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1.
Effects of probiotics on enteric flora and feeding tolerance in preterm infants.
Lee, SJ, Cho, SJ, Park, EA
Neonatology. 2007;(3):174-9
Abstract
BACKGROUND Probiotics are live microbes that colonize the gastrointestinal tract and benefit the host. Preterm infants develop abnormal patterns of bowel colonization, and only a few clinical trials have reported the outcomes of preterm infants treated with probiotics. PURPOSE We investigated the rate of colonization of Lactobacillus and the clinical variables affecting the colonization in preterm infants. METHODS Infants with gestational age less than 37 weeks treated at Ewha Womans University Hospital between March 2003 and July 2004 were eligible. Lactobacillus acidophilus (containing 10(8) CFU) was supplemented orally, mixed with breast milk or formula divided into three doses a day. Stool samples were collected before and 14 days after supplementation of the probiotic. Stool samples were anaerobically cultured on Rogosa agar and identified by Gram stain, catalase test and glucose fermentation test. Clinical characteristics were analyzed. RESULTS Seventy-three patients with an average gestational age of 33.0 +/- 2.5 weeks were studied. Meconium was cultured in 46 patients and Lactobacillus was not detected. Probiotic supplementation began on 3.4 +/- 6.8 days, and after 14 days of supplementation, Lactobacillus was cultured in an average of 3.01 x 10(8) CFU in the stool of 37.0% (27/73) of the patients. There was a tendency towards an increased incidence of sepsis in the Lactobacillus- group (p = 0.082). In the Lactobacillus+ group, a striking increase in feeding tolerance was detected. CONCLUSION In preterm infants, with the administration of probiotics, 37% of the preterm infants had Lactobacillus colonized in the gastrointestinal tract and improved feeding tolerance. A double-blind study is in progress for further investigation into the effect on other systemic diseases in premature infants.
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2.
Pharmacology and gastrointestinal safety of lumiracoxib, a novel cyclooxygenase-2 selective inhibitor: An integrated study.
Atherton, C, Jones, J, McKaig, B, Bebb, J, Cunliffe, R, Burdsall, J, Brough, J, Stevenson, D, Bonner, J, Rordorf, C, et al
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2004;(2):113-20
Abstract
BACKGROUND AND AIMS Lumiracoxib is a structurally novel, acidic selective inhibitor of cyclooxygenase (COX)-2. We coordinated existing methodologies in a single study to evaluate potency, selectivity, and effect on the human gastrointestinal tract. METHODS Twenty four healthy subjects (aged 18-45 years, 12 female) received high dose lumiracoxib (800 mg every day), standard dose naproxen (500 mg twice a day), or placebo for 8 days in a double-blind randomized crossover study. At the start and end of each dosing period, COX-2 selectivity was assessed by ex vivo serum thromboxane B(2) (COX-1) and lipopolysaccharide stimulated prostaglandin (PG) E(2) (COX-2), mucosal injury by endoscopy, and small and large bowel permeability by 0- to 5-hour and 5- to 24-hour (51)Cr-EDTA absorption. Plasma lumiracoxib was measured 2 hours after dosing on day 8 and vortex-stimulated ex vivo gastric mucosal PGE(2) synthesis at the end of each treatment period by enzyme immunoassay. RESULTS Lumiracoxib was well absorbed and demonstrated similar potency to naproxen as a COX-2 inhibitor (77% and 66% inhibition, respectively, vs. placebo), but it differed in being more selective (24% and 97% inhibition of thromboxane B(2) vs. placebo). Gastric PGE(2) was reduced by 69% by naproxen (P < 0.001 vs. placebo) and 29% by lumiracoxib (P < 0.01 vs. placebo and naproxen). No subjects developed gastroduodenal erosions on lumiracoxib (vs. 75% on naproxen and 12.5% on placebo). (51)Cr-EDTA absorption increased significantly with naproxen but not lumiracoxib. CONCLUSIONS Lumiracoxib is a potent selective inhibitor of COX-2 that causes little or no endoscopically detected stomach or duodenal injury or changes in bowel permeability.
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3.
