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


CONCLUSIONS
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.
Wada
Mariko
M
Department of Laboratory for Probiotics Research, Juntendo University School of Medicine, Tokyo 113-8421, Japan. maro@juntendo.ac.jp
Nagata
Satoru
S
Saito
Masahiro
M
Shimizu
Toshiaki
T
Yamashiro
Yuichiro
Y
Matsuki
Takahiro
T
Asahara
Takashi
T
Nomoto
Koji
K
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D001644:Bifidobacterium; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005243:Feces / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007694:Killer Cells, Natural; D007958:Leukocyte Count; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology; D019936:Probiotics / Q000627:therapeutic use*
D000970:Antineoplastic Agents
Pediatrics. 2002 Apr;109(4):678-84
11927715
Lancet. 2008 Feb 23;371(9613):651-659
18279948
J Dairy Sci. 1991 Apr;74(4):1187-95
1860970
J Appl Microbiol. 2001 Dec;91(6):985-96
11851805
J Infect Dis. 1985 Jul;152(1):99-103
3925032
Acta Paediatr Jpn. 1987 Feb;29(1):160-7
3144842
J Nutr. 2007 Mar;137(3 Suppl 2):791S-3S
17311976
Arch Dis Child Fetal Neonatal Ed. 1997 Mar;76(2):F101-7
9135288
Support Care Cancer. 2006 Mar;14(3):285-90
16175356
Pediatr Infect Dis J. 2005 Mar;24(3):278-80
15750472
Neoplasma. 2005;52(2):159-64
15800715
Appl Environ Microbiol. 2004 Dec;70(12):7220-8
15574920
Med Microbiol Immunol. 1999 Dec;188(3):111-6
10776840
Clin Nutr. 2002 Dec;21(6):527-30
12468374
BMJ. 2002 Jun 8;324(7350):1361
12052801
Br J Nutr. 2007 Oct;98 Suppl 1:S90-5
17922968
Keio J Med. 1987 Jul;36(3):298-314
3682553
Clin Infect Dis. 2003 Mar 15;36(6):775-80
12627362
Adv Exp Med Biol. 1999;473:11-30
10659341
Diagn Microbiol Infect Dis. 1989 Jul-Aug;12(4 Suppl):201S-207S
2686921
Infect Immun. 2004 Apr;72(4):2240-7
15039348
Ann Intern Med. 1972 Nov;77(5):707-14
4628214
J Vet Sci. 2004 Mar;5(1):41-8
15028884
Int J Food Microbiol. 1998 Feb 17;39(3):237-8
9553803
Clin Vaccine Immunol. 2006 Sep;13(9):997-1003
16960110
Gut. 2003 Jul;52(7):988-97
12801956
Curr Opin Clin Nutr Metab Care. 1999 Sep;2(5):405-11
10589383
Eur Urol. 1995;27(2):104-9
7744150
Antonie Van Leeuwenhoek. 1999 Jul-Nov;76(1-4):383-9
10532394