Immunomodulation and nitric oxide restoration by a probiotic and its activity in gut and peritoneal macrophages in diabetic rats

Background: The hyperglycemia leads to increased oxidative stress, causing lipid peroxidation and imbalance in the immune system.

Aims: To investigate the effect of Kefir - a probiotic containing different strains - on metabolic parameters, cytokines, nitric oxide (NO) production, phagocytic activity of peritoneal macrophages and intestinal modulation in diabetes.

Methods: Wistar rats received injection of streptozotocin (45 mg/kg, intravenously) and diabetes was defined as glycemia ≥200 mg/dL. The animals were distributed in four groups: control (CTL); control Kefir (CTLK); diabetic (DM); diabetic Kefir (DMK). Kefir was given at 1.8 mL/day by gavage, started on the 5th day of diabetes, during 8 weeks. The animals were allocated in metabolic cages, pre and post treatment with Kefir, for measurement of the metabolic parameters, such as water intake, food intake, diuresis, glycemia, body mass, insulin and lipid profile, these last two were only measured at the end of Kefir protocol. After treatment, the animals were euthanized and the peritoneal cavity was prepared, resident macrophages were collected and cultured for analysis of the phagocytic activity, cytokines (IL-10, TNF-α, IL-17, IL-1β) and NO. The intestinal modulation was performed by the quantification of Peyer's patches (PP) in the small intestine. The data were presented as mean ± SEM, with significance of p < 0.05.

Results: DM when compared to CTL showed increase in water intake (133 ± 7 vs. 28 ± 1 mL, p < 0.0001), food intake (40 ± 2 vs. 16 ± 1 g, p < 0.0001), diuresis (102 ± 5 vs. 13 ± 1 mL, p < 0.0001) and glycemia (567 ± 12 vs. 84 ± 3 mg/dL, p < 0.0001), while in DMK group all these metabolic parameters were decreased (96 ± 14; 36 ± 1; 86 ± 7 and 407 ± 19, respectively, p < 0.0001), presenting increase of body mass (42 ± 5 vs. 16 ± 4Δ, p < 0.0001) and insulin levels (0.3 ± 0.8 vs. 0.1 ± 0.04 ng/mL, p < 0.0001) compared to DM. The lipid profile of the diabetic groups showed tendency to increase compared to the respective controls. In relation to function of peritoneal macrophages, DMK group vs. DM showed improvement in phagocytic capacity (70 ± 5 vs. 51 ± 7%, p = 0,0023) and increased concentration of all the cytokines analyzed (pg/mL), as IL-10 (926 ± 69 vs. 556 ± 92, p = 0.0004), TNF-α (178 ± 20 vs. 109 ± 20, p = 0.005), IL-17 (33 ± 1 vs. 9 ± 1, p = 0.0001) and IL-1β (102 ± 14 vs. 70 ± 5, p = 0.0129), after 24 h of LPS stimulation; including NO bioavailability after 24 h (102 ± 9 vs. 66 ± 5 μM/mL, p = 0.0029) or 48 h (143 ± 8 vs. 119 ± 4 μM/mL, p = 0.0102) of LPS stimulation. Moreover, the number of PP in the whole small intestine of DMK group was also increased as compared to DM (22 ± 1 vs. 18 ± 1, p = 0.0292).

Conclusion: These results show that Kefir has a potential to modulate the immune response and activate peritoneal macrophages in diabetic animals, which suggests that it could enhance the immunocompetence of patients affected by diabetes mellitus. The hypoglycemic effect of this probiotic could be used as a tool to control glycemia, reducing or delaying the onset of complications associated with this disease.