Administration Of Lactobacillus GG Research Articles

Disrupted Intestinal Microbiota and Intestinal Inflammation in Children with Cystic Fibrosis and Its Restoration with Lactobacillus GG: A Randomised Clinical Trial

Background & AimsIntestinal inflammation is a hallmark of cystic fibrosis (CF). Administration of probiotics can reduce intestinal inflammation and the incidence of pulmonary exacerbations. We investigated the composition of intestinal microbiota in children with CF and analyzed its relationship with intestinal inflammation. We also investigated the microflora structure before and after Lactobacillus GG (LGG) administration in children with CF with and without antibiotic treatment.MethodsThe intestinal microbiota were analyzed by denaturing gradient gel electrophoresis (DGGE), real-time polymerase chain reaction (RT-PCR), and fluorescence in situ hybridization (FISH). Intestinal inflammation was assessed by measuring fecal calprotectin (CLP) and rectal nitric oxide (rNO) production in children with CF as compared with healthy controls. We then carried out a small double-blind randomized clinical trial with LGG.ResultsTwenty-two children with CF children were enrolled in the study (median age, 7 years; range, 2–9 years). Fecal CLP and rNO levels were higher in children with CF than in healthy controls (184±146 µg/g vs. 52±46 µg/g; 18±15 vs. 2.6±1.2 µmol/L NO2 −, respectively; P<0.01). Compared with healthy controls, children with CF had significantly different intestinal microbial core structures. The levels of Eubacterium rectale, Bacteroides uniformis, Bacteroides vulgatus, Bifidobacterium adolescentis, Bifidobacterium catenulatum, and Faecalibacterium prausnitzii were reduced in children with CF. A similar but more extreme pattern was observed in children with CF who were taking antibiotics. LGG administration reduced fecal CLP and partially restored intestinal microbiota. There was a significant correlation between reduced microbial richness and intestinal inflammation.ConclusionsCF causes qualitative and quantitative changes in intestinal microbiota, which may represent a novel therapeutic target in the treatment of CF. Administration of probiotics restored gut microbiota, supporting the efficacy of probiotics in reducing intestinal inflammation and pulmonary exacerbations.Trial RegistrationClinicalTrials.gov NCT 01961661

Administration of Lactobacillus GG to hospitalised children reduces the risk of gastrointestinal and respiratory tract infections

Commentary on: I Hojsak, S Abdovic, H Szajewska, et al.. Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics2010;125:e1171–7.

Lactobacillus GG in the Prevention of Nosocomial Gastrointestinal and Respiratory Tract Infections

The incidence of nosocomial infections, predominantly gastrointestinal and respiratory, in children in developed countries is high, ranging from 5% to 44%. There is no effective strategy for preventing these infections. The objective of our study was to investigate the role of Lactobacillus GG (LGG) in preventing nosocomial gastrointestinal and respiratory tract infections at a pediatric hospital. We conducted a randomized, double-blind, placebo-controlled trial of 742 hospitalized children. They were randomly allocated to receive for their hospitalization LGG at a dose of 10(9) colony-forming units in 100 mL of a fermented milk product (LGG group, n = 376) or placebo that was the same postpasteurized fermented milk product without LGG (placebo group, n = 366). In the LGG group, compared with the placebo group, we found a significantly reduced risk for gastrointestinal infections (relative risk [RR]: 0.40 [95% confidence interval (CI): 0.25-0.70]; number needed to treat: 15 [95% CI: 9-34)], respiratory tract infections (RR: 0.38 [95% CI: 0.18-0.85]; number needed to treat: 30 [95% CI: 16-159]), vomiting episodes (RR: 0.5 [95% CI: 0.3-0.9]), diarrheal episodes (RR: 0.24 [95% CI: 0.10-0.50]), episodes of gastrointestinal infections that lasted >2 days (RR: 0.40 [95% CI: 0.25-0.70]), and episodes of respiratory tract infections that lasted >3 days (RR: 0.4 [95% CI: 0.2-0.9]). Groups did not differ in hospitalization duration (P = .1). LGG administration can be recommended as a valid measure for decreasing the risk for nosocomial gastrointestinal and respiratory tract infections in pediatric facilities.

