The effect of probiotics on serum levels of cytokine and endotoxin in peritoneal dialysis patients: a randomised, double-blind, placebo-controlled trial
The effect of probiotics on serum levels of cytokine and endotoxin in peritoneal dialysis patients: a randomised, double-blind, placebo-controlled trial
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DOI：
10.3920/bm2014.0088
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发表时间：
2015-01-01
影响因子：
5.4
通讯作者：
Lin, H-C.
中科院分区：
文献类型：
--
作者：
Wang, I-K.;Wu, Y-Y.;Lin, H-C.
炎症标志物如白细胞介素（IL）-6和TNF-α在透析患者中升高，可以预测心血管事件和全因死亡率。内毒素是慢性肾脏病患者的重要来源，也是炎症的另一个标志物。本研究旨在评价口服益生菌对腹膜透析（PD）患者血清内毒素血症和细胞因子水平的影响。还记录了残余肾功能下降、腹膜炎发作和心血管事件。2011年7月至2012年6月，在PD患者中进行了一项随机、双盲、安慰剂对照试验。干预组每天接受一粒含有10（9）cfu两歧双歧杆菌A218、10（9）cfu链状双歧杆菌A302、10（9）cfu长双歧杆菌A101和10（9）cfu植物乳杆菌A87的益生菌胶囊，持续6个月，而安慰剂组接受含有麦芽糊精的类似胶囊，持续相同的时间。在干预前和干预后6个月测量血清TNF-α、干扰素γ、IL-5、IL-6、IL-10、IL-17和内毒素水平。39名患者完成了研究（益生菌组21名，安慰剂组18名）。在接受益生菌治疗的患者中，治疗6个月后血清TNF-α、IL-5、IL-6和内毒素水平显著降低，而血清IL-10水平显著升高。相比之下，安慰剂组在六个月后血清细胞因子和内毒素水平没有显著变化。此外，在接受益生菌的患者中保留了残余肾功能。结论：益生菌可显著降低PD患者血清内毒素、促炎细胞因子（TNF-α和IL-6）、IL-5水平，提高抗炎细胞因子（IL-10）水平，保护残余肾功能。
Inflammatory markers such as interleukin (IL)-6 and tumour necrosis factor-alpha (TNF-alpha) are elevated in dialysis patients and can predict cardiovascular events and all-cause mortality. Endotoxin is an important source and also another marker of inflammation in patients with chronic kidney disease. The aim of this study was to evaluate the impact of oral probiotics on serum levels of endotoxemia and cytokines in peritoneal dialysis (PD) patients. The decline of residual renal function, peritonitis episodes, and cardiovascular events were also recorded. From July 2011 to June 2012, a randomised, double-blind, placebo-controlled trial was conducted in PD patients. The intervention group received one capsule of probiotics containing 10(9) cfu Bifobacterium bifidum A218, 10(9) cfu Bifidobacterium catenulatum A302, 10(9) cfu Bifidobacterium longum A101, and 10(9) cfu Lactobacillus plantarum A87 daily for six months, while the placebo group received similar capsules containing maltodextrin for the same duration. Levels of serum TNF-alpha, interferon gamma, IL-5, IL-6, IL-10, IL-17, and endotoxin were measured before and six months after intervention. 39 patients completed the study (21 in the probiotics group and 18 in the placebo group). In patients receiving probiotics, levels of serum TNF-alpha, IL-5, IL-6, and endotoxin significantly decreased after six months of treatment, while levels of serum IL-10 significantly increased. In contrast, there were no significant changes in levels of serum cytokines and endotoxin in the placebo group after six months. In addition, the residual renal function was preserved in patients receiving probiotics. In conclusion, probiotics could significantly reduce the serum levels of endotoxin, pro-inflammatory cytokines (TNF-alpha and IL-6), IL-5, increase the serum levels of anti-inflammatory cytokine (IL-10), and preserve residual renal function in PD patients.