Commensal Propionibacterium strain UF1 mitigates intestinal inflammation via Th17 cell regulation

Consumption of human breast milk (HBM) attenuates the incidence of necrotizing enterocolitis (NEC), which remains a leading and intractable cause of mortality in preterm infants. Here, we report that this diminution correlates with alterations in the gut microbiota, particularly enrichment of Propionibacterium species. Transfaunation of microbiota from HBM-fed preterm infants or a newly identified and cultured Propionibacterium strain, P. UF1, to germfree mice conferred protection against pathogen infection and correlated with profound increases in intestinal Th17 cells. The induction of Th17 cells was dependent on bacterial dihydrolipoamide acetyltransferase (DlaT), a major protein expressed on the P. UF1 surface layer (S-layer). Binding of P. UF1 to its cognate receptor, SIGNR1, on dendritic cells resulted in the regulation of intestinal phagocytes. Importantly, transfer of P. UF1 profoundly mitigated induced NEC-like injury in neonatal mice. Together, these results mechanistically elucidate the protective effects of HBM and P. UF1-induced immunoregulation, which safeguard against proinflammatory diseases, including NEC.

Toll-like receptor 2 mediates inflammatory cytokine induction but not sensitization for liver injury by Propioni- bacterium acnes

Recognition of Gram-positive bacteria by Toll-like receptor 2 (TLR2) induces activation of proinflammatory pathways. In mice, sensitization with the Gram-positive Propionibacterium acnes followed by a challenge with the TLR4 ligand, lipopolysaccharide (LPS), results in fulminant hepatic failure. Here, we investigated the role of TLR2 in liver sensitization to LPS-induced injury. Stimulation of Chinese hamster ovary cells and peritoneal macrophages with heat-killed P. acnes required expression of TLR2 but not of TLR4, suggesting that P. acnes was a TLR2 ligand. Cell activation by P. acnes was myeloid differentiation primary-response protein 88 (MyD88)-dependent, and it was augmented by coexpression of CD14 in mouse peritoneal macrophages. In vitro, P. acnes behaved as a TLR2 ligand and induced TLR4 hetero- and TLR2 homotolerance in peritoneal macrophages. In vivo priming of wild-type mice with P. acnes, but not with the selective TLR2 ligands peptidoglycan and lipotheicoic acid, resulted in hepatocyte necrosis, hyperelevated serum levels of tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-6, interferon-gamma (IFN-gamma), and IL-12 (p40/p70), and increased RNA expression of proinflammatory cytokines (IL-12p40, IL-1alpha, IL-6, IL-1beta, IL-18, IFN-gamma) in the liver after a LPS challenge. Furthermore, P. acnes priming sensitized TLR2-deficient (TLR2-/-) but not MyD88-/- mice to LPS-induced injury, evidenced by hepatocyte necrosis, increased levels of serum TNF-alpha, IFN-gamma, IL-6, and liver proinflammatory cytokine mRNA expression. IFN-gamma, a cytokine sensitizing to endotoxin, was induced by P. acnes in splenocytes of TLR2-/- and TLR9-/- but not MyD88-/- mice. These results suggest that although P. acnes triggers TLR2-mediated cell activation, TLR2-independent but MyD88-dependent mechanisms mediate in vivo sensitization by P. acnes for LPS-induced liver injury.

In vitro and in vivo effects of an immunomodulator composed of Escherichia coli lipopolysaccharide and Propionibacterium granulosum-inactivated cells in pigs

The in vitro cytokine profiles of porcine alveolar macrophages and peripheral blood mononuclear cells (PBMC) were examined by reverse transcription-polymerase chain reaction or enzyme-linked immunosorbent assay after stimulation with the immunomodulatory compound INMD [lipopolysaccharide (LPS) and Propionibacterium granulosum]. Expression of interleukin-1 (IL-1), IL-6, IL-12 and tumour necrosis factor-alpha (TNF-alpha), but not of IL-10, was detected in INMD-stimulated alveolar macrophages. Stimulated PBMC expressed IL-1, IL-2, IL-4, IL-6, IL-10 and IL-12 and secreted interferon-gamma (IFN-gamma). In all cases, the level of response was lower with INMD than with E. coli LPS alone, except for IFN-gamma, which was secreted in higher levels in INMD-stimulated cells. In a second experiment, the ex vivo effect of the administration of INMD was evaluated using the product as a coadjuvant of a live attenuated Aujeszky's disease virus (ADV) vaccine. For this purpose, 85 8-10-week-old crossbred pigs were assigned to two groups (group A = 43 and group B = 42) and vaccinated with ADV. Group B received, simultaneously with the first dose of vaccine, an intramuscular dose of INMD equivalent to 20 micrograms/ml LPS and 250 micrograms/ml P. granulosum, while group A was given sterile saline solution as a placebo. At the time of vaccination, 97.6% (42 of 43) and 95.2% (40 of 42) of animals of groups A and B, respectively, had anti-gB maternal antibodies. Of those animals, anti-gE ADV antibodies were detected in 11.6% of animals of group A (five of 43) and 19% of group B (eight of 42). All animals were boosted with ADV vaccine alone 4 weeks later. Pigs to which INMD was administered together with the vaccine showed higher primary humoral responses than the vaccine-alone animals (P < 0.005). However, after boosting significant differences disappeared (P > 0.05).

