Dose-dependent effect of Lactobacillus rhamnosus on quantitative reduction of faecal rotavirus shedding in children

Abstract

Beneficial effects of probiotics in acute infectious diarrhoea in children are mainly seen in watery diarrhoea and viral gastroenteritis. Lactobacillus rhamnosus, one the most extensively studied probiotic strains, is effective in shortening courses of acute diarrhoea in children. However, the dose-dependent effect of Lactobacillus upon quantification of faecal rotavirus shedding in humans remains little known. Thus, an open-label randomized trial in 23 children with acute rotaviral gastroenteritis was undertaken by randomly allocating patients to receive one of the three regimens for 3 days: daily Lactobacillus rhamnosus 35 (Lcr35) with 0 CFU/day to six patients in the control group, 2 x 10(8) CFU/day to nine patients in the low-dose group, and 6 x 10(8) CFU/day to eight patients in the high-dose group. Faecal samples were collected before and after the 3-day regimen for measurements of rotavirus concentrations by ELISA. There was no statistically significant change in faecal rotavirus concentrations in either the control group (119.2 x 10(5) particles/ml vs. 23.7 x 10(5) particles/ml, p = 0.075) or the low-dose group (36.1 x 10(5) particles/ml vs. 73.5 x 10(5) particles/ml, p = 0.859). However, the high-dose group had a significant reduction of faecal rotavirus concentration (64.2 x 10(5) particles/ml vs. 9.0 x 10(5) particles/ml, p = 0.012). Without any exception, the faecal rotavirus concentrations of all eight patients in the high-dose Lcr35 group declined by 86% after 3 days when compared with those before Lcr35 administration. In conclusion, this is the first report to provide quantitative evidence of the dose-dependent effect of Lactobacillus rhamnosus, a minimal effective dose of 6 x 10(8) CFU for 3 days, upon the faecal rotavirus shedding in paediatric patients.

Intestinal Innate Antiviral Immunity and Immunobiotics: Beneficial Effects against Rotavirus Infection

“…L. sporogenes daily administered to newborns during 1 year, prevented the incidence and also diminished the duration of acute RVs diarrhea (37). Fang et al (38) demonstrated that a minimal effective dose of L. rhamnosus significantly reduced fecal shedding RVs concentration in pediatric patients. Although the administration of lyophilized Lactobacillus paracasei strain ST11 daily for 5 days had a clinically significant benefit in the management of non-RVs-induced diarrhea, ST11 treatment against severe RVs diarrhea was ineffective (39).…”

In vivo gut transcriptome responses toLactobacillus rhamnosusGG andLactobacillus acidophilusin neonatal gnotobiotic piglets

“…[8][9][10] LGG was effective in decreasing both duration and frequency of rotaviral diarrhea and also antibiotic-associated diarrhea in neonates. [11][12][13] People consuming L. acidophilus (LA) NCFM had reduced fever, cough, and runny nose.…”

Sepsis, the Liver and the Gut

“…23 children with acute rotavirus infection were randomised to placebo, low-dose or high-dose L rhamnosus. [142] This trial showed no significant reduction in viral shedding in the low dose group but a significant reduction in the high dose group suggesting that a minimum of 6 x 10 8 CFU (colony forming units) for 3 days has to be given to paediatric patients to achieve a good effect. Other studies [143] also suggest a definite but modest benefit in probiotic use in acute infectious diarrhoea, especially in rotavirus-induced diarrhoea.…”