Efficacy of Lactobacillus reuteri in clinical practice
DOI: 10.32364/2618-8430-2021-4-3-277-283
O.N. Komarova
Yu.E. Vel’tishchev Institute of Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russian Federation
This paper addresses the primary aspects of developing gut microbiota and the immune system and the role of gut microbiocenosis in this process. Optimal gut colonization and adequate immune response are critical factors in developing tolerance to commensal microbes and anti-infectious protection. The authors highlight various prenatal, neonatal, and postnatal factors which prevent normal colonization of gastrointestinal mucosa. One of the methods to restore the qualitative and quantitative composition of gut microbiota are probiotics. Probiotics demonstrating antagonistic activity for pathogens compete with these pathogens for the adhesion to mucosal epithelium and nutrients, thereby inhibiting the production of bacterial toxins, modulating the functions of the immune system, improving gut microbiocenosis, maintaining the integrity of the gastrointestinal mucosal barrier, and controlling gut inflammation. Probiotics are a heterogeneous group of living bacteria with species- and strain-specific properties. For example, Lactobacillus reuteri is an effective probiotic commonly prescribed in premature babies, children with acute gastroenteritis, and infantile colic.
Keywords: gut microbiota, microbiocenosis, premature, C-section, probiotics, bacteria, immune system, infantile colic, Lactobacillus reuteri.
For citation: Komarova O.N. Efficacy of Lactobacillus reuteri in clinical practice. Russian Journal of Woman and Child Health. 2021;4(3):277–283 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-277-283.
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3. Kumar S., Bansal A., Chakrabarti A., Singhi S. Evaluation of efficacy of probiotics in prevention of Candida colonization in a PICU —
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4. Хавкин А.И. Антибиотик-ассоциированная диарея: возможности применения пробиотиков. Трудный пациент. 2018;(1–2):48–52. [Khavkin A.I. Antibiotic-associated diarrhea: the possibilities of using probiotics. Trudnyy patsiyent. 2018;(1–2):48–52 (in Russ.)].
5. Nase L., Hatakka K., Savilahti E. Eqect of long-term consumption of Lactobacillus GG in milk on dental caries and caries risk in children. Caries Res. 2001;35:412–420. DOI: 10.1159/000047484.
6. Корниенко Е.А. Микробиота кишечника как ключевой фактор формирования иммунитета и толерантности. Возможности пробиотиков. Медицинский совет. 2020;(10):92–100. DOI: 10.21518/2079-701X-2020-10-92-100. [Kornienko E.A. Intestinal microbiota as a key factor in the formation of immunity and tolerance. Probiotics capabilities. Medical Council. 2020;(10):92–100 (in Russ.)]. DOI: 10.21518/2079-701X-2020-10-92-100.
7. Edwards C.A., Parret A.M. Intestinal flora during the first months of life: new perspectives. Br J Nutr. 2002;88(l 1):11–18.
8. O’Hara A.M., Shanahan F. The gut flora as a forgotten organ. EMBO Rep. 2006;7(7):688–693. DOI: 10.1038/sj.embor.7400731.
9. Adkins B. Neonatal T cell function. J Rediatr Gastroenterol Nutr. 2005;40(Suppl. 1):S5–S7.
10. Бельмер С.В., Хавкин А.И., ред. Кишечная микробиота у детей: норма, нарушения, коррекция. М.: МЕДПРАКТИКА-М; 2019. [Belmer S.V., Khavkin A.I., eds. Intestinal microbiota in children: norm, disorders, correction. M.: MEDPRAKTIKA-М; 2019 (in Russ.)].
11. Ouwehand A.C. What role for probiotics in Necrotising enterocolitis. Arch Pediatr. 2014;2(3):e14912. DOI: 10.5812/pedinfect.14912.
12. Khair K., Rahman M., Sultana T. et al. Early diagnosis of neonatal septicemia by hematologic scoring system, C-reactive protein and serum haptoglobin. Mymensingh Med J. 2012;21(1):85–92. PMID: 22314460.
13. Hill C.J., Lynch D.B., Murphy K. et al. Evolution of gut microbiota composition from birth to 24 weeks in the infantmet cohort. Microbiome. 2017;5:4. DOI: 10.1186/s40168-016-0213-y.