Effects of orally administered viable Lactobacillus rhamnosus GG and Propionibacterium freudenreichii subsp. shermanii JS on mouse lymphocyte proliferation

Immunomodulation by probiotics is a subject of growing interest, but the knowledge of dose response and time profile relationships is minimal. In this study we examined the effects of Lactobacillus rhamnosus GG (LGG) and Propionibacterium freudenreichii subsp. shermanii JS (PJS) on the proliferative activity of murine lymphocytes ex vivo. Dose dependency was assessed by treating animals perorally with a low or a high dose (i.e., 10(9) or 10(12) viable bacteria/kg of body weight) for 7 days. The lower dose levels of each strain appeared to enhance T-cell proliferation at the optimal concanavalin A (ConA) concentration (by 69 to 84%) and B-cell proliferation at the optimal and supraoptimal concentrations of lipopolysaccharide (by 57 to 82%). B-cell proliferation was also enhanced by the high LGG dose (by 32 to 39%) but was accompanied by a marginal decrease in T-cell proliferation (by 8%) at the optimal ConA concentration. The time profiles of the immune responses were assessed after daily treatment with the higher dose for 3, 7, and 14 days. A significant decrease in basal lymphoproliferation (by 32 to 42%) was observed with PJS treatment after the 3- and 7-day periods; however, this activity returned to control levels after 14 days of treatment, which also resulted in significantly enhanced T-cell proliferation at optimal and supraoptimal ConA concentrations (by 24 to 80%). The 14-day LGG treatment also enhanced the latter activity (by 119%). In conclusion, LGG and PJS have specific dose- and duration-dependent immunomodulatory effects on the proliferative activity of B and T lymphocytes and may also reduce lymphocyte sensitivity to the cytotoxic effects of lectin mitogens.

Study of the morphology of the cell walls of some strains of lactic acid bacteria and related species

The objective of the present study was to find an explanation for the biological effect of the bacteria present in a biotherapeutic milk (Lactobacillus casei CRL 431 and Lactobacillus acidophilus CRL 730). The ability of bacterial cell walls to induce an immune response when introduced into an organism is well known. In this paper we specifically analyzed the morphology of these cell walls. Besides the two bacterial strains used in the fermented milk, two other lactic acid bacteria, belonging to another genus and unable to induce an immune system response, as well as a strain of Propionibacterium, of which the immune modulating capacity is known, were used in this work. We found a structural particularly in strains with immunostimulating capacity (L. casei CRL 431 and P. acidopropionici CRL 1198): molecules which protrude from the cell surface. In L. casei CRL 431 these molecules were identified as lectins because they are able to agglutinate yeast cells treated with glutaraldehyde and glycine. The structures protruding from P. acidipropionici CRL 1198 cells were teichoic acids. Teichoic acid and lectin-like structures can participate in adhesion to intestinal cells. The immunostimulation observed can be induced by the adhesion phenomenon.

Protection and therapy of experimental herpesvirus infections in mice with immunomodulating Propionibacterium avidum KP-40 and/or acyclovir

Protection and therapy of NMRI mice with experimental herpes virus (HSV-1) encephalitis were investigated using heat-killed, lyophilized Propionibacterium avidum KP-40 (PA) and/or the herpes-specific antiviral substance acyclovir (ACL) as immunomodifier. Poly I:C as a potent macrophage activator was used as a reference compound for PA. Survival of experimental HSV-1 infections during 18 days following the inoculation of viruses was used for the evaluation of the effects of immunotherapy. The applied model of HSV-1 infection resulted in a mortality of about 87% of NMRI mice at 7-16 days following the inoculation of the virus. Treatment with ACL or Poly I:C at the day of HSV-1 infection resulted in a lowering of the mortality rate to about 40% (p < 0.05). PA applied 4 days before HSV-1 infection lowered the mortality rate to 27%, while treatment 2 days after infection was less effective and the mortality rate reached 44%, although still being significantly lower (p < 0.01) than in untreated controls. A combined treatment with ACL and PA on the day of HSV-1 infection protected 93% of animals against the development of clinically detectable herpesvirus encephalitis.

Oral administration of a bacterial immunomodulator enhances the immune response to cholera toxin

Attempts to achieve IgA responses in the intestine by oral immunization with non replicating antigens have been characterized by ineffective responses of short duration unless long term dosages are administered. Cholera toxin (CT) is an exception in that it is able to produce a high secretory and systemic immune response. We study the effects of a bacterial immunomodulator [3 x 10(10) Propionibacterium granulosum ml-1 and lipopolysaccharide (LPS) 5 mg ml-1] on the immune response to CT orally administered to Wistar rats. The immunomodulator was orally administered as follows: in schedule 1 during 7 days prior to the first dose of CT; and in schedule 2, 2 days before, together, and 3 days after the first dose of CT. Schedules 1 and 2 were effective in increasing the specific IgA in the intestinal fluid and specific IgG in serum (P < 0.001) when compared to controls. Besides, schedule 2 was more effective than schedule 1 when the levels of specific IgG in serum or specific IgA in intestinal fluid was measured (P < 0.05). Total IgA in the intestinal fluid was increased in rats receiving the immunomodulator (P < 0.01). However, the ratio of specific IgA per total IgA was higher in rats receiving treatment 1 or 2 when compared to controls (P < 0.01). The number of antitoxin antibody producing cells was not increased in the Peyer patches, but a significant increase was observed in the mesenteric lymph nodes and spleen when compared to controls (P < 0.05). The administration of LPS alone produced an increase in the antitoxin immune response when compared to controls, but it was lower than those produced by the administration of the immunomodulator. These results indicate that this immunomodulator is an effective adjuvant of the mucosal and systemic immune response to CT. The mechanisms of action possibly involve nonespecific and specific modulations of the immune response.

Influence of Propionibacterium avidum KP-40 on the cellular immune system after intensive sport activity

Intensive sport activities resulted in temporary downregulation of defined immune functions. To check its influence on the cellular immune system, 15 male professional ice hockey players of a German first league club were observed and a decrease of lymphocyte subset counts and activities was found after anaerobic exercise. To stabilize cellular immune functions, the players were orally treated with Propionibacterium avidum KP-40 (10 mg per administration; twice a day; 7 days), a well documented bacterial immunmodifier. After administration of Propionibacterium avidum KP-40, lymphocyte counts and activities after anaerobic exercise resembled normal values. For some subjects, defined lymphocyte subset counts and activities even exceeded normal values.

