Strain-Specificity of Probiotics in Pediatrics: A Rapid Review of the Clinical Evidence.
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
01 02 2023
01 02 2023
Historique:
pubmed:
24
12
2022
medline:
1
2
2023
entrez:
23
12
2022
Statut:
ppublish
Résumé
The dogma of probiotic strain-specificity is widely accepted. However, only the genus- and species-specific effects of probiotics are supported by evidence from clinical trials. The aim of this rapid review was to assess clinical evidence supporting the claim that the efficacy of probiotics in the pediatric population is strain-specific. The Cochrane Library, MEDLINE, and EMBASE databases were searched (up to August 2022) for randomized controlled trials (RCTs) conducted in children aged 0-18 years evaluating the effects of prophylactic or therapeutic administration of probiotics (well-characterized at the strain level) for conditions such as antibiotic-associated diarrhea, acute diarrhea, necrotizing enterocolitis, respiratory tract infections, Helicobacter pylori infection, and atopic dermatitis. To allow evaluation of strain-specificity, a trial could only be included in the review if at least one additional RCT assessed the effect of a different strain of the same species against the same comparator. RCTs without proper strain-level data were excluded. In the absence of identifying head-to-head strain versus strain RCTs, indirect comparisons were made between interventions. Twenty-three RCTs were eligible for inclusion. Out of the 11 performed comparisons, with 1 exception (two Lacticaseibacillus paracasei strains in reducing atopic dermatitis symptoms), no significant differences between the clinical effects of different strains of the same probiotic species were found. Head-to-head comparison is an optimal study design to compare probiotic strains, but such comparisons are lacking. Based on indirect comparisons, this rapid review demonstrates insufficient clinical evidence to support or refute the claim that probiotic effects in children are strain-specific.
Identifiants
pubmed: 36563089
doi: 10.1097/MPG.0000000000003675
pii: 00005176-202302000-00021
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
227-231Informations de copyright
Copyright © 2022 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Hill C, Guarner F, Reid G, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11:506–14.
Draper K, Ley C, Parsonnet J. A survey of probiotic use practices among patients at a tertiary medical centre. Benef Microbes. 2017;8:345–51.
Fijan S, Frauwallner A, Varga L, et al. Health professionals’ knowledge of probiotics: an international survey. Int J Environ Res Public Health. 2019;16:312817.
Szajewska H, Canani RB, Domellöf M, et al. Probiotics for the management of pediatric gastrointestinal disorders: position paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications. J Pediatr Gastroenterol Nutr. 2022.
Tan-Lim CSC, Esteban-Ipac NAR, Mantaring IJ, et al. Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: a systematic review and network meta-analysis. Pediatr Allergy Immunol. 2021;32:124–36.
Wang Y, Li X, Ge T, et al. Probiotics for prevention and treatment of respiratory tract infections in children: a systematic review and meta-analysis of randomized controlled trials. Medicine. 2016;95:e4509e4509.
Yan Y, Nguyen LH, Franzosa EA, Huttenhower C. Strain-level epidemiology of microbial communities and the human microbiome. Genome Med. 2020;12:71.
Sniffen JC, McFarland LV, Evans CT, et al. Choosing an appropriate probiotic product for your patient: an evidence-based practical guide. PLoS One. 2018;13:e0209205e0209205.
Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria. Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. Prevention. 2001;5:1–10.
Kolaček S, Hojsak I, Berni Canani R, et al. Commercial probiotic products: a call for improved quality control. A position paper by the ESPGHAN working group for probiotics and prebiotics. J Pediatr Gastroenterol Nutr. 2017;65:117–24.
McFarland LV. Efficacy of single-strain probiotics versus multi-strain mixtures: systematic review of strain and disease specificity. Dig Dis Sci. 2021;66:694–704.
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l–8.
Chaimani A, Caldwell DM, Li T, et al. Chapter 11: Undertaking network meta-analyses. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, eds. In: Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane; 2020. Available from www.training.cochrane.org/handbook .
Han Y, Kim B, Ban J, et al. A randomized trial of Lactobacillus plantarum CJLP133 for the treatment of atopic dermatitis. Pediatr Allergy Immunol. 2012;23:667–73.
Prakoeswa CRS, Herwanto N, Prameswari R, et al. Lactobacillus plantarum IS-10506 supplementation reduced SCORAD in children with atopic dermatitis. Benef Microbes. 2017;8:833–40.
D’Auria E, Panelli S, Lunardon L, et al. Rice flour fermented with Lactobacillus paracasei CBA L74 in the treatment of atopic dermatitis in infants: a randomized, double- blind, placebo- controlled trial. Pharmacol Res. 2021;163:105284.
Wang IJ, Wang JY. Children with atopic dermatitis show clinical improvement after Lactobacillus exposure. Clin Exp Allergy. 2015;45:779–87.
Gore C, Custovic A, Tannock GW, et al. Treatment and secondary prevention effects of the probiotics Lactobacillus paracasei or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years. Clin Exper Allergy. 2012;42:112–22.
Yan DC, Hung CH, Sy LB, et al. A randomized, double-blind, placebo-controlled trial assessing the oral administration of a heat-treated Lactobacillus paracasei supplement in infants with atopic dermatitis receiving topical corticosteroid therapy. Skin Pharmacol Physiol. 2019;32:201–11.