Consumption of Bifidobacterium lactis LKM512 yogurt reduces gut mutagenicity by increasing gut polyamine contents in healthy adult subjects.
Matsumoto, M, Benno, Y
Mutation research. 2004;(2):147-53
Abstract
The possible role of probiotic metabolites on human health effects of probiotics has received little research attention. In this study, we investigated the effects of consumption of Bifidobacterium lactis LKM512-containing yogurt (LKM512 yogurt) on fecal probiotic metabolites (polyamines, lactate, and acetate) and mutagenicity in seven healthy adults (one male and six females; average age: 30.5 years). Each volunteer was provided with 100g/day of LKM512 yogurt or placebo for 2 weeks. Fecal polyamines and mutagenicity were measured by HPLC and the umu-test, respectively. Consumption of LKM512 yogurt increased fecal spermidine levels, but not fecal lactate and acetate contents. The mutagenicity level significantly reduced to 79.2% (10-91.1%) and 47.9% (0-86.8%) following consumption of LKM512 yogurt (P=0.0293) and placebo (P=0.0314), respectively. LKM512 yogurt consumption significantly reduced the mutagenicity level compared with consumption of a placebo (P=0.0489). These results suggest that increased gut spermidine level by LKM512 yogurt was responsible for the reduction of mutagenicity in the gut of healthy adults. We suggest that spermidine produced by LKM512 yogurt consumption contributes to host health as a bioantimutagenic factor; to our knowledge, these substances have not been previously reported as antimutagens from probiotics or fermented milk.
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4.
L-ornithine alpha-ketoglutarate in HIV infection: effects on muscle, gastrointestinal, and immune functions.
Karsegard, VL, Raguso, CA, Genton, L, Hirschel, B, Pichard, C
Nutrition (Burbank, Los Angeles County, Calif.). 2004;(6):515-20
Abstract
OBJECTIVES There have been claims that l-ornithine alpha-ketoglutarate (OKG) exerts anticatabolic, anabolic, and immunomodulating properties. This study aimed at quantifying the effects of OKG on muscle force, body composition, and immune function in outpatients infected with the human immunodeficiency virus (HIV) and presenting weight loss. METHODS Forty-six HIV(+) patients were included in a double-blind, prospective, randomized, controlled trial for 12 wk (10 g/d of OKG or isonitrogenous placebo and nutritional counseling). Podometry, handgrip strength, step test, triceps skinfold thickness, 50-kHz bioelectrical impedance, 3-d diet record, CD4 cell count, HIV-1 RNA concentration (viral load), and gastrointestinal symptoms were assessed at 0, 4, 8, and 12 wk. RESULTS At baseline, patients (OKG, n = 22; placebo, n = 24) has similar CD4 counts (338 +/- 172 and 310 +/- 136 cells/mL), viral load (3.6 +/- 1.3 and 3.5 +/- 1.3 log(10) copies/mL), body mass index (20.0 +/- 2.4 and 20.6 +/- 3.0 kg/m(2)), weight loss (9.0 +/- 3.12 and 9.4 +/- 3.0 kg), and food intake (2509 +/- 962 and 2610 +/- 808 kcal/d). Twenty-nine patients completed the protocol. Both groups increased their body mass index (P = 0.02 versus baseline) and triceps skinfold thickness (P < 0.01 versus baseline). They showed a similar positive correlation between handgrip strength and fat-free mass. Frequency of gastrointestinal symptoms increased in the OKG group (86% versus 54% in the placebo group, P = 0.025). No other differences were observed between groups. CONCLUSIONS All patients increased their body mass index and triceps skinfold thickness due to food supplementation and diet counseling. Oral OKG failed to improve nutritional, functional, or immunologic status in these weight-losing HIV(+) patients and had important gastrointestinal side effects.
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5.
Gastrointestinal symptoms and blood indicators of copper load in apparently healthy adults undergoing controlled copper exposure.
