Scoping Review: Effects of Probiotics against The Immune System in Burn patients

Abstract

Background: One of the issues in burn patients is decreasing the body immune system and making it difficult to treat. Probiotics, which are commonly used to treat GI tract imbalances, are also known to be able to modulate the immune system. Objectives: This scoping review aims to explore literature about the effects of probiotics on the immune system in burn patients and to identify gaps in the existing literature. Methods: A systematic search was conducted in six electronic databases (PubMed, ScienceDirect, Scopus, Cochrane, EBSCO/CINAHL, DOAJ and other databases) to identify relevant peer-reviewed studies, with time limits from June 2005 until November 2020, using search terms with database-appropriate keywords. Articles were screened and assessed for eligibility. Results: We identified 901 articles. Of these, 10 articles met the inclusion criteria. In this Scoping Review, the proportion of probiotic combination types mostly used multi-strain probiotic combinations. The frequency and types of probiotic strains most widely used was Lactobacillus spp (58%). The highest concentration of oral probiotics route used was in the total probiotic cell content of 109 CFU (42%) and the duration of probiotic administration was 14 days (50%). Meanwhile, improvement of the immune system in burns has been shown by the laboratory outcome parameters (increased the secretion of IgA, decreased of CRP serum, IL-6, leukocytes, and neutrophils), and also the clinical outcome parameters (improvement of GI imbalance, decreased the mortality, decreased the risk of SIRS/sepsis, and shortened Length of Hospital Stay). Conclusions: To perform the modulation of the immune system in burns, the optimal dose, strain, and duration of probiotic administration has not been established or still varies widely. Therefore, more clinical studies are needed using placebos or controls to get better validity regarding the evidence of effectiveness and safety at various degrees of burns.