Effect of probiotic on the fecal slgA level in preterm infants (A randomized double-blind placebo control study)
Keywords:
preterm infant, probiotic, fecal sIgA
Abstract
Background Secretory immunoglobulin A (slgA) plays animportant role in the defense of gastrointestinal tract. Preterm
infants that developed abnormal pattern of bowel colonization
may benefit from strategy to support maturation of humoral im-
munity and endogenous production of slgA by early colonization
with probiotic.
Objective To evaluate the effect of pro biotic on the fecal slgA
level in newborn preterm infants.
Methods A randomized control study of newborn pre term infants
was conducted in NICU Dr Soetomo Hospital, Surabaya in
November-December 2007. Pro biotic group was given multi-
strain pro biotic containing 107 cfu of Lactobacillus acidophil us,
Bifidobacterium longum, and Streptococcus faecium once daily
for 14 days from second day of life. Fecal slgA was determined by
ELISA before and after intervention. Subjects who got respiratory
distress syndrome (RDS) or sepsis during the study was dropped
out. Statistical analysis used in this study were chi-square, inde-
pendent sample t-test, Mann-Whitney, Wilcoxon Signed-Ranks
test, and multivariate analysis of variance (a=O.OS).
Results Forty seven neonates were enrolled, seven of them were
dropped out. Forty analyzed neonates were divided in probiotic
(n = 20) and placebo group (n = 20). The basic characteristics of
two groups were similar. At first examination, median of fecal slgA
level did not differ significantly between groups (P=0.512), 0.164
and 0.174mg/g feces in probiotic and placebo group respectively.
There was higher increment of fecal slgA level in pro biotic than
placebo group post treatment(1.735 versus 1.449 mg/g feces,
P=0.003).
Conclusion Preterm infants may benefit from probiotic because
of the clear tendency to increase fecal slgA secretion
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6:1595-1600.
2. Mestecky J, Russel MW, Elson CO. Intestinal IgA: novel views
on its function in the defence of the largest mucosal surface.
Gut 1999;44:2-5.
3. Woof JM, Mestecky J. Mucosal immunoglobulins. Immunol
Rev 2005;206:64-82.
4. Millar MR, Bacon C, Smith SL,Walker V, Hall MA. Enteral
feeding of premature infants with Lactobacillus GG. Arch
Dis Child 1993;69:483-7.
5. Cebra JJ. Influences of microbiota on intestinal immune
system development. Am] Clin Nutr 1999;69 Suppl5: 1046S-
51S.
6. Stagg AJ, Hart AL, Knight SC, Kamm MA. The dendritic
cell: its role in intestinal inflammation and relationship with
gut bacteria. Gut 2003;52: 1522-9.
7. Zierikzee AM, van Tol EAF, Kroes H. Faecal SigA secretion
in infants fed on pre- or probiotic infant formula. Pediatr
Allergy Immunol 2006; 17:134-40.
8. FAO/WHO. Health and Nutritional Properties of Probiot-
ics in Food including Powder Milk with Live Lactic Acid
Bacteria. Report of a Joint FAO/WHO Expert Consulta-
tion on Evaluation of Health and Nutritional Properties of
Probiotics in Food Including Powder Milk with Live Lactic
Acid Bacteria, 2001.
9. Grewal HM, Karlsen TH, Vetvik H. Measurement of specific
lgA in faecal extracts and intestinal lavage fluid for moni-
toring of mucosal immune responses. J Immunol Methods
2000;239:53-62.
10. Fukushima Y, Kawata Y, Hara H, Terada A, Mitsuoka T. Ef-
fect of a pro biotic formula on intestinal immunoglobulin A
production in healthy children. Int J Food Microbiol1998;4 2
Suppll:39-44.
11. Cukrowska B, Lodi RA, Enders C, Sonnenborn U, Schulze J,
Tlaskalova-Hogenova H. Specific Proliferative and Antibody
Responses of Premature Infants to Intestinal Colonization
with Nonpathogenic Probiotic E. coli Strain Nissle 1917.
Scand J Immunol 2002;55:204-9.
12. Watanabe S, Narisawa Y, Arase S, Okamatsu H, Ikenaga T,
Tajiri, Y, et al. Differences in fecal microflora between patients
with atopic dermatitis and healthy control subjects. J Allergy
Clin Immunol2003;111 Suppl3: 112-9
13. Dion C, Montagne P, Bene MC, Faure G. Measurement of
faecal immunoglobulin A levels in young children. J Clin Lab
Anal2004;18:195-9.
14. Yaguchi Y, Fukatsu K, Moriya T, Maeshima Y, Ikezawa F,
Ornata J. et al. Influences of Long-Term Antibiotic Admin-
istration on Peyer's Patch Lymphocytes and Mucosal Immu-
noglobulin A Levels in a Mouse Model. J Parenter Enteral
Nutr 2006;30:395-399
15. Hoyos AB. Reduced incidence of necrotizing enterocolitis asso-
ciated with enteral administration of Lactobacillus acidophil us
and Bifidobacterium infantis to neonates in an intensive care
unit. Int J Infect Dis 1999;3 Suppl4: 197-202.
16. Lin HC, Su BH, Chen AC, Lin Tw, Tsai CH, Yeh TH, et al.
Oral probiotics reduce the incidence and severity of necrotiz-
ing enterocolitis in very low birth weight infants. Pediatrics
2005; 115:1-4.
17. Millar M, Wilks M, Costeloe K. Probiotics for preterm infants?
Arch Dis Child Fetal Neonatal 2003;88:354-8.
18. Zhang L, LiN, Neu J. Probiotics for pre term infants. NeoR-
eviews 2005;Suppl5:227 -32.
19. Ishibashi N, Yamazaki S. Probiotics and safety. Am J Clin
Nutr 2001;73 Suppl:465S-70S.
20. Kitajima H, Sumida Y, Tanaka R, Yuki N, Takayama H, Fu-
jimira M. Early administration of Bifidobacterium breve to
preterm infants: randomised controlled trial Arch Dis Child
Fetal Neonatal Ed 1997;76 Suppl2:101-7.
21. Uhlemann M, Heine W, Mohr C, Plath C, Pap S. Effects of
oral administration ofbifidobacteria on intestinal microflora
in premature and newborn infants. Z Geburtshilfe Neonatol
1999;203 Suppl5:213-7.
22. Costalos C, Skouteri V, Gounaris A, Sevastiadou S, Trianda-
filidou A, Ekonomidou C, et al. Enteral feeding of premature
infants with Saccharomyces boulardii. Early Human Dev
2003; 7 4:89-96.
Published
2008-08-31
How to Cite
1.
Retnaningtyas L, Sudarmo S, Harsono A, Damanik S. Effect of probiotic on the fecal slgA level in preterm infants (A randomized double-blind placebo control study). PI [Internet]. 31Aug.2008 [cited 26Nov.2024];48(4):246-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/576
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Received 2016-09-10
Accepted 2016-09-10
Published 2008-08-31
Accepted 2016-09-10
Published 2008-08-31
