacilli (Lactoba-cillus casei, L. plantarum, L. acidophilus, and L. delbrueckii subsp. bulgaricus), three strains of bifidobacteria (Bifidobacterium longum, B. breve, and B. infantis), and Streptococcus salivarius subsp. thermophilus.

Data from noncomparative trials suggest that VSL#3 has clinical potential in the treatment of active mild to moderate ulcerative colitis and as maintenance therapy for patients with ulcerative colitis in remission. In addition, a randomized, open-label, multicenter trial showed that VSL#3 in combination with low-dose balsalazide (a prodrug of mesalazine [mesalamine; 5-aminosalicylic acid]) was more effective than standard doses of basalazide or mesalazine monotherapy in the treatment of acute mild to moderate ulcerative colitis. Randomized, double-blind, placebo-controlled studies have shown VSL#3 is effective in preventing the onset of acute pouchitis in patients with newly formed surgical pouches, and in maintaining remission following antibacterial treatment of acute pouchitis in patients with a history of refractory or recurrent pouchitis. Treatment guidelines from the US and the UK include VSL#3 as a therapeutic option for the prevention of pouchitis relapse in patients with chronic pouchitis. In general, VSL#3 was well tolerated in clinical trials. Large, well designed, controlled confirmatory clinical trials will further determine the place of VSL#3 in the treatment of ulcerative colitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. VSL#3® is used as the proprietary or trade name of the probiotic mixture. This is mentioned for product identification purposes only and does not imply endorsement.

References

  1. VSL Pharmaceuticals Inc. VSL#3: the living shield [online]. Available from URL: http://www.vsl3.com [Accessed 2005 Nov 4]

  2. Campieri M, Gionchetti P. Probiotics in inflammatory bowel disease: new insight to pathogenesis or a possible therapeutic alternative? Gastroenterology 1999 May; 116: 1246–9

    Article  PubMed  CAS  Google Scholar 

  3. Hart AL, Lammers K, Brigidi P, et al. Modulation of human dendritic cell phenotype and function by probiotic bacteria. Gut 2004 Nov; 53(11): 1602–9

    Article  PubMed  CAS  Google Scholar 

  4. Lammers KM, Brigidi P, Vitali B, et al. Immunomodulatory effects of probiotic bacteria DNA: IL-1 and IL-10 response in human peripheral blood mononuclear cells. FEMS Immunol Med Microbiol 2003 Sep 22; 38(2): 165–72

    Article  PubMed  CAS  Google Scholar 

  5. Jijon H, Backer J, Diaz H, et al. DNA from probiotic bacteria modulates murine and human epithelial and immune function. Gastroenterology 2004 May; 126(5): 1358–73

    Article  PubMed  CAS  Google Scholar 

  6. Rachmilewitz D, Katakura K, Karmeli F, et al. Toll-like receptor 9 signaling mediates the anti-inflammatory effects of probiotics in murine experimental colitis. Gastroenterology 2004 Feb; 126(2): 520–8

    Article  PubMed  CAS  Google Scholar 

  7. Ulisse S, Gionchetti P, D'Alo S, et al. Expression of cytokines, inducible nitric oxide synthase, and matrix metalloproteinases in pouchitis: effects of probiotic treatment. Am J Gastroenterol 2001 Sep; 96: 2691–9

    Article  PubMed  CAS  Google Scholar 

  8. Lammers KM, Vergopoulos A, Babel N, et al. Probiotic therapy in the prevention of pouchitis onset: decreased interleukin-1beta, interleukin-8, and interferon-gamma gene expression. Inflamm Bowel Dis 2005 May; 11(5): 447–54

    Article  PubMed  Google Scholar 

  9. Bianchi-Salvadori B, Vesely R, Ferrari A, et al. Behaviour of the pharmaceutical probiotic preparation VSL#3 in human ileostomy effluent containing its own natural elements. New Microbiol 2001 Jan; 24(1): 23–33

    PubMed  CAS  Google Scholar 

  10. Brigidi P, Swennen E, Vitali B, et al. PCR detection of Bifidobacterium strains and Streptococcus thermophilus in feces of human subjects after oral bacteriotherapy and yogurt consumption. Int J Food Microbiol 2003 Mar 25; 81(3): 203–9

    Article  PubMed  CAS  Google Scholar 

  11. Venturi A, Gionchetti P, Rizzello F, et al. Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 1999 Aug; 13: 1103–8

    Article  PubMed  CAS  Google Scholar 

  12. Bibiloni R, Fedorak RN, Tannock GW, et al. VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis. Am J Gastroenterol 2005 Jul; 100(7): 1539–46

    Article  PubMed  Google Scholar 

  13. Tursi A, Brandimarte G, Giorgetti GM, et al. Low-dose balsalazide plus a high-potency probiotic preparation is more effective than balsalazide alone or mesalazine in the treatment of acute mild-to-moderate ulcerative colitis. Med Sci Monit 2004 Nov; 10(11): PI126–31

    PubMed  CAS  Google Scholar 

  14. Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000 Aug; 119(2): 305–9

    Article  PubMed  CAS  Google Scholar 

  15. Mimura T, Rizzello F, Helwig U, et al. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut 2004 Jan; 53(1): 108–14

    Article  PubMed  CAS  Google Scholar 

  16. Gionchetti P, Rizzello F, Helwig U, et al. Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology 2003 May; 124(5): 1202–9

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The full text article in Drugs 2006; 66 (10): 1371–87 was reviewed by: R. Bibiloni, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada; M. Campieri, Department of Internal Medicine and Gastroenterology, Division of Gastroenterology, University of Bologna, Bologna, Italy; R.N. Fedorak, Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada; P. Gionchetti, Department of Internal Medicine and Gastroenterology, Division of Gastroenterology, University of Bologna, Bologna, Italy; N. Martins, Department of Gastroenterology, University of Massachusetts Medical School, UMass Memorial Health Care, Worcester, Massachusetts, USA; T. Mimura, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan; M. Schultz, Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand; A. Tursi, Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Andria, Italy.

Author information

Authors and Affiliations

  1. Wolters Kluwer Health & Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, Auckland, 1311, New Zealand

    Therese M. Chapman, Greg L. Plosker & David P. Figgitt

Authors
  1. Therese M. Chapman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Greg L. Plosker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David P. Figgitt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Greg L. Plosker.

Additional information

This Spotlight is derived from abstract and summary text of an Adis Drug Evaluation originally published in full in Drugs 2006; 66 (10): 1371-87. The manufacturer of the agent under review was offered an opportunity to comment on the original article during the peer review process; changes based on any comments received were made on the basis of scientific and editorial merit

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chapman, T.M., Plosker, G.L. & Figgitt, D.P. Spotlight on VSL#3 Probiotic Mixture in Chronic Inflammatory Bowel Diseases. BioDrugs 21, 61–63 (2007). https://doi.org/10.2165/00063030-200721010-00007

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00063030-200721010-00007

Keywords

Search

Navigation