Effect of Lactobacillus GG on intestinal integrity in Malawian children at risk of tropical enteropathy.
BACKGROUND
Tropical enteropathy is an asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. The histology of tropical enteropathy resembles that seen in small-bowel bacterial overgrowth.


OBJECTIVE
This study tested the hypothesis that treatment of 3-5-y-old Malawian children with the probiotic Lactobacillus GG would improve their intestinal function and integrity.


METHODS
Clinically healthy children (n = 164) were enrolled in a placebo-controlled, randomized, double-blind trial. Intestinal function and integrity were measured by using the site-specific sugar-absorption test before and after 30 d of treatment with Lactobacillus GG or placebo. The primary outcomes were the ratios of urinary lactulose to mannitol (L:M) and of urinary sucrose to lactulose (S:L) excretion.


RESULTS
Of the 161 children who completed the study, 119 (73%) had tropical enteropathy on enrollment (L:M > 0.10). Children receiving Lactobacillus GG did not differ significantly from the placebo group in the excretion (in % of dose administered) of mannitol (mean +/- SD: 8.9 +/- 4.4 and 8.9 +/- 3.9, respectively), lactulose (0.31 +/- 0.20 and 0.33 +/- 0.23, respectively), or sucrose (0.078 +/- 0.058 and 0.082 +/- 0.075, respectively). L:M and S:L also did not differ significantly between the Lactobacillus and placebo groups (0.19 +/- 0.13 and 0.20 +/- 0.12, respectively, for L:M; 0.58 +/- 0.46 and 0.65 +/- 0.57, respectively, for S:L).


CONCLUSIONS
Administration of Lactobacillus GG for 30 d had no effect on the intestinal integrity of 3-5-y-old Malawian children.
Galpin
Lauren
L
Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
Manary
Mark J
MJ
Fleming
Katherine
K
Ou
Ching-Nan
CN
Ashorn
Per
P
Shulman
Robert J
RJ
D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005765:Gastrointestinal Agents / Q000493:pharmacokinetics / Q000652:urine; D006801:Humans; D007408:Intestinal Absorption; D007410:Intestinal Diseases / Q000378:metabolism* / Q000473:pathology; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology; D007778:Lactobacillus / Q000502:physiology*; D007792:Lactulose / Q000493:pharmacokinetics / Q000652:urine; D008295:Malawi; D008297:Male; D008353:Mannitol / Q000493:pharmacokinetics / Q000652:urine; D019936:Probiotics / Q000627:therapeutic use*; D012307:Risk Factors; D013395:Sucrose / Q000493:pharmacokinetics / Q000652:urine; D013549:Sweetening Agents / Q000493:pharmacokinetics; D013601:T-Lymphocytes; D016896:Treatment Outcome; D014330:Tropical Medicine
D005765:Gastrointestinal Agents; D013549:Sweetening Agents; D008353:Mannitol; D007792:Lactulose; D013395:Sucrose