Abstract
Background
The etiology of Hirschsprung’s disease associated enterocolitis (HAEC) is unknown. Previous investigations have suggested that several factors such as dilation of proximal bowel, changes in colonic mucosal defence, and overgrowth of toxigenic bacteria may be related with it. This study was to quantify bifidobacteria and lactobacilli in the feces of Hirschsprung’s disease (HD) patients with or without enterocolitis and those of normal children.
Methods
Fresh stool specimens were collected at the first three days of the admission from 30 HD patients (aged 2 weeks to 2 years) and 15 healthy age-matched non-HD patients in the morning once a day for at least three days. All of them have not been given probiotics or antibiotics at least 7 days before stool collection. Hematoxylin-eosin and acetylcholinesterase histochemical staining on rectal biopsies of patients with HD confirmed the diagnosis of HD in all 30 patients. The 30 HD patients were divided into two groups based on the clinical history of enterocolitis: the HAEC group (n=10) and HD group (n=20). Fecal bifidobacteria and lactobacilli were consecutively quantified by SYBR Green I-based real-time PCR assay. Data were analyzed using SAS v. 12.6 for Windows. All tests were twotailed, and P values <0.05 were considered statistically significant.
Results
The mean levels of bifidobacteria were 7.35±0.59, 8.16±1.17, and 8.35±0.74 in the HAEC, HD and control groups, respectively. The bifidobacteria colonization levels were lower in the HAEC group than in the HD and control groups (P<0.05, P<0.001 respectively). The mean level of lactobacilli in the HAEC (5.51±0.65) and HD groups (5.87±0.78) was significantly lower than that in the control group (6.39±0.56) (P<0.05). But there was no difference in log numbers of lactobacilli between HAEC and HD groups (P>0.05).
Conclusions
The scarcity of bifidobacteria and lactobacilli in HAEC patients may result in a decrease in epithelial barrier function and be a predisposing factor in the development of HAEC. This decline suggests that treatment with probiotics or prebiotics may be beneficial in these individuals. Further research will focus on whether probiotics can decrease the incidence of HAEC.
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References
Hirschsprung H. Stuhlträgheit Neugeborener infolge von Dilatation und Hypertrophie des Colons. Jahrbuch Kinderheilkunde 1887;27:1–7.
Teitelbaum DH, Coran AG. Enterocolitis. Semin Pediatr Surg 1998;7:162–169.
Teitelbaum DH, Caniano DA, Qualman SJ. The pathophysiology of Hirschsprung’s-associated enterocolitis: importance of histologic correlates. J Pediatr Surg 1989;24:1271–1277.
Wilson-Storey D, Scobie WG. Impaired gastrointestinal mucosal defense in Hirschsprung’s disease: a clue to the pathogenesis of enterocolitis? J Pediatr Surg 1989;24:462–464.
Urao M, Fujimoto T, Lane GJ, Seo G, Miyano T. Does probiotics administration decrease serum endotoxin levels in infants? J Pediatr Surg 1999;34:273–276.
Wilson-Storey D, Scobie WG, Raeburn JA. Defective white blood cell function in Hirschsprung’s disease: a possible predisposing factor to enterocolitis. J R Coll Surg Edinb 1988;33:185–188.
Vaarala O. Immunological effects of probiotics with special reference to lactobacilli. Clin Exp Allergy 2003;33:1634–1640.
Fryklund B, Tullus K, Berglund B, Burman LG. Importance of the environment and the faecal flora of infants, nursing staff and parents as sources of gram-negative bacteria colonizing newborns in three neonatal wards. Infection 1992;20:253–257.
Elhalaby EA, Coran AG, Blane CE, Hirschl RB, Teitelbaum DH. Enterocolitis associated with Hirschsprung’s disease: a clinical-radiological characterization based on 168 patients. J Pediatr Surg 1995;30:76–83.
Kaufmann P, Pfefferkorn A, Teuber M, Meile L. Identification and quantification of Bifidobacterium species isolated from food with genus-specific 16S rRNA-targeted probes by colony hybridization and PCR. Appl Environ Microbiol 1997;63:1268–1273.
