Probiotics May Help Colic in Breastfed But Not Formula Fed Babies

MedicalResearch.com Interview with:

Dr Valerie Sung MBBS (Hons) FRACP MPH PhD Department of Paediatrics The University of Melbourne Murdoch Childrens Research Institute Parkville, Australia

Dr. Sung

Dr Valerie Sung MBBS (Hons) FRACP MPH PhD
Department of Paediatrics
The University of Melbourne
Murdoch Childrens Research Institute
Parkville, Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infant colic is excessive crying in babies less than 3 months old with no underlying medical cause. It affects 1 in 5 newborns, is very distressing, and is associated with maternal depression, Shaken Baby Syndrome, and early cessation of breastfeeding. Up to now, there has been no single effective treatment for colic. The probiotic Lactobacillus reuteri DSM 17938 has recently shown promise but results from trials have been conflicting. In particular, a previous trial from Australia, the largest in the world so far, did not find the probiotic to be effective in both breastfed and formula-fed infants with colic.

This international collaborative study, which collected raw data from 345 infants from existing trials from Italy, Poland, Canada and Australia, confirms Lactobacillus reuteri to be effective in breastfed infants with colic. However, it cannot be recommended for formula-fed infants with colic.

Compared to a placebo, the probiotic group was two times more likely to reduce crying by 50 per cent, by the 21st day of treatment, for the babies who were exclusively breastfed. The number needed to treat for day 21 success in breastfed infants was 2.6.

In contrast, the formula fed infants in the probiotic group seemed to do worse than the placebo group, but the numbers for this group were limited.

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Probiotics May Influence Schizophrenia Symptoms Through Yeast in Microbiome

MedicalResearch.com Interview with:
Emily G. Severance PhD
Stanley Division of Developmental Neurovirology
Department of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD 21287

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previously, we found that people with schizophrenia and bipolar disorder had an increased susceptibility to Candida albicans yeast infections, which was sex specific and associated with memory deficits. Also in an earlier placebo-controlled probiotic study, we found that although probiotics improved the overall bowel function of people with schizophrenia, there was no effect by this treatment on psychiatric symptoms.  Given that C. albicans infections can upset the dynamics of the human microbiome, we decided to re-evaluate the potential benefit of probiotics in the context of a patient’s C. albicans yeast status.  Not only was bowel function again enhanced following intake of probiotics, but yeast antibody levels were decreased by this treatment.

Furthermore, psychiatric symptoms were actually improved over time for men receiving probiotics who did not have elevated C. albicans antibodies. Men who were positive for C. albicans exposure, however, consistently presented with worse psychiatric symptoms irrespective of probiotic or placebo treatment.

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Can Probiotics in Yogurt Protect Against Stress and Anxiety?

MedicalResearch.com Interview with:

Elizabeth Bryda, PhD Professor, Director, Rat Resource and Research Center Veterinary Pathobiology University of Missouri Columbia, Missouri

Dr. Elizabeth Bryda

Elizabeth Bryda, PhD
Professor, Director, Rat Resource and Research Center
Veterinary Pathobiology
University of Missouri
Columbia, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A number of groups have demonstrated the ability of probiotics to benefit digestive health and there is a growing body of evidence to suggest an association between mental health and “gut health”. We were interested to see if probiotic bacteria could decrease anxiety- or stress-related behavior in a controlled setting using zebrafish as our model organism of choice for these studies.

We were able to show that Lactobacillus plantarum decreased overall anxiety-related behavior and protected against stress-induced dysbiosis (microbial imbalance). The fact that administration of probiotic bacteria also protected other resident gut bacteria from the dramatic changes seen in “stressed” fish not receiving the probiotic was unexpected and suggested that these bacteria may be working at the level of the GI tract and the central nervous system.

