Effect of probiotic administration in inflammatory responses of thermal burns

Abstract

It is possible to damage the natural intestinal barrier following severe burn injuries. Oral probiotics' positive effects on the innate immune system or intestinal epithelial layer are proven. This research aimed to evaluate the role of probiotics on plasma inflammatory changes and bacterial colonization in the burned wound after high-grade thermal trauma. This double-blinded randomized controlled trial was conducted on 80 patients with a total body surface area of 20–70%. Patients were allocated to two groups based on four blocks randomization model. Intervention and control groups received daily LactoCare and placebo capsules for 14 consecutive days. Obtaining demographic data, burn and gastrointestinal symptoms were registered by filling out a questionnaire. Additionally, measuring plasma levels of highly sensitive C-reactive protein(hs-CRP), IgA, absolute neutrophilic, and lymphocytic count were performed cumulatively four times prior to and after the intervention. Considering eligible data, following the study period analysis showed significant mitigation of inflammatory status in probiotic receivers. The hs-CRP reduced following probiotic (21.38 ± 44.45) consumption compared with placebo (−36.36 ± 79.03) intake ( p < 0.001). Also, the plasma level of IgA significantly decreased in the intervention group (0.88 ± 0.65) than in the control group (0.79 ± 0.18) ( p < 0.001). Wound cultures showed no significant difference between groups, although the incidence rate of bacterial colonization was slightly lower after using probiotics ( p = 0.159). Regarding wound healing, data illustrated that probiotics could accelerate wound healing after 14 days of regular consumption ( p < 0.001). Probiotics have advantages for the mitigation of inflammation and wound healing following severe thermal burn injuries. Trends toward Improvement Immune system by increasing IgA level and lymphocytic count and possible Reduction of wound area with exogenous probiotic administration in patients with burns suggest that further investigation in larger sample size is necessary to corroborate our initial, promising findings.