Methods: Infants age 4 to 12 weeks (N=160) were randomized to one month of a combination of Lactobacillus reuteri DSM 17938 and Bifidobacterium longum infantis on three different schedules: daily, weekly, or biweekly (every two weeks) or to non-probiotic control and followed for two additional months. Stool samples were collected at baseline and weekly throughout the study and urines were collected at baseline and monthly. Intestinal absorption and permeability were estimated using the lactulose-mannitol (LM) ratio. Intestinal markers of inflammation were measured with commercial ELISA assays for myeloperoxidase (MPO) and alpha 1 antitrypsin (A1AT). A preliminary subset of samples is presented here.
Results: Of 82 infants, 65% at baseline and 71% at month 1 had lactulose/mannitol ratios >0.10, which is indicative of environmental enteropathy. At the end of probiotic administration the mean LM ratio was slightly lower in the probiotic arms than in the control arm (0.36 vs 0.47, p=0.68). MPO and A1AT levels in 40 infants were also somewhat lower in the daily arm (MPO = 13461ng/g, A1AT = 924ug/ml), than in the control arm (MPO = 21375ng/g, A1AT = 1211ug/ml, MPO p=0.36, A1AT p=0.34) although A1AT also differed prior to probiotics.
Conclusion: The majority of young infants in this population had evidence of inflammation and environmental enteropathy and this increased as the infants got older. The trend towards better gut function in probiotic arms over time supports further investigation in this area.
Y. E. Hoy-Schulz,
T. Roberts, None
S. Zaidi, None
M. M. Rahman, None
M. Alauddin, None
L. Unicomb, None
S. Luby, Proctor and Gamble: Consultant , Consulting fee
J. Parsonnet, None