Araya, M, Olivares, M, Pizarro, F, González, M, Speisky, H, Uauy, R
The American journal of clinical nutrition. 2003;(3):646-50
Abstract
BACKGROUND Mild and moderate effects of marginally low and marginally high copper exposure are poorly understood in humans. OBJECTIVE The objective was to assess acute gastrointestinal effects and blood markers of copper status in apparently healthy adults who underwent controlled copper exposure for 2 mo. DESIGN This was a 2-mo, randomized, controlled, double-blind study of 1365 apparently healthy adults in whom acute gastrointestinal symptoms (nausea, vomiting, diarrhea, and abdominal pain) were assessed as responses to copper exposure (<0.01, 2, 4, or 6 mg/L water). Blood markers were measured in 240 participants at the end of the survey. Subjects with anemia, inflammation, or infection were excluded. Serum and erythrocyte copper, peripheral mononuclear cell copper, serum ceruloplasmin, the nonceruloplasmin bound copper fraction, superoxide dismutase activity, hemoglobin, mean corpuscular volume, serum ferritin, and liver enzyme activities were measured. RESULTS The percentage of subjects reporting gastrointestinal symptoms was higher in the 6-mg Cu group than in the <0.01-mg Cu group (P < 0.02). One hundred ninety-five subjects fulfilled the inclusion criteria for the blood studies. Although a significant relation between copper intake and total gastrointestinal symptoms was observed, no relation was found between copper intake or reported symptoms and copper-load variables. CONCLUSIONS Gastrointestinal symptoms increased significantly in response to 6 mg Cu/L water. No detectable changes were observed in indicators of copper status, which suggests competent homeostatic regulation. The results of liver function tests remained normal in all subjects. The lack of change in superoxide dismutase activity supports the Food and Nutrition Board's latest recommendation of 0.9 mg Cu/d for adults.
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6.
The effect of supplemental enteral glutamine on plasma levels, gut function, and outcome in severe burns: a randomized, double-blind, controlled clinical trial.
Zhou, YP, Jiang, ZM, Sun, YH, Wang, XR, Ma, EL, Wilmore, D
JPEN. Journal of parenteral and enteral nutrition. 2003;(4):241-5
Abstract
BACKGROUND This research was conducted to evaluate the effect of enterally administered glutamine (gln) dipeptide on metabolic, gastrointestinal, and outcome parameters after severe burn injury. METHODS Forty thermally injured patients with total body surface burns ranging between 50% and 80%, and third-degree burns ranging between 20% and 40% and without respiratory injuries, were randomized into a prospective, double-blind, controlled clinical trial. One group received gln-enriched enteral nutrition and the other group received the standard enteral formulation. Tube feedings were initiated on postburn day 1 (PBD +1), and isocaloric and isonitrogenous feedings were administered to both groups until PBD +12. The gln was given as the dipeptide of alanyl-gln (Ajinomoto, Tokyo, Japan), which provided 0.35 g gln/kg body weight/d. Plasma amino acid profiles, serum endotoxin concentrations, and the lactulose/mannitol absorption ratio (which reflects gut permeability) were measured at specific times throughout the clinical course. Wound healing at day 30 was assessed, and length of hospital stay and total costs were determined at discharge. RESULTS The 2 groups were similar in terms of age and extent of injury. Plasma gln concentrations were approximately 300 umol/L in both groups on PBD +1 and remained low in the control group (399 +/- 40 umol/L, mean +/- SD) but increased toward normal in the supplemented group to 591 +/- 74 (p = .048). Lactulose/mannitol ratios were increased above normal on POD +1 (control, 0.221 +/- 0.169; gln, 0.268 +/- 0.202; not significant), reflecting increased intestinal permeability after burn injury. On POD +3, the ratio in the gln group was lower than control (0.025 +/- 0.008 versus 0.049 +/- 0.016; p = .0001), and both groups returned toward normal ratios with time. Endotoxin levels on PBD +1 were elevated in both groups (control, 0.089 +/- 0.023 EU/mL; gln, 0.103 +/- 0.037 EU/mL; NS) but decreased significantly on PBD +3 in the patients receiving gln. Hospital stay was significantly shorter in the gln group than controls (67 +/- 4 days versus 73 +/- 6; p = .026). On day 30, wound healing was 86% +/- 2% complete in the gln group compared with 72% +/- 3% in controls (p = .041). Total cost of hospitalization was 62794 +/- 6178 RMB (dollar 7593 +/- 747 US dollars) in the gln group and 68996 +/- 8620RMB (dollar 8343 +/- 1042, p = .031) in controls, although the cost of the enteral nutrition was higher in the gln-supplemented patients. CONCLUSION Enteral gln supplementation using a commercially available dipeptide supported plasma gln levels, improved gut permeability, and initially decreased plasma endotoxin levels in severely thermally injured patients. These alterations were associated with a reduction in the length of hospitalization and lower costs.
