Mutaflor® Escherichia coli strain Nissle 1917 was entered on the Australian Register of Therapeutic Goods in February 2012 and is still today the only probiotic in Australia registered at AUST R level.
Mutaflor® is registered in Australia for the relief and management of chronic constipation. Your healthcare practitioner may also utilise this strain for its pharmacological, metabolic and immunomodulation properties.
Mutaflor® still today contains this very Nissle strain but manufactured in a modern GMP facility, lyophilized or freeze-dried, a process to remove moisture whilst the strain remains frozen and filled into gelatine capsules that are enteric coated in order that they do not open until the large intestine is reached.
If symptoms persist consult your healthcare practitioner. While no prescription is required it is important that you speak with your Doctor or Pharmacist about any changes to your bowel habits as these changes may be associated with other medical conditions and warrant further investigation.
Mutaflor® Chronic Constipation Study MU9202 M.Mollenbrink & E.Bruckschen (1994) Med.Klin89:587-593 Med Klin (Munich). 1994 Nov 15;89(11):587-93.[Treatment of chronic constipation with physiologic Escherichia coli bacteria. Results of a clinical study of the effectiveness and tolerance of microbiological therapy with the E. coli Nissle 1917 strain (Mutaflor)]. [Article in German]
Möllenbrink M, Bruckschen E.
Cell-free supernatants of Escherichia coli Nissle 1917 modulate human colonic motility: evidence from an in vitro organ bath study. Bär F, Von Koschitzky H, Roblick U, Bruch HP, Schulze L, Sonnenborn U, Böttner M, Wedel T. Neurogastroenterol Motil. 2009 May;21(5):559-66, e16-7. Epub 2009 Feb 11.
Int J Colorectal Dis. 2012 April; 27(4): 467–474. Published online 2011 December 2. doi: 10.1007/s00384-011-1363-9 PMCID: PMC3307993 A double-blind placebo-controlled trial to study therapeutic effects of probiotic Escherichia coli Nissle 1917 in subgroups of patients with irritable bowel syndrome Wolfgang Kruis, 1 Sigrun Chrubasik,2 Stephan Boehm,1 Christiane Stange,3 and Juergen Schulze
Mutaflor® is a probiotic that comprises as its active substance a viable non-pathogenic strain of Escherichia coli (E.coli). First isolated in 1917 by Professor Alfred Nissle from the faeces of a soldier during the First World War who as he remarked, “in contrast to the large majority of his comrades, had suffered neither from dysentery nor from any other intestinal diseases”. Thereafter, appropriately named Escherichia coli strain Nissle 1917.
Mutaflor® is registered in Australia at AUST R level for the relief and management of chronic constipation. Your healthcare practitioner may also wish to utilise this strain for its pharmacological and metabolic properties.
Characteristics of Escherichia coli strain Nissle 1917.
- the ability to colonize
- antagonistic activity – Inhibition of growth and or killing of pathogens
- anti-invasive – prevention of colonisation in the gut by pathogens
- synthesis of endogenous antimicrobial peptides-defensins
- mucosal integrity – contributing to luminal metabolism and stability of intestinal milieu-enhanced epithelial barrier function
- anti-inflammatory and immunomodulatory effects
- stimulation of colonic mucosa
The therapeutic effects of Mutaflor® are strain specific and have been demonstrated by in-vitro and in-vivo experiments and clinical studies. Mutaflor® Escherichia coli strain Nissle 1917 (EcN) is arguably one of the best studied and field tested probiotic strains and fulfills all the demanding criteria and characteristics required for a medicinal probiotic.
The origins of Mutaflor® are somewhat less than auspicious. First isolated in 1917 from the faeces of a soldier in World War One who did not succumb to dysentery unlike most of his other comrades in regions that were highly contaminated by enteropathogens.
Long before even the advent of antibiotics the Physicians and Microbiologists at that time all understood the role of bacteria in disease but Professor Alfred Nissle had come to recognise that some fecal E.coli isolates showed signs of antagonistic action against pathogens in vitro.
It then becomes quite apparent as to why Nissle was only interested in the soldier who was not affected by dysentery.