Satokari RM, Vaughan EE, Akkermans AD, Saarela M, de Vos WM. Bifidobacterial diversity in human feces detected by genus-specific PCR and denaturing gradient gel electrophoresis. Appl Environ Microbiol 2001;67:504–513.
Heilig HG, Zoetendal EG, Vaughan EE, Marteau P, Akkermans AD, de Vos WM. Molecular diversity of Lactobacillus spp. and other lactic acid bacteria in the human intestine as determined by specific amplification of 16S ribosomal DNA. Appl Environ Microbiol 2002;68:114–123.
Chen J, Cai W, Feng Y. Development of intestinal bifidobacteria and lactobacilli in breast-fed neonates. Clin Nutr 2007;26:559–566.
Marty TL, Seo T, Matlak ME, Sullivan JJ, Black RE, Johnson DG. Gastrointestinal function after surgical correction of Hirschsprung’s disease: long-term follow-up in 135 patients. J Pediatr Surg 1995;30:655–658.
Cass DT, Zhang AL, Morthorpe J. Aganglionosis in rodents. J Pediatr Surg 1992;27:351–355; discussion 355–356.
Thomas DF, Fernie DS, Bayston R, Spitz L, Nixon HH. Enterocolitis in Hirschsprung’s disease: a controlled study of the etiologic role of Clostridium difficile. J Pediatr Surg 1986;21:22–25.
Tannock GW, Munro K, Harmsen HJ, Welling GW, Smart J, Gopal PK. Analysis of the fecal microflora of human subjects consuming a probiotic product containing Lactobacillus rhamnosus DR20. Appl Environ Microbiol 2000;66:2578–2588.
Schultz M, Linde HJ, Lehn N, Zimmermann K, Grossmann J, Falk W, et al. Immunomodulatory consequences of oral administration of Lactobacillus rhamnosus strain GG in healthy volunteers. J Dairy Res 2003;70:165–173.
Otte JM, Podolsky DK. Functional modulation of enterocytes by gram-positive and gram-negative microorganisms. Am J Physiol Gastrointest Liver Physiol 2004;286:G613–626.
Campbell JM, Fahey GC Jr, Lichtensteiger CA, Demichele SJ, Garleb KA. An enteral formula containing fish oil, indigestible oligosaccharides, gum arabic and antioxidants affects plasma and colonic phospholipid fatty acid and prostaglandin profiles in pigs. J Nutr 1997;127:137–145.
Delgado S, Flórez AB, Mayo B. Antibiotic susceptibility of Lactobacillus and Bifidobacterium species from the human gastrointestinal tract. Curr Microbiol 2005;50:202–207.
Reuter G. The Lactobacillus and Bifidobacterium microflora of the human intestine: composition and succession. Curr Issues Intest Microbiol 2001;2:43–53.
Ouwehand AC, Salminen S, Arvola T, Ruuska T, Isolauri E. Microbiota composition of the intestinal mucosa: association with fecal microbiota? Microbiol Immunol 2004;48:497–500.
Matsumiya Y, Kato N, Watanabe K, Kato H. Molecular epidemiological study of vertical transmission of vaginal Lactobacillus species from mothers to newborn infants in Japanese, by arbitrarily primed polymerase chain reaction. J Infect Chemother 2002;8:43–49.
Kleessen B, Bunke H, Tovar K, Noack J, Sawatzki G. Influence of two infant formulas and human milk on the development of the faecal flora in newborn infants. Acta Paediatr 1995;84:1347–1356.
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Shen, DH., Shi, CR., Chen, JJ. et al. Detection of intestinal bifidobacteria and lactobacilli in patients with Hirschsprung’s disease associated enterocolitis. World J Pediatr 5, 201–205 (2009). https://doi.org/10.1007/s12519-009-0038-x
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DOI: https://doi.org/10.1007/s12519-009-0038-x