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01.06.2010 | Original Article

Effects of the enteral administration of Bifidobacterium breve on patients undergoing chemotherapy for pediatric malignancies

verfasst von: Mariko Wada, Satoru Nagata, Masahiro Saito, Toshiaki Shimizu, Yuichiro Yamashiro, Takahiro Matsuki, Takashi Asahara, Koji Nomoto

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2010

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Abstract

Purpose

Probiotics are expected to be effective in prophylaxis of infection in cancer patient, since infections in neutropenics are mainly caused by endogenous flora through the intestinal mucosa. However, the experience with the use of probiotics in immunocompromised patients is limited, and precise fecal bacteria analysis has not been reported. The aim of the study was to evaluate the effects of the enteral administration of the probiotic, Bifidobacterium breve strain Yakult, on its ability to prevent infection, fecal micro flora, and intestinal environments in cancer patients on chemotherapy.

Methods

A placebo-controlled trial was performed at Juntendo University Hospital. Patients with malignancies admitted for chemotherapy (n = 42) were randomized into two groups receiving probiotic or placebo. The effects on infectious complications, natural killer cells, fecal micro flora, fecal organic acid concentrations, and fecal pH were studied.

Results

The frequency of fever and the use of intravenous antibiotics were lower in the probiotic group than the placebo group. The probiotic administration enhanced the habitation of anaerobes. Disruption of the intestinal microbiota after chemotherapy such as the increase in the population levels of Enterobacteriaceae was observed at more pronounced manner in the placebo group in comparison to the probiotic group. The concentrations of total organic acids were maintained most of the time at the normal level, which constantly maintained the pH below 7.0 only in the probiotic group.

Conclusion

These data, although based on a limited number of patients and samples, suggest that administration of B. breve strain Yakult could be an effective approach for achieving clinical benefits in immunocompromised hosts by improving their intestinal environments.

Schimpff SC, Young VM, Greene WH, Vermeulen GD, Moody MR, Wiernik PH (1972) Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Ann Intern Med 77:707–714PubMed

Klastersky J (1989) A review of chemoprophylaxis and therapy of bacterial infections in neutropenic patients. Diagn Microbiol Infect Dis 12:201S–207SCrossRefPubMed

Marshall JC (1999) Gastrointestinal flora and its alterations in critical illness. Curr Opin Clin Nutr Metab Care 2:405–411CrossRefPubMed

Guarner F, Schaafsma GJ (1998) Probiotics. Int J Food Microbiol 39:237–238CrossRefPubMed

Nova E, Warnberg J, Gomez-Martinez S, Diaz LE, Romeo J, Marcos A (2007) Immunomodulatory effects of probiotics in different stages of life. Br J Nutr 98:S90–S95CrossRefPubMed

Van Niel CW, Feudtner C, Garrison MM, Christakis DA (2002) Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 109:678–684CrossRefPubMed

Yasui H, Ohwaki M (1991) Enhancement of immune response in Peyer’s patch cells cultured with Bifidobacterium breve. J Dairy Sci 74:1187–1195CrossRefPubMed

Resta-Lenert S, Barrett KE (2003) Live probiotics protect intestinal epithelial cells from the effects of infection with enteroinvasive Escherichia coli (EIEC). Gut 52:988–997CrossRefPubMed

Takagi A, Matsuzaki T, Sato M, Nomoto K, Morotomi M, Yokokura T (1999) Inhibitory effect of oral administration of Lactobacillus casei on 3-methylcholanthrene-induced carcinogenesis in mice. Med Microbiol Immunol 188:111–116CrossRefPubMed

10.

Aso Y, Akaza H, Kotake T, Tsukamoto T, Imai K, Naito S (1995) Preventive effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer in a double-blind trial. The BLP study group. Eur Urol 27:104–109PubMed

11.

Lee JW, Shin JG, Kim EH, Kang HE, Yim IB, Kim JY et al (2004) Immunomodulatory and antitumor effects in vivo by the cytoplasmic fraction of Lactobacillus casei and Bifidobacterium longum. J Vet Sci 5:41–48PubMed

12.

Takeda K, Okumura K (2007) Effects of a fermented milk drink containing Lactobacillus casei strain shirota on the human NK-cell activity. J Nutr 137:791S–793SPubMed

13.

Shida K, Suzuki T, Kiyoshima-Shibata J, Shimada S, Nanno M (2006) Essential roles of monocytes in stimulating human peripheral blood mononuclear cells with Lactobacillus casei to produce cytokines and augment natural killer cell activity. Clin Vaccine Immunol 13:997–1003CrossRefPubMed

14.

