Utilizzo dei probiotici in pazienti affetti da uveite cronica-ricorrente

Background Uveitis is the most common extra-ocular manifestation of rheumatic diseases (particularly seronegative arthritis) and autoimmune diseases. If not promptly treated, grape inflammation can lead to very serious complications such as blindness. Unfortunately, it is not always possible to determine the etiological agent of this disease. So, the only therapeutic choises are prolonged and/or re-administered steroid and immunosuppressive treatments during the phases of exacerbation of the disease. Our research group, examining and reviewing the available literature, decided to evaluate the efficacy of an adjuvant therapy with probiotics in patients affected by chronic recurrent uveitis, through a case control study. The objective of this study is to demonstrate that adjuvant therapy with the administration of probiotics, reducing the systemic low-grade inflammation and modulating the immune response, should be able to reduce the number of relapses during a one-year follow-up. Furthermore, reducing the topical and systemic administrations of steroids we should observe a reduction the adverse effects connected to their administration. Material and Methods A single-blind prospective comparative pilot study was conducted (investigators were blinded to treatment) of 24 patients (9 males and 15 females; age range 10 to 45 years; mean age was 29.6 years) randomized (https://www.random.org/lists/) divided into two groups. Group A treated with a combined therapy of topical steroids (standard treatment) and probiotic supplementation. Group B treated with a combined therapy of topical steroids (standard treatment) and placebo integration. In both groups we decided to continue the steroid treatment only during the acute phases of the uveitis. Results and Conclusion In both roups, steroid treatment reduced the signs of inflammation during the exacerbation phases, with no statistically significant differences in response to treatment based on age. We found a statistically significant difference between the two groups (p<0.05) in the number of recurrences and in the intensity of the inflammatory symptoms associated with them. Notably, the number of signs of uveitis activity was statistically lower in the group treated with probiotic supplementation than in the group treated with placebo supplementation. Alterations in the balance of the gut microbiome have been associated with immune-mediated inflammatory diseases, both enteric and extra-enteric. The rationale behind probiotic integration carried out in our work lies in the fact that the content of the prepared mixture is capable of beneficially influencing the host. This would stimulate the growth of some species of intestinal bacteria, modulating the intestinal microbiome and immune status and conferring a health benefit when administered at the right doses and for an adequate period of time. Furthermore, probiotic supplementation was found to be safe and effective and therefore not related to the occurrence of adverse effects.