Safety of D(‐)‐Lactic Acid Producing Bacteria in the Human Infant

Connolly, Eamonn; Abrahamsson, Thomas; Björkstén, Bengt

doi:10.1097/01.mpg.0000176179.81638.45

Cited by 64 publications

(44 citation statements)

References 23 publications

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“…10 8 CFU of Lactobacillus reuterii ATCC 55730 from birth, normal blood D -lactate levels were found after 6 and 12 months, and at both time points levels were similar to the placebo group [43] . In a study in adults, de Vrese et al [20] demonstrated that after an oral D -lactate load (6 mmol/kg) the plasma level peaked at 40 min and returned to baseline 2 h later, whereas increased urinary excretion persisted for 10 h. Based on this, our results make it rather improbable that D -lactate blood concentrations were increased in the La1 group at any time.…”

Section: Discussionmentioning

confidence: 84%

Urinary D-Lactate Excretion in Infants Receiving Lactobacillus johnsonii with Formula

et al. 2008

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Background/Aims: Supplementation with certain probiotics can improve gut microbial flora and immune function but should not have adverse effects. This study aimed to assess the risk of D-lactate accumulation and subsequent metabolic acidosis in infants fed on formula containing Lactobacillus johnsonii (La1®). Methods: In the framework of a double-blind, randomized controlled trial enrolling 71 infants aged 4–5 months, morning urine samples were collected before and 4 weeks after being fed formulas with or without La1 (1 × 10⁸/g powder) or being breastfed. Urinary D- and L-lactate concentrations were assayed by enzymatic, fluorimetric methods and excretion was normalized per mol creatinine. Results: At baseline, no significant differences in urinary D-/L-lactate excretion among the formula-fed and breastfed groups were found. After 4 weeks, D-lactate excretion did not differ between the two formula groups, but was higher in both formula groups than in breastfed infants. In all infants receiving La1, urinary D-lactate concentrations remained within the concentration ranges of age-matched healthy infants which had been determined in an earlier study using the same analytical method. Urinary L-lactate also did not vary over time or among groups. Conclusions: Supplementation of La1 to formula did not affect urinary lactate excretion and there is no evidence of an increased risk of lactic acidosis.

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Section: Discussionmentioning

confidence: 84%

Urinary D-Lactate Excretion in Infants Receiving Lactobacillus johnsonii with Formula

et al. 2008

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“…Comparison of blood levels of D(-)-lactate between those receiving placebo and the probiotic were similar at the six-month time age of the infants. 145 Studies in newborns and infants younger than six months most at risk of this problem are lacking.…”

Section: Measurement Of Safety: Limitations Of Existing Modelsmentioning

confidence: 99%

Safety assessment of probiotics for human use

et al. 2010

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The safety of probiotics is tied to their intended use, which includes consideration of potential vulnerability of the consumer or patient, dose and duration of consumption, and both the manner and frequency of administration. Unique to probiotics is that they are alive when administered, and unlike other food or drug ingredients, possess the potential for infectivity or in situ toxin production. Since numerous types of microbes are used as probiotics, safety is also intricately tied to the nature of the specific microbe being used. The presence of transferable antibiotic resistance genes, which comprises a theoretical risk of transfer to a less innocuous member of the gut microbial community, must also be considered. Genetic stability of the probiotic over time, deleterious metabolic activities, and the potential for pathogenicity or toxicogenicity must be assessed depending on the characteristics of the genus and species of the microbe being used. Immunological effects must be considered, especially in certain vulnerable populations, including infants with undeveloped immune function. A few reports about negative probiotic effects have surfaced, the significance of which would be better understood with more complete understanding of the mechanisms of probiotic interaction with the host and colonizing microbes. Use of readily available and low cost genomic sequencing technologies to assure the absence of genes of concern is advisable for candidate probiotic strains. The field of probiotic safety is characterized by the scarcity of studies specifically designed to assess safety contrasted with the long history of safe use of many of these microbes in foods.

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“…Among the additional potential toxicities, there is also a theoretical possibility that d-lactate production might occur, with the development of lactic acidosis [81]. Studies have been performed in healthy humans with an ileostomy.…”

Section: Theoretical Adverse Risks Of Probioticsmentioning

confidence: 99%

“…Studies have been performed in healthy humans with an ileostomy. L. acidophilus and Bifidobacterium species have been shown to transform conjugated bile acid into nontoxic secondary salts [81]. In patients with short small bowel syndrome, it is possible that the conjugated bile acid metabolites might accumulate and lead to malabsorption [82].…”

Section: Theoretical Adverse Risks Of Probioticsmentioning

confidence: 99%

The Safety of Probiotics

Snydman¹

2008

CLIN INFECT DIS

291

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Probiotics are generally defined as microorganisms that, when consumed, generally confer a health benefit on humans. There is considerable interest in probiotics for a variety of medical conditions, and millions of people around the world consume probiotics daily for perceived health benefits. Lactobacilli, bifidobacteria, and lactococci have generally been regarded as safe. There are 3 theoretical concerns regarding the safety of probiotics: (1) the occurrence of disease, such as bacteremia or endocarditis; (2) toxic or metabolic effects on the gastrointestinal tract; and (3) the transfer of antibiotic resistance in the gastrointestinal flora. In this review, the evidence for safety of the use of or the study of probiotics is examined. Although there are rare cases of bacteremia or fungemia related to the use of probiotics, epidemiologic evidence suggests no population increase in risk on the basis of usage data. There have been many controlled clinical trials on the use of probiotics that demonstrate safe use. The use of probiotics in clinical trials should be accompanied by the use of a data-safety monitoring board and by knowledge of the antimicrobial susceptibilities of the organism used.

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Safety of D(‐)‐Lactic Acid Producing Bacteria in the Human Infant

Cited by 64 publications

References 23 publications

Urinary <i>D</i>-Lactate Excretion in Infants Receiving <i>Lactobacillus johnsonii</i> with Formula

Urinary <i>D</i>-Lactate Excretion in Infants Receiving <i>Lactobacillus johnsonii</i> with Formula

Safety assessment of probiotics for human use

The Safety of Probiotics

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