臨床小児科: オープンアクセス
オープンアクセス

概要

Prebiotics and Probiotics: New Adjuvant Therapies for Children with Idiopathic Relapsing Nephrotic Syndrome

Rehab A. Mohammed1* , Sherin Khamis Hussein2 , Sylvana N. Gaber3 , Fatma A. Ahmed3 , Walaa Abdelfattah4 , Eman S. Said5

Background: Idiopathic Nephrotic syndrome (INS) is an autoimmune disease characterized by repeated relapses with allergic conditions. The etiology remains unknown, new evidence correlates to the dysfunction of T Regulatory cells (T-Reg) which could be due to gut microbiota dysbiosis.

Aim: To investigate the effect of prebiotics and probiotics as adjuvant therapies for children with relapsing idiopathic nephrotic syndrome.

Methods: The study was designed as a prospective open label randomized clinical trial; involving 30 children diagnosed as relapsing NS. Children were randomly divided into two groups, group treated with prednisone only and group treated with prebiotics and probiotics in addition to prednisone. Fresh stool samples were collected from the children. Lactobacillus species were isolated and identified by conventional microbiological methods. Counting the total number of Lactobacillus species were also performed in each stool sample. The populations of T-reg cells in Peripheral Blood Mononuclear Cells (PBMC) were analyzed using the flow cytometry.

Results: Children treated with prebiotics and probiotics in addition to steroids showed a significant increase in (CD4⁺/CD25⁺/FOXp3⁺) T-reg in peripheral blood (p-value<0.0001) and a higher count of Lactobacilli species in their stool (p-value<0.003) with a significant decrease in the rate of relapses in this group compared to group 1 (pvalue< 0.0001).

Conclusion: Treatment with prebiotics and probiotics increases T-reg cells and decreases the rate of relapses of INS significantly.