Altered Gut Flora and Environment in SIRS: Are Synbiotics Viable Treatment Strategy ?

• Shimizu Kentaro

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Ogura Hiroshi

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Goto Miki

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Asahara Takashi

  Yakult Central Institute for Microbiological Research

• Nomoto Koji

  Yakult Central Institute for Microbiological Research

• Morotomi Masami

  Yakult Central Institute for Microbiological Research

• Hiraide Atsushi

  Center for Medical Education, Kyoto University Graduate School of Medicine

• Matsushima Asako

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Tasaki Osamu

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Kuwagata Yasuyuki

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Tanaka Hiroshi

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Shimazu Takeshi

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

• Sugimoto Hisashi

  Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine

Bibliographic Information

Other Title

• ＳＩＲＳ患者における腸内細菌叢，腸内環境の変化とシンバイオティクス療法の有効性
• Are Synbiotics Viable Treatment Strategy?

Abstract

The gut is the natural habitat for a large and dynamic bacterial community, and is considered an important target organ of injury following severe insult such as sepsis, trauma, and shock. Previous reports have shown that critically ill patients are susceptible to injury of the intestinal mucosa, changes in gut permeability, and failure of intestinal defense mechanisms. The impact of bacterial translocation and inflammatory mesenteric lymph on systemic inflammatory responses and multiple organ damage has been investigated in animals, but dynamic changes in the gut flora and environment have not been com-pletely elucidated in critically ill patients. We quantitatively evaluated changes in the gut microflora and environment in patients with SIRS and examined the effects of synbiotic treatment on clinical course. We show the following results with reviews on gut function in critically ill patients. 1) The gut flora and environment are significantly altered in patients with SIRS. Analysis of fecal flora confirmed that patients with SIRS showed significantly lower total anaerobic bacterial counts, in particular, 2-4log units fewer beneficial Bifidobacterium and Lactobacillus and 2log units more pathogenic Staphylococcus and Pseudomonas group counts than did healthy volunteers. Concentrations of total fecal organic acids, in particular, beneficial short-chain fatty acids such as acetic acid, propionic acid, and butyric acid, were significantly decreased in the patients, whereas pH was markedly increased. 2) Synbiotics maintain the gut flora and environment in patients with SIRS and significantly reduce the incidence of septic complications. The incidences of infectious complications in patients with SIRS were significantly lower in the synbiotics group than in the control group (enteritis, 7% vs. 46%, pneumonia, 20% vs. 52%, and bacteremia, 10% vs. 33%, respectively). These beneficial effects of synbiotics in the present study may be due to improved gut flora, increased short-chain fatty acids, and decreased pH. 3) Synbiotics may be used as a novel strategy to protect the critically ill patients from infectious complications. Further study is needed to clarify the mechanisms by which synbiotics decrease septic complications in patients with SIRS.

Journal

• Nihon Kyukyu Igakukai Zasshi

  Nihon Kyukyu Igakukai Zasshi 17 (12), 833-844, 2006

  Japanese Association for Acute Medicine

Keywords

• short-chain fatty acid
• pH

Details

• CRID: 1390282679345610240
• NII Article ID: 10018552157
• NII Book ID: AN10284604
• DOI: 10.3893/jjaam.17.833
• ISSN: 18833772
• ISSN: 0915924X
• Web Site: https://search.jamas.or.jp/link/ui/2007113712
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed