Probiotics and zinc in acute infectious gastroenteritis in children: are they effective?

Salvatore, S.; Hauser, Bruno; Devreker, Thierry; Vieira, Mário César; Luini, C.; Arrigo, Silvio; Nespoli, Luigi; Vandenplas, Yvan

doi:10.1016/j.nut.2007.03.008

Cited by 32 publications

(20 citation statements)

References 82 publications

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“…Nearly five years have elapsed and substantial additional evidence [14], [15], [16], [17], [18], [19] has accumulated since the inception of the practice of zinc supplementation. The existing paradigm strongly supports the notion of zinc supplementation; however, recent scientific reports suggest several interesting cues described below indicate that a more focused approach to zinc supplementation may be required.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Value of Zinc Supplementation in Acute and Persistent Diarrhea: A Systematic Review

et al. 2010

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BackgroundFor over a decade, the importance of zinc in the treatment of acute and persistent diarrhea has been recognized. In spite of recently published reviews, there remain several unanswered questions about the role of zinc supplementation in childhood diarrhea in the developing countries. Our study aimed to assess the therapeutic benefits of zinc supplementation in the treatment of acute or persistent diarrhea in children, and to examine the causes of any heterogeneity of response to zinc supplementation.Methods and FindingsEMBASE®, MEDLINE ® and CINAHL® databases were searched for published reviews and meta-analyses on the use of zinc supplementation for the prevention and treatment of childhood diarrhea. Additional RCTs published following the meta-analyses were also sought. The reviews and published RCTs were qualitatively mapped followed by updated random-effects meta-analyses, subgroup meta-analyses and meta-regression to quantify and characterize the role of zinc supplementation with diarrhea-related outcomes. We found that although there was evidence to support the use of zinc to treat diarrhea in children, there was significant unexplained heterogeneity across the studies for the effect of zinc supplementation in reducing important diarrhea outcomes. Zinc supplementation reduced the mean duration of diarrhea by 19.7% but had no effect on stool frequency or stool output, and increased the risk of vomiting. Our subgroup meta-analyses and meta-regression showed that age, stunting, breast-feeding and baseline zinc levels could not explain the heterogeneity associated with differential reduction in the mean diarrheal duration. However, the baseline zinc levels may not be representative of the existing zinc deficiency state.ConclusionsUnderstanding the predictors of zinc efficacy including the role of diarrheal disease etiology on the response to zinc would help to identify the populations most likely to benefit from supplementation. To improve the programmatic use of zinc, further evaluations of the zinc salts used, the dose, the frequency and duration of supplementation, and its acceptability are required. The significant heterogeneity of responses to zinc suggests the need to revisit the strategy of universal zinc supplementation in the treatment children with acute diarrhea in developing countries.

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Section: Introductionmentioning

confidence: 99%

Therapeutic Value of Zinc Supplementation in Acute and Persistent Diarrhea: A Systematic Review

et al. 2010

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“…The symptoms, which however, diminished by the eight day could be attributed to the active role played by zinc as discovered in a heavy metal analysis (unpublished data). In a metaanalyses by Salvatore et al, 16 and Hoque and Binder 17 , zinc supplementation was confirmed to lessen the duration and severity of acute and chronic diarrhoea and reduce the risk of a recurrent episode for the next 2-3 months. These symptoms being present in only female rats could be because they are more sensitive to acute toxic effects of chemicals than male rats 18 .…”

Section: Discussionmentioning

confidence: 94%

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2018

IJPSR

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Acalypha inferno(AI) is a well-known ornamental plant, presently with no known documentation concerning its therapeutic use and safety profile. However, other plants of the same genus, Acalypha, have been reported to have various uses ranging from food to medicine with their related adverse effects. This study therefore focused on the acute and subchronic toxicity effects of aqueous ethanolic leaf extract of Acalypha inferno leaves (AIE) in animals. The acute toxicity study was performed using the fixed dose method. In the subchronic assessment, both male and female rats were separately administered with AIE at doses of 100 mg/kg, 250 mg/kg and 500 mg/kg twice daily for 28 days. Change in body weight, relative organ weight, haematological parameters and biochemical parameters were recorded and analysed. In the acute toxicity study, no deleterious effect was observed up to 5000 mg/kg, hence the LD 50 ≥5000 mg/kg. In the subchronic toxicity study, significant increase in weight was observed at all doses in male rats whilst a significant decrease was observed only at 500 mg/kg in female rats. A significant increase in weight of uterus was also observed at 100 mg/kg and 250 mg/kg. Decreased levels of ALT, AST, creatinine, WBC and P-LCR were observed, whereas increasing levels of FBG, platelet count and total bilirubin were observed in male rats at high doses. AIE produced no significant adverse effects and could therefore be considered safe with controlled use.

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“…Macro and micro nutrients may directly affect oral (host-bacteria) biofilms by modifying salivary pellicle function (as suggested for milk casein peptides [33]), bacterial glycolysis and other enzymatic events (as suggested for medium-chain fatty acids [34] and zinc [35]) or re- and demineralization events (as suggested for calcium and phosphate [36,37]). Macro and micro nutrients like zinc may also indirectly modify the host innate and immune status among children [38,39], and may act in concert to maintain a biofilm homeostasis to prevent dental caries. Finally, the weak positive associations for carbohydrates/sucrose are consistent with the lack of firm links between sugars and caries in many studies.…”

Section: Discussionmentioning

confidence: 99%

Improved ability of biological and previous caries multimarkers to predict caries disease as revealed by multivariate PLS modelling

et al. 2009

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BackgroundDental caries is a chronic disease with plaque bacteria, diet and saliva modifying disease activity. Here we have used the PLS method to evaluate a multiplicity of such biological variables (n = 88) for ability to predict caries in a cross-sectional (baseline caries) and prospective (2-year caries development) setting.MethodsMultivariate PLS modelling was used to associate the many biological variables with caries recorded in thirty 14-year-old children by measuring the numbers of incipient and manifest caries lesions at all surfaces.ResultsA wide but shallow gliding scale of one fifth caries promoting or protecting, and four fifths non-influential, variables occurred. The influential markers behaved in the order of plaque bacteria > diet > saliva, with previously known plaque bacteria/diet markers and a set of new protective diet markers. A differential variable patterning appeared for new versus progressing lesions. The influential biological multimarkers (n = 18) predicted baseline caries better (ROC area 0.96) than five markers (0.92) and a single lactobacilli marker (0.7) with sensitivity/specificity of 1.87, 1.78 and 1.13 at 1/3 of the subjects diagnosed sick, respectively. Moreover, biological multimarkers (n = 18) explained 2-year caries increment slightly better than reported before but predicted it poorly (ROC area 0.76). By contrast, multimarkers based on previous caries predicted alone (ROC area 0.88), or together with biological multimarkers (0.94), increment well with a sensitivity/specificity of 1.74 at 1/3 of the subjects diagnosed sick.ConclusionMultimarkers behave better than single-to-five markers but future multimarker strategies will require systematic searches for improved saliva and plaque bacteria markers.

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Probiotics and zinc in acute infectious gastroenteritis in children: are they effective?

Cited by 32 publications

References 82 publications

Therapeutic Value of Zinc Supplementation in Acute and Persistent Diarrhea: A Systematic Review

Therapeutic Value of Zinc Supplementation in Acute and Persistent Diarrhea: A Systematic Review

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Improved ability of biological and previous caries multimarkers to predict caries disease as revealed by multivariate PLS modelling

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