Probiotics for Infectious Diarrhea in Children in South India

益生菌治疗印度南部儿童感染性腹泻

• 批准号: 7599643
• 负责人: Honorine D Ward
• 金额: $ 8.05万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7599643
• 关键词: Acute; Adverse event; Antigens; Antiviral Agents; Bacteria; Carbohydrates; Cessation of life; Child; Clinical; Clinical Research; Collaborations; Communities; Complementary therapies; Controlled Clinical Trials; Cryptosporidiosis; Cryptosporidium; Data; Defecation; Developed Countries; Developing Countries; Diarrhea; Disease; Double-Blind Method; Dysentery; Enteral; Epithelial; Food; Frequencies; Future; Gastroenteritis; Gastrointestinal tract structure; Goals; HIV; Healed; Health; Hygiene; Immune response; Immunoglobulin A; Immunoglobulin G; Incidence; India; Infection; Intestines; Investigation; Knowledge; Lactobacillus casei rhamnosus; Lead; Long-Term Effects; Malabsorption Syndromes; Malnutrition; Maternal and Child Health; Measures; Medical center; Morbidity - disease rate; New England; Nutritional status; Oral; Outcome; Permeability; Phase; Pilot Projects; Placebo Control; Placebos; Probiotics; Property; Public Health; Randomized; Randomized Controlled Clinical Trials; Rehydrations; Reporting; Research; Resolution; Rotavirus; Rotavirus Infections; Safety; Serum; Supplementation; Symptoms; System; Vaccines; Viral; Water; Work; absorption; aged; attributable mortality; base; cell mediated immune response; cost; cost effective; effective therapy; healing; improved; innovation; interest; medical schools; microorganism; mortality; nitazoxanide; novel; pathogen; prevent; programs; repaired; response; restoration; treatment effect

DESCRIPTION (provided by applicant): The overall goal of this collaborative study submitted in response to PAR-07-216 (Indo- US Program for Maternal and Child Health) is to investigate whether the modulatory effects of probiotics in the gastrointestinal tract promote restoration of intestinal function and enhance the immune response in children with cryptosporidial or rotaviral infections in South India. Rotavirus and Cryptosporidium spp. are the most important viral and parasitic causes of gastroenteritis in children in south India. Both infections can lead to severe dehydrating gastroenteritis in young children as well as long term deleterious effects on nutritional status, likely due to intestinal damage. Most episodes of infectious gastroenteritis resolve with rehydration, but oral rehydration remains under-utilized, in part due to the lack of effect on frequency of bowel movements and duration of illness. Probiotics are known to beneficially modulate several host functions, the most important of which are immune responses and intestinal barrier integrity. Based on the established efficacy of Lactobacillus rhamnosus GG (LGG) for the treatment of a variety of diarrheal diseases and the documented modulation of immune responses and strengthening of intestinal epithelial barrier function by probiotics, we plan to conduct mechanistic studies on the effect of LGG vs. placebo in the resolution of symptoms and restoration of intestinal function, particularly permeability and carbohydrate absorption, in children with either rotaviral or cryptosporidial diarrhea and no other detected enteric infection. We will also study the effects of four weeks of supplementation with LGG on immune response to these infections. This study is a first step towards the goal of providing an understanding of a complementary therapy to treat acute diarrheal illness and its long term adverse consequences. LGG has the potential to be an easily accessible, cost effective approach to these pathogens of major public health importance. /Relevance Diarrhea causes significant death and disease in developing countries and the agents are usually acquired through food, water and poor hygiene. In these studies, we will study the effect of treatment of children with diarrhea due to the two most common pathogens in southern India, with probiotics or "good" bacteria in order to determine whether they help in preventing or repairing damage to the intestinal wall and whether they help in promoting an immune response that will protect from further infections. These studies are important to help understand whether and how probiotics work in protecting and healing the intestine.

描述（由申请方提供）：本合作研究的总体目标是响应PAR-07-216（印度-美国妇幼健康计划），研究益生菌在胃肠道中的调节作用是否促进了印度南部隐孢子虫或轮状病毒感染儿童的肠道功能恢复并增强了免疫应答。轮状病毒和隐孢子虫属是印度南部儿童胃肠炎最重要的病毒和寄生虫原因。这两种感染都可能导致幼儿严重的脱水性胃肠炎，以及对营养状况的长期有害影响，可能是由于肠道损伤。大多数感染性胃肠炎发作通过补液解决，但口服补液仍然没有得到充分利用，部分原因是对排便频率和疾病持续时间缺乏影响。已知益生菌有益地调节几种宿主功能，其中最重要的是免疫应答和肠屏障完整性。基于鼠李糖乳杆菌GG（LGG）治疗多种肠道疾病的既定功效以及益生菌对免疫应答的调节和肠上皮屏障功能的增强，我们计划对LGG与安慰剂相比在缓解症状和恢复肠道功能（特别是渗透性和碳水化合物吸收）方面的作用进行机制研究，在患有轮状病毒或隐孢子虫腹泻且未检测到其他肠道感染的儿童中。我们还将研究四周补充LGG对这些感染的免疫反应的影响。这项研究是朝着提供一种补充疗法的理解，以治疗急性牙周炎疾病及其长期不良后果的目标迈出的第一步。LGG有可能成为一种容易获得的，具有成本效益的方法，以应对这些具有重大公共卫生意义的病原体。腹泻在发展中国家造成大量死亡和疾病，病原体通常是通过食物、水和不良卫生条件获得的。在这些研究中，我们将研究治疗印度南部两种最常见病原体引起的腹泻儿童的效果，使用益生菌或“好”细菌，以确定它们是否有助于预防或修复肠壁损伤，以及它们是否有助于促进免疫反应，以防止进一步感染。这些研究对于帮助了解益生菌是否以及如何保护和愈合肠道非常重要。