Is Lactobacillus GG Helpful in Children With Crohn’s Disease? Results of a Preliminary, Open-Label Study

Gupta, Puneet; Andrew, Haikaeli; Kirschner, Barbara S.; Guandalini, Stefano

doi:10.1097/00005176-200010000-00024

Cited by 364 publications

(205 citation statements)

References 27 publications

Supporting

Mentioning

194

Contrasting

Unclassified

Order By: Relevance

“…18 Oral administration of LGG reduced the severity of Crohn's disease in children as judged by a reduction in PCDAI score. 19 In addition, it has been suggested that Lactobacillus exerts an anti-inflammatory effect in milk-hypersensitive children as a result of downregulation of the immunoinflammatory response. 20 The second aim of this pilot study was to test the hypothesis that the administration of probiotics reduces intestinal inflammation in CF.…”

Section: Introductionmentioning

confidence: 99%

Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration

Bruzzese

Raia

Gaudiello

et al. 2004

Aliment Pharmacol Ther

166

124

View full text Add to dashboard Cite

Summary Aims : To assess the incidence of intestinal inflammation in children with cystic fibrosis and to investigate whether probiotics decrease it. Study design : In this two‐phase, controlled, prospective study, faecal calprotectin was measured by enzyme‐linked immunosorbent assay in 30 children with cystic fibrosis, 30 healthy controls and 15 children with active inflammatory bowel disease. Ten children with cystic fibrosis received Lactobacillus GG, and faecal calprotectin was re‐measured 4 weeks later. Rectal nitric oxide production was measured with the rectal dialysis bag technique in 20 children with cystic fibrosis, 20 healthy controls and 15 children with inflammatory bowel disease. Five children with cystic fibrosis received Lactobacillus GG and nitric oxide was re‐measured 4 weeks later. Results : Mean faecal calprotectin was significantly higher in the two groups of patients than in controls. Abnormal values were detected in 27 of 30 cystic fibrosis and in 15 of 15 inflammatory bowel disease children. Also mean nitric oxide production was increased in both group of patients, and abnormal values were detected in 19 of 20 cystic fibrosis and in 15 of 15 inflammatory bowel disease children. Calprotectin and nitric oxide concentrations were reduced after probiotics administration. Conclusions : Intestinal inflammation is a major feature of cystic fibrosis and is reduced by probiotics. The latter finding suggests that intestinal microflora play a major role in intestinal inflammation in cystic fibrosis children.

show abstract

Section: Introductionmentioning

confidence: 99%

Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration

Bruzzese

Raia

Gaudiello

et al. 2004

Aliment Pharmacol Ther

166

124

View full text Add to dashboard Cite

show abstract

“…21,22 Probiotics have already been used safely in intestinal bowel diseases 23 such as ulcerative colitis or in chronic pouchitis, 24 to decrease symptoms in patients with irritable bowel syndrome, 25 or even to improve the clinical status of children with stable Crohn's disease. 26 In addition, new recombinant strains of probiotics are used as novel therapeutic strategies to deliver vaccines 27 or biologically active compounds such as interleukin-10 in murine colitis. 28,29 Lactobacillus plantarum is a nonpathogenic, noninvasive, Gram-positive bacterium found in the normal mucosal flora of the human mouth and intestine and frequently associated with lactic acid fermented foods of plant origin.…”

mentioning

confidence: 99%

Control of acute, chronic, and constitutive hyperammonemia by wild-type and genetically engineered Lactobacillus plantarum in rodents

