Effect of Synbiotics in Reducing the Systemic Inflammatory Response and Septic Complications in Moderately Severe and Severe Acute Pancreatitis: A Prospective Parallel-Arm Double-Blind Randomized Trial

Rohith, Gorrepati; Sureshkumar, Sathasivam; Anandhi, Amaranathan; Kate, Vikram; B, Rajesh; Abdulbasith, K M; Nanda, Nivedita; Chinnakali, Palanivel; Vijayakumar, Chellappa

doi:10.1007/s10620-022-07618-1

Cited by 10 publications

(7 citation statements)

References 23 publications

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“…Therefore, the prevention of bacterial translocation could potentially attenuate the severity of AP and thus, reducing the mortality rate. Clinical studies have shown that probiotics could reduce the length of hospital stay in patients with AP; however, their effects on mortality and infectious complications remain conflicting [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis

Werawatganon

Vivatvakin

Somanawat

et al. 2023

BMC Complement Med Ther

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Background Severe acute pancreatitis is a potentially life-threatening disease. Despite being a common disorder, acute pancreatitis lacks a specific treatment. The present study aimed to examine the effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis. Methods Male ICR mice were randomly divided into 4 groups (n = 6 per group). The control group received two intraperitoneal (i.p.) injections of normal saline as a vehicle control. The acute pancreatitis (AP) group received two i.p. injections of L-arginine 450 mg/100 g body weight. AP plus probiotics groups received L-arginine to induce acute pancreatitis as above. In the single-strain and mixed-strain groups, mice received 1 mL of Lactobacillus plantarum B7 1 × 108 CFU/mL and 1 mL of Lactobacillus rhamnosus L34 1 × 108 CFU/mL and Lactobacillus paracasei B13 1 × 108 CFU/mL by oral gavage, respectively for 6 days starting 3 days prior to the AP induction. All mice were sacrificed 72 h after L-arginine injection. Pancreatic tissue was obtained for histological evaluation and immunohistochemical studies for myeloperoxidase, whereas ileal tissue was used for immunohistochemical studies for occludin, and claudin-1. Blood samples were collected for amylase analysis. Results Serum amylase levels and pancreatic myeloperoxidase levels in the AP group were significantly higher than in controls and significantly decreased in probiotic groups compared with the AP group. Ileal occludin and claudin-1 levels were significantly lower in the AP group than in controls. Ileal occludin levels significantly increased, whereas ileal claudin-1 levels did not significantly change in both probiotic groups as compared with the AP group. The pancreatic histopathology showed significantly higher degree of inflammation, edema, and fat necrosis in the AP group, and these changes improved in mixed-strained probiotic groups. Conclusions Probiotics, particularly the mixed-strain ones, attenuated AP via the reduction of inflammation and the maintenance of intestinal integrity.

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Section: Discussionmentioning

confidence: 99%

Effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis

Werawatganon

Vivatvakin

Somanawat

et al. 2023

BMC Complement Med Ther

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“…Synbiotics have also been shown to reduce septic complications in moderately severe and severe acute pancreatitis patients. Synbiotics significantly reduced LOH without reducing fatality rates or medical interventions ( Table 1 ) in [ 155 ].…”

Section: Probiotics As Allayers Of Gallbladder Ailmentsmentioning

confidence: 99%

The Anti-Inflammatory and Curative Exponent of Probiotics: A Comprehensive and Authentic Ingredient for the Sustained Functioning of Major Human Organs

Virk,

et al. 2024

Nutrients

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Several billion microorganisms reside in the gastrointestinal lumen, including viruses, bacteria, fungi, and yeast. Among them, probiotics were primarily used to cure digestive disorders such as intestinal infections and diarrhea; however, with a paradigm shift towards alleviating health through food, their importance is large. Moreover, recent studies have changed the perspective that probiotics prevent numerous ailments in the major organs. Probiotics primarily produce biologically active compounds targeting discommodious pathogens. This review demonstrates the implications of using probiotics from different genres to prevent and alleviate ailments in the primary human organs. The findings reveal that probiotics immediately activate anti-inflammatory mechanisms by producing anti-inflammatory cytokines such as interleukin (IL)-4, IL-10, IL-11, and IL-13, and hindering pro-inflammatory cytokines such as IL-1, IL-6, and TNF-α by involving regulatory T cells (Tregs) and T helper cells (Th cells). Several strains of Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus casei, Lactobacillus reuteri, Bifidobacterium longum, and Bifidobacterium breve have been listed among the probiotics that are excellent in alleviating various simple to complex ailments. Therefore, the importance of probiotics necessitates robust research to unveil the implications of probiotics, including the potency of strains, the optimal dosages, the combination of probiotics, their habitat in the host, the host response, and other pertinent factors.

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“…Nevertheless, trials that were aimed to reduce the gut pathobiome (collection of pathogens) though antibiotics or enhance the commensal microbiota with pre or probiotics did not lead to an effective and safe prophylactic treatment for administration in the early, hyperinflammatory phase of acute pancreatitis. Two recent randomized trials showed that synbiotics (Bifilac) in moderate and severe pancreatitis and probiotics (Bacillus subtilis and Enterococcus faecium) in mild pancreatitis, respectively, reduced the length of hospital stay but did not affect clinically important outcomes [21,22]. Chen et al [23] have randomized 49 patients with severe acute pancreatitis between soluble dietary fibers (polydextrose) or control.…”

Section: Pre Pro-and Postbioticsmentioning

confidence: 99%

Update on the management of acute pancreatitis

Berg

Boermeester

2023

Current Opinion in Critical Care

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Purpose of reviewThis review provides insight into the recent advancements in the management of acute pancreatitis.Recent findingsModerate fluid resuscitation and Ringer's lactate has advantages above aggressive fluid resuscitation and normal saline, respectively. A normal “on-demand” diet has a positive effect on recovery from acute pancreatitis and length of hospital stay. A multimodal pain management approach including epidural analgesia might reduce unwarranted effects of opiate use. A more targeted use of antibiotics is starting to emerge. Markers such as procalcitonin may be used to limit unwarranted antibiotic use. Conversely, many patients with infected necrotizing pancreatitis can be treated with only antibiotics, although the optimal choice and duration is unclear. Delay of drainage as much as is possible is advised since it is associated with less procedures. If drainage is required, clinicians have an expanding arsenal of interventional options to their disposal such as the lumen-apposing metal stent for transgastric drainage and (repeated) necrosectomy. Immunomodulation using removal of systemic cytokines or anti-inflammatory drugs is an attractive idea, but up to now the results of clinical trials are disappointing. No additional preventive measures beside non-steroidal anti-inflammatory drugs (NSAIDs) can be recommended for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.SummaryMore treatment modalities that are less invasive became available and a trend towards less aggressive treatments (fluids, starvation, interventions, opiates) of acute pancreatitis is again emerging. Despite recent advancements, the pathophysiology of specific subgroup phenotypes is still poorly understood which reflects the disappointing results of pharmacological and immunomodulatory trials.

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Effect of Synbiotics in Reducing the Systemic Inflammatory Response and Septic Complications in Moderately Severe and Severe Acute Pancreatitis: A Prospective Parallel-Arm Double-Blind Randomized Trial

Cited by 10 publications

References 23 publications

Effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis

Effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis

The Anti-Inflammatory and Curative Exponent of Probiotics: A Comprehensive and Authentic Ingredient for the Sustained Functioning of Major Human Organs

Update on the management of acute pancreatitis

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