Dietary Lactobacillus rhamnosus GG Supplementation Improves the Mucosal Barrier Function in the Intestine of Weaned Piglets Challenged by Porcine Rotavirus.

Lactobacillus rhamnosus GG (LGG) has been regarded as a safe probiotic strain. The aim of this study was to investigate whether dietary LGG supplementation could alleviate diarrhea via improving jejunal mucosal barrier function in the weaned piglets challenged by RV, and further analyze the potential roles for apoptosis of jejunal mucosal cells and intestinal microbiota. A total of 24 crossbred barrows weaned at 21 d of age were assigned randomly to 1 of 2 diets: the basal diet and LGG supplementing diet. On day 11, all pigs were orally infused RV or the sterile essential medium. RV infusion increased the diarrhea rate, increased the RV-Ab, NSP4 and IL-2 concentrations and the Bax mRNA levels of jejunal mucosa (P<0.05), decreased the villus height, villus height: crypt depth, the sIgA, IL-4 and mucin 1 concentrations and the ZO-1, occludin and Bcl-2 mRNA levels of jejunal mucosa (P<0.05), and affected the microbiota of ileum and cecum (P<0.05) in the weaned pigs. Dietary LGG supplementation increased the villus height and villus height: crypt depth, the sIgA, IL-4, mucin 1 and mucin 2 concentrations, and the ZO-1, occludin and Bcl-2 mRNA levels of the jejunal mucosa (P<0.05) reduced the Bax mRNA levels of the jejunal mucosa (P<0.05) in weaned pigs. Furthermore, dietary LGG supplementation alleviated the increase of diarrhea rate in the weaned pigs challenged by RV (P<0.05), and relieve the effect of RV infection on the villus height, crypt depth and the villus height: crypt depth of the jejunal mucosa (P<0.05), the NSP4, sIgA, IL-2, IL-4, mucin 1 and mucin 2 concentrations of jejunal mucosa (P<0.05), the ZO-1, occludin, Bax and Bcl-2 mRNA levels of the jejunal mucosa (P<0.05), and the microbiota of ileum and cecum (P<0.05) in the weaned pigs challenged by RV. These results suggest that supplementing LGG in diets alleviated the diarrhea of weaned piglets challenged by RV via inhibiting the virus multiplication and improving the jejunal mucosal barrier function, which was possibly due to the decreasing apoptosis of jejunal mucosal cells and the improvement of intestinal microbiota.

N-Acetylcysteine treatment of rotavirus-associated diarrhea in children.

Rotaviruses are the leading cause of severe, acute, and dehydrating diarrhea affecting children under 5 years of age worldwide. Despite an important reduction in rotavirus-caused deaths as a consequence of the rotavirus vaccine, alternative or complementary strategies for preventing or treating rotavirus-associated diarrhea are needed mainly in the poorest countries. We describe the cases of four rotavirus-unvaccinated 12-13-month-old girls and a 5-year-old boy who developed rotavirus-associated diarrhea confirmed by enzyme-linked immunosorbent assay, Western blotting, and immunochemistry analyses. After the first day of diarrheal episodes, three of the five patients were immediately administered oral N-acetylcysteine (NAC) 60 mg/kg daily, divided into three equal doses every 8 hours. The other two patients did not receive NAC and served as controls. Administration of NAC resulted in a decreased number of diarrheal episodes, excretion of fecal rotavirus antigen, and resolution of symptoms after 2 days of treatment. Our results suggest that NAC treatment after the first diarrheal episode could be an efficient strategy for treating rotavirus-affected children and preventing the associated severe life-threatening accompanying dehydration.

Effective prophylaxis against rotavirus diarrhea using a combination of Lactobacillus rhamnosus GG and antibodies.

BACKGROUND: Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an evaluation of the therapeutic potential of different probiotics and their combination with anti - rotavirus antibodies in a mouse model of rotavirus diarrhea. RESULTS: Of the six probiotic bacteria tested, Lactobacillus rhamnosus strain GG had the strongest influence in reducing prevalence, duration and severity of diarrhea and was therefore chosen for combination treatment with immunoglobulins. The combination treatment reduced the diarrhea outcome measures significantly, prevented histopathological changes and reduced the virus load in the intestines. CONCLUSION: The advantages associated with immunoglobulins and probiotics based therapy is that the treatment provides a rapid therapeutic effect and is cost efficient. These components do not require special storage conditions and could potentially complement the rehydration therapy that is currently used.