14. Nutten S., Schumann A., Donnicola D. et al. Antibiotic administration early in life impairs specific humoral responses to an oral antigen and increases intestinal mast cell numbers and mediator concentrations. Clin Vaccine Immunol. 2007;14(2):190–197. DOI: 10.1128/CVI.00055-06.
15. M’Rabet L., Vos A.P., Boehm G., Garssen J. Breast-feeding and its role in early development of the immune system in infants: consequences for health later in life. J Nutr. 2008;138(9):1782–1790. DOI: 10.1093/jn/138.
16. Forsberg A., Huoman J., Söderholm S. et al. Pre- and postnatal Lactobacillusreuteri treatment alters DNA methylation of infant T helper cells. Pediatr Allergy Immunol. 2020;31(5):544–553. DOI: 10.1111/pai.13240.
17. McKeen S., Young W., Mullaney J. et al. Infant Complementary Feeding of Prebiotics for the Microbiome and Immunity Nutrients. 2019;11(2):364. DOI: 10.3390/nu11020364.
18. Oelschlaeger T.A. Mechanisms of probiotic actions — A review. Int J Med. Microbiol. 2010;300:57–62. DOI: 10.1016/j.ijmm.2009.08.005.
19. Markowiak Р., Śliżewska К. Effects of probiotics, prebiotics, and synbiotics on human health. Nutrients. 2017;9(9):1021. DOI: 10.3390/nu9091021.
20. Бельмер С.В. Кисломолочные продукты: от истории к современности. Российский вестник перинатологии и педиатрии. 2019;64:(6):119–125. [Belmer S.V. Sour-milk products: from history to the present. Ros Vestn Perinatol i Pediatr. 2019;64(6):119–125 (in Russ.)]. DOI: 10.21508/1027-4065-2019-64-6-119-125.
21. Калюжин О.В., Афанасьев С.С., Быков А.С. Пероральные пробиотики как стимуляторы противоинфекционного иммунного ответа в респираторном тракте. Терапевтический архив. 2016;88(5):118–124. DOI: 10.17116/terarkh2016885118-124. [Kalyuzhin O.V., Afanas’ev S.S., Bykov A.S. Oral probiotics as anti-infectious immune response stimulators in the respiratory tract. Terapevticheskii Arkhiv. 2016;88(5):118–124 (in Russ.)]. DOI: 10.17116/terarkh2016885118-124.
22. Borchers A.T., Selmi C., Meyers F.J. et al. Probiotics and immunity. J Gastroenterol. 2009;44:26–46. DOI: 10.1007/s00535-008-2296-0.
23. Шевяков М.А., Бурыгина Е.В. Перспективные иммунонутриенты в общеврачебной практике. Терапевтический архив. 2014;86(2):96–101. [Sheviakov M.A., Burygina E.V. Promising immunonutrients in general medical practice. Terapevticheskii Arkhiv. 2014;86(2):96–101 (in Russ.)].
24. Probiotics and prebiotics. World Gastroenterology Organisation Global Guidelines. February 2017. (Electronic resource.) URL: https://www.worldgastroenterology.org/UserFiles/file/guidelines/probiotics-and-prebiotics-english-2017.pdf. (access date: 05.15.2021).
25. Mu Q., Tavella V.J., Luo X.M. Role of Lactobacillus reuteri in Human Health and Diseases. Front Microbiol. 2018;9:757. DOI: 10.3389/fmicb.2018.00757.
26. Freedman S.B., Pasichnyk D., Black K.J. et al. Gastroenteritis Therapies in Developed Countries: Systematic Review and Meta-Analysis. PLoS ONE. 2015;10:e0128754. DOI: 10.1371/journal.pone.0128754.
27. Rosander A., Connolly E., Roos S. Removal of antibiotic resistance gene-carrying plasmids from Lactobacillus reuteri ATCC 55730 and characterization of the resulting daughter strain, L. reuteri DSM 17938. Appl Environ Microbiol. 2008;74:6032–6040. DOI: 10.1128/AEM.00991-08.