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7.
Uranium gastrointestinal absorption: the f1 factor in humans.
Limson Zamora, M, Zielinski, JM, Meyerhof, D, Moodie, G, Falcomer, R, Tracy, B
Radiation protection dosimetry. 2003;(1-4):55-60
Abstract
The present investigation was undertaken by the Department of Health, Canada, to determine the most appropriate value to use for uranium gastrointestinal absorption (f1) in setting the guideline for drinking water. Fifty participants, free from medical problems, were recruited from two communities: a rural area where drinking water, supplied from drilled wells, contained elevated levels of uranium and an urban area where the water supplied by the municipal water system contained < 1 microg l(-1). Uranium intake through food, drinking water and other beverages was monitored using the duplicate diet approach. Intake and excretion were measured by inductively coupled plasma-mass spectrometry (ICP-MS) in samples collected concurrently from the same individuals over a 3 d period. The range of f1 values was between 0.001 and 0.06, with a median of 0.009. These values were independent of gender, age, duration of exposure, daily total uranium intake and allocation of intake between food and water. Consistent with the recommendation of ICRP Publication 69, 78% were below 0.02.
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8.
The effect of Shen-Fu on gastrointestinal tract injury and its potential mechanism during cardio-pulmonary bypass in patients undergoing cardiac surgery.
Xia, ZY, Zhan, LY, He, YH, Liu, XY
Chinese journal of traumatology = Zhonghua chuang shang za zhi. 2003;(4):245-8
Abstract
OBJECTIVE To investigate the effect of Shen-Fu (SF) injection on gastrointestinal tract injury and its potential mechanism. METHODS Thirty-eight patients undergoing elective open heart surgery were assigned to Group C (control group, n=18) and Group SF (n=20) randomly. In Group SF, the patients received intravenous injection of SF (0.5 ml/kg) at the beginning of the surgery followed by a continuous infusion of 100 ml SF (1.0 ml/kg) solution diluted by saline at a rate of 0.004 ml x Kg(-1) x min(-1) with a Grasby pump. The control group was injected with normal saline in the same volume. Gastric intramucosal pH (pHi), activity of blood diamine oxidase (DAO), and concentrations of blood LPS and IL-6 were measured before CPB (S0) and 1 h (S1) and 2 h (S2) after aortic declamping, respectively. RESULTS In Group C, pHi value was significantly lower at S1 and S2 than at S0 (mean P<0.01) and blood DAO and concentrations of LPS and IL-6 were significantly higher at S1 and S2 than at S0 (mean P<0.01). In Group SF, pHi was obviously lower at S1 and S2 than at S0 (P<0.05) but LPS and IL-6 levels and DAO were higher at S0 (mean P<0.05). Blood DAO and LPS level demonstrated significant negative correlations with pHi (mean P<0.01) while LPS concentration showed a positive correlation with blood DAO (P<0.01) and IL-6 concentration (P<0.05). At S1 and S2 after aortic declamping, the levels of pHi were higher in Group SF than in Group C (mean P<0.01 ) but DAO and LPS and IL-6 levels were significantly lower in Group SF than in Group C (P<0.01). CONCLUSIONS SF has a protective effect on gastrointestinal tract and can reduce inflammatory actions.
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9.
Effects of oral Lactobacillus GG on enteric microflora in low-birth-weight neonates.