Effect of animal plasma proteins on intestinal damage and recovery of neonatal pigs infected with rotavirus.

Rotaviruses infect and elicit diarrhea in neonates of most mammalian species and cause 800,000 infant deaths a year. We used neonatal piglets to study the effects of dietary animal plasma proteins on intestinal health following rotavirus infection. Plasma protein contains a diverse mixture of functional components with biological activity and improves the health of animals challenged with other diarrhea-causing pathogens. In a 2 x 2 factorial design, we compared plasma protein- and soy protein-based diets in rotavirus-infected and noninfected piglets to determine if plasma protein reduced acute rotavirus intestinal damage or improved recovery. All infected animals shed rotavirus particles in their feces. Infected, plasma protein-fed piglets maintained growth rates similar to noninfected piglets in the first 3 days of infection; however, soy protein-fed piglets experienced reduced gains. Furthermore, infected, plasma protein-fed piglets showed no clinical signs of diarrhea. Infection reduced intestinal villus height and the villus height/crypt depth ratio by Day 3 of infection; however, reductions were not attenuated with dietary plasma protein. Infected, plasma protein-fed pigs maintained greater intestinal mucosa protein and estimated total lactase activity than infected, soy protein-fed piglets. Plasma proteins contain growth factors that may aid in rate of recovery as well as virus-binding proteins that may reduce infection pressure in the intestine. These data, combined with findings from other studies using plasma proteins in animal models of diarrhea, indicate the potential for using plasma proteins to improve the health of diarrheic neonates.

Weaning piglets as a model for studying pathophysiology of diarrhea.

During fifty years weaning age of piglets decreased from, in former days, ten to twelve weeks till, nowadays, three to five weeks. Early weaned piglets frequently have diarrhea. When piglets had diarrhea after weaning, enterotoxigenic E.coli (ETEC) or rotavirus were generally detected in the faeces; however, they were also detected in faeces of piglets without diarrhea. So, other causal factors must be involved in the occurrence of diarrhea after weaning. Mortality, due to diarrhea, was associated with severe villus shortening and crypt deepening. Furthermore, weaning piglets was also associated with villus shortening and crypt deepening and giving supplementary feed during the suckling period was effective in preventing villus shortening after weaning. Giving piglets sow's milk immediately after weaning is also effective in preventing villus atrophy. As shown with a small intestine segment perfusion test weaning was also associated with a loss of net absorption in both uninfected and ETEC-infected small intestine. The loss of net absorption was less in piglets that were given supplementary feed during the suckling period. Net absorption in the small intestine increased significantly one day after a rotavirus infection and decreased significantly after subsequent infection with ETEC. Function of the large intestine also influences the severity of diarrhea in just weaned piglets. It may be concluded that weaning piglets at an age of three to five weeks changes the flora, the morphology, and the function of the intestine; these changes together result frequently in diarrhea.

Use of the piglet to study the role of growth factors in neonatal intestinal development.

Milk growth factors are thought to contribute to postnatal gastrointestinal growth. The roles of epidermal growth factor (EGF) and insulin-like growth factor-I (IGF-I) in the neonatal piglet intestine were investigated. In the first study, piglets were infected with rotavirus on d 4 postpartum and received formula containing 0, 500 or 1000 micrograms/l of EGF for 8 days. A non-infected control group received no EGF. Infected piglets developed severe diarrhea and gained 60% less weight than controls. Rotaviral infection caused a 37% decrease in villus height and 40% decreases in intestinal enzyme activities compared to control. Oral EGF increased villus height and lactase activity in a linear dose-response fashion. Our results suggest that supplementation of formulas with high physiological levels of EGF may aid in small intestinal recovery. A second study investigated absorption of orally administered IGF-I. Newborn piglets were fitted with catheters via the umbilical artery and vein. Piglets were given formula containing 25 microCi of [125I]-IGF-I and blood samples were drawn for 24O min. Total radioactivity, protein bound counts, and counts immunoprecipitable with an antibody to IGF-I were determined in plasma. Radioactivity was detected in portal and arterial plasma within 15 min and rose throughout the study, however, protein bound counts were stable at 20-30% of total counts between 30 and 180 min postgavage. Approximately 10% of the counts were immunoprecipitable by a polyclonal antibody to IGF-I, suggesting that up to 10% of orally administered IGF-I may be absorbed intact.