PMID- 36397441 OWN - NLM STAT- MEDLINE DCOM- 20221121 LR - 20230103 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 101 IP - 45 DP - 2022 Nov 11 TI - Adjuvant probiotic Bifidobacterium animalis subsp. lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study. PG - e31030 LID - 10.1097/MD.0000000000031030 [doi] LID - e31030 AB - BACKGROUND: Probiotics had been used to decreased bilirubin level in neonatal jaundice (NJ) without being further studied mechanism and stratification. The intestinal pathogen Escherichia coli produced beta-glucuronidase would increase enterohepatic circulation and elevate serum bilirubin levels (SBLs) which might worsen the disease process of NJ. STUDY OBJECTIVE: We hypothesized that some probiotics could decrease bilirubin level through inhibiting the growth of E. coli. It's assumed that adjuvant probiotic intervention might accelerate the phototherapy for NJ and alleviate the severity of the NJ. Besides, it's further study the efficacy of the probiotic intervention in NJ among the full-term and preterm newborns. MATERIALS AND METHODS: Firstly, the Bifidobacterium animalis subsp. lactis CP-9 was screened for its anti-E. coli activity. Then, it was orally administered to newborns with NJ in combination with conventional phototherapy (wavelength 425-457 nm) to determine its efficacy. 83 neonatal patients whose serum bilirubinemia was at a concentration of >/= 15 mg/dL were participated the double-blind randomized trial and conducted in the neonatal ward of China Medical University Children's Hospital (CMUCH, Taichung, Taiwan). The test was conducted in 2 groups: experimental group: phototherapy + B. animalis subsp. lactis CP-9 (n = 43; 5 x 109 CFU/capsule) and control group: phototherapy + placebo (n = 40). The SBL and total phototherapy duration were measured. RESULTS: The experimental group showed improved serum bilirubin decline rate (-0.16 +/- 0.02 mg/dL/h; P = .009, 95% CI -0.12 to -0.2), particularly in the first 24 hour of in-hospital care, and reduced total phototherapy duration (44.82 +/- 3.23 h; P = .011, 95% CI: 51.3-38.2) compared with the control group. Especially, probiotics had a significant therapeutic effect (serum bilirubin decline rate: -0.18 +/- 0.02 mg/dL/h, 95% CI -0.12 to -0.23, P = .014; phototherapy duration: 43.17 +/- 22.72 h, 95% CI 51.9-34.3, P = .019) in the low-risk subgroup (full-term newborns). CONCLUSIONS: In conclusion, B. animalis subsp. lactis CP-9 synergistically improves treatment outcomes of NJ during in-hospital phototherapy including reduced total phototherapy duration and improved serum bilirubin decline rate, particularly in full-term newborns. CI - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc. FAU - Tsai, Ming-Luen AU - Tsai ML AD - Division of Neonatology, Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan. AD - School of Medicine, China Medical University, Taichung, Taiwan. FAU - Lin, Wen-Yang AU - Lin WY AD - Research and Development Department, Glac Biotech Co., Ltd., Tainan, Taiwan. FAU - Chen, Yin-Ting AU - Chen YT AD - Division of Neonatology, Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan. AD - School of Medicine, China Medical University, Taichung, Taiwan. FAU - Lin, Hsiang-Yu AU - Lin HY AD - Division of Neonatology, Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan. AD - School of Medicine, China Medical University, Taichung, Taiwan. FAU - Ho, Hsieh-Hsun AU - Ho HH AD - Research and Development Department, Glac Biotech Co., Ltd., Tainan, Taiwan. FAU - Kuo, Yi-Wei AU - Kuo YW AD - Research and Development Department, Glac Biotech Co., Ltd., Tainan, Taiwan. FAU - Lin, Jia-Hung AU - Lin JH AD - Research and Development Department, Glac Biotech Co., Ltd., Tainan, Taiwan. FAU - Huang, Yen-Yu AU - Huang YY AD - Research and Development Department, Glac Biotech Co., Ltd., Tainan, Taiwan. FAU - Wang, Hui-Shan AU - Wang HS AD - Research and Development Department, Glac Biotech Co., Ltd., Tainan, Taiwan. FAU - Chiu, Hsiao-Yu AU - Chiu HY AD - Division of Neonatology, Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan. AD - School of Chinese Medicine, China Medical University, Taichung, Taiwan. FAU - Lin, Hung-Chih AU - Lin HC AUID- ORCID: 0000-0002-8111-8371 AD - Division of Neonatology, Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan. AD - School of Chinese Medicine, China Medical University, Taichung, Taiwan. AD - Asia University Hospital, Asia University, Taichung, Taiwan. LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - RFM9X3LJ49 (Bilirubin) SB - IM MH - Child MH - Humans MH - Infant, Newborn MH - *Jaundice, Neonatal/therapy MH - *Bifidobacterium animalis MH - *Probiotics/therapeutic use MH - Treatment Outcome MH - Bilirubin PMC - PMC9666203 EDAT- 2022/11/19 06:00 MHDA- 2022/11/22 06:00 PMCR- 2022/11/11 CRDT- 2022/11/18 01:04 PHST- 2022/11/18 01:04 [entrez] PHST- 2022/11/19 06:00 [pubmed] PHST- 2022/11/22 06:00 [medline] PHST- 2022/11/11 00:00 [pmc-release] AID - 00005792-202211110-00125 [pii] AID - 10.1097/MD.0000000000031030 [doi] PST - ppublish SO - Medicine (Baltimore). 2022 Nov 11;101(45):e31030. doi: 10.1097/MD.0000000000031030.