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Investigate the Effects of Chemotherapy Drugs on Intestinal Flora of Children with Cancer and the Intervention of Microbioecologics

Author: ZhaoXueMin
Tutor: RongXiaoPing
School: Hebei Medical University
Course: Pediatrics
Keywords: Pediatric Hematology and Oncology Chemotherapy Intestinal flora Immunity Real-time PCR Microbial modulator
CLC: R733
Type: Master's thesis
Year: 2011
Downloads: 60
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Abstract

Objective: Infection is the a blood tumor most common in children with complications and one of the major cause of death. According to statistics, 60 percent to 70 percent of leukemia / lymphoma patients died of infection. Increased opportunities for children with malignant tumors after chemotherapy, bone marrow suppression and neutropenia, combined with low immunity, cause infection, often become exacerbations in children, treatment failure, or even the main cause of death, seriously affect the malignant treatment and prognosis, it is to find a clinical pediatrician must face the problem and analyze pathways and etiology of infection. The intestine is the body's largest bacteria and endotoxin repository of the normal case with dynamic micro-ecological balance is maintained between the body and the normal flora, Bifidobacterium based the obligate anaerobes mucosal surface specificity receptors, to form a fairly stable bacterial membrane structure, constituting the anti-colonization force biological barrier, can be effective against the invasion of bacteria on the body, plays an important role in maintaining intestinal structure and function. Once the ecological balance and biological barrier is damaged, you can make a lot of bacteria and endotoxin by the portal system into the systemic circulation caused by of endotoxemia enterogenic and vertical translocation of bacteria, and stimulate cytokine and under certain conditions The chain reaction of inflammatory mediators cause damage to the organs of the body. Therefore, of hematological malignancies intestinal microflora in children quantitative analysis helps to understand the impact of the disease itself and chemotherapy drugs on the intestinal flora relationship from the angle of microecosystem chemotherapy drugs and changes in intestinal flora, and provide the basis for microbial modulator for the prevention and treatment of infections and side effects of chemotherapy. Microbial modulator according to the principle of the micro-ecology, by adjusting dysbiosis maintain the micro-ecological balance, improve the health level of the host, using the normal microbial beneficial to the host or promote substance made preparations, including probiotics and their metabolites product and the growth promoting factor. Microbial modulator directly supplement the body's normal flora or selectively stimulating the growth and reproduction of normal flora, thus competitively inhibits exogenous pathogens and endogenous opportunistic pathogen overgrowth and colonization, effectively to prevent the occurrence and development of endogenous infection. Clinical microecological regulators are mainly used in the treatment of diarrheal disease and liver disease, prophylactic use of microbial modulator to reduce endogenous infection little studied in the pediatric hematological malignancies during chemotherapy. The study by 16SrRNA/DNA real-time quantitative PCR technique intestinal E. coli and Bifidobacterium changes during chemotherapy in children with malignant tumors of different degree of bone marrow suppression quantitative analysis, and compared with the healthy group and the intervention group, in order to understand chemotherapy different degree of bone marrow suppression in children with intestinal E. coli and Bifidobacterium change state, as well as microbial modulator state of intestinal microflora in children on chemotherapy, explore microbial modulator for the process of maintenance chemotherapy of malignant tumors intervention role of the balance of intestinal microflora in children. And in order to take advantage of this opportunity to reduce or mitigate the various intestinal-borne infections occur in children with malignant tumors during chemotherapy, in order to ensure the smooth implementation of the chemotherapy, and improve the level of treatment, to extend the survival of children with. Method: grouping the Fourth Hospital of Hebei Medical University, and the Children's Hospital of Hebei Province Department of Hematology, children with malignant tumors were treated 40 cases of lymphoma 30 cases, to leukemia 10 cases, lymphoma leukemia with CAM CAM, BB programs