Immunostimulation by propionibacteria--effects on immune status and antineoplastic treatment

Experimental studies were performed to investigate further the effects of immunotherapy with Propionibacterium avidum KP-40 on thymocyte proliferation, maturation and emigration in BALB/c-mice. Thymus weight and thymocyte counts, especially cells presenting the immature or cytotoxic/suppressor phenotype were significantly increased. Due to enhanced emigration, peripheral blood lymphocyte and monocyte counts as well as expression of activation markers were significantly upregulated. The antimetastatic effect of Propionibacterium avidum KP-40 was demonstrated in BALB/c-mice, where RAW 117-H10 lymphosarcoma liver colonization was significantly reduced after immunostimulation. Clinical investigations proved that surgical treatment of colorectal carcinoma induced an evident decrease of peripheral blood lymphocytes as compared with preoperative counts. However, single preoperative Propionibacterium avidum KP-40 administration induced a considerable increase of peripheral white blood cell counts, especially lymphocytes. Clinical effects of preoperative immunostimulation by Propionibacterium granulosum KP-45 were investigated in a prospective randomized trial in colorectal carcinoma patients. Positive effects on survival time, local tumor recurrence and distant metastasis could be demonstrated in stages I and II, whereas no advantage of immunotherapy was found in advanced stages III and IV. A recent prospective randomized clinical trial was initiated on the quality of life of colorectal carcinoma patients. Three months after surgical treatment negative effects could not be determined after immunotherapy. Quality of life even proved to be better in patients with abdominoperineal resection as compared to non Propionibacterium avidum KP-40 treated control patients.

In vitro modulation of keratinocyte-derived interleukin-1 alpha (IL-1 alpha) and peripheral blood mononuclear cell-derived IL-1 beta release in response to cutaneous commensal microorganisms

The ability of a range of skin commensal microorganisms to modulate interleukin-1 (IL-1) release by cultured human keratinocytes and peripheral blood mononuclear cells (PBMCs) was investigated by a combination of enzyme-linked immunosorbent assays and bioassays. Three fractions (formaldehyde-treated whole cells, culture supernatants, and cellular fractions) were prepared from Propionibacterium acnes, Propionibacterium granulosum, Staphylococcus epidermidis, Staphylococcus capitis, Staphylococcus hominis, and Malassezia furfur serovar B. The levels of immunochemical IL-1 alpha released by cultured keratinocytes during coincubations with these microbial fractions ranged from 0 to 136 pg/ml and were maximal after 72 h. No microbial fraction consistently upregulated immunochemical IL-1 alpha release by freshly isolated keratinocytes from two donors and a transformed cell line, all of which produced the cytokine constitutively to various extents. Bioassays revealed that most of the IL-1 released was biologically inactive. In contrast, whole cells of formaldehyde-treated P. granulosum and S. epidermidis significantly stimulated release of IL-1 beta by PBMCs from three donors compared with the negative control (culture medium). Release was maximal at 24 h. Coincubation with intact cells of the yeast M. furfur significantly decreased levels of IL-1 beta below the values for the negative control by PBMCs from all three donors. There was good correlation between bioassay data and immunoassay data for IL-1 beta, and the depressive effect of M. furfur cells on cytokine production by all three cultures of PBMCs was mirrored in the levels of bioactive cytokine. This reduction in IL-1 beta release by PBMCs by M. furfur may provide an explanation why dermatoses thought to be caused by this yeast are essentially noninflammatory or only mildly inflammatory.

Influence of propionibacterium avidum KP-40 on the proliferation, maturation, emigration and activity of thymocytes and monocytes

Inactivated cells of Propionibacterium avidum KP-40 could be shown to induce thymocyte proliferation and maturation in BALB/c-mice after intraperitoneal administration of the optimal immunomodulating dosage (1 mg per mouse). The increase in thymus weight and thymocyte numbers per mg organ weight was most pronounced and statistically significant 10 days after P. avidum KP-40 administration. Determinations of lymphatic subsets revealed a considerable up-regulation of mature cells expressing helper/inducer (L3T4+) or cytotoxic/suppressor (Lyt-2+) phenotypes and immature cells presenting both L3T4+/Lyt-2+ antigens. Obviously, P. avidum KP-40 administration accelerated murine thymocyte proliferation and maturation. Counts of BALB/c-mouse peripheral blood lymphocytes (PBL) and monocytes (PBM) revealed statistically significant increases after P. avidum KP-40 administration with peak values after 6-10 days. The determination of activated PBL (expressing interleukin-2 receptors) or PBM (expressing MAC-3 antigens) proved that P. avidum KP-40 induced a potent immunostimulation since counts of these cells were significantly enhanced after P. avidum KP-40 treatment.

Combined immunomodulation (Propionibacterium avidum KP-40) and lectin blocking (D-galactose) prevents liver tumor colonization in BALB/c-mice

The protective effect of combined treatment (immunomodulation with Propionibacterium avidum KP-40; liver lectin blocking by D-galactose administration) on the liver colonization of RAW 117-H10 lymphosarcoma was investigated in BALB/c-mice. Both, immunomodulation with P. avidum KP-40 as well as liver lectin blocking by D-galactose treatment significantly decreased the number of liver tumor colonies in this experimental model. However, the combination of P. avidum KP-40 and D-galactose obviously proved to be superior to each monotherapy since the liver colonization by RAW 117-H 10 lymphosarcoma could be completely inhibited.

Preoperative immunostimulation by Propionibacterium granulosum KP-45 in colorectal cancer

In order to improve the perioperative resistance to the spread of cancer during operation the effect of preoperative stimulation of the immunesystem by Propionibacterium granulosum KP-45 was investigated in patients with colorectal carcinoma. In a prospective randomized trial 101 patients were allocated to either treatment (n = 51) or control (n = 50). In the treatment 10 mg of Propioni bacteria were administered intravenously between the seventh and third day prior to surgical treatment. At the time of operation 21 tumours were classified as stage I (treatment n = 12, control n = 9), 22 as stage II (treatment n = 10, control n = 2). Postoperatively wound infections requiring treatment were more prevalent in the control group (n = 4) than in the treated group (n = 0). All patients were subsequently followed up for 76 months. For stage I carcinoma the survival rates, excluding perioperative deaths, were 91% in the treated and 63% in the control group respectively. One case of tumour metastasis was seen in the control group. For stage II carcinoma the survival rate was 90% for the treated group with distant spread in 1 case and 45% in the control group where the rate of recurrence was 55%. For stages III and IV there was no statistically significant difference in survival between the treated and the control groups.