28. Украинцев С.Е., Корниенко Е.А., Кафарская Л.И., Дубровская М.И. Микробы внутри нас: случайные попутчики или условие нашего выживания? Или зачем нужны пробиотики в детских молочных смесях. Педиатрия. Журнал им. Г.Н. Сперанского. 2020;99(6):163–171. [Ukraintsev S.E., Kornienko E.A., Kafarskaya L.I., Dubrovskaya M.I. Microbes inside our bodies: casual companions, or prerequisite for our survival? Or why probiotics are needed in infant formulae. Pediatria. 2020;99(6):163–171 (in Russ.)].
29. Oncel M.Y., Sari F.N., Arayici S. et al. Lactobacillus reuteri for the prevention of necrotising enterocolitis in very low birthweight infants: a randomised controlled trial. Arch Dis Child-Fetal Matern Ed. 2014;99(2):F110–F115. DOI: 10.1136/archdischild-2013-304745.
30. Cui X., Shi Y., Gao S. et al. Effects of Lactobacillus reuteri DSM 17938 in preterm infants: a double-blinded randomized controlled study. Ital J Pediatr. 2019;45(1):140. DOI: 10.1186/s13052-019-0716-9.
31. Liu Y., Fatheree N.Y., Mangalat N., Rhoads J.M. Lactobacillus reuteri strains reduce incidence and severity of experimental necrotizing enterocolitis via modulation of TLR4 and NF-κB signaling in the intestine. Am J Physiol Gastrointest Liver Physiol. 2012;302(6):G608–GG17. DOI: 10.1152/ajpgi.00266.2011.
32. Hunter C., Dimaguila M.A.V., Gal P. et al. Effect of routine probiotic, lactobacillus reuteri DSM 17938, use on rates of necrotizing enterocolitis in neonates with birthweight < 1000 grams: a sequential analysis. BMC Pediatr. 2012;12(1):142. DOI: 10.1186/1471-2431-12-142.
33. Dylag K., Hubalewska-Mazgaj M., Surmiak M. et al. Probiotics in the mechanism of protection against gut and therapy of gastrointestinal disorders. Curr Pharm Des. 2014;20(7):1149–1155. DOI: 10.2174/13816128113199990422.
34. World health statistics overview 2019: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2019 (WHO/DAD/2019.1). Licence: CC BY-NC-SA 3.0 IGO. (Electronic resource.) URL: https://www.nhp.gov.in/NHPfiles/WHO%20DAD.pdf (access date: 05.15.2021).
35. Захарова И.Н., Бережная И.В., Камилова А.Т., Дедикова О.В. Орально-регидратационные растворы при водянистых диареях у детей: что нового? Медицинский совет. 2020;(10):34–40. DOI: 10.21518/2079-701X-2020-10-34-40. [Zakharova I.N., Berezhnaya I.V., Kamilova A.T., Dedikova O.V. Oral rehydration solutions in watery diarrhea in children: what’s new? Medical Council. 2020;(10):34–40 (in Russ.)]. DOI: 10.21518/2079-701X-2020-10-34-40.
36. Shornikova A., Casas I.A., Isolauri E. et al. Lactobacillus Reuteri as a Therapeutic Agent in Acute Diarrhea in Young Children. J Pediatr Gastroenterol Nutr. 1997;24(4):399–404. DOI: 10.1097/00005176-199704000-00008.
37. Francavilla R., Lionetti E., Castellaneta S. et al. Randomised clinical trial: Lactobacillus reuteri DSM 17938 vs. placebo in children with acute diarrhoea — a double-blind study. Aliment Pharmacol Ther. 2012;36(4):363–369. DOI: 10.1111/j.1365-2036.2012.05180.x.
38. Gutierrez-Castrellon P., Lopez-Velazquez G., Diaz-Garcia L. et al. Diarrhea in preschool children and lactobacillus reuteri: a randomized controlled trial. Pediatrics. 2014;133(4):904–909. DOI: 10.1542/peds.2013-0652.
39. Wu R.Y., Pasyk M., Wang B. et al. Spatiotemporal maps reveal regional differences in the effects on gut motility for Lactobacillus reuteri and rhamnosus strains. Neurogastroenterol Motil. 2013;25:e205–e214. DOI: 10.1111/nmo.12072.
40. Kunze W.A., Mao Y.K., Wang B. et al. Lactobacillus reuteri enhances excitability of colonic AH neurons by inhibiting calcium-dependent potassium channel opening. J Cell Mol Med. 2009;13:2261–2270. DOI: 10.1111/j.1582-4934.2009.00686.x.
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