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Lactobacillus plantarum 299v Does Not Reduce Enteric Bacteria or Bacterial Translocation in Patients Undergoing Colon Resection

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Abstract

Background

Probiotics may exert beneficial effects in the gastrointestinal tract. This randomized trial investigated the effect of the probiotic Lactobacillus plantarum 299v on the intestinal load of potentially pathogenic bacteria, bacterial translocation, and cell proliferation in elective colon surgery.

Methods

Seventy-five patients were randomized to pre- and postoperative oral intake of Lactobacillus plantarum 299v or placebo. Rectal swabs and mucosal biopsies were taken before the start of intake, after 1 week, at surgery, and after 6 days, weeks, and months. Viable counts were quantified for clostridia, Enterobacteriaceae, Gram-negative anaerobes, and lactobacilli. Bacterial translocation was determined by the analysis of bacterial DNA genes in mesenteric lymph nodes. Ki-67 was used as a marker of cell proliferation in normal mucosa and tumor.

Results

Lactobacillus plantarum 299v was given without adverse effects. Lactobacillus plantarum 299v as well as Enterobacteriaceae and Gram-negative anaerobes increased in the colon 1 week after the administration of Lactobacillus plantarum 299v. There were no significant differences between patients receiving Lactobacillus plantarum 299v and placebo in the incidence of bacterial translocation (27 vs. 13 %) and postoperative complications (16 vs. 31 %).

Conclusions

Lactobacillus plantarum 299v was established in the intestine, but no inhibitory effect on enteric bacteria, bacterial translocation, or postoperative complications was found. The mechanism behind the protective effects of probiotics found in animal and some human studies remain elusive and require further explorations. No adverse effects were recorded after the administration of high doses of Lactobacillus plantarum 299v.

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References

  1. Schrezenmeir J, de Vrese M. Probiotics, prebiotics, and synbiotics—approaching a definition. Am J Clin Nutr. 2001;73:361S–364S.

    PubMed  CAS  Google Scholar 

  2. Mao Y, Nobaek S, Adawi D, Molin G, Jeppsson B. Comparison of the effects of different strains of Lactobacillus in reducing bacterial translocation on methtrexate-induced enterocolitis in rats. Dig Surg. 1997;14:284–291.

    Article  Google Scholar 

  3. Adawi D, Ahrné S, Molin G. Effects of different probiotic strains of Lactobacillus and Bifidobacterium on bacterial translocation and liver injury in an acute liver injury model. Int J Food Microbiol. 2001;70:213–220.

    Article  PubMed  CAS  Google Scholar 

  4. Mangell P, Lennernäs P, Wang M, et al. Adhesive capability of Lactobacillus plantarum 299v is important for preventing bacterial translocation in endotoxemic rats. APMIS. 2006;114:611–618.

    Article  PubMed  Google Scholar 

  5. Rayes N, Seehofer D, Hansen S, et al. Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation. 2002;74:123–127.

    Article  PubMed  Google Scholar 

  6. Rayes N, Seehofer D, Müller AR, Hansen S, Bengmark S, Neuhaus P. Influence of probiotics and fibre on the incidence of bacterial infections following major abdominal surgery—results of a prospective trial. Z Gastroenterol. 2002;40:869–876.

    Article  PubMed  CAS  Google Scholar 

  7. McNaught CE, Woodcock NP, MacFie J, Mitchell CJ. A prospective randomised study of the probiotic Lactobacillus plantarum 299V on indices of gut barrier function in elective surgical patients. Gut. 2002;51:827–831.

    Article  PubMed  CAS  Google Scholar 

  8. Anderson ADG, McNaught CE, Jain PK, MacFie J. Randomised clinical trial of synbiotic therapy in elective surgical patients. Gut. 2004;53:241–245.

    Article  PubMed  CAS  Google Scholar 

  9. Reddy BS, Gatt M, Sowdi R, MacFie J. Surgical manipulation of the large intestine increases bacterial translocation in patients undergoing elective colorectal surgery. Colorectal Dis. 2006;8:596–600.

    Article  PubMed  CAS  Google Scholar 

  10. Horvat M, Krebs B, Potrc S, Ivanecz A, Kompan L. Preoperative synbiotic bowel conditioning for elective colorectal surgery. Wien Klin Wochenschr. 2010;122:26–30.

    Article  PubMed  Google Scholar 

  11. Klarin B, Wullt M, Palmquist I, Molin G, Larsson A, Jeppsson B. Lactobacillus plantarum 299v reduces colonisation of Clostridium difficile in critically ill patients treated with antibiotics. Acta Anaesthesiol Scand. 2008;52:1096–1102.