[Clinical evaluation of serious forms of acne treated with autovaccine]

In this paper a clinical assessment of the treatment of serious forms of acne vulgaris with the use of autovaccines containing Propionibacterium strains was presented. It was shown that the associative therapy including parallel administration of both autovaccine and the antibiotic is remarkably efficacious.

Prophylactic application of Propionibacterium avidum KP-40 in swine with acute experimental infections. II. Bacterial infections: pleuropneumonia and swine erysipelas

The potent immunomodifier Propionibacterium avidum KP-40 (PA) demonstrated prophylactic potency in swine infected experimentally with Haemophilus (Actinobacillus) pleuropneumoniae or Erysipelothrix rhusiopathiae. Animals received PA either together with the respective vaccine or PA only; 3 resp. 4 weeks later all animals were inoculated with virulent pathogens. Eight of 10 swine immunized with inactivated pleuropneumonia vaccine developed mild-moderate forms of infection with temporary stagnation of body weight; application of the vaccine together with PA lowered the morbidity rate to 1 of 10 (p < 0.05). Also in non-vaccinated swine infected with pleuropneumonia or erysipelas PA application resulted in milder clinical symptoms, faster recovery and a larger gain of body weight.

Prophylactic application of Propionibacterium avidum KP-40 in swine with acute experimental infections. I. Viral infections--Aujeszky's disease and classical swine fever

The usefulness of the prophylactic application of Propionibacterium avidum KP-40 (PA), a potent stimulator of the macrophage-monocyte system and inducer of endogenous interferons, was demonstrated in swine infected experimentally with Aujeszky's disease or classical swine fever viruses. Some of the infected animals were preimmunized with respective vaccines containing live, attenuated viruses. In vaccinated and non-vaccinated swine infected with Aujeszky's disease virus, pretreatment with PA lowered the morbidity rate, shortened the period of fever and fastened the recovery. Infection with classical swine fever virus resulted in 100% mortality of PA-pretreated non-vaccinated swine, but the length survival of the animals was significantly longer (p < 0.05).

Adjuvant properties of Propionibacterium avidum KP-40 in vaccination against endemic viral and bacterial infections. II. Swine immunized with inactivated Haemophilus pleuropneumoniae vaccine and experimentally infected with different virulent serotypes of H. pleuropneumoniae

Forty 3-month old swine were treated with immunomodulating Propionibacterium avidum KP-40 (PA) and/or vaccinated with a formalin-inactivated mixture of serotypes 1, 3, 5 and 9 of Haemophilus pleuropneumoniae (Pleurovac). Three weeks after revaccination all animals were inoculated with viable single serotypes of Haemophilus pleuropneumoniae. The IgG antibodies induced by vaccination agglutinated all serotypes of Haemophilus pleuropneumoniae, except for serotype 5. Antibody titers were not influenced by the application of PA together with the vaccine. Infection of vaccinated piglets resulted in the development of pleuropneumonia in 8 out of 10 animals, while vaccination together with application of PA lowered the morbidity rate to 1 out of 10 (p < 0.05). The usefulness of a PA prophylaxis was also demonstrated in non-vaccinated piglets infected with Haemophilus pleuropneumoniae. Because of the considerable variability of strains and serotypes of Haemophilus pleuropneumoniae and the generally low prophylactic potency of pleuropneumonia vaccines it is concluded that long-lasting enhancement of non-specific antiinfective resistance caused by PA may lower the risk of endemic infections in vaccinated piglets.

Adjuvant properties of Propionibacterium avidum KP-40 in vaccination against endemic viral and bacterial infections. III. Swine immunized with live attenuated Erysipelothrix rhusiopathiae vaccine and experimentally infected with virulent strains R203 and R270B of E. rhusiopathiae

Fifty 4-month old piglets were treated with immunomodulating Propionibacterium avidum KP-40 (PA) and/or immunized with live attenuated Erysipelothrix rhusiopathiae vaccine (Orvac). Four weeks after vaccination all animals were inoculated with viable Erysipelothrix rhusipathiae. The vaccine induced the appearance of high titers of specific IgG antibodies with peak values (1:115-1:200) three weeks after immunization. Administration of PA together with the vaccine did not influence antibody titers. Analysis of the course of experimental erysipelas infection in vaccinated and/or PA-treated swine revealed the prophylactic and beneficial effects of PA. PA-treated animals showed a significantly lower lethality rate than untreated controls and the course of the disease was considerably milder, with a shorter period of fever and a faster recovery. Vaccination provided good protection of swine against the development of erysipelas and therefore, the only significant difference in animals treated with PA applied together with the vaccine was a higher gain of body mass after infection.

Adjuvant properties of propionibacterium avidum KP-40 in vaccination against endemic viral and bacterial infections. I. Swine immunized with live attenuated Aujeszky's disease virus vaccine and experimentally infected with virulent viruses

Forty 5-month old swine were treated with immunomodulating Propionibacterium avidum KP-40 (PA) and/or immunized with live attenuated Aujeszky's disease (AD) virus vaccine (SuivacA); 8 weeks later all animals were infected with virulent AD viruses (NIA-3). Seven of 10 swine vaccinated without PA developed mild/moderate symptoms of infection with 3- to 5-day fever and a temporary halt in weight gain. Application of PA together with the vaccine lowered the morbidity rate, shortened the period of fever and speeded recovery. Only low levels of virus-neutralizing IgG antibodies were found in vaccinated swine and application of PA did not influence antibody titers.

