Probiotics Have Clinical, Microbiologic, and Immunologic Efficacy in Acute Infectious Diarrhea
Probiotics Have Clinical, Microbiologic, and Immunologic Efficacy in Acute Infectious Diarrhea
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DOI：
10.1097/inf.0b013e3181b530bf
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发表时间：
2010-02-01
影响因子：
3.6
通讯作者：
Lin, Tzou-Yien
中科院分区：
文献类型：
--
作者：
Chen, Chien-Chang;Kong, Man-Shan;Lin, Tzou-Yien
背景：急性感染性腹泻是儿童发病率和家庭经济负担的主要原因。我们评价了益生菌治疗急性感染性腹泻的临床、微生物学和免疫学效果。方法：将304例因急性腹泻住院的3个月至6岁的儿童随机分为Bio-3(肠系膜芽孢杆菌、粪肠球菌和酪酸梭菌的混合物)或安慰剂，每日3次，共7天。粪便标本匀浆进行细菌培养，分离血细胞进行细胞培养和细胞因子分析。结果：益生菌组开始治疗后的平均腹泻持续时间为60.1h，安慰剂组为86.3h(P=0.003)。益生菌组的住院时间比安慰剂组短(P=0.009)。益生菌(Bio-Three)组的粪便培养中双歧杆菌和乳杆菌菌种的数量有所增加。益生菌组血清和细胞培养上清液中IL-10水平升高，肿瘤坏死因子-α水平下调。与安慰剂组相比，益生菌组的干扰素-γ和IL-12水平略有升高。结论：益生菌混合物可降低急性腹泻患儿的腹泻严重程度和住院时间。除了恢复有益的肠道菌群外，益生菌还可以增强宿主保护性免疫，抑制促炎细胞因子的下调和抗炎细胞因子的上调。
Background: Acute infectious diarrhea is a major cause of childhood morbidity and economic burden for families. We evaluate the clinical, microbiologic, and immunologic effects of probiotics in acute infectious diarrhea.Methods: Children (n = 304) aged 3 months to 6 years hospitalized for acute diarrhea were randomized to receive Bio-three (a mixture of Bacillus mesentericus, Enterococcus faecalis, and Clostridium butyricum) or placebo orally 3 times daily for 7 days. Fecal samples were homogenized for bacterial Culture and blood cells were isolated for cell Culture and cytokine analysis. This study is registered (NCT00463190).Results: The mean duration of diarrhea after start of therapy was 60.1 hours in the probiotics group versus 86.3 hours in the placebo group (P = 0.003). Hospital stay was shorter in the probiotics group than in the placebo group (P = 0.009). Counts of Bifidobacteria and Lactobacillus species were elevated in stool culture of the probiotics (Bio-three) group. IL-10 was increased in the serum and supernatants of cell culture in the probiotics group, and tumor necrosis factor-alpha values were down-regulated. Interferon-gamma and IL-12 were mildly elevated in the probiotics group, compared with the placebo group.Conclusions: This probiotics mixture reduced the severity of diarrhea and length of hospital stay in children with acute diarrhea. In addition to restoring beneficial intestinal flora, probiotics may enhance host protective immunity quell as down-regulation of pro-inflammatory cytokines and up-regulation of anti-inflammatory cytokines.