Woodcock N P, McNaught C E, Morgan D R, Gregg K L, MacFie J
Combined Gastroenterology Unit, Scarborough Hospital, Woodlands Drive, North Yorkshire YO12 6QL, UK.
Clin Nutr. 2004 Oct;23(5):1069-73. doi: 10.1016/j.clnu.2004.01.010.
The gut-associated lymphoid tissue (GALT) is an important component of the gut barrier. We have previously demonstrated a significant increase in various parameters of gut immune function in association with bacterial translocation. Animal studies have suggested that the probiotic Lactobacillus plantarum 299v improves the immunological status of the intestinal mucosa. The aim of this study was to determine whether the same is true in humans.
This was a prospective randomised controlled study, in which immunohistochemical techniques were used to measure the concentrations of plasma cells, IgA positive cells and IgM positive cells in the lamina propria, together with the concentrations of IgA and IgM at the mucosal surface in specimens of normal small bowel obtained from patients undergoing elective abdominal surgery who had consumed an oral preparation containing the probiotic Lactobacillus plantarum 299v (ProViva) during the immediate preoperative period. These were compared with similar specimens obtained from control subjects who did not receive the probiotic.
A total of 22 patients were studied (probiotic group n = 11, control group n = 11). The median volume of ProViva consumed was 3250 ml (range 2100-9000 ml), for a median duration of 9 days (range 5-18 days). There were no significant differences between the probiotic and control groups in terms of concentrations of plasma cells, IgA positive cells or IgM positive cells in the lamina propria. There was a significantly higher concentration of IgM at the mucosal surface in the control group (P = 0.02, Fishers Exact test mid P), but no difference in terms of IgA.
The increase in IgA observed in the intestinal mucosa in response to probiotics in animal studies does not occur in humans. The significance of the increase in IgM at the mucosal surface in the controls is unclear.
肠道相关淋巴组织（GALT）是肠道屏障的重要组成部分。我们之前已经证明，肠道免疫功能的各项参数会随着细菌易位而显著增加。动物研究表明，益生菌植物乳杆菌299v可改善肠黏膜的免疫状态。本研究的目的是确定在人类中是否也是如此。
这是一项前瞻性随机对照研究，采用免疫组织化学技术测量从接受择期腹部手术的患者术前即刻服用含益生菌植物乳杆菌299v（ProViva）的口服制剂后获得的正常小肠标本中固有层浆细胞、IgA阳性细胞和IgM阳性细胞的浓度，以及黏膜表面IgA和IgM的浓度。将这些结果与未接受益生菌的对照受试者获得的类似标本进行比较。
共研究了22例患者（益生菌组n = 11，对照组n = 11）。ProViva的中位服用量为3250毫升（范围2100 - 9000毫升），中位服用持续时间为9天（范围5 - 18天）。益生菌组和对照组在固有层浆细胞、IgA阳性细胞或IgM阳性细胞浓度方面无显著差异。对照组黏膜表面IgM浓度显著更高（P = 0.02，Fisher精确检验双侧P值），但IgA方面无差异。
动物研究中观察到的肠道黏膜中因益生菌而导致的IgA增加在人类中并未出现。对照组黏膜表面IgM增加的意义尚不清楚。
