Probiotics prevent Hirschsprung’s disease-associated enterocolitis: a prospective multicenter randomized controlled trial
- 929 Downloads
Enterocolitis (EC) is the most common and serious postoperative complication of Hirschsprung’s disease (HD). Probiotics potentially play a protective role in maintaining intestinal mucosal integrity. Based on the beneficial effects of probiotics, we hypothesized that oral probiotics could decrease the incidence and severity of Hirschsprung’s disease-associated enterocolitis (HAEC).
We conducted a prospective, multicenter, randomized, and controlled trial to assess whether oral probiotics could decrease the incidence and severity of HAEC. HD patients were randomly assigned into the control group and probiotic-treated group. All children in probiotic-treated group were fed with probiotics per day for 4 weeks. In next 3 months, the incidence and severity of HAEC were analyzed. The peripheral blood T lymphocyte subsets and cytokines, including TNF-α, IFN-γ, IL-6, and IL-10, were analyzed by flow cytometry and enzyme immunoassay (EIA).
Compared with the control group, the incidence of HAEC in the probiotic-treated group was significantly diminished. The severity of EC was also remarkably decreased. Furthermore, probiotics balanced T lymphocyte subsets. Moreover, pro-inflammatory cytokines TNF-α, IFN-γ, and IL-6 were significantly decreased and anti-inflammatory cytokine IL-10 was notably increased in probiotic-treated group.
Probiotics not only significantly diminished the incidence but also decreased the severity of HAEC. Moreover, our study revealed that probiotics decreased pro-inflammatory cytokine and increased anti-inflammatory cytokine and furthermore balanced T lymphocytes (registered with ClinicalTrials.gov, NCT number: NCT01934959).
KeywordsProbiotics Hirschsprung’s disease-associated enterocolitis Prospective multicenter randomized controlled trial
This study was funded by National Key Specialty ConstructionProgram (2013544) and National Natural Science Foundation of China (PI:Zhi Li;No:81400579).
Zhi Li and Xiaolin Wang wrote the manuscript. Jiexiong Feng designed the trial and revised the manuscript. Xiaolin Wang, Zhi Li, Zhilin Xu, Zhongrong Wang, and Jiexiong Feng coordinately conducted this trial.
- 14.Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF, Oh W (2005) Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatr 115(1):1–4Google Scholar
- 20.Caneiro P, Brereton R, Drake D et al (1992) Enterocolitis in Hirschsprung’s disease. Pediatr Surg Int 7:356–360Google Scholar
- 21.Teitelbaum DH, Cilley RE, Sherman NJ, Bliss D, Uitvlugt ND, Renaud EJ, Kirstioglu I, Bengston T, Coran AG (2000) A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: a multicenter analysis of outcomes. Ann Surg 232(3):372–380PubMedCentralPubMedCrossRefGoogle Scholar
- 22.De Filippo C, Pini-Prato A, Mattioli G, Avanzini S, Rapuzzi G, Cavalieri D, Di Paola M, Stefanini I, Ceccherini I, Mavilio D, Lionetti P, Jasonni V (2010) Genomics approach to the analysis of bacterial communities dynamics in Hirschsprung’s disease-associated enterocolitis: a pilot study. Pediatr Surg Int 26:465–471PubMedCrossRefGoogle Scholar
- 26.Reis EA, Hagan JE, Ribeiro GS, Teixeira-Carvalho A, Martins-Filho OA, Montgomery RR, Shaw AC, Ko AI, Reis MG (2013) Cytokine response signatures in disease progression and development of severe clinical outcomes for leptospirosis. PLoS Negl Trop Dis 7(9):e2457PubMedCentralPubMedCrossRefGoogle Scholar