Probiotics decrease the stress response and intestinal permeability of term neonates with low Apgar scores

Abstract

To observe the effect of probiotics on the stress responses and intestinal permeability of term neonates with low Apgar scores, the present study retrospectively analyzed the clinical data of 78 term neonates (42 males and 36 females). In the control group (n=38), total parenteral nutrition and comprehensive treatment (anti-infection therapy) were provided. In the observation group (n=40), the neonates were administered Lactobacillus Complex Capsules in addition to the control group treatment. The corticotropin-releasing factor level was determined using ELISA; cortisol levels were determined using a radioimmunoprecipitation assay; D-lactate and diamine oxidase levels were determined using ultraviolet spectrometry; procalcitonin levels were determined using ECL; and C-reactive protein levels were determined using a protein analyzer. Following treatment, the levels of all parameters were lower in the observation group compared with the control group, and the differences were statistically significant (P<0.05). In the observation group, the daily milk intake was 16.57±2.58 ml, which was significantly higher than that of the control group (13.26±1.87 ml), while the length of hospital stay and total parenteral nutrition time, which were 12.31±2.02 and 6.21±1.26 days, respectively, in the observation group, were significantly shorter than those of the control group (14.86±2.58 and 8.86±1.78 days, respectively), and the differences were statistically significant (P<0.001). The results of the present study suggested that probiotics can ameliorate the stress response and intestinal permeability of term neonates with low Apgar scores, thereby, facilitating gastrointestinal function recovery.

Reducing Risk Factors for Necrotizing Enterocolitis

“…The stress of hypoxia or sepsis adversely affects the neuroendocrine and GI systems, inducing intestinal permeability and impaired functionality that may be regulated by probiotics 12. A retrospective clinical study from 2018 administered Bifidobacterium triple live capsules to neonates with initial Apgar scores of less than 7 points.…”

“…10 Administration of Bifidobacterium triple live capsules to neonates 37 to 41 weeks was linked to higher daily milk intake than controls (16.57 ± 2.58 mL vs 13.26 ± 1.87 mL). 12…”

“…11 The stress of hypoxia or sepsis adversely affects the neuroendocrine and GI systems, inducing intestinal permeability and impaired functionality that may be regulated by probiotics. 12 A retrospective clinical study from 2018 administered Bifidobacterium triple live capsules to neonates with initial Apgar scores of less than 7 points. Levels of serum corticotropinreleasing factor (CRF), a neuroendocrine peptide regulating the stress response, d-lactate, diamine oxidase (DAO), procalcitonin (PCT), and high-sensitivity C reactive protein (Hs-CRP), were made to determine stress response and tight junction permeability.…”

“…Measures of intestinal permeability and damage (d-lactate, PCT, and DAO) were also significantly lower in the probiotic cohort (P < .001). 12 A subset of patients with LOS may be related to translocation of pathogens from impaired gut barrier function in preterm infants that may be mitigated with colonization by probiotic bacteria. 13 A multicenter, randomized, double-blind (DB), placebo-controlled study dosed preterm infants with Lactobacillus rhamnosus KL53A and Bifidobacterium breve PB04, both stimulators of enteric tight junction proteins.…”

“…6 Risk factors associated with NEC in the preterm infant, such as GI compromise and loss of enteric tight junctions, abnormal colonization with pathogenic species, feeding type and timing, exposure at delivery, and sepsis, 1,7 may be positively impacted by probiotics. Proposed biologic mechanisms of select probiotic strains include competitive colonization, 8 strengthening immunoglobulin A (IgA) mucosal response, 9,10 maintaining tight junctions in the GI tract, [11][12][13] antimicrobial peptides, 5 and upregulation of the immune response. 14 Probiotics are defined by a working group of the Food and Agricultural Organization/World Health Organization (FAO/WHO) as "Live micro-organisms which when administered in adequate amounts confer a health benefit on the host."…”