The Human Microbiome is made up of all the bacterial colonies on and in the human body. This collection of bacteria numbers some 10 times the number of human cells in our body.
The Gut Microbiome or Gut Microbiota accounts for up to 1000 species of bacteria and these number some 10¹⁴ microorganisms with most residing in the large intestine.
There is continuous significant interest and study of our Gut Microbiota and its relationship with our health. Rarely a week passes without a new study being published that confirms this link to overall health and a number of chronic conditions. It is well established that we humans and these microbiota communities enjoy a mutualistic and symbiotic relationship in that we depend on each other for survival.
The role of our gut bacteria is maily one of nutrition, metabolism and immunity.Established at birth and by chance as evolution intended, the gut microbiota continues to change during development. Factors in our lives, such as medication, diet and lifestyle will affect the composition of these microbes.
There are many important metabolites produced by Escherichia coli strain Nissle 1917, this and together with all its characteristics makes this strain one of the most important for overall gut health.
As one of the first colonizers of the infant gut, Escherichia coli strain Nissle 1917 plays a vital role in the establishment and maintenance of a healthy gut and provides microbial barrier against pathogenic bacteria.
Its metabolic activities, consumption of oxygen, production of short chain fatty acids (SCFA) helps create an environment in which subsequent anaerobic microorganism can establish and so begins this complex Gut Microbiome which plays a crucial role in our health.
Escherichia coli is responsible for the production of a number of important metabolites.
Escherichia coli produces – Chorismate
Chorismate is the precursor to the production of:
menaquinone (Vit K2)
Escherichia coli strain Nissle 1917 has shown to effect the immune system by influencing the maturation and development of the gut-associated lymphoid tissue (GALT) and can regulate the production of some immune mediators.
When there is a change in the composition of our gut microbiota there will also be a change in the metabolites produced and these in turn will place stress on the bacterial community. This change or altered bacterial composition is often referred to as Dysbiosis.
Talk to your Doctor or healthcare practitioner if Mutaflor® may be of benefit to you.
Strain-Specific Characteristics of Escherichia coli strain Nissle 1917.
- the ability to colonize 1,2,3,4,5
- antagonistic activity – Inhibition of growth and or killing of pathogens 6,7,8
- anti-invasive – prevention of colonisation in the gut by pathogens 9
- synthesis of endogenous antimicrobial peptides-defensins 10,11
- mucosal integrity – contributing to luminal metabolism and stability of intestinal milieu-enhanced epithelial barrier function 12,13,14
- anti-inflammatory and immunomodulatory effects 15,16,17,18
- stimulation of colonic mucosa 19,20,21
Evidence – Clinical and Pharmacological
1. Lasaro MA, SalingerN, Zhang J, Wang Y, Zhong Z, Goulian M, et. F1C fimbriae play an important role in biofilms formation and intestinal colonization by the Escherichia coli commensal strain Nisssle 1917. Appl Environ Microbiol 2009;75:246-51.
2. Monterio C, Saxena I, Wang X, Kader A, Bokranz W, Simm R, et al. Characterization of cellulose production in Escherichia coli Nissle 1917 and its biological consequences.
Environ Microbiol 2009;11:1105-16
3. Blum G, Marre R, Hacker J,. Properties of Escherichia coli strains of serotype 06. Infection 1995;23:234-6.
4. Stentebjerg-Olesen B, Chakraborty T, Klemm P. Type 1 fimbriation and phase switching in a natural Escherichia coli fimb null strain, Nissle 1917. J bacterial 1999;181:7470-8.
5. Troge A, Scheppach W, Schroeder BO, Rund SA, Heuner K, Wehkamp J, Stange EF, Oelschlaeger TA. More than a marine propeller–the flagellum of the probiotic Escherichia coli strain Nissle 1917 is the major adhesin mediating binding to human mucus.
Int J Med Microbiol. 2012 Dec;302(7-8):304-14. doi: 10.1016/j.ijmm.2012.09.004. Epub 2012
6. Henker et al. Eur J Pediatr (2007) 166:311-318. The probiotic Escherichia coli strain Nissle 1917 (EcN) stops acute diarrhoea in infants and toddlers.
