Background: Infection is the commonest cause of death in acute pancreatitis. Early reduction of commensal flora (particularly Lactobacillus species) and, at the same time, overgrowth of Enterobacteriaceae, especially Escherichia coli, have recently been described during acute pancreatitis. Lactobacillus plantarum has been shown to be effective in reducing the egress of endotoxin and microbial translocation in several experimental models such as chemically induced hepatitis and ulcerative colitis. Aim: The aim of the study was to determine whether L. plantarum 299v (Lp 299v) is capable of effectively reducing microbial translocation in experimental pancreatitis. Methods: Acute pancreatitis was induced by isolation and ligation of the biliopancreatic duct in Lewis rats weighing 250–350 g. The animals were divided into 3 groups: group A, sham operation; group B, induction of pancreatitis and no further treatment, and group C, induction of pancreatitis + daily administration by gavage of a 5-ml/day suspension of Lp 299v at 0.5–1.0 × 109 bacteria/ml for 8 days, 4 days before and 4 days after induction of pancreatitis. All animals were sacrificed after 96 h. Histological studies and microbiological analyses were performed. Results: At sacrifice, 40/55 animals showed signs of severe pancreatitis. Since acute pancreatitis was the specific disease investigated, only these animals were subjected to further study. In group B, we found pathogenic micro-organisms in the mesenteric lymph nodes in 14/20 animals and in the pancreatic tissue in 10/20. The bacterial flora consisted predominantly of E. coli, Enterococcus faecalis, Pseudomonas and Proteus species. In contrast, when the animals were kept under an ’umbrella’ of Lp 299v, growth of E. faecalis or E. coli were detected only in 4/20 mesenteric lymph node cultures and in 3/20 pancreatic tissue cultures. Conclusions:Lp 299v is effective in reducing microbial translocation in experimental pancreatitis. Treatment with probiotic bacteria seems to be a promising alternative to antibiotic therapy.

Keywords:
Acute pancreatitis, Experimental pancreatitis, Lactobacillus plantarum
1.
Beger HG, Bittner R, Buchler M: Bacterial contamination of pancreatic necrosis – A prospective clinical study. Gastroenterology 1986;91:433–438.
2.
Buchler M, Malfertheiner P, Friess H, Isenmann R, Vanek E, Grimm H, Schegel P, Friess T, Beger HG: Human pancreatic tissue concentration of bactericidal antibiotics. Gastroenterology 1992;103:1902–1908.
3.
Bassi C, Falconi M, Talamini G, Uomo G, Papaccio G, Dervenis C, Salvia R, Minelli EB, Pederzoli P: Controlled clinical trial of pefloxacin vs. imipenem in severe acute pancreatitis. Gastroenterology 1998;115:1513–1517.
4.
Deitch EA, Maejima K, Berg R: Effect of oral antibiotics and bacterial overgrowth on the translocation of the GI tract microflora in burned rats. J Trauma 1985;25:385–392.
5.
Redan JA, Rush BF, Lysz TW, Smith S, Machiedo SW: Organ distribution of gut-derived bacteria caused by bowel manipulation ischemia. Am J Surg 1990;159:85–89.
6.
Maddaus MA, Wells CL, Platt JL, Candie RM, Simmons RL: Effect of T cell modulation on the translocation of bacteria from the gut and mesenteric lymph nodes. Ann Surg 1988:207: 387–398.
7.
Runkel NSF, Moody FG, Smith GS, Rodriguez LF, La Rocco MT, Miller TA: The role of the gut in the development of acute pancreatitis. J Surg Res 1991;51:18–23.
8.
Baker JW, Deitch EA, Li M, Berg RD, Specian RD: Hemorrhagic shock induces bacterial translocation from the gut. J Trauma 1988;28:896–906.
9.
Sori AJ, Rush BF, Lysz TW: The gut as a source of sepsis after hemorrhagic shock. Am J Surg 1988;155:187–192.
10.
Leveau P, Wang X, Soltesz V: Alterations in intestinal permeability and microflora in experimental acute pancreatitis. Int J Pancreatol 1996;20:119–125.
11.
Andersson R, Wang X, Ihse I: The influence of abdominal sepsis on acute pancreatitis in rats: A study on mortality, permeability, arterial blood pressure and intestinal blood flow. Pancreas 1995;11:365–373.
12.
Kasravi FB, Adawi D, Molin G, Bengmark S, Jeppsson B: Effect of oral supplementation of lactobacilli on bacterial translocation in acute liver injury induced by D-galactosamine. J Hepatol 1997;26:417–424.
13.
Adlerberth I, Ahrné S, Johansson ML, Molin G, Wold A: A mannose-specific adherence mechanism in Lactobacillus plantarum conferring binding to the human colonic line HT-29. Appl Environ Microbiol 1996;62:2244–2251.
14.
Johansson ML, Molin G, Jeppsson B, Nobaek S, Ahrné S, Bengmark S: Administration of different Lactobacillus strains in fermented oat meal soup: In vivo colonization and effect on the indigenous flora. Appl Environ Microbiol 1993;59:15–20.
15.
Bernet M, Brassart D, Neeser JR, Servin A: Lactobacillus acidophilus LA1 binds to intestinal cell lines and inhibits cell attachment and cell invasion by enterovirulent. Gut 1994;35:483–489.
16.
Silva M, Jacobus NV, Deneke C, Gorbach SL: Antimicrobial substance from human Lactobacillus strain. Antimicrob Agents Chemother 1987;31, 8:1231–1233.
17.
Goldin BR, Gorbach SL, Saxelin M, Barakat S, Gualtieri L, Salminen S: Survival of Lactobacillus species (strain GG) in human gastrointestinal tract. Dig Dis Sci 1992;37:121–128.
18.
Adawi I, Ahrnè S, Johansson ML, Molin G, Wold A: A mannose specific adherence mechanism in Lactobacillus plantarum conferring binding to the human colonic cell line HT-29. Appl Environ Microbiol 1996;62:2244–2251.
19.
Fabia R, Ar-Rajab A, Johansson ML, Andersson R, Willen R, Jeppsson B, Molin G, Bengmark S: Impairment of bacterial flora in human ulcerative colitis and experimental colitis in the rat. Digestion 1993;54:248–255.
20.
Bilchik AJ, Leach SD, Zucker KA, Modlin IM: Experimental models of acute pancreatitis. J Surg Res 1990;48:639–647.
21.
Barie PS: A critical review of antibiotic prophylaxis in severe acute pancreatitis. Am J Surg 1996;172:38S–43S.
22.
Okada M, Bothin C, Kanazawa K, Midtvedt T: Experimental study of the influence of intestinal flora on the healing of intestinal anastomoses. Br J Surg 1999;86:961–965.
© 2001 S. Karger AG, Basel
2001
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.