    Article  PubMed  CAS  Google Scholar 

  12. Karlsson C, Ahrné S, Molin G, et al. Probiotic therapy to men with incipient arteriosclerosis initiates increased bacterial diversity in colon: a randomized controlled trial. Atherosclerosis. 2010;208:228–233.

    Article  PubMed  CAS  Google Scholar 

  13. Efthymiou C, Hansen PA. An antigenic analysis of Lactobacillus acidophilus. J Infect Dis. 1962;110:258–267.

    Article  PubMed  CAS  Google Scholar 

  14. Quednau M, Ahrné S, Petersson AC, Molin G. Identification of clinically important species of Enterococcus within 1 day with randomly amplified polymorphic DNA (RAPD). Curr Microbiol. 1998;36:332–336.

    Article  PubMed  CAS  Google Scholar 

  15. MacFie J, Reddy BS, Gatt M, Jain PK, Sowdi R, Mitchell CJ. Bacterial translocation studied in 927 patients over 13 years. Br J Surg. 2006;93:87–93.

    Article  PubMed  CAS  Google Scholar 

  16. Johansson M-L, Molin G, Jeppsson B, Nobaek S, Ahrné S, Bengmark S. Administration of different Lactobacillus strains in fermented oatmeal soup: in vivo colonization of human intestinal mucosa and effect on the indigenous flora. Appl Environ Microbiol. 1993;59:15–20.

    PubMed  CAS  Google Scholar 

  17. Johansson M-L, Nobaek S, Berggren A, et al. Survival of Lactobacillus plantarum DSM 9843 (299v), and effect on the short-chain fatty acid content of faeces after ingestion of a rose-hip drink with fermented oats. Int J Food Microbiol. 1998;42:29–38.

    Article  PubMed  CAS  Google Scholar 

  18. Rayes N, Seehofer D, Theruvath T, et al. Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant. 2005;5:125–130.

    Article  PubMed  Google Scholar 

  19. Oláh A, Belágyi T, Issekutz A, Gamal ME, Bengmark S. Randomized clinical trial of specific lactobacillus and fibre supplement to early enteral nutrition in patients with acute pancreatitis. Br J Surg. 2002;89:1103–1107.

    Article  PubMed  Google Scholar 

  20. Besselink MG, van Santvoort HC, Renooij W, et al. Intestinal barrier dysfunction in a randomized trial of a specific probiotic composition in acute pancreatitis. Ann Surg. 2009;250:712–719.

    Article  PubMed  Google Scholar 

  21. Goossens DAM, Jonkers DMAE, Russel MGVM, Stobberingh EE, Stockbrügger RW. The effect of a probiotic drink with Lactobacillus plantarum 299v on the bacterial composition in faeces and mucosal biopsies of rectum and ascending colon. Aliment Pharmacol Ther. 2006;23:255–263.

    Article  PubMed  CAS  Google Scholar 

  22. Thomas S, Kang G, Balasubramanian KA. Surgical manipulation of the intestine results in quantitative and qualitative alterations in luminal Escherichia coli. Ann Surg. 2004;240:248–254.

    Article  PubMed  Google Scholar 

  23. Reddy BS, MacFie J, Gatt M, Larsen CN, Jensen SS, Leser TD. Randomized clinical trial of effect of synbiotics, neomycin and mechanical bowel preparation on intestinal barrier function in patients undergoing colectomy. Br J Surg. 2007;94:546–554.

    Article  PubMed  CAS  Google Scholar 

  24. Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition. 2002;18:609–615.

    Article  PubMed  Google Scholar 

  25. Mack DR, Michail S, Wei S, McDougall L, Hollingsworth MA. Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am J Physiol. 1999;276:G941–G950.

    PubMed  CAS  Google Scholar 

  26. Caballero-Franco C, Keller K, de Simone C, Chadee K. The VSL#3 probiotic formula induces mucin gene expression and secretion in colonic epithelial cells. Am J Physiol Gastrointest Liver Physiol. 2007;292:G315–G322.

    Article  PubMed  CAS  Google Scholar 

  27. Ono S, Tsujimoto H, Yamauchi A, Hiraki S, Takayama E, Mochizuki H. Detection of microbial DNA in the blood of surgical patients for diagnosing bacterial translocation. World J Surg. 2005;29:535–539.

