Lactobacillus plantarum Reduces Infection of Pancreatic Necrosis in Experimental Acute Pancreatitis

Abstract

Background: Infection is the commonest cause of death in acute pancreatitis. Early reduction of commensal flora (particularly Lactobacillus species) and, at the same time, overgrowth of Enterobacteriaceae, especially Escherichia coli, have recently been described during acute pancreatitis. Lactobacillus plantarum has been shown to be effective in reducing the egress of endotoxin and microbial translocation in several experimental models such as chemically induced hepatitis and ulcerative colitis. Aim: The aim of the study was to determine whether L. plantarum 299v (Lp 299v) is capable of effectively reducing microbial translocation in experimental pancreatitis. Methods: Acute pancreatitis was induced by isolation and ligation of the biliopancreatic duct in Lewis rats weighing 250–350 g. The animals were divided into 3 groups: group A, sham operation; group B, induction of pancreatitis and no further treatment, and group C, induction of pancreatitis + daily administration by gavage of a 5-ml/day suspension of Lp 299v at 0.5–1.0 × 10⁹ bacteria/ml for 8 days, 4 days before and 4 days after induction of pancreatitis. All animals were sacrificed after 96 h. Histological studies and microbiological analyses were performed. Results: At sacrifice, 40/55 animals showed signs of severe pancreatitis. Since acute pancreatitis was the specific disease investigated, only these animals were subjected to further study. In group B, we found pathogenic micro-organisms in the mesenteric lymph nodes in 14/20 animals and in the pancreatic tissue in 10/20. The bacterial flora consisted predominantly of E. coli, Enterococcus faecalis, Pseudomonas and Proteus species. In contrast, when the animals were kept under an ’umbrella’ of Lp 299v, growth of E. faecalis or E. coli were detected only in 4/20 mesenteric lymph node cultures and in 3/20 pancreatic tissue cultures. Conclusions:Lp 299v is effective in reducing microbial translocation in experimental pancreatitis. Treatment with probiotic bacteria seems to be a promising alternative to antibiotic therapy.

Effects of probiotics on the severity of experimental acute pancreatitis

“…Oláh et al (2002a) reported that when patients with acute pancreatitis received Lactobacillus plantarum 299, they had lower incidence of pancreatic sepsis and needed less surgical interventions compared with control patients. It was also reported that the treatment with probiotics was effective in reducing microbacterial translocation in an experimental pancreatitis model (Mangiante et al, 2001). The rate of bacterial translocation was also affected by administration of probiotics in experimental acute pancreatitis in our study.…”

Probiotics in patients with severe acute pancreatitis: a meta-analysis

“…So another method using probiotics has been proposed to reduce the infection of necrosis by intestinal bacteria. One experimental study is effective in reducing microbial translocation in pancreatitis [24]. The studies of Oláh et al 2002 [14] and Oláh et al 2007 [16] found enteral feeding with probiotic was effective in reducing infections and mortality, as well as reducing the number of surgical interventions.…”

Probiotic strains ofLactobacillusandBifidobacteriumaffect the translocation and intestinal load ofEnterobacteriaceaedifferently after D-galactosamine-induced liver injury in rats

“…Recent reports have shown that the instillation of SCFAs orally or rectally stimulated gut epithelial cell proliferation (36). Results from a previous study showed that L. plantarum DSM 9843 is effective in preventing microbial translocation in experimental pancreatitis (37,38). Recent data demonstrated that pretreatment with L. plantarum protects against Escherichia coli -induced increase in intestinal permeability (39).…”