Insights from 100 Years of Research with Probiotic E. Coli Original paper
Researched by:
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Divine Aleru
ID
Divine Aleru
Read MoreI am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Microbes
Microbes
Microbes, short for microorganisms, are tiny living organisms that are ubiquitous in the environment, including on and inside the human body. They play a crucial role in human health and disease, functioning within complex ecosystems in various parts of the body, such as the skin, mouth, gut, and respiratory tract. The human microbiome, which is […]
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Probiotics
Probiotics
Probiotics are live microorganisms that offer significant health benefits when administered in adequate amounts. They primarily work by modulating the gut microbiome, supporting a balanced microbial ecosystem. Probiotics have been shown to improve gut health, modulate immune responses, and even influence metabolic and mental health disorders. With growing evidence supporting their therapeutic potential, probiotics are increasingly recognized for their role in treating conditions like irritable bowel syndrome (IBS), antibiotic-associated diarrhea (AAD), and even mental health conditions like depression and anxiety through their impact on the gut-brain axis.
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Divine Aleru
Read More
Researched by:
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Divine Aleru
ID
Divine Aleru
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was reviewed?
This review synthesized 100 years of clinical and mechanistic research on E. coli Nissle 1917 and other E. coliprobiotics. The review compared EcN (Mutaflor), Symbioflor 2, and Colinfant. It assessed human studies, animal models, genomics, and safety. The review also traced origins, dosing, colonization, and proposed modes of action and summarized outcomes in ulcerative colitis, infant diarrhea, functional gut disorders, and immune markers. It examined the proximity of probiotic strains to uropathogenic E. coli at the genomic level and noted microcin production, iron acquisition systems, and adhesins. The review by Wassenaar provided the integrated evidence base. It considered ethical issues for neonatal use where hemolysin appears. It mapped research trends and future applications against antimicrobial resistance.
Who was reviewed?
Adults with ulcerative colitis received EcN and showed remission maintenance comparable to mesalazine. Children with ulcerative colitis tolerated EcN and maintained remission. Patients with Crohn’s disease did not benefit. Healthy adults showed β-defensin induction after Symbioflor 2. Newborns and preterm infants colonized transiently with EcN and showed higher stool or mucosal IgA. Infants with acute viral diarrhea had shorter illness with EcN. Adults with constipation improved stool frequency. Liver cirrhosis data were limited. Elderly residents did not clear multidrug-resistant E. coli with EcN. Evidence for Colinfant came mainly from a single research group in infants.
Most important findings
EcN supports ulcerative colitis remission at rates similar to mesalazine. It does not treat Crohn’s disease. Its benefits likely reflect host–microbe signaling, not durable engraftment. Fecal detection in adults declines weeks after dosing. Human β-defensins rise after exposure to Symbioflor 2. Infant studies show higher EcN-specific IgA and fewer detected enteric pathogens. EcN produces microcins M and H47. These peptides inhibit Enterobacteriaceae and Shiga-toxin–producing E. coli in vitro. Strong iron uptake and yersiniabactin support nutrient competition against Salmonella in animal models. Genomes of EcN and Colinfant resemble uropathogenic E. coli, including adhesins and hemolysin loci, yet clinical safety is good. Symbioflor 2 harbors multiple genotypes with distinct traits. One genotype drives β-defensin induction. Another genotype colonizes more persistently. Together, these signatures point to a probiotic profile characterized by transient carriage, microcin-mediated pathogen suppression, innate immune priming, and iron-linked competitive exclusion.
Key implications
Clinicians can consider EcN to maintain remission in ulcerative colitis. It is not indicated for Crohn’s disease. Expect transient colonization and host-mediated effects. Benefits may come from microcins and defensin induction. Infant diarrhea may shorten with EcN. Monitor products for hemolysin in neonatal settings. Genomic proximity to uropathogens warrants vigilance, yet observed safety is strong. Probiotic strategies may regain value as antibiotic resistance grows. Personalization will matter because colonization varies. Use clear endpoints, stool microbiome reads, immune markers, and relapse rates to guide care.
E. coli Nissle 1917
Escherichia coli Nissle 1917 (EcN) is a rare, non-pathogenic strain of E. coli discovered during World War I from a soldier who did not get dysentery while others did. Unlike harmful E. coli, EcN acts as a probiotic: it settles in the gut, competes with bad bacteria for food and space, produces natural antimicrobials, and even helps strengthen the gut barrier.
Escherichia coli (E. coli)
Escherichia coli (E. coli) is a versatile bacterium, from gut commensal to pathogen, linked to chronic conditions like endometriosis.
Probiotics
Probiotics are live microorganisms that offer significant health benefits when administered in adequate amounts. They primarily work by modulating the gut microbiome, supporting a balanced microbial ecosystem. Probiotics have been shown to improve gut health, modulate immune responses, and even influence metabolic and mental health disorders. With growing evidence supporting their therapeutic potential, probiotics are increasingly recognized for their role in treating conditions like irritable bowel syndrome (IBS), antibiotic-associated diarrhea (AAD), and even mental health conditions like depression and anxiety through their impact on the gut-brain axis.