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Effects of probiotics on ghrelin and lungs in children with acute lung injury: A double-blind randomized, controlled
Yu Wang1, Li Gao1, Zhongwen Yang1
1Department of Pediatrics, People's Hospital of Henan Province, Zhengzhou, 450003, Henan Province, China.
Insights
Probiotics significantly reduced lung inflammation and improved pulmonary function in children with acute lung injury (ALI). This intervention also enhanced circulation, suggesting a beneficial role for probiotics in pediatric ALI management.
Area of Science:
- Pediatric critical care medicine
- Gastroenterology
- Immunology
Background:
- Acute lung injury (ALI) in children presents significant challenges in pediatric intensive care units (PICUs).
- Current treatments for ALI focus on supportive care, with limited options to address underlying inflammation and metabolic derangements.
- Ghrelin, a hormone primarily known for appetite regulation, has also been implicated in inflammatory processes and lung protection.
Purpose of the Study:
- To investigate the efficacy of probiotic supplementation in mitigating lung inflammation and improving pulmonary function in pediatric patients diagnosed with ALI.
- To assess the impact of probiotics on serum ghrelin levels and key inflammatory markers in children with ALI.
Main Methods:
- A double-blind, randomized, controlled trial was conducted in a PICU involving children with ALI.
- Participants received either probiotic treatment or a placebo for 10 days.
- Serum levels of ghrelin, surfactant protein-A (SP-A), TNF-α, and IL-6 were measured, alongside pulmonary function tests and echocardiography.
Main Results:
- Probiotic administration led to significantly lower levels of SP-A, TNF-α, and IL-6 compared to the placebo group (P < 0.01).
- Children receiving probiotics showed elevated serum ghrelin levels (P < 0.05) and improved pulmonary function, indicated by higher VPEF and TPEF/TE ratios (P < 0.05).
- Mean arterial pressure (MAP) and pulmonary artery pressure (PAP) also improved in the probiotic group (P < 0.05), with significant correlations observed between ghrelin, inflammatory markers, and hemodynamic parameters.
Conclusions:
- Probiotic supplementation in children with ALI effectively alleviates lung inflammation and enhances pulmonary function.
- The study suggests that probiotics may improve pulmonary circulation and overall respiratory outcomes in pediatric ALI, potentially mediated through ghrelin modulation.
Aim:
To assess the effects of probiotics on serum ghrelin levels and protection for lungs in children with acute lung injury (ALI).
Methods:
This study was performed as a double-blind, randomized, and controlled trial in a pediatric intensive care unit (PICU). The eligible children with ALI were assigned to either probiotic treatment or an identical placebo for 10 days. Serum ghrelin, SP-A(surfactant protein-A), TNF-α, and IL-6 concentrations were assessed at baseline and at the end of trial. Meanwhile, pulmonary function test and echocardiography were examined, then VPEF (volume to peak tidal expiratory flow), TPEF/TE (the ratio of time taken to reach peak expiratory flow to total expiratory time), MAP (mean arterial pressure), and PAP (pulmonary artery pressure) were recorded.
Results:
Eighty participants fulfilled the study requirements with 40 children for each group. The groups were comparable in baseline characteristics. Serum SP-A, TNF-α, and IL-6 levels in the probiotic group were 212.6 ± 52.9 ng/mL, 401.9 ± 56.4 pg/mL, and 245.1 ± 55.1 pg/mL on day 10, respectively, significantly lower levels compared to the control group where the same parameters were 248.2 ± 57 ng/mL, 449.4 ± 60.1 pg/mL, and 308.3 ± 92.2 pg/mL (P < 0.01). However, ghrelin concentrations were elevated in the intervention group (P < 0.05). On measurement of pulmonary function, the probiotic group demonstrated a VPEF of 26.1 ± 4.2 mL and TPEF/TE of 29.1 ± 4.7%, which were higher than the control group (24.7 ± 4.3 mL and 26.9 ± 4.7%, respectively) (P < 0.05). MAP and PAP also improved in the probiotic group (P < 0.05). Furthermore, ghrelin, SP-A, TNF-α, IL-6, and PAP were negatively correlated. Positive correlations were found between ghrelin, TPEF/TE, and MAP. There were no probiotic-associated adverse events during the observation.
Conclusion:
Probiotics administrated to children with ALI alleviates the inflammation of lungs, improves pulmonary function and circulation by ghrelin.
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