Bilberry ingestion improves disease activity in mild to moderate ulcerative colitis

Bilberry ingestion improves disease activity in mild to moderate ulcerative colitis

Bilberries (Vaccinium myrtillus), also referred to as “European blueberries”, and other members of the Vaccinium family possess a naturally high content of polyphenols, of which anthocyanins constitute the biggest fraction with 50–80%. [14] and [15] An anthocyanin rich bilberry extract was shown to alter the expression of various genes implicated in the pathogenesis of atherosclerosis in an apo E-deficient mouse model.16 In a randomized human study including individuals at increased risk for cardiovascular disease significant decreases in plasma concentrations of C-reactive protein (CRP), interleukin (IL)-6, IL-15, and monokine induced by INF-c (MIG) were observed in the group receiving bilberry juice.17 Moreover, anthocyanins inhibited the adhesion of Neisseria meningitidis to cultured human epithelial cells.18 In rats, bilberry extract was protective against doxorubicin induced oxidative cardiotoxicity.19 In humans, a decrease in postprandial insulin demand after the ingestion of a bilberry containing drink was shown recently.20 In addition, a potential chemopreventive effect of anthocyanins in colorectal cancer (CRC) was suggested in a pilot trial of human subjects with CRC, where bilberry intake induced a significant decrease of proliferative markers in tumor tissue.21

In an open pilot trial with a total follow-up of 9 weeks the effect of a daily standardized anthocyanin-rich bilberry preparation was tested in 13 patients with mild to moderate UC. Clinical, biochemical, endoscopic and histologic parameters were assessed.

At the end of the 6 week treatment interval 63.4% of patients achieved remission, the primary endpoint, while 90.9% of patients showed a response. In all patients a decrease in total Mayo score was detected (mean: 6.5 and 3.6 at screening and week 7, respectively; p < 0.001). Fecal calprotectin levels significantly decreased during the treatment phase (baseline: mean 778 μg/g, range 192–1790 μg/g; end of treatment: mean 305 μg/g, range < 30–1586 μg/g; p = 0.049), including 4 patients achieving undetectable levels at end of treatment. A decrease in endoscopic Mayo score and histologic Riley index confirmed the beneficial effect. However, an increase of calprotectin levels and disease activity was observed after cessation of bilberry intake. No serious adverse events were observed.

This is the first report on the promising therapeutic potential of a standardized anthocyanin-rich bilberry preparation in UC in humans. These results clearly indicate a therapeutic potential of bilberries in UC. Further studies on mechanisms and randomized clinical trials are warranted.

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