Cited by 89Probiotics and Fermented FoodsSepsis Diagnosis and TreatmentGut microbiota and health

Probiotic administration reduces mortality and improves intestinal epithelial homeostasis in experimental sepsis

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Khailova, Ludmila, Frank, Daniel N., Dominguez, Jessica A., Wischmeyer, Paul E.·2013·Anesthesiology

Abstract

BACKGROUND: Recent clinical trials indicate that probiotic administration in critical illness has potential to reduce nosocomial infections and improve clinical outcome. However, the mechanism(s) of probiotic-mediated protection against infection and sepsis remain elusive. The authors evaluated the effects of Lactobacillus rhamnosus GG (LGG) and Bifidobacterium longum (BL) on mortality, bacterial translocation, intestinal epithelial homeostasis, and inflammatory response in experimental model of septic peritonitis. METHODS: Cecal ligation and puncture (n=14 per group) or sham laparotomy (n=8 per group) were performed on 3-week-old FVB/N weanling mice treated concomitantly with LGG, BL, or vehicle (orally gavaged). At 24 h, blood and colonic tissue were collected. In survival studies, mice were given probiotics every 24 h for 7 days (LGG, n=14; BL, n=10; or vehicle, n=13; shams, n=3 per group). RESULTS: Probiotics significantly improved mortality after sepsis (92 vs. 57% mortality for LGG and 92 vs. 50% mortality for BL; P=0.003). Bacteremia was markedly reduced in septic mice treated with either probiotic compared with vehicle treatment (4.39±0.56 vs. 1.07±1.54; P=0.0001 for LGG; vs. 2.70±1.89; P=0.016 for BL; data are expressed as mean±SD). Sepsis in untreated mice increased colonic apoptosis and reduced colonic proliferation. Probiotics significantly reduced markers of colonic apoptosis and returned colonic proliferation to sham levels. Probiotics led to significant reductions in systemic and colonic inflammatory cytokine expression versus septic animals. Our data suggest that involvement of the protein kinase B pathway (via AKT) and down-regulation of Toll-like receptor 2/Toll-like receptor 4 via MyD88 in the colon may play mechanistic roles in the observed probiotic benefits. CONCLUSIONS: Our data demonstrate that probiotic administration at initiation of sepsis can improve survival in pediatric experimental sepsis. The mechanism of this protection involves prevention of systemic bacteremia, perhaps via improved intestinal epithelial homeostasis, and attenuation of the local and systemic inflammatory responses.

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  • Improved survival has been reported in a mouse model of sepsis with probiotics.

    “Improved survival has been reported in a mouse model of sepsis.”

    From The microbiome and critical illness (2016) · cites this paper as [152]

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  1. [14]Clark JA Clark AT Hotchkiss RS Buchman TG Coopersmith CM Epidermal growth factor treatment decreases mortality and is associated with improved gut integrity in sepsis Shock 2008 30 36 42 18004230 PMC2551558
  2. [22]Siempos II Ntaidou TK Falagas ME Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: A meta-analysis of randomized controlled trials Crit Care Med 2010 38 954 62 20016381
  3. [64]Morrow LE Kollef MH Casale TB Probiotic prophylaxis of ventilator-associated pneumonia: A blinded, randomized, controlled trial Am J Respir Crit Care Med 2010 182 1058 64 20522788 PMC2970846

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Authors
Khailova, L., Frank, D. N., Dominguez, J. A., & Wischmeyer, P. E.
Affiliations
  • University of Colorado Anschutz (US)
  • Assistant Professor
Venue
Anesthesiology
Published
2013-07-01
Volume
119
Issue
1
Pages
166-177
ISSN
0003-3022 (ISSN-L)
OpenAlex
W1984035466
Cited by
89
References
69
Citations by year
2026: 2 · 2025: 12 · 2024: 4 · 2023: 12 · 2022: 9 · 2021: 10 · 2020: 6 · 2019: 5 · 2018: 8 · 2017: 2 · 2016: 8 · 2015: 6 · 2014: 2 · 2013: 3
FWCI
9.43
Type
journal article
Language
en
Open access
Locations
  • Anesthesiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of General Medical Sciences (R01GM078312)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
probiotics, sepsis, Lactobacillus rhamnosus GG, Bifidobacterium longum, septic peritonitis, cecal ligation and puncture, mortality, bacterial translocation, bacteremia, intestinal epithelial homeostasis, inflammatory cytokines, Akt signaling, TLR2, TLR4, MyD88, pediatric sepsis, gut-lung axis
MeSH terms
Animals, Bifidobacterium, Colon, Homeostasis, Immunohistochemistry, Intestinal Mucosa, Peritonitis, RNA, Tumor Necrosis Factor-alpha, Blotting, Western, Interleukin-6, Bacteremia, Apoptosis, Sepsis, Probiotics, Cell Proliferation, Proto-Oncogene Proteins c-akt, Oncogene Protein v-akt, Toll-Like Receptors, Mice, Lacticaseibacillus rhamnosus, Real-Time Polymerase Chain Reaction

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