Lactobacillus GG in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centers: A randomized, double-blind, placebo-controlled trial

The aim of our study was to investigate the role of Lactobacillus GG (LGG) in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centers. We conducted a randomized, double-blind, placebo-controlled trial in 281 children who attend day care centers. They were randomly allocated to receive LGG at a dose of 10(9) colony-forming units in 100ml of a fermented milk product (LGG group, n=139) or placebo that was the same post-pasteurized fermented milk product without LGG (placebo group, n=142) during the 3-month intervention period. Compared to the placebo group, children in the LGG group had a significantly reduced risk of upper respiratory tract infections (RR 0.66, 95% CI 0.52 to 0.82, NNT 5, 95% CI 4 to 10), a reduced risk of respiratory tract infections lasting longer than 3 days (RR 0.57, 95% CI 0.41 to 0.78, NNT 5, 95% CI 4 to 11), and a significantly lower number of days with respiratory symptoms (p<0.001). There was no risk reduction in regard to lower respiratory tract infections (RR 0.82, 95% CI 0.24 to 2.76). Compared with the placebo group, children in the LGG group had no significant reduction in the risk of gastrointestinal infections (RR 0.63, 95% CI 0.38 to 1.06), vomiting episodes (RR 0.60, 95% CI 0.29 to 1.24), and diarrheal episodes (RR 0.63, 95% CI 0.35 to 1.11) as well as no reduction in the number of days with gastrointestinal symptoms (p=0.063). LGG administration can be recommended as a valid measure for decreasing the risk of upper respiratory tract infections in children attending day care centers.

Routinary probiotic Lactobacillus rhamnosus GG administration in preterm very-low-birth-weight neonates: A retrospective, 6-year cohort study from two large tertiary NICUs in Italy

Background: Probiotics are important in restoring gut normal microbiota, and/or in preventing its disturbances. Several data from neonatal studies disclose efficacy of certain mixtures of probiotics in preventing NEC, ameliorating feeding tolerance, and preventing gut fungal colonization. Nevertheless, concerns still exist about safety and tolerability of routinary, long-lasting administration of living microorganisms in immature patients. We report a 6-year clinical experience from two large tertiary NICUs in Italy. Design/methods: Retrospective study by review of patient charts on infants with birth weight Standard protocol of administration of Lactobacillus GG in the two NICUs consisted of 3 × 10 9 CFU/day, in a single oral dose, since the 4th day of life, for 3 to 4 week courses. Nutritional policy in the two NICUs relied on administration of fresh, expressed maternal milk, whenever possible, and supplementation of premature formaulae when needed. Data about safety and tolerance to probiotic administration, concomitant sepsis, feeding tolerance, and microbiological clinical and surveillance cultures, were retrieved and analysed. Results: During the study period, 811 VLBW infants (mean birth weight 1056 g [± 88]; mean gestational age 29.5 weeks [± 1.1]) were born at the two facilities and survived till discharge. Complete data were obtained for 743 of them. A total number of 17,108 doses of the probiotic LGG were administered (mean 23.1 per infant). No adverse effects or intolerances putatively attributable to LGG occurred. Over the study period, 5350 clinical and surveillance cultures from 13 different sites or devices were performed (7.2 mean cultures from 6.5 mean different sites per infant). None of these cultures ever grew Lactobacillus GG, or other Lactobacilli; no episode of sepsis was attributable to LGG. Full enteral feeding was achieved at 19.2 mean days-of-life [± 8]; 73% of the infants were fed exclusive or partial maternal milk. 14 cases of NEC occurred (1.9%), among them 5 (0.7%) were > stage 2b. Conclusions: Routinary use of probiotic Lactobacillus GG in two large Italian NICUs over a 6-year period was safe and well tolerated. No isolation of Lactobacillus GG from clinical and surveillance cultures occurred. No clinical episode of sepsis attributable to Lactobacillus GG was recorded.

Inhibitory Effect ofLactobacillus gasseriTMC0356 andLactobacillusGG on Enhanced Vascular Permeability of Nasal Mucosa in Experimental Allergic Rhinitis of Rats

The nasal vascular permeability of ovablumin (OVA)-sensitized Brown Norway rats was evaluated by analyzing a brilliant blue concentration in perfusate from the nose after exposure of the nasal mucus to OVA. Oral administration of Lactobacillus GG and L. gasseri TMC0356 significantly inhibited the increase in nasal vascular permeability (P<0.01). The serum IgE of the tested rats also decreased, although the change was not statistically significant. These results indicate that Lactobacillus GG and L. gasseri TMC0356 might alleviate nasal allergic symptoms by suppressing the increase in nasal vascular permeability caused by local inflammation associated with allergic rhnititis.

