Viable Probiotics Might Help the Critically Ill

Reuters Health Information 2007.
By David Douglas

NEW YORK (Reuters Health) Mar 27 - Therapy with viable probiotics increases aspects of immune function in critically ill patients receiving intensive care, Canadian researchers report in the March issue of the American Journal of Clinical Nutrition.

"These studies show that live probiotic bacteria are effective in enhancing immune activity in patients at risk of developing sepsis, suggesting that viable probiotic preparations may be effective as adjunctive therapy under a variety of clinical conditions," senior investigator Dr. Karen Madsen told Reuters Health.

Dr. Madsen, of the University of Alberta, Edmonton, and colleagues note that multiple organ dysfunction syndrome (MODS) is a major cause of mortality in intensive care units. A breakdown in gut barrier function and immune dysfunction is associated with the onset of MODS.

The researchers sought to determine whether a probiotic compound in a viable or nonviable formulation might modulate intestinal permeability and immune function and thus prevent the onset of MODS.

To investigate, the team randomized a total of 28 critically-ill medical, surgical and trauma patients to receive daily treatment with viable probiotics, equivalent probiotic bacterial sonicates or placebo.

At the end of the 7-day study, patients in the viable probiotics group had significantly larger increase in systemic IgA and IgG concentrations than those who received sonicates or placebo. They also had a greater reduction in intestinal permeability.

However, there was no significant reduction in MODS score, and the researchers suggest that larger studies in patients with a similar disease profile may be required to demonstrate such an effect.

Am J Clin Nutr 2007;85:816-823.