et al. 2008

View full text Add to dashboard Cite

Hyperammonemia is a common complication of acute and chronic liver diseases. Often accompanied with side effects, therapeutic interventions such as antibiotics or lactulose are generally targeted to decrease the intestinal production and absorption of ammonia. In this study, we aimed to modulate hyperammonemia in three rodent models by administration of wild-type Lactobacillus plantarum, a genetically engineered ammonia hyperconsuming strain, and a strain deficient for the ammonia transporter. Wild-type and metabolically engineered L. plantarum strains were administered in ornithine transcarbamoylase-deficient Sparse-fur mice, a model of constitutive hyperammonemia, in a carbon tetrachloride rat model of chronic liver insufficiency and in a thioacetamide-induced acute liver failure mice model. Constitutive hyperammonemia in Sparse-fur mice and hyperammonemia in a rat model of chronic hepatic insufficiency were efficiently decreased by Lactobacillus administration. In a murine thioacetamide-induced model of acute liver failure, administration of probiotics significantly increased survival and decreased blood and fecal ammonia. The ammonia hyperconsuming strain exhibited a beneficial effect at a lower dose than its wild-type counterpart. Improved survival in the acute liver failure mice model was associated with lower blood ammonia levels but also with a decrease of astrocyte swelling in the brain cortex. Modulation of ammonia was abolished after administration of the strain deficient in the ammonium transporter. Intestinal pH was clearly lowered for all strains and no changes in gut flora were observed. Conclusion: Hyperammonemia in constitutive model or after acute or chronic induced liver failure can be controlled by the administration of L. plantarum with a significant effect on survival. The mechanism involved in this ammonia decrease implicates direct ammonia consumption in the gut. (HEPATOLOGY 2008;48:1184-1192 H yperammonemia (HA) is a well-known complication of acute and chronic liver diseases and plays a central role in the pathogenesis of hepatic encephalopathy (HE). [1][2][3][4][5] This neurological dysfunction results, at least in part, from an increase in plasma ammonia level and the severity of the symptoms correlates with blood ammonia level. 6-9 Animal models used in studying hyperammonemic disorders are multiple: fulminant hepatic failure, 10 chronic liver failure, 11 or urea cycle deficiency. 12 Ammonia is produced by many tissues but its major external source results from deaminase and urease activities of the gut flora. Although its absorption occurs through the intestinal epithelium, ammonia is carried by the portal vein into the liver where it is metabolized into urea. 13 Classical treatments of HE, except through liver transplantation and liver replacement therapies, consist in decreasing the ammonia production of urease-positive bacteria by antibiotics or decreasing the ammonia absorption into the gut by acidifying the colon content with nonabsorbable sugars such as lactulose. 4,[13][14][1...

show abstract

“…In the maintenance phase there was a non-significant trend towards decreased relapse rates in the E. coli group v. the placebo group. Gupta et al (2000) have examined the effects of LGG in four children with steroid refractory CD, two of whom were taking concomitant metronidazole. Colonisation with LGG and a sustained reduction in disease activity associated with improved intestinal permeability was demonstrated in all patients, suggesting a mechanism for the therapeutic effect.…”

Section: Probiotics and Prebiotics To Treat Activementioning

confidence: 99%

Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials

2007

View full text Add to dashboard Cite

Human subjects and their enteric microbiota have evolved together to reach a state of mutual tolerance. Mounting evidence from both animal models and human studies suggests that inflammatory bowel disease (IBD) represents a malfunction of this relationship. The enteric microecology therefore represents an attractive therapeutic target with few side effects. Probiotics and prebiotics have been investigated in clinical trials as treatments for IBD, with conflicting results. The evidence for the use of probiotics in the management of pouchitis is persuasive and several studies indicate their effectiveness in ulcerative colitis. Trials of probiotics and prebiotics in Crohn's disease are less convincing. However, methodologies vary widely and a range of probiotic, prebiotic and combination (synbiotic) treatments have been tested in a variety of patient groups with an assortment of end points. Conclusions about any one treatment in a specific patient group can therefore only be drawn on evidence from relatively small numbers of patients. The present article reviews the role of the intestinal microbiota in the pathogenesis of IBD and addresses the clinical evidence for the therapeutic manipulation of bowel microbiota using probiotics, prebiotics and synbiotics in IBD.

show abstract

Is Lactobacillus GG Helpful in Children With Crohn’s Disease? Results of a Preliminary, Open-Label Study

Cited by 364 publications

References 27 publications

Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration

Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration

Control of acute, chronic, and constitutive hyperammonemia by wild-type and genetically engineered Lactobacillus plantarum in rodents

Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials

Contact Info

Product

Resources

About