DAE programs, and randomly divided into two groups, one for the observation group, a group for the intervention group, another random selection of 20 cases of normal children in a primary school as a healthy control group. The intervention group in viable cells of chemotherapy beginning on the day the oral microbial regulator - Bifidobacterium Lactobacillus triple sheet (Jinshuangqi), dose oral dose of the drugs specified in the instructions to stop when bone marrow suppression Ⅳ grade. These three groups: observation group, the average age of 7.2 (± 1.5) years old, male: female = l: 1.12; intervention group, the average age of 7.0 (± 1.5) years old, male: female = l: 1.15; healthy control group, the average age of 6.9 ( Guests 1.2 years), male: female = l: 1.2; three age groups, gender was no difference (P gt; 0.05), more than select objects 2 weeks had no history of antibiotic use and gastrointestinal disease history. 2 specimens in each group of children per person specimens from bone marrow suppression as 0, grade Ⅱ, Ⅳ grade stool specimens 0 taken before chemotherapy faeces collected with sterile plastic tubes at -80 ℃ rear No. spare . 2.1 intestinal bacterial DNA bacterial DNA extracted from stool specimens and standard strains DNA was prepared according to the instructions on the fecal bacterial genomic DNA extraction cartridge. 2.2 conventional PCR reaction Qualitative analysis of bacterial DNA extracted. 2.3 PCR reaction, melting curve drawn, and the production of standard curves and quantitative analysis. Result: a control group, the observation group and the intervention group stool specimens in the number of bifidobacteria on numerical comparison control group, the number of bifidobacteria value of 9.23 ± 0.59, the observation group 0, Ⅱ grade Ⅳ bone marrow suppression Bifidobacterium the number of values ??were 7.26 ± 0.41,4.33 ± 0.66,4.18 ± 0.31; intervention group Ⅱ, Ⅳ grade bone marrow suppression Bifidobacterium number of values ??were 7.18 ± 0.44,6.16 ± 0.26,6.21 ± 0.21, The statistics, the observation group and the intervention group 0 bone marrow suppression, the value of the number of bifidobacteria significantly reduced compared with the control group, a significant difference (P lt; 0.05); observation group and the number of bifidobacteria in the intervention group 0 bone marrow suppression value between no significant difference (P gt; 0.05); observation group and the intervention group II, the number of bifidobacteria grade Ⅳ bone marrow suppression between values, there were significant differences (P lt; 0.05). 2 control group, on the value of the observation group and the intervention group the number of E. coli in stool specimens against the logarithm of the number of E. coli bacteria was 7.44 ± 0.48, observation group Ⅱ, Ⅳ grade bone marrow suppression E. coli bacterial counts on values ??were 6.65 ± 0.30,3.92 ± 0.46,4.01 ± 0.21; intervention group, Ⅱ grade Ⅳ bone marrow suppression, the logarithm of E. coli bacterial counts were 6.68 ± 0.52,4.09 ± 0.19,4.16 ± 0.18, statistical there is a significant difference (P lt; 0.05); number of the logarithm of the observation group and the intervention group 0 bone marrow suppression E. coli bacteria between 0 E. coli bacterial counts in the intervention group and the observation group than the control group on the numerical count of E. coli no significant difference (P gt; 0.05); observation group and the intervention group II, grade Ⅳ bone marrow suppression E. coli bacteria between the logarithm of the number of significant differences (P lt; 0.05). The conclusion: a blood tumor in children before chemotherapy reduced intestinal bifidobacteria and E. coli than healthy children, indicating that the intestinal flora is already in a certain degree of imbalance in the blood tumor in children chemotherapy. 2 during chemotherapy in children with hematological tumor intestinal E. coli and the number of bifidobacteria to further reduce the degree of bone marrow suppression of Grade Ⅱ minimize the number of intestinal flora, showed that chemotherapy drugs can inhibit the normal intestinal flora growth and increased intestinal tract flora, bone marrow suppression II level is the most obvious inhibition. Microbial modulator bifidobacteria the Lactobacillus triple viable piece can significantly increase the number of intestinal bifidobacteria blood tumor in children during chemotherapy, and foster the growth of normal flora, adjust the intestinal flora.

Investigate the Effects of Chemotherapy Drugs on Intestinal Flora of Children with Cancer and the Intervention of Microbioecologics

Abstract

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