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. 2019 Mar 31;32(1):70-76.

Effects of probiotic administration on IGA and IL-6 level in severe burn patients: a randomized trial

I D Saputro  1 , O N Putra  2 , H Pebrianton  3 , Suharjono  4
Affiliations

Effects of probiotic administration on IGA and IL-6 level in severe burn patients: a randomized trial

I D Saputro et al. Ann Burns Fire Disasters. .

Abstract
in English, French

Severe burn injuries are associated with systemic inflammation or even sepsis. A beneficial effect of probiotics on burn patients is reported by regulating the function of the intestinal barrier and reducing inflammation. Immunoglobulin A (IgA) acts as an anti-inflammation antibody, and interleukin 6 (IL-6) as a pro-inflammatory mediator, released extensively in burns. The aim of this study was to investigate the effect of single and mixed strain probiotics on the level of IgA and IL-6 in severe burn patients. A randomized double-blind trial was conducted in the burn centre of the Dr. Soetomo Hospital. Severe burn patients with more than 20% total body surface area burned were randomized into two groups. Group one received a single strain and the second group received mixed strain probiotics, once daily for fourteen days. Serum levels of IgA and IL-6 were measured on day 4 post burn injury (before treatment) and day 19 (after treatment). Seventeen burn patients were enrolled in this study. IgA increased significantly from 1.01±0.67 to 1.89±0.98 mg/mL (p<0.001) in the single strain group, and 0.96±0.48 to 2.10±1.09 mg/mL (p=0.025) in the mixed strain group by paired t-test. There was no significant decrease in IL-6 in either group. No significant differences between the two groups were observed for IgA or IL-6. Administration of single and mixed strain probiotics increased IgA level, while there was no decrease in IL-6 level.

Les patients sévèrement brûlés développent SIRS et sepsis. Un effet positif des probiotiques chez ces patients a été évoqué. Il repose sur la régulation de la barrière intestinale et sur un effet anti inflammatoire. IgA est anti inflammatoire, IL-6, secrétée en très grande quantité chez le brûlé, comme pro inflammatoire. Le but de cette étude randomisée en double aveugle réalisée dans le CTB de l’hôpital Dr Soetomo était d’évaluer l’effet de probiotiques (1 ou plusieurs souches) sur les taux d’IgA et d’IL-6 de 17 patients gravement brûlés (> 20% SCT). Le groupe G1 recevait une seule souche de probiotique, le groupe G2 un mélange de souches, 1 fois par jour pendant 2 semaines. Les taux d’IgA et d’IL-6 étaient mesurés à J4 post-brûlure (avant traitement) et à J19 (après traitement). Les 2 groupes étaient statistiquement comparables. L’augmentation d’IgA était significative dans les 2 groupes : 1,01 +/- 0,67 puis 1,89 +/- 0,98 ; p< 0,001 dans le groupe G1 ; 0,98 +/- 0,48 puis 2,1 +/- 1,09 ; p=0,25 dans le groupe G2. Les variations d’IL6 n’étaient pas significatives. Donc l’administration de 1 ou plusieurs souches de probiotiques augmente les taux d’IgA et ne diminue pas ceux d’IL6.

Keywords: Interleukin-6; burn injury; immunoglobulin A; probiotics.

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Figures

Table I
Table I. Demographic data of this study
Fig. 1
Fig. 1. Overview of the study
Fig. 2
Fig. 2. Causes of burns
Fig. 3
Fig. 3. Mean (±SD) IgA levels in the two groups of patients *Patients in the single strain probiotic group (P=0,000) and mixed strain probiotic group (P=0,025) had significantly higher IgA levels by day 19
Table II
Table II. Serum levels of IgA and IL-6 at day 4 and day 19
Table III
Table III. Outcome data of this study
Fig. 4
Fig. 4. Mean (±SD) IL-6 levels in the two groups of patients *Patients in the single strain probiotic group (P=0,804) and mixed strain probiotic group (P=0,683) had no significantly lower IL-6 levels by day 19
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