The effect of probiotics on serum levels of cytokine and endotoxin in peritoneal dialysis patients: a randomised, double-blind, placebo-controlled trial

Abstract

Inflammatory markers such as interleukin (IL)-6 and tumour necrosis factor-alpha (TNF-α) are elevated in dialysis patients and can predict cardiovascular events and all-cause mortality. Endotoxin is an important source and also another marker of inflammation in patients with chronic kidney disease. The aim of this study was to evaluate the impact of oral probiotics on serum levels of endotoxemia and cytokines in peritoneal dialysis (PD) patients. The decline of residual renal function, peritonitis episodes, and cardiovascular events were also recorded. From July 2011 to June 2012, a randomised, double-blind, placebo-controlled trial was conducted in PD patients. The intervention group received one capsule of probiotics containing 10(9) cfu Bifobacterium bifidum A218, 10(9) cfu Bifidobacterium catenulatum A302, 10(9) cfu Bifidobacterium longum A101, and 10(9) cfu Lactobacillus plantarum A87 daily for six months, while the placebo group received similar capsules containing maltodextrin for the same duration. Levels of serum TNF-α, interferon gamma, IL-5, IL-6, IL-10, IL-17, and endotoxin were measured before and six months after intervention. 39 patients completed the study (21 in the probiotics group and 18 in the placebo group). In patients receiving probiotics, levels of serum TNF-α, IL-5, IL-6, and endotoxin significantly decreased after six months of treatment, while levels of serum IL-10 significantly increased. In contrast, there were no significant changes in levels of serum cytokines and endotoxin in the placebo group after six months. In addition, the residual renal function was preserved in patients receiving probiotics. In conclusion, probiotics could significantly reduce the serum levels of endotoxin, pro-inflammatory cytokines (TNF-α and IL-6), IL-5, increase the serum levels of anti-inflammatory cytokine (IL-10), and preserve residual renal function in PD patients.

Efficacy of Probiotics Supplementation On Chronic Kidney Disease: a Systematic Review and Meta-Analysis

“…After reviewing titles, abstracts and full texts, only 9 articles of 8 studies [2,10,11,[17][18][19][20][21][22] were selected for our meta-analysis ( Fig. 1).…”

“…Even in different randomized controlled trials (RCTs), however, the therapeutic regimens of probiotics were inconsistent. Some researchers found a positive effect of probiotics on decreasing inflammation biomarkers in CKD patients [10], while others reported no remarkable changes [11]. A variety of confounding factors, such as treatment duration, diversity of strains, sample size, etc, make studies difficult to be compared directly.…”

Kronik Böbrek Hastalığında Renal İnflamasyon ve Bazı Güncel Diyet Bileşenleri İlişkisi

“…Peritoneal diyaliz tedavisi alan son evre böbrek yetmezliği hastalarında probiyotik suplemantasyonunun (6 ay boyunca her gün; 10 9 koloni oluşturan birim (kob) bifidobakterium bifidum, 10 9 kob bifidobakterium catenulatum, 10 9 kob bifidobakterium longum ve 10 9 kob laktobasillus plantarum içeren kapsül) serum endoksin ve pro-inflamatuvar sitokinlerin (TNF-α ve IL-6) düzeyini düşürdüğü gösterilmiştir. Bunun yanı sıra suplemantasyon ile anti-inflamatuvar sitokinlerin (IL-10) serum düzeyinde anlamlı oranda artış gözlenmiştir (106).…”

Alteraciones en el eje intestino-riñón durante la enfermedad renal crónica: causas, consecuencias y propuestas de tratamiento

“…Entre los resultados destacan la disminución de IS y pCS en plasma Alteraciones en el eje intestino-riñón durante la enfermedad renal crónica: causas, consecuencias y propuestas de tratamiento y de otras toxinas urémicas (dimetilamina y nitrosodimetilamina) 38 . Otro de los objetivos ha sido evaluar el impacto en la respuesta inflamatoria, observando disminución en TNF-α, IL-6 y LPS en 46 pacientes en diálisis peritoneal tras 6 meses de suplementación con Bifidobacterium bifidum, B. catenulatum, B. longum y Lactobacillus plantarum 39 . Se ha descrito también una disminución en proteína C reactiva e indoxil glucorónido en 22 pacientes en hemodiálisis tras 6 meses de suplementación con Streptococcus thermophilus, L. acidophilus y B. longum, sin alcanzar significancia estadística 40 .…”