title: Probiotics prevent Hirschsprung's disease-associated enterocolitis: a prospective multicenter randomized controlled trial.
abstract: BACKGROUND
  Enterocolitis (EC) is the most common and serious postoperative complication of Hirschsprung's disease (HD). Probiotics potentially play a protective role in maintaining intestinal mucosal integrity. Based on the beneficial effects of probiotics, we hypothesized that oral probiotics could decrease the incidence and severity of Hirschsprung's disease-associated enterocolitis (HAEC).
  
  
  METHODS
  We conducted a prospective, multicenter, randomized, and controlled trial to assess whether oral probiotics could decrease the incidence and severity of HAEC. HD patients were randomly assigned into the control group and probiotic-treated group. All children in probiotic-treated group were fed with probiotics per day for 4 weeks. In next 3 months, the incidence and severity of HAEC were analyzed. The peripheral blood T lymphocyte subsets and cytokines, including TNF-α, IFN-γ, IL-6, and IL-10, were analyzed by flow cytometry and enzyme immunoassay (EIA).
  
  
  RESULTS
  Compared with the control group, the incidence of HAEC in the probiotic-treated group was significantly diminished. The severity of EC was also remarkably decreased. Furthermore, probiotics balanced T lymphocyte subsets. Moreover, pro-inflammatory cytokines TNF-α, IFN-γ, and IL-6 were significantly decreased and anti-inflammatory cytokine IL-10 was notably increased in probiotic-treated group.
  
  
  CONCLUSIONS
  Probiotics not only significantly diminished the incidence but also decreased the severity of HAEC. Moreover, our study revealed that probiotics decreased pro-inflammatory cytokine and increased anti-inflammatory cytokine and furthermore balanced T lymphocytes (registered with ClinicalTrials.gov, NCT number: NCT01934959).
authors.affiliation: Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wang
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.forename: Zhilin
authors.initials: Z
authors.lastname: Xu
authors.forename: Zhongrong
authors.initials: Z
authors.lastname: Wang
authors.forename: Jiexiong
authors.initials: J
authors.lastname: Feng
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D015704:CD4 Antigens / Q000097:blood; D016827:CD8 Antigens / Q000097:blood; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D004760:Enterocolitis / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006627:Hirschsprung Disease / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D015704:CD4 Antigens; D016827:CD8 Antigens; D016207:Cytokines