7. Reissbrodt R, Hammes WP, Dal Bello F, Prager R, Fruth A, Hantke K, Rakin A, Starcic-Erjavec M, Williams PH ‘Inhibition of growth of Shiga toxin-producing Escherichia coli by nonpathogenic Escherichia coli. FEMS Microbiology Letters, 290 (1): 62-69 / 2009
8. Leatham MP et al. Precolonized human commensal Escherichia coli strains serve as a barrier to E.coli O157:H7 growth in the streptomycin-treated mouse intestine.
Infection & Immunity 2009;77:2876-86.
9. Altenhoefer et al. The probiotic Escherichia coli strain Nissle 1917 interferes with invasion of human intestinal epithelial cells by different enteroinvasive bacterial pathogens. FEMS Immunology and Medical Microbiology 49 (2004) 223-229
10. Wehkamp et al. Infection And Immunity, Oct.2004, p.5750-5758 NF-kB- and AP-1-Mediated Induction of Human Beta Defensin-2 in Intestinal Epithelial Cells by Escherichia coli Nissle 1917: a Novel Effect of a Probiotic Bacterium.
11. Schlee M, Wehkamp J, Altenhoefer A, Oelschlaeger TA, Stange EF, Fellermann K ’The induction of human beta-defensin-2 by the probiotic Escherichia coli Nissle 1917 is mediated through flagellin. Infection and Immunity. 75 (5): 2399-2407 (2007)
12. Zyrek aa, Cichon C, Helms S, Enders C, Sonnenborn U, Schmidt MA. Molecular mechanisms underlying the probiotic effects of Escherichia coli Nissle 1917 involve ZO-2 and PKCZeta redistribution resulting in tight junction and epithelial barrier repair. Cell Microbiol 2007;9:804-16.
13. Ukena SN, Singh A, Dringenberg U, Engelhardt R, Seidler U, Hansen W, Bleich A, Bruder D, FranzkeA, Rogler G, Suerbaum S, Buer J, Gunzer F, Westendorf AM. Probiotic Escherichia coli Nissle 1917 inhibits leaky gut by enhancing mucosal integrity. PloS one, 2 (12): e1308 / 2007
14. Otte JM, Podolsky DK. Functional modulation of enterocytes by gram-positive and gram-negative microorganisms. Am J Physiol Gastrointest Liver Physiol. 286 (4): G613-626, 2004
15. Kamada et al. Infection and Immunity, Jan. 2008, p. 214-220
Nonpathogenic Escherichia coli Strain Nissle 1917 Inhibits Signal Transduction in Intestinal Epithelial Cells.
16. Arribas B, Rodriguez-Cabesas ME, Camuesco D, Comalada M, Bailon E, Utrilla P, Nieto A, Concha A, Zarzuelo A, Galvez J. A probiotic strain of Escherichia coli, Nissle 1917, given orally exerts local and systemic anti-inflammatory effects in lipopolysaccharide-induced sepsis in mice. British Journal of Pharmacology, 157 (6): 1024-1033 / 2009
17. Helwig U, Lammers KM, Rizzello F, Brigidi P, Rohleder V, Caramelli E, Gionchetti P, Schrezenmeir J, Foelsch UR, Schreiber S, Campieri M. Lactobacilli, bifidobacteria and E. coli nissle induce pro- and anti-inflammatory cytokines in peripheral blood mononuclear cells. World Journal of Gastroenterology, 12 (37): 5978-5986 / 2006
18. Otte JM, Mahjurian-Namari R, Brand S, Werner I, Schmidt WE, Schmitz F. Probiotics regulate the expression of COX-2 in intestinal epithelial cells. Nutrition and Cancer. 61(1):103-113/2009
19. Bruckschen E, Horosiewicz H. Chronische Obstipation, Vergleich von mikrobiologischer Therapie und Lactulose. Munch med Wochenschr 1994;16:241-5.
20. Mollenbrink M, Bruckschen E. Behandlung der chronischen Obstipation mit physiologischen Escherichia-coli-Bakterien. Med Klin 1994;89:587-93.
21. Bar et al. Neurogastroenterol Motil (2009) 21, 559-317 Cell-free supernatants of Escherichia coli Nissle 1917 modulate human colonic motility: evidence from an in vitro organ bath study.