Protective effects of the combination Bifidobacterium longum plus lactoferrin against NSAID-induced enteropathy

Objectives Non-steroidal anti-inflammatory drugs can exert detrimental effects in the lower digestive tract. This study examined the protective effects of a combination of the probiotic Bifidobacterium longum BB536 (Bifidobacterium) with the prebiotic lactoferrin in a rat model of diclofenac-induced enteropathy. Methods Enteropathy was induced in 40-week-old male rats by intragastric diclofenac (4 mg/kg BID, 14 days). Lactoferrin (100 mg/kg BID), Bifidobacterium (2.5•106 CFU/rat BID) or their combination were administered 1 hour before diclofenac. At the end of treatments, the ileum was processed for the evaluation of histological damage, myeloperoxidase (MPO) and malondialdehyde (MDA) levels, as well as the expression of toll-like receptors 2 and 4 (TLR-2/-4) and the activation of downstream signaling molecules (MyD88 and NF-kB p65). Blood hemoglobin and fecal calprotectin were also assessed. Results Diclofenac induced intestinal damage, along with increments of MPO and MDA, overexpression of TLR-2, TLR-4, MyD88 and NF-kB p65, increase in fecal calprotectin and decrease in blood hemoglobin levels. Lactoferrin or Bifidobacterium alone prevented diclofenac-induced enteric damage, and the changes in blood hemoglobin, MPO, MDA, fecal calprotectin and NF-kB p65. Bifidobacterium, but not lactoferrin, decreased TLR-4 expression, while none of them affected MyD88 overexpression. TLR-2 expression was slightly enhanced by all treatments. The combined administration of lactoferrin and Bifidobacterium reduced further the intestinal damage, and restored MPO and blood hemoglobin levels. Conclusions Diclofenac induced ileal mucosal lesions by activation of inflammatory and pro-oxidant mechanisms. These detrimental actions were prevented by the combination of lactoferrin with Bifidobacterium likely through the modulation of TLR-2/-4/NF-kB pro-inflammatory pathways.