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Basic science (nutrition)
PMO-030 Soluble plant fibres, particularly leek and plantain, inhibit adherence of diarrhoea-associated pathogens C difficile and enterotoxigenic Escherichia coli to intestinal epithelial cells
  1. H L Simpson,
  2. C L Roberts,
  3. J M Rhodes,
  4. B J Campbell
  1. Department of Gastroenterology, University of Liverpool, Liverpool, UK

Abstract

Introduction It has long been thought that dietary fibre promotes intestinal health and we have previously shown that the soluble non-starch polysaccharide (NSP) from plantain bananas (Musa spp.) can inhibit the epithelial adhesion and microfold (M)-cell translocation of Crohn's-associated Escherichia coli (Gut 2010;59:1331–9) and a range of diarrhoeal pathogens including Salmonella and Shigella (Gut 2011;60:A96). Here we examined NSP from representative examples of monocotyledon and dicotyledon plant fibres, for efficacy to inhibit epithelial interactions of Clostridium difficile, a major cause of antibiotic associated diarrhoea, and enterotoxigenic E coli (ETEC), the commonest cause of traveller's diarrhoea.

Methods Human intestinal epithelial cell-line Caco2-cl1 cell monolayers were pre-treated for 30 min with NSP preparations, including those from vegetable (broccoli, leek), fruit (plantain, apple) and cereal (oat) sources, followed by infection with C. difficile (for 2 h, at multiplicity of infection MOI of 100) or ETEC (4 h; MOI 100). In parallel experiments, adherence of bacteria to cell monolayers was examined following fixation, Giemsa stain and light microscopy.

Results C difficile adhesion to Caco2-cl1 cells was significantly inhibited in the presence of broccoli, leek and plantain NSP. Leek NSP, at 5 mg/ml, had the most significant effect on inhibition of C difficile adhesion (54.9±9.7% reduction) compared to untreated controls (n=3−9, p<0.001, ANOVA). Neither apple nor oat NSP had any significant ability to prevent C difficile adhesion to CaCo2-cl1 cells. ETEC adhesion to CaCo2-cl1 cells was also significantly inhibited in the presence of leek NSP (53.7±13.6%; p<0.01) and plantain NSP (40.9±9.3%; p<0.001) but no efficacy was observed for soluble broccoli, apple nor oat fibre. Blockade of adherence to Caco2-cl1 cells by NSP was also confirmed by Giemsa stain.

Conclusion Leek, plantain and/or broccoli NSP show efficacy at blocking C difficile and ETEC adhesion in a dose dependent manner to the intestinal epithelium in vitro and at concentrations readily achievable in vivo. The close proximity of C difficile and ETEC to the host epithelium is almost certainly essential for the release of their respective toxins and the exertion of their pathogenic effect. Disruption of bacterial-epithelial adherence to the intestinal mucosa by soluble plant fibres may therefore be of therapeutic benefit.

Competing interests H Simpson grant/research support from: industrial case studentship with support from Provexis plc, C Roberts conflict with: past employee of Provexis plc, J Rhodes consultant for: is a member of advisory boards for Atlantic, Procter and Gamble and Falk, speaker bureau with: Has received speaking honoraria from Abbott, Falk, Ferring, Glaxo Smith Kline, Procter and Gamble, Schering Plough, Shire and Wyeth, Conflict with: holds a patent with the University of Liverpool and Provexis UK for use of a soluble fibre preparation as maintenance therapy for Crohn's disease plus a patent pending for its use in antibiotic-associated diarrhoea, B Campbell grant/research support from: grant support from Provexis plc and the Bo & Vera Ax:son Johnson Foundation Ltd.

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