VSL#3 probiotic treatment reduces chemotherapy-induced diarrhea and weight loss

Background: One of the most common toxicities of cancer treatment is diarrhea. Probiotics have been shown effective at preventing diarrhea in inflammatory bowel disease and may prove useful in the oncology setting. Aim: The primary aim of this study was to investigate the probiotic mixture, VSL#3, for amelioration of chemotherapy-induced diarrhea (CID). Methods: This experiment was carried out in a clinically relevant model of CID. VSL#3 was administered to female DA rats in one of three schedules. Irinotecan was used to induce mucositis and diarrhea, with rats monitored for seven days to record incidence of weight-loss and diarrhea. At study completion, intestines were collected to investigate histological and proliferative changes, apoptosis levels and mucin composition. Results: VSL#3 reduced weight loss following irinotecan when administered before and after chemotherapy. Moderate and severe diarrhea was also prevented in these rats. This was associated with a significant increase in crypt proliferation combined with an inhibition of apoptosis in both the small and large intestines. VSL#3 also prevented irinotecan-induced increases in goblet cells within jejunal crypts. Conclusions: VSL#3 is effective at preventing severe diarrhea following chemotherapy with irinotecan and therefore has potential to be used clinically by cancer patients.