Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial

Department of Pediatrics, Regina Margherita Children Hospital, University of Turin, Piazza Polonia, 94 10126 Turin, Italy.
PEDIATRICS (Impact Factor: 5.47). 09/2010; 126(3):e526-33. DOI: 10.1542/peds.2010-0433
Source: PubMed


To test the efficacy of Lactobacillus reuteri on infantile colic and to evaluate its relationship to the gut microbiota.
Fifty exclusively breastfed colicky infants, diagnosed according to modified Wessel's criteria, were randomly assigned to receive either L reuteri DSM 17 938 (10(8) colony-forming units) or placebo daily for 21 days. Parental questionnaires monitored daily crying time and adverse effects. Stool samples were collected for microbiologic analysis.
Forty-six infants (L reuteri group: 25; placebo group: 21) completed the trial. Daily crying times in minutes/day (median [interquartile range]) were 370 (120) vs 300 (150) (P=.127) on day 0 and 35.0 (85) vs 90.0 (148) (P=.022) on day 21, in the L reuteri and placebo groups, respectively. Responders (50% reduction in crying time from baseline) were significantly higher in the L reuteri group versus placebo group on days 7 (20 vs 8; P=.006), 14 (24 vs 13; P=.007), and 21 (24 vs 15; P=.036). During the study, there was a significant increase in fecal lactobacilli (P=.002) and a reduction in fecal Escherichia coli and ammonia in the L reuteri group only (P=.001). There were no differences in weight gain, stooling frequency, or incidence of constipation or regurgitation between groups, and no adverse events related to the supplementation were observed.
L. reuteri DSM 17 938 at a dose of 10(8) colony-forming units per day in early breastfed infants improved symptoms of infantile colic and was well tolerated and safe. Gut microbiota changes induced by the probiotic could be involved in the observed clinical improvement.

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    • "infantis CECT 7210) and evaluating their effects on RV diarrhea in animal preclinical experiments are underway (Munoz et al., 2011). In a recent study, 2 genotypically and phenotypically distinct strains of L. reuteri, DSM 17938 and ATCC PTA 6475, safe and effective in treating infantile colic (Savino et al., 2010;Savino et al., 2007), reduced RVA diarrhea duration in neonatal mouse pups and enhanced diversity of the intestinal microbiome (Preidis et al., 2012). Some observed probiotic effects were strain-specific and some were influenced by the mouse nutritional status. "
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    ABSTRACT: Different probiotic strains of Lactobacillus and Bifidobacterium genera possess significant and widely acknowledged health-promoting and immunomodulatory properties. They also provide an affordable means for prevention and treatment of various infectious, allergic and inflammatory conditions as demonstrated in numerous human and animal studies. Despite the ample evidence of protective effects of these probiotics against rotavirus (RV) infection and disease, the precise immune mechanisms of this protection remain largely undefined, because of limited mechanistic research possible in humans and investigated in the majority of animal models. Additionally, while most human clinical probiotic trials are well-standardized using the same strains, uniform dosages, regimens of the probiotic treatments and similar host age, animal studies often lack standardization, have variable experimental designs, and non-uniform and sometime limited selection of experimental variables or observational parameters. This review presents selected data on different probiotic strains of lactobacilli and bifidobacteria and summarizes the knowledge of their immunomodulatory properties and the associated protection against RV disease in diverse host species including neonates.
    Full-text · Article · Jan 2016 · Veterinary Immunology and Immunopathology
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    • "The choice of probiotics in this study was based on a literature review and strong safety data in infants. Lactobacillus reuteri DSM 17938 (parent strain L. reuteri ATCC 55730) [9] has been safely used in infants [10] and adults in the US and Europe [11] and recently in adults in the Peruvian Amazon [12] and has been reported to prevent or reduce diarrhea and gastrointestinal and respiratory infections131415, reduce pathogen colonization and alter microbiota composition [16, 17], reduce infant colic and crying time181920, suppress Helicobacter pylori and gastric symptoms [21], relieve constipation [22], control reflux and abdominal pain [23], and improve infant weight gain [24] . Bifidobacterium longum subspecies infantis is commonly found in both breast milk [25] and healthy infant stools [4] and is generally recognized as safe [26]. "

    Preview · Article · Dec 2015 · BMC Complementary and Alternative Medicine
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    • "Several clinical trials have shown diverse findings regarding DSM as an effective treatment to inhibit the symptoms of infantile colic (Savino et al., 2010; Szajewska et al., 2013; Sung et al., 2014). Since there is evidence that dichotomizing axons from T4-L1 DRG neurons innervate both the stomach and small intestine (Zhong et al., 2008) and because it is less invasive, we tested DSM's effects on the pseudoaffective responses to GDin vivo to supplement our ex vivo electrophysiological data (Results). "
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    ABSTRACT: Certain bacteria exert visceral antinociceptive activity, but the mechanisms involved are not determined. Lactobacillus reuteri DSM 17938 was examined since it may be antinociceptive in children. Since transient receptor potential vanilloid 1 (TRPV1) channel activity may mediate nociceptive signals, we hypothesized that TRPV1 current is inhibited by DSM. We tested this by examining the effect of DSM on the firing frequency of spinal nerve fibres in murine jejunal mesenteric nerve bundles following serosal application of capsaicin. We also measured the effects of DSM on capsaicin-evoked increase in intracellular Ca2+ or ionic current in dorsal root ganglion (DRG) neurons. Furthermore, we tested the in vivo antinociceptive effects of oral DSM on gastric distension in rats. Live DSM reduced the response of capsaicin- and distension-evoked firing of spinal nerve action potentials (238 ± 27.5% vs. 129 ± 17%). DSM also reduced the capsaicin-evoked TRPV1 ionic current in DRG neuronal primary culture from 83 ± 11% to 41 ± 8% of the initial response to capsaicin only. Another lactobacillus (Lactobacillus rhamnosus JB-1) with known visceral anti-nociceptive activity did not have these effects. DSM also inhibited capsaicin-evoked Ca2+ increase in DRG neurons; an increase in Ca2+ fluorescence intensity ratio of 2.36 ± 0.31 evoked by capsaicin was reduced to 1.25 ± 0.04. DSM releasable products (conditioned medium) mimicked DSM inhibition of capsaicin-evoked excitability. The TRPV1 antagonist 6-iodonordihydrocapsaicin or the use of TRPV1 knock-out mice revealed that TRPV1 channels mediate about 80% of the inhibitory effect of DSM on mesenteric nerve response to high intensity gut distension. Finally, feeding with DSM inhibited perception in rats of painful gastric distension. Our results identify a specific target channel for a probiotic with potential therapeutic properties. Journal compilation
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