Pathogenicity of Actinomyces israelii and Arachnia propionica: experimental infection in guinea pigs and phagocytosis and intracellular killing by human polymorphonuclear leukocytes in vitro

Strains of Actinomyces israelii and Arachnia propionica, isolated from clinical cases of failed endodontic therapy, were examined for: (i) their ability to survive and establish themselves in the soft connective tissue that grew into subcutaneously implanted tissue cages in guinea pigs; (ii) cell-surface hydrophobicity; and (iii) phagocytosis and killing by human polymorphonuclear leukocytes (PMNs) under aerobic and anaerobic conditions. Bacteria were inoculated into the tissue cages in guinea pigs and the cage contents were retrieved after 1, 7, 14 and 21 d for culturing and light and electron microscopy. Both bacterial species showed substantial decline in the number of bacteria by day 7 after the inoculation. Thereafter, the A. israelii strain recovered and, by day 21, had started to increase in number. Light and electron microscopy revealed the formation of typical actinomycotic colonies. A. propionica, on the other hand, continued to decline in number during the entire period of experimental infection and did not form colonies. Both strains were hydrophobic, readily phagocytosed and were efficiently killed by human PMNs under aerobic and anaerobic conditions in vitro. These results suggest that the pathogenicity of A. israelii is due to its ability to establish characteristic cohesive colonies consisting of branching filamentous organisms that are enmeshed in an extracellular matrix. It seems that the organisms existing in such colonies can collectively evade destruction and elimination by host phagocytic cells, whereas in vitro suspensions of the bacteria are easily phagocytosed and efficiently killed by PMNs. With respect to A. propionica, further investigations are necessary to understand its pathogenicity.

Stimulation of granulopoiesis in pregnant swine and their offspring by Propionibacterium avidum KP-40

Functional parameters of granulopoiesis were measured in gilts, in pregnant sows and in their offspring. Groups of dams and piglets were injected with a potent immunomodulator--killed lyophilized Propionibacterium avidum KP-40 (PA). Administration of PA (0.1 mg/kg body wt for sows and 0.2 mg/kg body wt for piglets) resulted in significant stimulation of all measured parameters of granulopoiesis as well as in a faster gain of body weight. PA stimulation of sows prior to farrowing had no measurable influence on the development of their offspring.

Immunomodulation by propionibacteria

The ability of bacteria and bacterial products to modulate the immune response to unrelated antigens is well documented. Propionibacteria are amongst the most potent immunomodulators stimulating cell populations involved in nonspecific resistance. Generally, the activated immune system provides protection from infectious pathogens and malignancies via mechanisms of recognition and elimination. Accordingly, administration of propionibacteria could be shown to be of benefit in the treatment of neoplastic and infectious diseases. Thus, it can be recommended for further clinical investigations.

Comparative study on lymphocyte subpopulations in cancer patients after immunostimulation with propionibacteria and in renal transplant patients after combined immunosuppression

In two groups of patients the influence of unspecific immunostimulation (group 1) and combined immunosuppression (group 2) on lymphocyte subpopulations was studied. Patients constituting group 1 suffered from gastric and colorectal carcinoma, respectively, and were preoperatively treated with 10 mg whole cell preparation of immunostimulating Propionibacterium avidum KP-40 (Köln-Propioni, strain 40). Patients of group 2 were submitted to combined immunosuppressive therapy and treated with antilymphocyte globulin, prednisone, and azathioprine subsequent to renal transplantation. Immunostimulation with P. avidum KP-40 resulted in a significant increase (p less than or equal to 0.01) of the natural killer (NK) cell population, whereas total leukocyte and lymphocyte counts as well as helper and suppressor T lymphocyte subsets did not evidently differ from control values. On the contrary after immunosuppression all subsets of lymphocytes as well as NK cells significantly decreased.

Behaviour of lymphocyte subsets in response to immunotherapy with Propionibacterium avidum KP-40 in cancer patients

In 15 patients the influence of unspecific immunostimulation/immunomodulation was studied. Patients constituting the therapeutical group suffered from colorectal- and gastric carcinoma, respectively, and were preoperatively treated with 10 mg whole cell preparation of immunomodulating Propionibacterium avidum KP-40. This adjuvant immunotherapy resulted in a significant increase (p less than 0.01) of the natural killer (NK)-cell population, however, total leukocyte and lymphocyte count as well as helper- and suppressor T-lymphocyte subsets did not significantly differ form control values.

Preoperative immunostimulation with propionibacterium avidum KP-40 in patients with gastric carcinoma: a prospective randomized study

Sixty-eight patients admitted for resection of gastric carcinoma entered a prospectively randomized trial. Patients in the therapy group (n = 34) received a preoperative controlled infusion of 10 mg Propionibacterium avidum KP-40. The therapy and control group did not differ with regard to postoperative complications, tumor recurrence rates (therapy group: 41%, control group: 38%), and patient survival rates (survival rate in the therapy group after 25 months: 53%, in the control group after 25 months: 50%).

[Propionibacterium granulosum KP-45 in the treatment of subacute sclerosing panencephalitis]

3 groups of patients, who suffered on SSPE (without treatment, with isoprinosine therapy, combined treatment with propionibacterium granulosum and isoprinosine) are compared. The results show a favourable effect of the combined treatment in a part of the patients. They are discussed in detail.

Analysis of the proinflammatory property of epidermal cyst contents: chemotactic C5a anaphylatoxin generation

We investigated in vitro the contents of epidermal cysts for complement activation and found that they activated complement mainly through the alternative pathway. Chemotactic C5a anaphylatoxin produced by the cyst contents after contact with serum most likely plays a significant role in the initiation and aggravation of inflammation in ruptured epidermal cysts. Our additional study disclosed that components of three representative follicular resident microorganisms (Pityrosporum ovale, Propionibacterium acnes, and Staphylococcus epidermidis) also produced C5a anaphylatoxin mainly through the alternative pathway; the C5a production was more vigorous than that by a virulent pathogen, Staphylococcus aureus. These results suggest that accidental colonization of the cyst contents by these follicular microbial flora further augments the inflammatory changes in ruptured epidermal cysts.