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Probiotics Found Effective in Preventing Clostridium difficile in Hospitalized Adults Receiving Antibiotics

MedicalResearch.com Interview with:

Dr. Nicole Shen New York-Presbyterian/Weill Cornell Medical College

Dr. Nicole Shen

Dr. Nicole Shen
New York-Presbyterian/Weill Cornell Medical College

MedicalResearch.com: What is the background for this study?

Dr. Shen: Clostridium difficile infection (CDI) is a persistent, healthcare associated infection with significant morbidity and mortality that costs the US billions of dollars annually. Prevention is imperative, particularly for patients at high risk for infection – hospitalized adults taking antibiotics. Trials have suggested probiotics may be useful in preventing CDI. We conducted a systematic review with meta-analysis in this high-risk population, hospitalized adults receiving antibiotics, to evaluate the current evidence for probiotic use for prevention of CDI.

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Probiotics May Reduce Risk of Type 1 Diabetes

Dr. Ulla Uusitalo PhD University of South Florida, TampaMedicalResearch.com Interview with:
Dr. Ulla Uusitalo PhD
University of South Florida, Tampa

Medical Research: What is the background for this study? What are the main findings?

Dr. Uusitalo: The TEDDY Study is an international prospective cohort study with the primary goal to identify environmental causes of Type 1 Diabetes (T1D). It is carried out in six clinical research centers, in four countries: University of Colorado Health Science Center (US), Georgia Regents University (US), Pacific Northwest Diabetes Research Institute (US), Turku University Hospital (Finland), Institute of Diabetes Research (Germany), and Lund University (Sweden), since 2004.

One possible environmental factor related to Type 1 Diabetes etiology is diet. Dietary supplements including probiotics as well as various types of infant formulas including probiotic fortified infant formula are studied. The microbial composition of gut has been shown to be associated with the development of  Type 1 Diabetes. Colonization of the infant gut starts already in utero and early microbial exposures have been found to be important in defining the trajectory of colonization. Probiotics have been demonstrated to induce favorable immunomodulation and it has been suggested that probiotic treatment could prevent T1D. Therefore we wanted to study the early exposures of probiotic and risk of islet autoimmunity, a condition often preceding Type 1 Diabetes.

This study produced very interesting results. The main finding was that we found 60% decrease in the risk of islet autoimmunity among children with HLA genotype of DR3/4 (high risk), who were exposed to probiotics during the first 27 days of life.

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Dairy Products May Enhance Efficacy of Probiotics

Maria L Marco, PhD Associate Professor Department of Food Science & Technology Davis, CA  95616MedicalResearch.com Interview with:
Maria L Marco, PhD

Associate Professor
Department of Food Science & Technology
Davis, CA  95616

Medical Research: What is the background for this study? What are the main findings?

Dr. Marco: Probiotics encompass certain strains of bacteria and yeast that when administered alive and in sufficient amounts can confer specific health benefits. Probiotics are increasingly added to foods, beverages, and intestinal supplements for delivery to the digestive tract. (Fermented) dairy products are currently the most popular food carriers for probiotic strains in clinical studies and commercial products. Although microorganisms generally respond quickly and adapt to their surrounding environments (e.g. in foods), the importance of the carrier format on probiotic function in vivo has yet to be systematically and mechanistically investigated. To address this need, we performed a couple studies in rodents to (i) examine whether probiotic Lactobacillus casei produces different proteins during low temperature (refrigeration) incubation in milk and (ii) measure whether incubation in milk is required for L. casei protection against inflammation. We found by shot-gun proteomics that L. casei does adapt for growth and survival in milk by producing a variety of (extra)cellular proteins, even at low-temperatures used to store dairy products prior to consumption. Such exposure of L. casei to milk was also essential for reducing the severity of disease in a mouse model of Ulcerative Colitis (UC), an inflammatory bowel disease characterized by continuous inflammation in the large intestine. Consuming milk alone also provided some protection against weight loss and intestinal inflammation in the Ulcerative Colitis mouse model but was not as effective as L. casei and milk in combination. Lastly, the importance of dairy for L. casei in preventing Ulcerative Colitis was confirmed by our findings that L. casei mutants lacking the capacity to synthesize proteins which are selectively produced during low-temperature incubation in milk were also impaired in preventing inflammatory responses in the intestine.

