• Gabriella d'Ettorre, Giacomo Rossi, Carolina Scagnolari, Mauro Andreotti, Noemi Giustini, Sara Serafino, Ivan Schietroma, Giuseppe Corano Scheri, FardSaeid NajafiSNDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy., Vito Trinchieri, Paola Mastromarino, Carla Selvaggi, Silvia Scarpona, Gianfranco Fanello, Fausto Fiocca, Giancarlo Ceccarelli, Guido Antonelli, Jason M Brenchley, and Vincenzo Vullo.
• Department of Public Health and Infectious Diseases, Azienda Policlinico Umberto I of Rome, Rome, Italy.
• Immun Inflamm Dis. 2017 Sep 1; 5 (3): 244-260.

IntroductionHIV infection is characterized by a persistent immune activation associated to a compromised gut barrier immunity and alterations in the profile of the fecal flora linked with the progression of inflammatory symptoms. The effects of high concentration multistrain probiotic (Vivomixx®, Viale del Policlinico 155, Rome, Italy in EU; Visbiome®, Dupont, Madison, Wisconsin in USA) on several aspects of intestinal immunity in ART-experienced HIV-1 patients was evaluated.MethodsA sub-study of a longitudinal pilot study was performed in HIV-1 patients who received the probiotic supplement twice a day for 6 months (T6). T-cell activation and CD4+ and CD8+ T-cell subsets expressing IFNγ (Th1, Tc1) or IL-17A (Th17, Tc17) were stained by cytoflorimetric analysis. Histological and immunohistochemical analyses were performed on intestinal biopsies while enterocytes apoptosis index was determined by TUNEL assay.ResultsA reduction in the frequencies of CD4+ and CD8+ T-cell subsets, expressing CD38+ , HLA-DR+ , or both, and an increase in the percentage of Th17 cell subsets, especially those with central or effector memory phenotype, was recorded in the peripheral blood and in gut-associated lymphoid tissue (GALT) after probiotic intervention. Conversely, Tc1 and Tc17 levels remained substantially unchanged at T6, while Th1 cell subsets increase in the GALT. Probiotic supplementation was also associated to a recovery of the integrity of the gut epithelial barrier, a reduction of both intraepithelial lymphocytes density and enterocyte apoptosis and, an improvement of mitochondrial morphology sustained in part by a modulation of heat shock protein 60.ConclusionsThese findings highlight the potential beneficial effects of probiotic supplementation for the reconstitution of physical and immunological integrity of the mucosal intestinal barrier in ART-treated HIV-1-positive patients.© 2017 The Authors. Immunity, Inflammation and Disease Published by John Wiley & Sons Ltd.

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