Studies on a biological response modifying LYSAT from Propionibacterium avidum KP 40

Propionibacterium avidum KP 40 cells were mechanically disintegrated in order to obtain the soluble immunostimulatory (antineoplastic) LYSAT. Chemiluminescence measurements of human leukocyte function yielded enhanced activation of the cells after incubation with 2.5 and 5 mg of LYSAT. As compared to non-treated controls, administration of LYSAT to BALB/c-mice (1, 2.5 and 5 mg; intraperitoneally, subcutaneously, intranasal; 7, 4 and 2 days prior to challenge) induced a significant enlargement of the spleen as well as significantly reduced sarcoma L-1 lung colonization 14 days after challenge and evidently enhanced chemiluminescence response of peritoneal macrophages.

Beneficial response of local immunotherapy with Propionibacterium granulosum KP-45 in combined treatment of inflammatory breast carcinoma

Nine 44- to 67-year-old patients with inflammatory breast carcinoma were treated over 2 weeks with intratumoral injections of Propionibacterium granulosum KP-45 (KP). This period of immunotherapy was succeeded by four courses of chemoimmunotherapy (FAC: 5-fluorouracil, adriamycin, and cyclophosphamide + intratumoral KP). Inflammatory symptoms disappeared in three patients during immunotherapy and in the remaining six patients during the following chemoimmunotherapy. Finally, 3 to 4 months after starting the therapy, all nine patients were free from inflammatory symptoms and it became possible to perform radical (seven cases) or simple (two cases) surgery. Thereafter routine therapy (radiotherapy, fractionated dose of 5500 R, followed by 10 FAC courses + single injections of KP for each FAC course) was used. After 19 to 32 months observation time all patients are still in complete remission with no local recurrences. Only one patient showed distant metastases during the observation period.

[Preoperative nonspecific immunostimulation with Propionibacterium granulosum KP-45 in patients with colorectal cancer. A prospective randomized study]

The effect of preoperative unspecific immunomodulation with Propionibacterium granulosum KP-45 (P.g.) on postoperative complications and patient survival was evaluated in a prospectively randomized trial in patients with colorectal tumor resection. Patients of the therapy group (n = 51) received at least 3 days before operation an infusion of 10 mg P.g., patients of the control group (n = 49) were not treated at all. The wound infection rate and the number of re-explorations were significantly lower in the therapy group, however, patient survival and tumor recurrence rates were not positively affected by this P.g. pre-treatment.

[Effect of Propionibacterium granulosum KP-45 on the resistance to Listeria monocytogenes and Salmonella typhimurium infections]

Killed bacterial cells of Propionibacterium granulosum KP-45 were found to be potent modifiers of non-specific resistance of mice against infection with either Listeria monocytogenes or Salmonella typhimurium. Injection of P. granulosum 7 days prior to infection resulted in marked splenomegaly. Disseminated acute inflammatory foci were found histologically in the liver. These mice were apparently less susceptible to infection, since definitely lower bacterial counts were determined. Simultaneous application of both P. granulosum KP-45 and L. monocytogenes resulted, however, in increased susceptibility of mice to infection, since definitely higher bacterial counts were found and the inflammatory reaction to infection was markedly enhanced.

The role of hepatic lectins and the activity of the mononuclear phagocyte system in systemic Listeria monocytogenes infection in Balb/c mice

Hepatic lectin blocking experiments with D-galactose in Balb/c mice showed that parenchymal liver cells are obviously not involved in Listeria monocytogenes infection (strain SLCC 4013, 5 X 10(6) cells i.v.). Using the bacterial immunomodifier Propionibacterium avidum KP-40 the importance of an activated mononuclear phagocyte system in the early stage of Listeria infection could be demonstrated.

Combined immunostimulation (Propionibacterium avidum KP 40) and anticoagulation (heparin) prevents metastatic lung and liver colonization in mice

The antineoplastic activity of Propionibacterium avidum KP-40 and its enhancement by anticoagulation with heparin was studied. In Balb/c mice syngeneic sarcoma L-1 exclusively caused tumor colonization of the lungs. After neuraminidase treatment the organotropism of this tumor was changed, with tumor nodules developing in lung and liver. After single systemic application of Propionibacterium avidum KP-40 the number of lung and liver colonies decreased evidently. Combination of this immunomodulating therapy with temporary anticoagulation resulted in further reduction of tumor colonies in lung and liver.

The influence of killed Propionibacterium granulosum on experimental infection with Escherichia coli

Mice infected subcutaneously with 5 X 10(3) viable cells of Escherichia coli ATCC 25922 incorporated in liquified agar developed a systemic infection. Increasing bacterial numbers could be recovered from the liver at several days following infection. Ultimately, the animals died 6 days after infection. Treatment of mice with 1 mg killed Propionibacterium granulosum KP-45 lead to an increased spleen weight at day 7 after intraperitoneal injection. Hence, the animals were highly susceptible to the lethal action of endotoxin. They were, however, markedly protected against infection with E. coli, since definitely lower bacterial counts were found in the liver of pretreated mice in comparison to controls.

Local immunotherapy with propionibacterium granulosum KP-45 in advanced breast cancer

50 patients with advanced metastatic breast cancer were matched into 25 "twin" pairs. In each pair, one "twin" received chemotherapy (FAC) and the other received chemoimmunotherapy (FAC + intratumorally Propionibacterium granulosum KP-45 (PG)). The therapeutic effects of this 2-year follow-up study were carefully documented and analysed. The mean survival time of FAC + PG-treated patients was about 17 months as compared to 8.5 months in FAC controls. PG-therapy responders showed increasing values of T-lymphocytes in peripheral blood, as well as higher blast transformation indices than nonresponders and controls. The skin reactivity to PHA, Distreptase, and Tuberculin was markedly enhanced in the FAC + PG-group. The incidence rate of hematological and/or infectious complications was significantly lower in PG-treated patients than in the controls. Local PG-immunotherapy was proven beneficial in advanced breast cancer when combined with FAC-chemotherapy, providing better toleration of chemotherapy and lower risk of myelosuppression and infections.

