Pediococcus acidilactici CE51 e seus pós-bióticos: efeitos na integridade intestinal, inflamação e complicações musculares associadas à doença inflamatória intestinal

Abstract

Inflammatory bowel diseases (IBD) are chronic conditions characterized by persistent inflammation of the gastrointestinal tract, often associated with systemic alterations such as intestinal dysbiosis and metabolic impairment. Among these complications, sarcopenia stands out, negatively impacting patients’ quality of life and prognosis. In this context, there is a growing interest in innovative therapeutic strategies, such as the use of probiotics and, more recently, postbiotics, due to their potential to modulate the microbiota and the inflammatory response. This thesis aimed to investigate the therapeutic potential of Pediococcus acidilactici CE51 and its postbiotics in modulating intestinal inflammation and systemic complications associated with inflammatory bowel diseases (IBD), with emphasis on sarcopenia. Article 1, a review study, aimed to critically analyze the scientific evidence regarding the role of postbiotics derived from lactic acid bacteria in the management of muscle complications associated with IBD. The methodology consisted of a narrative literature review, including experimental and clinical studies related to the pathophysiology of sarcopenia, intestinal microbiota, and mechanisms of action of postbiotics. The results demonstrated that chronic intestinal inflammation, dysbiosis, and metabolic alterations directly contribute to the loss of muscle mass and function, and that metabolites such as short-chain fatty acids, bioactive peptides, and exopolysaccharides exert anti-inflammatory, antioxidant, and muscle metabolism-modulating effects, highlighting their potential in the prevention and attenuation of sarcopenia associated with IBD. Article 2 aimed to evaluate the effects of the probiotic Pediococcus acidilactici CE51 and its cell-free supernatant in an experimental model of indomethacin-induced enteropathy. A total of 45 male Wistar rats were used, distributed into five groups: CMC (control – 200 µL/kg), I (indomethacin 10 mg/kg), IP (indomethacin + probiotic 10⁸ CFU), ICFS (indomethacin + cell-free supernatant 200 µL/kg), and IS (indomethacin + sulfasalazine 10 mg/kg). The animals were pretreated for 28 days and then subjected to inflammatory induction for 4 days, totaling approximately 32 days of experimentation. Inflammatory induction resulted in a significant reduction in weight gain (p<0.05), moderate intestinal inflammation, and important systemic alterations, including anemia, thrombocytopenia, and hypoproteinemia. A marked increase in genotoxic damage was observed in the I group, with a significant elevation in micronucleus frequency compared to the control (p<0.05). Regarding treatments, the ICFS and IS groups showed significant recovery in platelet counts (p<0.05) and increased leukocyte levels compared to the inflammatory group. The IS group demonstrated more pronounced improvement in albumin and total protein levels (p<0.05), while the ICFS group stood out for its modulation of the intestinal microbiota, with a significant increase in Lactobacillaceae and the genus Lactobacillus (p<0.05), along with a reduction in dysbiosis-associated groups. Additionally, the treated groups (IP, ICFS, and IS) showed a significant reduction in micronucleus frequency compared to the I group (p<0.05), with values close to the control group. Overall, the cell-free supernatant (ICFS) demonstrated greater biological consistency compared to the probiotic, particularly in microbiota modulation and reduction of systemic damage, although without complete reversal of all induced alterations. These findings reinforce the potential of postbiotics as a more stable and effective therapeutic alternative, contributing to the advancement of innovative strategies for the management of IBD and its systemic complications.