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Could Probiotics Improve Your Mood?

MedicalResearch.com Interview with:
Laura Steenbergen
Leiden University, Institute for Psychological Research, Cognitive Psychology
Leiden, The Netherlands

Medical Research: What is the background for this study? What are the main findings?

Response: Food supplements, among which probiotics, are becoming more and more popular. A lot is known about the effect of probiotics on the physical functioning, but even though there are some rat studies on the effects of probiotics on mental well-being, not much is known about the effect in humans. The few studies on humans that are available show beneficial effects on mood when people experience a bad mood, or psychological distress. Worldwide, millions of people are suffering from mood disorders like for instance depression, but not everyone receives treatment for this. Probiotics are safe and easily available, and we therefore wanted to investigate if probiotics could perhaps be promising in serving as a preventive or adjuvant therapy for mood disorders of anxiety or depression. We therefore focused on cognitive reactivity to sad mood, which measures the degree to which people activate dysfunctional thought patterns when experiencing a sad mood. This measure is known to be predictive of the onset and development of depression. Compared to subjects who received a 4-week placebo intervention, participants who received a 4-week multispecies probiotics intervention showed significantly reduced aggressive and ruminative thoughts. Even if preliminary, these results provide the first evidence that the intake of probiotics may help reduce negative thoughts associated with sad mood. As such, our findings shed an interesting new light on the potential of probiotics to serve as adjuvant or preventive therapy for depression.

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Probiotics: Not Helpful in Soothing Infants With Colic

Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health, The Royal Children’s HospitalMedicalResearch.com Invitation with:
Dr Valerie Sung MBBS(Hons) FRACP MPH
NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute
Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital

MedicalResearch.com: What are the main findings of the study?

Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this.

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Probiotics and Effect on Allergic Rhinitis?

MedicalResearch.com Interview with:
Dr Kamal Ivory
Institute of Food Research
Norwich Research Park Norwich, UK
Gut Health & Food Safety ISP
The Institute of Food Research receives strategic funding from BBSRC

MedicalResearch.com: What are the main findings of the study?

Dr. Ivory: In the present study we show that administration of probiotics in the gut can induce changes at the nasal mucosa where the immune system meets pollen allergen. This implies a potential to alter the course of allergic rhinitis. However, in our single high dose pollen challenge in the clinic (out of pollen season), we did not measure any significant changes in the clinical parameters we had set. It is not clear if this was because a single challenge fails to replicate occurrence during natural seasonal exposure to pollen in terms of dosage and timing. That aside, the mode of action may vary from one probiotic organism to another and it is possible that a cocktail of probiotic organisms may be needed for clinical effectiveness. If funding becomes available, we would like to repeat the study during the pollen season.
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Rhinovirus Infections and Probiotics Supplementation in Preterm Infants

MedicalResearch.com Interview with:
Raakel Luoto, MD
Department of Paediatrics and Adolescent Medicine
Turku University Hospital, Turku, Finland

MedicalResearch.com: What are the main findings of the study?