Agarwal, R, Sharma, N, Chaudhry, R, Deorari, A, Paul, VK, Gewolb, IH, Panigrahi, P
Journal of pediatric gastroenterology and nutrition. 2003;(3):397-402
Abstract
BACKGROUND Colonization patterns, especially by anaerobic flora, may play an important role in neonatal gut function. Probiotics could affect disease risk either directly through colonization or indirectly by promoting changes in gut microbial ecology. METHODS To study the ability of Lactobacillus GG(LGG) to colonize the neonatal gut and modify its microbial ecology, a prospective, randomized study was performed in 71 preterm infants of less than 2000 g birth weight. Infants less than 1500 g (24 treated, 15 control) received 10(9) LGG orally twice daily for 21 days. Those infants weighing 1500 to 1999 g (23 treated, 9 control) were treated for 8 days. Stools were collected before treatment and on day 7 to 8 (and day 14 and 21, in the infants weighing less than 1500 g) for quantitative aerobic and anaerobic cultures. RESULTS Colonization with LGG occurred in 5 of 24 (21%) infants who weighed less than 1500 g versus 11 of 23 (47%) in larger infants. Colonization was limited to infants who were not on antibiotics within 7 days of treatment with LGG. There was a paucity of bacterial species at baseline, although larger infants had more bacterial species (1.59 +/- 0.13 (SEM) vs 1.11 +/- 0.12; P < 0.03) and higher mean log colony forming units (CFU) (8.79 +/- 0.43 vs 7.22 +/- 0.63; P < 0.05) compared with infants weighing less than 1500 g LGG. Treatment in infants weighing less than 1500 g resulted in a significant increase in species number by day 7, with further increases by day 21. This increase was mainly the result of increased Gram (+) and anaerobic species. No difference in species number was noted in controls. Mean log CFU of Gram (-) bacteria did not change in treated infants weighing less than 1500 g. However, Gram (+) mean log CFU showed a significant increase on day 21 (6.1 +/- 0.9) compared with day 0 (3.5 +/- 0.9) (P < 0.05). No significant changes in species number or quantitative counts were noted after LGG treatment in the infants weighing 1500 to 1999 g LGG was well tolerated in all infants. CONCLUSION The neonatal response to a probiotic preparation is dependent on gestational and post-natal age and prior antibiotic exposure. Although LGG is a relatively poor colonizer in infants, especially those infants weighing less than 1500 g at birth, it does appear to affect neonatal intestinal colonization patterns.
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10.
Probiotic bacteria in the management of atopic disease: underscoring the importance of viability.
Kirjavainen, PV, Salminen, SJ, Isolauri, E
Journal of pediatric gastroenterology and nutrition. 2003;(2):223-7
Abstract
OBJECTIVES The aim of this study was to assess the efficacy of oral supplementation of viable and heat-inactivated probiotic bacteria in the management of atopic disease and to observe their effects on the composition of the gut microbiota. METHODS The study population included 35 infants with atopic eczema and allergy to cow's milk. At a mean age of 5.5 months, they were assigned in a randomized double-blind manner to receive either extensively hydrolyzed whey formula (placebo group) or the same formula supplemented with viable (viable LGG group) or heat-inactivated Lactobacillus GG (heat-inactivated LGG group), respectively. The changes in symptoms were assessed by the SCORAD method and the presence of some predominant bacterial genera in the feces detected with 16S rRNA-specific probes. RESULTS The treatment with heat-inactivated LGG was associated with adverse gastrointestinal symptoms and diarrhea. Consequently, the recruitment of patients was stopped after the pilot phase. Within the study population, atopic eczema and subjective symptoms were significantly alleviated in all the groups; the SCORAD scores (interquartile range) decreased from 13 (range, 4-29) to 8 (range, 0-29) units in the placebo group, from 19 (range, 4-47) to 5 (range, 0-18) units in the viable LGG group, and from 15 (range, 0-29) to 7 (range, 0-26) units in the heat-inactivated LGG group. The decrease in the SCORAD scores within the viable LGG group tended to be greater than within the placebo group. The treatments did not appear to affect the bacterial numbers within the genera enumerated. CONCLUSIONS Supplementation of infant formulas with viable but not heat-inactivated LGG is a potential approach for the management of atopic eczema and cow's milk allergy.