Intestinal permeability and effects of Lactobacillus rhamnosus therapy in children with short bowel syndrome.
BACKGROUND
The present study was conducted to investigate the effects of Lactobacillus rhamnosus (also known as LGG) on intestinal permeability (IP) in children with short bowel syndrome (SBS).


METHODS
In a double-blind, placebo-controlled crossover clinical trial, baseline IP (ie, lactulose-to-mannitol ratio) was measured in subjects with SBS and healthy control subjects. Subjects with SBS received LGG or placebo for 4 weeks, followed by a 3-week washout before therapy was crossed over for another 4 weeks. IP, quantitative fecal cultures for Lactobacillus species (in colony-forming units [cfu] per gram of stool) and hydrogen breath test (HBT) were performed during LGG and placebo phases of therapy.


RESULTS
Twenty-one children (SBS, n = 9; control, n = 12) with a median age of 4.5 years (range 1.6-16.4 years) enrolled. Baseline IP measurements were similar in patients with SBS and control subjects: 0.08 +/- 0.06 (mean +/- SD) versus 0.07 +/- 0.05 (P = 1.0). IP was correlated with age in control subjects (r = -0.83, P = 0.001) but not among patients with SBS (r = -0.55, P = 0.16). Fecal colonization with Lactobacillus species did not differ during LGG versus placebo therapy (median 1.4 x 10(9) cfu/g [range 4.0 x 10(5) to 4.0 x 10(9) cfu/g] vs 6.0 x 10(9) cfu/g [1.0 x 10(3) to 1.0 x 10(10) cfu/g], respectively; P = 0.83). LGG therapy had no consistent effects on IP (P = 0.58) or its relationship with age (r = -0.40, P = 0.29), and was associated with conversion to positive HBT results in 1 subject.


CONCLUSIONS
In this sample of children with SBS, the IP was within normal limits but did not correlate with age. LGG therapy had no consistent effects on IP. These findings do not support empiric LGG therapy to enhance IP in children with SBS.
Sentongo
Timothy A
TA
Division of Gastroenterology, Hepatology & Nutrition, University of Chicago, Comer Children's Hospital, Chicago, IL 60637, USA. tsentong@peds.bsd.uchicago.edu
Cohran
Valeria
V
Korff
Simona
S
Sullivan
Chris
C
Iyer
Kishore
K
Zheng
Xiaotian
X
D000293:Adolescent; D018988:Bacterial Translocation; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption; D007422:Intestines / Q000382:microbiology / Q000503:physiopathology; D052201:Lacticaseibacillus rhamnosus / Q000254:growth & development / Q000502:physiology*; D008297:Male; D010919:Placebos; D019936:Probiotics / Q000627:therapeutic use*; D012778:Short Bowel Syndrome / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*
D010919:Placebos