Small-cell lung cancer and immunochemotherapy with Propionibacterium granulosum KP 45

Seventy-nine patients with small-cell lung cancer were treated with vincristin, methotrexate, and cyclophosphamide in inductive therapy and with methotrexate, cyclophosphamide, and procarbazine in maintenance therapy. Patients were divided at random into two groups: one group received chemotherapy alone and the second group was additionally subjected to systemic immunotherapy with Propionibacterium granulosum strain KP-45. In general, differences in the frequency of therapy response and in duration of remission could not be stated between the two groups of patients, but patients responding to chemotherapy showed a significantly longer remission time and lower complication rates. This benificial effect of chemoimmunotherapy is not related to a direct antitumor activity of the immunomodifier used, but to the lowered risk of myelosuppression and infections. Immunomodulation in combination with chemo- and/or radiotherapy can be recommended for the treatment of small-cell lung cancer.

Cytotoxic lymphocytes in rat tumor in situ: effect of intraperitoneal injections of Propionibacterium avidum

In vitro cytotoxicity against tumor cells of lymphocytes in sc implanted BC47 bladder tumor of ACI/N rats with or without Propionibacterium avidum (P. avidum) treatment was studied. Tumor-associated lymphoid cells (TAL) were obtained from tumor tissues by mechanical treatment (NDi fraction) and by enzymatic treatment with Dispase I, a proteolytic enzyme (Di fraction), followed by passage through glass wool columns to deplete tumor cells. NDi fraction of TAL from P. avidum-treated animals showed a significant cytolytic activity against BC47 cells, but not against other ACI/N bladder tumor cell lines, BC12 and BC50. These TAL lost the cytolytic activity on treatment with anti-rat thymocyte serum or anti-rat T cell monoclonal antibodies, R1-3B3 and R1-10B5, and complement. Natural killer activity determined with YAC-1 cells was low in the cells of NDi fraction and scarcely detectable in the cells of Di fraction from both P. avidum-treated and untreated rats. These results indicate that the antigen-specific cytotoxic T cells in the tumor in situ are induced by in vivo P. avidum treatment. On the other hand, P. avidum treatment augmented nonspecific cytolytic activity of peripheral lymphoid cells such as plastic-nonadherent peritoneal cells, spleen cells and blood lymphocytes in normal and BC47-bearing rats. However, the antigen-specific cytolytic T cells were predominantly induced and recovered in the plastic nonadherent peritoneal cells of BC47-bearing rats by the treatment with P. avidum.

Tumour necrosis factor and the lysosomal enzymes of macrophages or macrophage-like cell line

The relationship between tumour necrosis factor (TNF) and macrophages or macrophage-like cell line, especially the lysosomal enzymes was investigated. The serum lysosomal enzymes and LDH activities were increased in proportion to the TNF production even in different strains of mice. Lysosomal enzymes and TNF activity were released into the supernatant of the culture medium of macrophage-enriched peritoneal exudate cells (PEC) or spleen cells derived from Propionibacterium acnes-primed mice after addition of lipopolysaccharide (LPS). After passage through a Sephadex G-10 column, TNF activity could not be detected in the supernatant of these spleen cells after addition of LPS. Also TNF activity could not be detected in the supernatant following destruction of PEC. These results suggest that TNF producibility is strongly related to the degree of activation of macrophages, especially the lysosomal enzymes. The murine macrophage-like cell line, J774, also released TNF activity and lysosomal enzymes after addition of LPS.

Stimulatory effect of Propionibacterium granulosum KP-45, glucan and pyran copolymer on the activity of natural killer (NK) cells in murine lungs

Propionibacterium granulosum KP-45, glucan and pyran copolymer stimulated the elimination of 75Selenomethionine-labelled 3LL tumor cells from murine lungs, as measured 4 hr after intravenous injection of these cells into 16- to 25-week-old B6DF1 mice. This effect was most pronounced 4 to 6 days following intravenous administration of the above biological response modifiers and disappeared 6 to 8 days later. Intraperitoneal injection of all three agents produced only insignificant stimulation results. Spontaneous clearance of 3LL cells from lungs of 8-week-old B6DF1 mice was significantly more effective than in animals over 16 weeks old. Cyclophosphamide suppressed the elimination of tumor cells from lungs in both young and older mice and neutralized the stimulatory effect of P. granulosum KP-45 and glucan. The results suggest that the effector cells responsible for the clearance of radiolabelled 3LL cells from lungs of B6DF1 mice are at least similar to natural killer (NK) lymphocytes.

Immunotherapy of chronic active viral hepatitis B with propionibacterium granulosum

12 HBsAg-positive patients with chronic active hepatitis B were treated monthly with cell walls (5 or 10 mg) of Propionibacterium granulosum KP-45 (PG) intravenously administered for a period of 6-10 months. The clinical state was evaluated according to an arbitrary 6-grade scale based on serum biochemical tests, HBV markers and the morphology of liver biopsy samples. Intravenous administration of PG was well tolerated, and no serious side effects were observed. All patients exhibited complete or partial normalization of biochemical parameters and HB5AG and DNA-polymerase levels were decreasing after 6 months of therapy. Prior to treatment, HBeAG was detected in 9 patients, in 4 of whom seroconversion occurred with appearance of anti-HBeAg. Excellent results were seen in 3 patients and beneficial results in a further 3 patients; signs of improvement were seen in 5 patients, and only one patient did not react in a clearly positive way. In 11 of these patients, before and during treatment, isolated peripheral blood lymphocytes were investigated for their ability to show rosette E formation, their reactivity to phytomitogens (PHA, ConA), and their suppressor T lymphocyte activity. In five patients interferon levels were investigated.

Immunomodulation by Propionibacterium granulosum KP 45 and experimental trichinellosis in mice

Swiss mice were infected orally with 200 Trichinella spiralis larvae and injected intraperitoneally with a potent immunomodulator (isolated cell walls of Propionibacterium granulosum strain KP 45). In control mice 22 871 +/- 9913 larvae were found in the whole body, whereas in mice treated with P. granulosum KP 45 on the day of inoculation 9450 larvae +/- 8244 larvae were counted (p less than 0.01). Immunomodulation 7 days before or 7 days after T. spiralis inoculation gave less pronounced effects but the decreasing number of larvae was still significant. It is suggested that the above effects are due to an activation of macrophages.