    Article  PubMed  Google Scholar 

  28. Chiba M, Kono M, Hoshina S, et al. Presence of bacterial 16S ribosomal RNA gene segments in human intestinal lymph follicles. Scand J Gastroenterol. 2000;35:824–831.

    Article  PubMed  CAS  Google Scholar 

  29. Langlands SJ, Hopkins MJ, Coleman N, Cummings JH. Prebiotic carbohydrates modify the mucosa associated microflora of the human large bowel. Gut. 2004;53:1610–1616.

    Article  PubMed  CAS  Google Scholar 

  30. Linsalata M, Russo F, Berloco P, et al. Effects of probiotic bacteria (VSL#3) on the polyamine biosynthesis and cell proliferation of normal colonic mucosa of rats. In Vivo. 2005;19:989–995.

    PubMed  CAS  Google Scholar 

  31. Matsuki T, Watanabe K, Fujimoto J, Takada T, Tanaka R. Use of 16S rRNA gene-targeted group-specific primers for real-time PCR analysis of predominant bacteria in human feces. Appl Environ Microbiol. 2004;70:7220–7228.

    Article  PubMed  CAS  Google Scholar 

  32. Rinttilä T, Kassinen A, Malinen E, Krogius L, Palva A. Development of an extensive set of 16S rDNA-targeted primers for quantification of pathogenic and indigenous bacteria in faecal samples by real-time PCR. J Appl Microbiol. 2004;97:1166–1177.

    Article  PubMed  Google Scholar 

  33. Picard FJ, Ke D, Boudreau DK, et al. Use of tuf sequences for genus-specific PCR detection and phylogenetic analysis of 28 streptococcal species. J Clin Microbiol. 2004;42:3686–3695.

    Article  PubMed  CAS  Google Scholar 

  34. Karch H, Schubert S, Zhang D, et al. A genomic island, termed high-pathogenicity island, is present in certain non-O157 Shiga toxin-producing Escherichia coli clonal lineages. Infect Immun. 1999;67:5994–6001.

    PubMed  CAS  Google Scholar 

  35. Nowrouzian F, Adlerberth I, Wold AE. P fimbriae, capsule and aerobactin characterize colonic resident Escherichia coli. Epidemiol Infect. 2001;126:11–18.

    PubMed  CAS  Google Scholar 

  36. Wang RF, Cao WW, Cerniglia CE. PCR detection and quantitation of predominant anaerobic bacteria in human and animal fecal samples. Appl Environ Microbiol. 1996;62:1242–1247.

    PubMed  CAS  Google Scholar 

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Acknowledgments

The authors wish to thank Alejandra Vásquez Moreno, Nadja Elginaid Osman, and Susanne Eiswohld for their excellent technical assistance in the laboratory. Very special thanks go to Ingrid Palmquist for the invaluable logistical management, patient handling, and sampling. Probi AB, Lund, Sweden, kindly provided the study preparations.

Conflict of interest

None.

Funding

This study was funded by the following organizations: the Swedish Cancer Foundation, the Swedish Research Council, Dir. A. Påhlsson’s Foundation, the Gunnar Nilsson Foundation, Malmö University Hospital, Apotekare Hedberg’s Foundation, the Bengt Ihre Foundation, the Ruth and Richard Juhlin Foundation, the Einar and Inga Nilsson Foundation, and the Agnes Nilsson Foundation.

Author information

Authors and Affiliations

  1. Department of Clinical Sciences, Lund University, 205 02, Malmö, Sweden

    Peter Mangell, Henrik Thorlacius, Ingvar Syk, Crister Olsson & Bengt Jeppsson

  2. Department of Surgery, Skane University Hospital, 205 02, Malmö, Sweden

    Peter Mangell, Henrik Thorlacius, Ingvar Syk & Bengt Jeppsson

  3. Department of Food Technology, Engineering and Nutrition, Lund University, 221 00, Lund, Sweden

    Siv Ahrné & Göran Molin

Authors
  1. Peter Mangell
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  2. Henrik Thorlacius
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  4. Siv Ahrné
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  7. Bengt Jeppsson
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Correspondence to Peter Mangell.

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Mangell, P., Thorlacius, H., Syk, I. et al. Lactobacillus plantarum 299v Does Not Reduce Enteric Bacteria or Bacterial Translocation in Patients Undergoing Colon Resection. Dig Dis Sci 57, 1915–1924 (2012). https://doi.org/10.1007/s10620-012-2102-y

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  • DOI: https://doi.org/10.1007/s10620-012-2102-y

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