Tojo M, Oikawa T, Morikawa Y, Yamashita N, Iwata S, Satoh Y et al (1987) The effects of Bifidobacterium breve administration on Campylobacter enteritis. Acta Paediatr Jpn 29:160–167PubMed

15.

Hotta M, Sato Y, Iwata S, Yamashita N, Sunakawa K, Oikawa T et al (1987) Clinical effects of Bifidobacterium preparations on pediatric intractable diarrhea. Keio J Med 36:298–314PubMed

16.

Kanamori Y, Hashizume K, Sugiyama M, Mortomi M, Yuki N, Tanaka R (2002) A novel synbiotic therapy dramatically improved the intestinal function of a pediatric patient with laryngotracheo-esophageal cleft (LTEC) in the intensive care unit. Clin Nutr 21:527–530CrossRefPubMed

17.

Sonoike K, Mada M, Mutai M (1986) Selective agar medium for counting viable cells of bifidobacteria in fermented milk. J Food Hyg Soc Jpn 27:238–244

18.

Matsuki T, Watanabe K, Fujimoto J, Takada T, Tanaka R (2004) Use of 16S rRNA gene-targeted group-specific primers for real-time PCR analysis of predominant bacteria in human feces. Appl Environ Microbiol 70:7220–7228CrossRefPubMed

19.

Kikuchi H, Yajima T (1992) Correlation between water-holding capacity of different types of cellulose in vitro and gastrointestinal retention time in vivo of rats. J Sci Food Agric 60:139–146CrossRef

20.

Mego M, Ebringer L, Drgona L, Mardiak J, Trupl J, Greksak R et al (2005) Prevention of febrile neutropenia in cancer patients by probiotic strain Enterococcus faecium M-74. Pilot study phase I. Neoplasma 52:159–164PubMed

21.

Mego M, Koncekova R, Mikuskova E, Drgona L, Ebringer L, Demitrovicova L et al (2006) Prevention of febrile neutropenia in cancer patients by probiotic strain Enterococcus faecium M-74. Phase II study. Support Care Cancer 14:285–290CrossRefPubMed

22.

D’Souza AL, Rajkumar C, Cooke J, Bulpitt CJ (2002) Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. BMJ 324:1361CrossRefPubMed

23.

Yasui H, Shida K, Matsuzaki T, Yokokura T (1999) Immunomodulatory function of lactic acid bacteria. Antonie Van Leeuwenhoek 76:383–389CrossRefPubMed

24.

Berg RD (1999) Bacterial translocation from the gastrointestinal tract. Adv Exp Med Biol 473:11–30PubMed

25.

Tancrède CH, Andremont AO (1985) Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies. J Infect Dis 152:99–103PubMed

26.

Asahara T, Nomoto K, Shimizu K, Watanuki M, Tanaka R (2001) Increased resistance of mice to Salmonella enterica serovar Typhimurium infection by synbiotic administration of Bifidobacteria and transgalactosylated oligosaccharides. J Appl Microbiol 91:985–996CrossRefPubMed

27.

Asahara T, Shimizu K, Nomoto K, Hamabata T, Ozawa A, Takeda Y (2004) Probiotic Bifidobacteria protect mice from lethal infection with Shiga toxin-producing Escherichia coli O157:H7. Infect Immun 72:2240–2247CrossRefPubMed

28.

Asahara T, Shimizu K, Nomoto K, Watanuki M, Tanaka R (2001) Antibacterial effect of fermented milk containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus against indigenous Escherichia coli infection in mice. Microb Ecol Health Dis 13:16–24CrossRef

29.

Borriello SP, Hammes WP, Holzapfel W, Marteau P, Schrezenmeir J, Vaara M et al (2003) Safety of probiotics that contain lactobacilli or bifidobacteria. Clin Infect Dis 36:775–780CrossRefPubMed

30.

De Groote MA, Frank DN, Dowell E, Glode MP, Pace NR (2005) Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 24:278–280CrossRefPubMed

31.

Besselink MG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM et al (2008) Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 371:651–659CrossRefPubMed

32.

Kitajima H, Sumida Y, Tanaka R, Yuki N, Takayama H, Fujimura M (1997) Early administration of Bifidobacterium breve to preterm infants: randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 76:F101–F107CrossRefPubMed

Titel: Effects of the enteral administration of Bifidobacterium breve on patients undergoing chemotherapy for pediatric malignancies
verfasst von: Mariko Wada
Satoru Nagata
Masahiro Saito
Toshiaki Shimizu
Yuichiro Yamashiro
Takahiro Matsuki
Takashi Asahara
Koji Nomoto
Publikationsdatum: 01.06.2010
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 6/2010
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-009-0711-6

Springer Medizin

Effects of the enteral administration of Bifidobacterium breve on patients undergoing chemotherapy for pediatric malignancies