Effects Of Probiotics On Cytokines Levels And Clinical Significance In Very-low-birth-weight Preterm Neonates

ObjectiveTo give prophylactic probiotics feeding in very-low-birth-weight preterm neonateswhen these neonates start feeding, and explore cytokines in the system level andclinical changes in these neonates.MethodsA prospective, blinded, randomized controlled trial was conducted in pretermneonates with a birth weight between1000g to1499g.According to the inclusioncriteria, from January1,2011, to October31,2011,we enrolled VLBW pretermneonates who were born in our hospital in this study. The neonates randomly assignedto probiotics group or control group. The neonates in probiotics group assigned toreceive a daily feeding supplementation with probiotics mixture(Bifidobacteriainfantis, Streptococcus thermophilus and Lactobacillus) of0.5×10^7colony formingunits twice per day from the day stared to receive enteral feeding until day28of life.Recording and analyzing the perinatal risk factors, feeding amount, weight gain,clinical variables during hospitalization and the changes of the pro-inflammatory andanti-inflammatory cytokines of Interlukin-l0, Transforming Growth Factor-andTumor Necrosis Factor-in the day of born and day28of life.Results1. There was not significant statistically differences in the perinatal relative factorsand the history of born in these two groups. 2. The incidence of pneumonia was6.7%in the probiotics group, and26.7%in thecontrol group (p=0.038).Probiotics group has lower incidence of neonatal sepsisand used of broad-spectrum antibiotics than the control group, but there was nosignificant statistically difference between them (p>0.05).3. Patients in probiotics group had feeding intolerance less than the control group(10.0%vs33.3%), the difference was statistically significant (p=0.028), in day28after born, probiotics group had a higher proportion of full enteral feeding(p=0.038) than the control group.4. There was no significant statistically differences in birth weight with these twogroup. In the day of21after born, probiotic group has a higher average weightgain than the control group, but the difference has no significant statisticallydifferences (p=0.118). On the day28, probiotic group has a higher averageweight gain than the control group (p=0.043).5. Patients in these two groups have not obviously difference level of IL-10,TGF-and TNF-on birth(p>0.05), but on the day28after birth, patients in theprobiotics group have higher level in IL-10and TGF-,while the level of TNF-were lower than the control group(p=0.043,p=0.006,p=0.001).Conclusion1. Prophylactic probiotics supplementation could increase the system level of IL-10and TGF-, decrease the level of TNF-to keeps the balance betweenpro-inflammatory and anti-inflammatory cytokines in VLBW preterm neonates.2. Prophylactic probiotics do not increase the mobility of sepsis, pneumonia andneonatal necrotizing enterocolitis.3. Prophylactic probiotics improves the gastrointestinal intolerance in pretermneonates weighing less than1500g at birth, shortened to achieve full enteralfeeding and speeds up the progress of weight gain.