Published online Jun 28, 2016. doi: 10.3748/wjg.v22.i24.5505
Peer-review started: January 13, 2016
First decision: February 18, 2016
Revised: March 12, 2016
Accepted: May 4, 2016
Article in press: May 4, 2016
Published online: June 28, 2016
Processing time: 162 Days and 12.3 Hours
Ulcerative colitis (UC) is a chronic inflammatory disease, whose etiology is still unclear. Its pathogenesis involves an interaction between genetic factors, immune response and the “forgotten organ”, Gut Microbiota. Several studies have been conducted to assess the role of antibiotics and probiotics as additional or alternative therapies for Ulcerative Colitis. Escherichia coli Nissle (EcN) is a nonpathogenic Gram-negative strain isolated in 1917 by Alfred Nissle and it is the active component of microbial drug Mutaflor® (Ardeypharm GmbH, Herdecke, Germany and EcN, Cadigroup, In Italy) used in many gastrointestinal disorder including diarrhea, uncomplicated diverticular disease and UC. It is the only probiotic recommended in ECCO guidelines as effective alternative to mesalazine in maintenance of remission in UC patients. In this review we propose an update on the role of EcN 1917 in maintenance of remission in UC patients, including data about efficacy and safety. Further studies may be helpful for this subject to further the full use of potential of EcN.
Core tip:Escherichia coli (E. coli) Nissle is a nonpathogenic Gram-negative strain used as a probiotic with very good quality paper assessing its bio-equivalence to mesalazine in maintaining remission in ulcerative colitis. Mechanisms of actions of this compound include immune-modulatory properties, reinforcement of intestinal barrier and inhibitory effect towards other pathogenic E. coli.