Evaluation of Effect of Probiotics on Cytokine Levels in Critically Ill Children With Severe Sepsis
Autor: | Arun Bansal, Muralidharan Jayashree, Suresh Kumar Angurana, Sunit Singhi, Ritu Aggarwal, Navdeep Mangat, Manila Salaria |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Critical Illness medicine.medical_treatment Placebo-controlled study macromolecular substances Critical Care and Intensive Care Medicine Tertiary care law.invention Sepsis Double blind 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial law Intensive Care Units Neonatal Internal medicine medicine Humans 030212 general & internal medicine Child Severe sepsis Critically ill business.industry Probiotics Infant 030208 emergency & critical care medicine medicine.disease Treatment Outcome Cytokine Child Preschool Cytokines Female business Biomarkers |
Zdroj: | Critical Care Medicine. 46:1656-1664 |
ISSN: | 0090-3493 |
Popis: | To evaluate the effect of probiotics on cytokines in children with severe sepsis.Randomized, double-blind, placebo-controlled trial.ICU of a tertiary care teaching hospital in North India.Children 3 months to 12 years old with severe sepsis.Enrolled children were randomized to probiotic (n = 50) and placebo (n = 50) groups. Probiotic group received VSL#3 (Danisco-Dupont USA, Madison, WI) (Lactobacillus paracasei, L. plantarum, L. acidophilus, L. delbrueckii, Bifidobacterium longum, B. infantis, B. breve, Streptococcus salivarius; maltose and silicon dioxide), and placebo group received maltose and silicon dioxide. Dose was 1 sachet twice daily for 7 days. Blood was collected on days 1 and 7 for estimation of interleukin-6, interleukin-12p70, interleukin-17, tumor necrosis factor-α, interleukin-10, and transforming growth factor -β1. "Primary outcome": Change in cytokine levels in probiotic and placebo groups from day 1 to 7. "Secondary outcomes": Sequential Organ Failure Assessment score, healthcare-associated infections, ICU stay, and mortality.On day 7, probiotic group had significantly lower levels of proinflammatory cytokines (interleukin-6 [80 vs 186 pg/mL, p = 0.001]; interleukin-12p70 [44 vs 79 pg/mL, p = 0.001]; interleukin-17 [217 vs 293 pg/mL, p = 0.01]; and tumor necrosis factor-α [192 vs 348 pg/mL, p = 0.01]) and higher levels of antiinflammatory cytokines (interleukin-10 [320 vs 240 pg/mL, p = 0.02] and transforming growth factor-β1 [311 vs 221 ng/mL, p = 0.01]) than placebo group. From day 1 to 7, probiotic group showed significant decrease in proinflammatory cytokines (interleukin-6 [196-80 pg/mL, p = 0.001]; interleukin-12p70 [71-44 pg/mL, p = 0.01]; interleukin-17 [258-217 pg/mL, p = 0.01]; and tumor necrosis factor-α [347-192 pg/mL, p = 0.001]) and increase in antiinflammatory cytokines (interleukin-10 [198-320 pg/mL, p = 0.001] and transforming growth factor-β1 [216-311 ng/mL, p = 0.001]) as compared to placebo group. Sequential Organ Failure Assessment score on day 7 was significantly less in probiotic group (1 vs 3). There was a nonsignificant trend toward lower incidence of healthcare-associated infections (14% vs 20%) and duration of ICU stay (6.5 vs 9 d) in probiotic group. Mortality was similar in two groups.Probiotics supplementation for 7 days resulted in significant decrease in proinflammatory and increase in antiinflammatory cytokines in children with severe sepsis. |
Databáze: | OpenAIRE |
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