Probiotics prevent Hirschsprung's disease-associated enterocolitis: a prospective multicenter randomized controlled trial

Int J Colorectal Dis. 2015 Jan;30(1):105-10. doi: 10.1007/s00384-014-2054-0. Epub 2014 Nov 5.

Abstract

Background: 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).

Methods: 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).

Results: 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.

Conclusions: 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).

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • CD4 Antigens / blood
  • CD8 Antigens / blood
  • Child
  • Child, Preschool
  • Cytokines / blood
  • Enterocolitis / blood
  • Enterocolitis / etiology
  • Enterocolitis / prevention & control*
  • Female
  • Hirschsprung Disease / complications*
  • Humans
  • Infant
  • Male
  • Probiotics / therapeutic use*
  • Prospective Studies
  • Severity of Illness Index

Substances

  • CD4 Antigens
  • CD8 Antigens
  • Cytokines

Supplementary concepts

  • Hirschsprung disease 1

Associated data

  • ClinicalTrials.gov/NCT01934959