Effects of Lactobacillus GG on genes expression pattern in small bowel mucosa

Background and aims. Probiotics have been used for cure and prevention of several clinical conditions. However, further insights into the mechanism of action are needed to understand the rationale of their use. The aim of this study was to investigate the influence of Lactobacillus GG on the genetic expression patterns in the small bowel mucosa. Methods. Six male patients (38 ± 5 years) with endoscopically proven oesophagitis were enrolled. All patients were treated for 1 month with esomeprazole and randomised to receive Lactobacillus GG or placebo. After 1 month of treatment, upper endoscopy was repeated. Biopsies of the duodenal mucosa were taken prior to and after the treatment, and the genes expression patterns were assessed using GeneChip Human U133A array. Genes with significant expression changes were selected and analysed to identify specific cellular pathways modified by Lactobacillus GG. To support the array data, 10 target genes were studied using Syber-Green PCR. Results. Microarray analysis showed that Lactobacillus GG administration determined the up- and down-regulation of 334 and 92 genes, respectively. Real-time PCR confirmed the reliability of the analysis. Lactobacillus GG mainly affected the expression of genes involved in immune response and inflammation (TGF-beta and TNF family members, cytokines, nitric oxide synthase 1, defensin alpha 1), apoptosis, cell growth and cell differentiation (cyclins and caspases, oncogenes), cell–cell signalling (ICAMs and integrins), cell adhesion (cadherins), signal transcription and transduction. Conclusions. These data indicate that administration of Lactobacillus GG is associated with a complex genetic response of the duodenal mucosa, reflected by the up- and down-regulation of several genes involved in specific cellular pathways.

Oral administration of Lactobacillus GG (LGG) induces an antiinflammatory, TH-2 mediated systemic immune response towards intestinal organisms

Oral administration of Lactobacillus GG (LGG) induces an antiinflammatory, TH-2 mediated systemic immune response towards intestinal organisms

Study of the effect of lactobacillus GG supplementation in combination with and without arginine aspartate on lipoproteins and liver peroxidation in cholesterol-fed rats

The effect of diet integration with lactobacillus GG and arginine aspartate administered singly or together to rats submitted to a cholesterol-enriched diet have been evaluated by measuring both the changes in the levels of cholesterol and tryglycerides and the variations of the most indicative parameters of peroxidation in plasma lipoproteins and livers. The administration of lactobacillus GG alone is able to induce a significant hypocholesterolaemic effect while the arginine aspartate singly or together with the lactobacillus does not seem to promote any significant hypocholesterolaemic effect. The cholesterol levels (expressed as mg × dL -1) are in fact: 45.5 for the control diet; 185.4 for the cholesterol-enriched diet; 131.1 for the cholesterol-enriched diet + lactobacillus; 178.2 for the cholesterol enriched diet + arginine aspartate and 122.4 for the cholestorol-enriched diet + lactobacillus + arginine aspartate. On the contrary, the co-administration of lactobacillus and arginine aspartate gives rise to a very high preventive activity against the cholesterol-induced peroxidation damages both in the plasma lipoproteins and in the liver. Such preventive activity is higher by far than that obtainable when lactobacillus or arginine aspartate are administered singly to the rats.

Management of acute diarrhoea with low osmolarity oral rehydration solutions and Lactobacillusstrain GG

Two hypotonic oral rehydration solutions with osmolarities of 224 mosmol/l (Na+ 60 mmol/l, glucose 84 mmol/l) and 204 mosmol/l (Na+ 60 mmol/l, glucose 64 mmol/l), respectively, and oral treatment withLactobacillus...

Effect of Administration ofLactobacillus caseiStrain GG on the Gastrointestinal Microbiota of Newborns

The aim of the study was to determine whether Lactobacillus casei strain GG could colonise the intestine of newborns and the influence of its administration on establishment of the microbiota. The faecal bacterial population of 25 under 1 mth old newborns was studied: in addition to breastfeeding, 15 babies (GG group) received for 2 wk immediately after birth Lactobacillus GG supplement as freeze-dried powder diluted in water in a dose of 10 10 -10 11 c.f.u./g; 10 newborns (control group) did not receive any supplement to breastfeeding. The faecal bacterial composition of meconium was similar in both groups studied. Ten newborns (67 per cent) excreted Lactobacillus GG, while in eight cases (53.3 per cent) Lactobacillus GG was found even 2 wk after the administration was stopped. The faecal concentrations and the relative proportion of Lactobacillus GG were individually different. In 3-4 d, 5-7 d and 1 mth old newborns of the GG group the faecal concentrations of lactobacilli exceeded those of the control group. The faecal microorganisms predominance pattern did not differ in the case of 1 wk and 1 mth old newborns of the GG group. The study shows that 2 wk administration of Lactobacillus GG, which starts right after birth, increases intestinal lactobacilli concentrations and does not impair the establishment of a normal faecal bacterial microbiota. Keywords - Lactobacillus casei GG, Neonatal faecal bacteria.