Modification of intestinal flora with multispecies probiotics reduces bacterial translocation and improves clinical course in a rat model of acute pancreatitis
Modification of intestinal flora with multispecies probiotics reduces bacterial translocation and improves clinical course in a rat model of acute pancreatitis
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DOI：
10.1016/j.surg.2006.10.007
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发表时间：
2007-04-01
期刊：
影响因子：
3.8
通讯作者：
Akkermans, Louis M. A.
中科院分区：
文献类型：
--
作者：
van Minnen, L. Paul;Timmerman, Harro M.;Akkermans, Louis M. A.
背景肠道细菌引起的胰腺坏死是重症急性胰腺炎患者发病和死亡的主要原因。预防性抗生素的使用仍然存在争议。本实验的目的是评估用专门设计的多物种益生菌修饰肠道植物群是否减少急性胰腺炎大鼠模型中的细菌移位或改善结果。将雄性Sprague-Dawley大鼠分为3组：（1）对照组（假手术，无治疗），（2）胰腺炎和安慰剂组，以及（3）胰腺炎和益生菌组。通过导管内甘氨脱氧胆酸盐和静脉内蛙皮素输注诱导急性胰腺炎。从诱导胰腺炎前5天至诱导胰腺炎后7天，每日胃内给予益生菌或安慰剂。收集组织和体液样本进行细菌移位的微生物学和定量实时PCR分析。益生菌减少了潜在病原体的十二指肠细菌过度生长（Log（10）菌落形成单位[CFU]/g 5.0 +/- 0.7 [安慰剂] vs 3.5 +/- 0.3 CFU/g [益生菌]，P <0.05），导致细菌移位至肠外部位减少，包括胰腺（5.38 +/- 1.0 CFU/g [安慰剂] vs 3.1 +/- 0.5 CFU/g [益生菌]，P <0.05）。因此，健康评分更好，晚期死亡率降低：分别为27%（4/15，安慰剂）和0%（0/13，益生菌），P <0.05。本实验支持以下假设：在实验性急性胰腺炎的过程中，用多菌种益生菌修饰肠道植物群导致细菌移位、发病率和死亡率降低。
Background. Infection of Pancreatic necrosis by gut bacteria is a major cause of morbidity and mortality in patients with severe acute pancreatitis. Use of prophylactic antibiotics remains controversial. The aim of this experiment was assess if modification of intestinal flora with specifically designed multispecies probiotics reduces bacterial translocation or improves outcome in a rat model of acute pancreatitis.Methods. Male Sprague-Dawley rats were allocated into 3 groups: (1) controls (sham-operated, no treatment), (2) pancreatitis and placebo, and (3) pancreatitis and probiotics. Acute pancreatitis was induced by intraductal glycodeoxycholate and intravenous cerulein infusion. Daily probiotics or placebo was administered intragastrically from 5 days prior until 7 days after induction of pancreatitis. Tissue and fluid samples were collected for microbiologic and quantitative real-time PCR analysis of bacterial translocation.Results. Probiotics reduced duodenal bacterial overgrowth of potential pathogens (Log(10) colony-forming units [CFU]/g 5.0 +/- 0.7 [placebo] vs 3.5 +/- 0.3 CFU/g [probiotics], P < .05), resulting in reduced bacterial translocation to extraintestinal sites, including the pancreas (5.38 +/- 1.0 CFU/g [placebo] vs 3.1 +/- 0.5 CFU/g [probiotics], P < .05). Accordingly, health scores were better and late phase mortality was reduced: 27% (4/15, placebo) versus 0% (0/13, probiotics), respectively, P < .05.Conclusions. This experiment supports the hypothesis that modification of intestinal flora with multispecies probiotics results in reduced bacterial translocation, morbidity, and mortality in the course of experimental acute pancreatitis.