Morphology and function of liver after intravenous and intraportal injections of the immunomodulating agent Propionibacterium granulosum

An immunomodulator, cell walls from Propionibacterium granulosum strain KP-45 (PG), has been applied in rabbits to test its influence on morphology and function of liver cells. For investigation of distribution in internal organs, the PG preparation was 51Cr-labelled and injected i.v. into mice. Functional liver tests were performed in rabbits injected intravenously or intraportally with PG. Morphologic studies (light and electron microscopy) of liver sections were performed in mice and rats injected intravenously with PG, 1-60 d prior to liver examination. Intravenous or intraportal application of PG did not cause detectable clinical symptoms during the whole observation period (1-60 d). During the first 3-7 d, elevation of serum globulins and transaminases (SGOT, SGPT) were noted with reappearance of normal values after 14-20 d. 131I-labelled Bengal Rose injected into PG-treated rabbits was trapped mostly in the spleen, and to a smaller extent in liver, where radioactivity was significantly lower than in saline-injected control animals. 51Cr-labelled PG injected i.v. into mice were after 60-90 min localized preferentially in lungs and liver, where the radioactivity was much higher than in the spleen. Morphological studies revealed that 6 h following i.v. injection of PG, there appeared partial clearing of the hepatocyte cytoplasm and lowering of their basophilic content with enhancement of pinocytic activity of the hepatocytes. This was accompanied by enlargement of RES cells in liver with enhanced intracellular digestion, higher number of lysosomes and appearance of phagocytic vacuoles.(ABSTRACT TRUNCATED AT 250 WORDS)

Difficulties in producing antibodies to purified Propionibacterium acnes exocellular enzymes

Attempts were made to produce antisera to purified preparations of Propionibacterium acnes lipase, hyaluronate lyase and acid phosphatase in rabbits. Antiserum to lipase (neutralizing titre I:32) was produced using conventional methods. Lipase (30 micrograms) in Freund's complete adjuvant (FCA) was injected into multiple sites thrice at weekly intervals. Antibody levels were boosted by i.v. injections of 30 micrograms in saline at 2-weekly intervals for 2 months. Such regimes failed to raise antibodies to hyaluronate lyase and acid phosphatase. In order to produce antiserum to hyaluronate lyase, rabbit mononuclear cells were incubated with 45 micrograms of hyaluronate lyase in vitro (I h at 37 degrees C) prior to injection subcutaneously above the rabbit ankle joint. Simultaneous injections of hyaluronate lyase in FCA (45 micrograms) were administered into the footpad and thigh. Three treatments at weekly intervals produced an antiserum with a neutralizing titre of I:256. A similar regime failed to raise antibodies to acid phosphatase. Antibodies to P. acnes lipase and hyaluronate lyase also neutralize the enzymes produced by P. granulosum. The neutralization curves suggest that the enzymes produced by both species are related antigenically but not identical.

Inhibition of Lewis lung carcinoma in mice by local microwave hyperthermia combined with immunomodulating Propionibacterium granulosum KP-45

C-57 BL/6 mice with Lewis lung carcinoma were treated 2 weeks after tumor implantation with local microwave hyperthermia (2450 MHz, tumor temperature 43.5 degrees C, 30 min) and/or intratumoral or intraperitoneal injection of 1 mg cell walls of Propionibacterium granulosum KP-45. Tumor growth, survival time of the animals, and the delayed skin hypersensitivity to oxazolone were followed up, as well as the 3H-thymidine uptake of tumorous tissues and the number of lung metastases. The combined treatment of microwave hyperthermia with immunomodulating P. granulosum KP-45 resulted in significantly stronger inhibition of tumor growth than with each of these methods alone. The number of lung metastases could be significantly lowered, and the skin reactivity to oxazolone remained enhanced during the whole observation period (over 70 days after tumor implantation). The implications of the test observation are discussed.

Mode of protection of mice against herpes simplex virus type 2 infection by Propionibacterium

We compared various strains of Propionibacterium with regard to protection of young adult mice against lethal infection with herpes simplex virus type 2 (HSV-2). Propionibacterium acnes, P. granulosum, and P. avidum were protective, while P. acidi-propionici and P. lymphophilum were ineffective. The protective effect proved to be in the cell wall fraction. Attempts were made to elucidate possible mechanisms of the protection using both effective and ineffective strains. The results strongly suggest that induction of interferon rather than activation of macrophages and natural killer cells by Propionibacterium pretreatment plays a crucial role, directly or indirectly, in protection against infection by herpes simplex virus. Propionibacterium only moderately protected newborn mice against HSV-2 infection.

[Pharmacological aspects of immunostimulants]

Immunostimulants are chemical substances capable of increasing the overall activity of a normal immune system as well as normalizing the function of an impaired immune system (immune restauration). This review is concerned with substances of microbial or chemical origin and excludes the so-called physiological inductors or regulators, e.g. thymic factors, interferon etc. During the last decade considerable progress has been achieved with respect to the isolation of effective compounds and the elucidation of their chemical structure. However, the knowledge of their mechanism of action and their effects in the living organism is still poor because of the complexity of the immune system, lack of appropriate standardization methods, lack of internationally agreed test conditions or diseases in intact animals or conditions for controlled clinical trials in man.

Effects of various coryneforms on mononuclear phagocyte system function and on production of tumour necrosis factor in mice

Vaccines of 6 strains of the genera Corynebacterium and Propionibacterium were tested for induction of hepatosplenomegaly and stimulation of clearance of injected colloidal carbon and viable Listeria monocytogenes. These effects were compared with the ability of these strains to support the endotoxin-induced liberation of tumour necrosis factor, interferon and heat-stable cytostatic factors in mouse circulation. Five strains caused good stimulation of macrophage functions and induced high levels of all factors. One strain was nearly lacking in macrophage stimulatory capacity and also failed to support factor production. These data are discussed in relation to the production mechanisms of the factors.