THE DEGREE OF SECRETORY IMMUNOGLOBULIN A IN BURN PATIENTS WITH PROBIOTIC THERAPY
Background: One of the problems with burn patients is the impairment of host immunity, which makes difficult to treat. In burns, immunoglobulin
A has demonstrated to decrease. Immunoglobulin A is the main product of mucous immune system, which increases viral clearance and decreases
bacterial adhesion in the intestine. Probiotics consist of living microflora, which control the balance of lactobacilli and bifidobacteria in the intestine.
Instead of producing organic component, increasing the acidity of intestine, mucin and bacteriocin, they also activate the intestinal immune system
and secretory immunoglobulin A (sIgA). The goal of this study was to propose that regular intake of probiotic might help to improve the mucous
immune system, especially sIgA in intestines in burn patients.
Methods: An experimental, double-blind, controlled clinical trial was carried out in 33 burn patients. Those patients were divided into two groups.
The first group was given daily probiotic and the second group was given only placebo for 10 days. The treatment began on the 4th day admission, and
then, the degree of sIgA was evaluated before treatment and day 14 from fecal specimen.
Results: Significant differences between probiotic and control group were observed (p<0.0001). The degree of sIgA in the probiotic group increased
61.25%, and in the control group, it decreased to 36.80%.
Conclusion: The mucous immune system, especially sIgA, increases by probiotic intake.
GT 3rd, et al. Bacterial translocation and intestinal atrophy after thermal
injury and burn wound sepsis. Ann Surg 1990;211:399-405.
2. Sanyal SC. Microbiology of septicaemia in burn patients. Ann Burn
Fire Disaster 1998;11:1-4.
3. Murray C, Hospenthal DR. “Burn Wound Infections”. Emedicine; 2008.
Available from: http://www.emedicine.medscape.com/article/213595-
overview. [Last accessed on 2018 Apr 14].
4. Muster AM. In: Baue AE, Faist E, Fry DE. Multiple Organ Failure,
Pathophysiology, Prevention and Therapy. New York. Springer; 2000.
5. Wiest R, Garcia-Tsao G. Bacterial translocation (BT) in cirrhosis.
6. Chadwick RW, George SE, Claxton LD. Role of the gastrointestinal
mucoda and microflora in the bioactivation of dietary and environmental
mutagens or carcinogens. Drug Metab Rev 1992;24:425-92.
7. Gun F, Salman T, Gurler N, Olgac V. Effect of probiotic supplementation
on bacterial translocation in thermal injury. Surg Today 2005;35:760-4.
8. Grewal HM, Karlsen TH, Vetvik H, Ahrén C, Gjessing HK,
Sommerfelt H, et al. Measurement of specific igA in faecal extracts and
intestinal lavage fluid for monitoring of mucosal immune responses.
J Immunol Methods 2000;239:53-62.
9. Perdigón G, Fuller R, Raya R. Lactic acid bacteria and their effect on
the immune system. Curr Issues Intest Microbiol 2001;2:27-42.
10. Moenadjat Y. Systemic inflammatory response syndrome (SIRS) dan
multi system organ dysfunction syndrome (MODS) pada luka bakar. In:
Penanganan Luka Bakar. Surabaya: Airlangga University Press; 2006.
11. Noer MS. Penanganan Luka Bakar Akut. In: Penanganan Luka Bakar.
Surabaya: Airlangga University Press; 2006. p. 3-22.
12. Fonseca J. Burn Wound Infections. Retrieved from Drugs and Diseases,
Infectious Disease; 2016. Available from: https://www.emedicine.
medscape.com/article/213595-overview. [Last accessed on 05 January
13. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound
infections. Clin Microbiol Rev 2006;19:403.
14. Cakir B, Yegen B. Systemic responses to burn injury. Turk J Med Sci
15. Mayer L. Mucosal immunity. Pediatrics 2003;111:1595-600.
16. Mestecky J, Elson CO. Peyer’s patches as the inductive site for IgA
responses. J Immunol 2008;180:1293-4.
17. Belcher HJ. Immunological responses. In: Settle JA, editor. Principles
and Practice of Burns Management. New York: Churchill Livingstone;
1996. page 163-76.
18. Cebra JJ. Influences of microbiota on intestinal immune system
development. Am J Clin Nutr 1999;69:1046S-1051S.
19. Pitono S, Subijanto MS, Suhartono TP, Judajana FM. Gangguan Sistem
Imun Mukosa Intestinal. Surabaya, Seri Gramik: Immunoglobulin
20. Amansec SG. Role of Resistant Starch and Probiotics in Colon
Inflammation. Sydney: The University of New South Wales; 2005.
21. Fuller R. Probiotics in human medicine. Gut 1991;32:439-42.
22. Woof JM, Mestecky J. Mucosal immunoglobulins. Immunol Rev
23. Judarwanto W. Imunologi Mukosa Saluran Cerna; 2008. Available from:
http://www.alergianak.bogspot.com. [Last accessed on 2010 Feb 10].
24. Arturson G. Mecahanism of Injury. In: Settle JA, editor. Principles and
Practices of Burns Management. New York: Churchill Livingstone;
1996. p. 61-82.
This work is licensed under a Creative Commons Attribution 4.0 International License.