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Published on: November 30, 2021
Cytokine responses to symbiotic and lactoferrin combination in very low birth weight neonates: a randomized control
Ozge Serce Pehlevan1, Derya Benzer2, Tugba Gursoy3
1Zeynep Kamil Maternity and Children's Training and Research Hospital, Neonatology Unit, Istanbul, Turkey. ozge_serce@hotmail.com.
Insights
This study found that a symbiotic combination of probiotics and oligosaccharides with lactoferrin reduced interleukin-10 (IL-10) levels in very low birth weight neonates. Other cytokine levels did not significantly change with this intervention.
Area of Science:
- Neonatal immunology
- Gastroenterology
- Microbiome research
Background:
- Probiotics and prebiotics show potential in managing chronic mucosal inflammation, including necrotizing enterocolitis prevention.
- The precise immunomodulatory mechanisms and outcomes of these agents remain unclear.
- Investigating the cytokine response in vulnerable neonates is crucial for understanding therapeutic effects.
Purpose of the Study:
- To evaluate the impact of a symbiotic combination (probiotics and oligosaccharides) plus lactoferrin on cytokine profiles in very low birth weight neonates.
- To clarify the immunomodulatory effects of this specific symbiotic and lactoferrin formulation.
Main Methods:
- A randomized placebo-controlled trial involving very low birth weight infants (≤ 32 GWs, ≤ 1,500 g).
- Intervention group received a symbiotic combination and lactoferrin; control group received placebo.
- Serum cytokine levels (interferon-gamma, IL-5, IL-10, IL-17A) were measured at multiple time points post-birth.
Main Results:
- The study group showed a significant decrease in interleukin-10 (IL-10) levels over the study period (p = 0.011).
- Interleukin-5 (IL-5) levels decreased in the study group after 14 days (p = 0.042), while fluctuating in the control group.
- No significant changes were observed in interferon-gamma or IL-17A levels in either group.
Conclusions:
- The combined administration of probiotics, oligosaccharides, and lactoferrin is associated with a reduction in IL-10 levels in very low birth weight neonates.
- The intervention did not significantly alter other measured cytokine levels.
- Further research is needed to fully elucidate the clinical implications of these immunomodulatory changes.
Introduction:
Probiotics and prebiotics, which are multifunctional agents, have potential benefits in chronic mucosal inflammation, including the prevention of necrotizing enterocolitis. However, the mechanisms and the results of these immunomodulatory effects are not clear. This study aimed to investigate the cytokine response to the combination of Lactobacillus and Bifidobacterium together with fructo- and galacto-oligosaccharides (symbiotic) and lactoferrin in very low birth weight neonates.
Population And Methods:
Infants ≤ 32 GWs and ≤ 1,500 g were randomly assigned to receive a symbiotic combination or 1 ml distilled water as placebo starting with the first feed until discharge. Blood samples were obtained at postnatal 0 ± 2, 14 ± 2, and 28 ± 2 days, and the serum levels of interferon-y, interleukin (IL)-5, IL-10, and IL-17A were measured.
Results:
In the study group (n = 25), the IL-10 levels decreased throughout the study period (p = 0.011) but did not change in the control group. The IL-5 levels remained steady in the first 14 days and decreased significantly thereafter (p = 0.042) in the study group, whereas they increased in the first 14 days (p = 0.019), and then decreased in 28 days (p = 0.011) in the control group (n = 25). The levels of the other cytokines did not change throughout the study period.
Conclusion:
The combined use of probiotics with oligosaccharides and lactoferrin was associated with a decrease in IL-10 levels, but no change was observed in the other cytokines.