Dr. Luoto: Firstly, we found a significantly lower incidence of respiratory tract infections (RTIs) in infants receiving specific prebiotics or probiotics compared to those receiving placebo. Also, the incidence of rhinovirus –induced episodes, comprising 80% of all RTI episodes, was found to be significantly lower both in the prebiotic and in the probiotic group compared to the placebo group. Secondly, neither of interventions was found to have an impact on the duration or severity of RTIs.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Luoto: Actually the impact of both prebiotic and probiotic supplementation in the incidence of RTIs was better than our study team did expect.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Luoto: Based on our results, gut microbiota modulation with specific pre- and/or probiotics could offer a cost-effective tool in the fight against RTIs, which are a major cause of mortality and morbidity particularly during the first years of life. Preterm infants carry a heightened risk of infectious ailments, of both bacterial and viral causes. Although strict hygienic measures have been shown to reduce viral transmission and thus to diminish the incidence of RTIs, no definitive preventive measures have thus far been discovered for the effective control of this entity.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Luoto: Most importantly, more investigations and clinical studies are needed to evaluate the impact of gut microbiota modulation on nonintestinal infections. Further studies should also repeat our results with larger study population.  Additionally, the exact mechanisms behind such an effect need to be elucidated in the future.

Citation:

Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: A randomized, placebo-controlled trial.

Luoto R, Ruuskanen O, Waris M, Kalliomäki M, Salminen S, Isolauri E.

Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.

J Allergy Clin Immunol. 2013 Oct 13. pii: S0091-6749(13)01307-9. doi: 10.1016/j.jaci.2013.08.020. [Epub ahead of print

 

Probiotics and Infant Colic

MedicalResearch.com Interview with:
Dr Valerie Sung MBBS(Hons) FRACP MPH
NHMRC PhD Candidate

Department of Paediatrics, University of Melbourne, and
Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
Parkville | 3052 | Victoria
 Australia

MedicalResearch.com: What are the main findings of the study?

Dr. Sung: The systematic review identified 12 studies (1825 infants)  that investigated the use of probiotics to treat or prevent infant colic (excessive crying of unknown cause in babies less than 3 months old). Three of the 5 treatment trials concluded probiotics effectively treat colic in breastfed babies; one suggested possible effectiveness in formula-fed babies with colic, and one suggested ineffectiveness in breastfed babies with colic. The three effective trials used the probiotic Lactobacillus reuteri in breastfed babies only; in two of these trials, the mothers were on a dairy-free diet. Five of the 7 prevention trials suggested probiotics to be ineffective in preventing colic.

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Are Probiotics Effective in Preventing C.diff diarrhea in Elderly Patients?

Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK.Prof. Steve Allen
Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow
Room 314, The College of Medicine, Swansea University,
Swansea, SA2 8PP, UK.

MedicalResearch.com: What are the main findings of the study?

Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo.

Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit.

In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm.
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Study: Oral Probiotic Supplement Significantly Increased Circulating Vitamin D Levels

MedicalResearch.com Interview with:
Dr. Mitchell Jones, MD, PhD Faculty of Medicine at McGill University in MontrealDr. Mitchell Jones, MD, PhD
Faculty of Medicine at McGill University in Montreal

MedicalResearch.com: What are the main findings of the study?

Dr. Jones: We had previously reported on the cholesterol lowering efficacy of bile salt hydrolase active L. reuteri NCIMB 30242 due to reduced intestinal sterol absorption.

However, the effects of bile salt hydrolase active L. reuteri NCIMB 30242 on fat soluble vitamins was previously unknown and was the focus of the study.
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Probiotics for the prevention of antibiotic-associated diarrhea and C.diff among hospitalized patients

MedicalResearch.com eInterview with: Dr. Reena Pattani MD
Department of Medicine
St. Michael’s Hospital
30 Bond Street, Toronto ON M5B 1W8

MedicalResearch.com: What are the main findings of the study?

Dr. Pattani: We performed a meta-analysis of 16 studies that assessed the effectiveness of probiotics administered concurrently with antibiotics compared to the use of antibiotics alone. The use of probiotics among patients in these trials reduced the risk of antibiotic-associated diarrhea by almost 40% and decreased the rate of Clostridium difficile infection by 63%. On subgroup analysis, the reduction remained statistically significant for the subgroups of good quality trials, trials in which a primarily Lactobacillus-based regimen was used, and those studies which had a follow-up period of less than 4 weeks.
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