The effects of probiotic supplementation on experimental acute pancreatitis: a systematic review and meta-analysis.
The effects of probiotic supplementation on experimental acute pancreatitis: a systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0048811
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Ritskes-Hoitinga M
中科院分区：
文献类型：
--
作者：
Hooijmans CR;de Vries RB;Rovers MM;Gooszen HG;Ritskes-Hoitinga M
2008年2月，发表了益生菌治疗胰腺炎试验（PROPATRIA）的结果。本研究调查了益生菌在重症急性胰腺炎患者中的应用。两组之间的任何主要终点均无差异。然而，益生菌组的死亡率明显高于安慰剂组。根据试验方案中提及的动物研究结果，该结果是非预期的。我们使用系统综述和荟萃分析的方法，仔细研究了益生菌和胰腺炎的动物研究与PROPATRIA试验之间的关系，重点关注有害影响和疗效的适应症。在PubMed和Embase中检索关于益生菌对实验性急性胰腺炎影响的原始文章，得到13项符合纳入标准的研究。提取了死亡率、细菌移位和胰腺组织学损伤的数据，以及研究质量指标。在PROPATRIA之前发表的四项动物研究的荟萃分析表明，益生菌补充剂不会降低死亡率，降低胰腺的总体组织病理学评分，并减少细菌移位至胰腺和肠系膜淋巴结。在考虑到迄今为止发表的所有相关研究后，发现了类似的结果。对PROPATRIA试验研究方案发表之前（和之后）进行的所有相关动物研究的更全面分析无法预测PROPATRIA试验中发现的益生菌的有害影响。此外，临床前动物研究的荟萃分析确实显示了疗效的证据。然而，可能有人认为，尚未进行与人体试验设计相关的最合适的动物实验，这损害了动物研究和PROPATRIA试验结果之间的公平比较。
In February 2008, the results of the PRObiotics in PAncreatitis TRIAl (PROPATRIA) were published. This study investigated the use of probiotics in patients suffering from severe acute pancreatitis. No differences between the groups were found for any of the primary endpoints. However, mortality in the probiotics group was significantly higher than in the placebo group. This result was unexpected in light of the results of the animal studies referred to in the trial protocol. We used the methods of systematic review and meta-analysis to take a closer look at the relation between the animal studies on probiotics and pancreatitis and the PROPATRIA-trial, focussing on indications for harmful effects and efficacy. Both PubMed and Embase were searched for original articles concerning the effects of probiotics in experimental acute pancreatitis, yielding thirteen studies that met the inclusion criteria. Data on mortality, bacterial translocation and histological damage to the pancreas were extracted, as well as study quality indicators. Meta-analysis of the four animal studies published before PROPATRIA showed that probiotic supplementation did not diminish mortality, reduced the overall histopathological score of the pancreas and reduced bacterial translocation to pancreas and mesenteric lymph nodes. Comparable results were found when all relevant studies published so far were taken into account. A more thorough analysis of all relevant animal studies carried out before (and after) the publication of the study protocol of the PROPATRIA trial could not have predicted the harmful effects of probiotics found in the PROPATRIA-trial. Moreover, meta-analysis of the preclinical animal studies did show evidence for efficacy. It may be suggested, however, that the most appropriate animal experiments in relation to the design of the human trial have not yet been conducted, which compromises a fair comparison between the results of the animal studies and the PROPATRIA trial.
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影响因子：
2.4
作者：
Hooijmans CR;Tillema A;Leenaars M;Ritskes-Hoitinga M
通讯作者：
Ritskes-Hoitinga M
影响因子：
2.4
作者：
de Vries RB;Hooijmans CR;Tillema A;Leenaars M;Ritskes-Hoitinga M
通讯作者：
Ritskes-Hoitinga M
影响因子：
2.9
作者：
Akyol, S;Mas, MR;Kocar, IH
通讯作者：
Kocar, IH
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
3.8
作者：
van Minnen, L. Paul;Timmerman, Harro M.;Akkermans, Louis M. A.
通讯作者：
Akkermans, Louis M. A.