Lionetti E, Miniello VL, Castellaneta SP, et al. Lactobacillus reuteri therapy to reduce side-effects during anti- Helicobacter pylori treatment in children: a randomized placebo controlled trial. Aliment Pharmacol Ther. 2006;24:1461–8.
Shahraki T, Shahraki M, Shahri ES, et al. No significant impact of Lactobacillus reuteri on eradication of Helicobacter pylori in children (double-blind randomized clinical trial). Iranian Red Crescent Med J. 2017;19: 1–5.
Costeloe K, Hardy P, Juszczak E, Wilks M, Millar MR. Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial. Lancet. 2016;387:649–60.
Fujii T, Ohtsuka Y, Lee T, et al. Bifidobacterium breve enhances transforming growth factor beta1 signaling by regulating Smad7 expression in preterm infants. J Pediatr Gastroenterol Nutr. 2006;43:83–8.
Kitajima H, Sumida Y, Tanaka R, Yuki N, Takayama H, Fujimura M. Early administration of Bifidobacterium breve to preterm infants: randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 1997;76:F101–7.
Oshiro T, Nagata S, Wang C, et al. Bifidobacterium supplementation of colostrum and breast milk enhances weight gain and metabolic responses associated with microbiota establishment in very-preterm infants. Biomed Hub. 2019;4:1–10.
Patole S, Keil AD, Chang A, et al. Effect of Bifidobacterium breve M-16V supplementation on fecal bifidobacteria in preterm neonates—a randomised double blind placebo controlled trial. PLoS One. 2014;9:e89511.
Hojsak I, Snovak N, Abdović S, Szajewska H, Misak Z, Kolacek S. 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. Clin Nutr. 2010;29:312–6.
Cáceres P, Montes S, Vega N, et al. Effects of Lactobacillus rhamnosus HN001 on acute respiratory infections and intestinal secretory IgA in children. J Pediatr Infect Dis. 2010;5:353–62.
Damholt A, Keller MK, Baranowski K, et al. Lacticaseibacillus rhamnosus GG DSM 33156 effects on pathogen defence in the upper respiratory tract: a randomised, double-blind, placebo-controlled paediatric trial. Benef Microbes. 2022;13:13–23.
Kumpu M, Kekkonen RA, Kautiainen H, et al. Milk containing probiotic Lactobacillus rhamnosus GG and respiratory illness in children: a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2012;66:1020–3.
Hatakka K, Savilahti E, Pönkä A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ. 2001;322:1327.
Arvola T, Laiho K, Torkkeli S, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics. 1999;104:e64.
Esposito C, Roberti A, Turra F, et al. Frequency of antibiotic-associated diarrhea and related complications in pediatric patients who underwent hypospadias repair: a comparative study using probiotics vs placebo. Probiotics Antimicrob Proteins. 2018;10:323–8.
Szajewska H, Albrecht P, Topczewska-Cabanek A. Randomized, double-blind, placebo-controlled trial: effect of Lactobacillus GG supplementation on Helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr. 2009;48:431–6.
Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr. 1999;135:564–8.
Ruszczynski M, Radzikowski A, Szajewska H. Clinical trial: effectiveness of Lactobacillus rhamnosus (strains E/N, Oxy and Pen) in the prevention of antibiotic-associated diarrhoea in children. Aliment Pharmacol Ther. 2008;28:154–61.
Heuvelin E, Lebreton C, Grangette C, Pot B, Cerf-Bensussan N, Heyman M. Mechanisms involved in alleviation of intestinal inflammation by Bifidobacterium breve soluble factors. PLoS One. 2009;4:e5184.
Letizia F, Albanese G, Testa B, et al. In vitro assessment of bio-functional properties from Lactiplantibacillus plantarum strains. Cur Issues Mol Biol. 2022;44:2321–34.
Ramos CL, Thorsen L, Schwan RF, Jespersen L. Strain-specific probiotics properties of Lactobacillus fermentum , Lactobacillus plantarum and Lactobacillus brevis isolates from Brazilian food products. Food Microbiol. 2013;36:22–9.
Rosander A, Connolly E, Roos S. Removal of antibiotic resistance gene-carrying plasmids from Lactobacillus reuteri ATCC 55730 and characterization of the resulting daughter strain, L. reuteri DSM 17938. Appl Environ Microbiol. 2008;74:6032–40.
Piatek J, Krauss H, Ciechelska-Rybarczyk A, et al. In-vitro growth inhibition of bacterial pathogens by probiotics and a synbiotic: product composition matters. Int J Environ Res Public Health. 2020;17:3332.
Ceapa C, Lambert J, van Limpt K, et al. Correlation of Lactobacillus rhamnosus genotypes and carbohydrate utilization signatures determined by phenotype profiling. Appl Environ Microbiol. 2015;81:5458–70.
Plaza-Diaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil A. Mechanisms of action of probiotics. Adv Nutr. 2019;10:S49–66.
Pavlović N, Stankov K, Mikov M. Probiotics—interactions with bile acids and impact on cholesterol metabolism. Appl Biochem Biotechnol. 2012;168:1880–95.
van der Hee B, Wells JM. Microbial regulation of host physiology by short-chain fatty acids. Trends Microbiol. 2021;29:700–12.
Gómez-Llorente C, Muñoz S, Gil A. Role of Toll-like receptors in the development of immunotolerance mediated by probiotics. Proc Nutr Soc. 2010;69:381–9.
Tillisch K, Labus J, Kilpatrick L, et al. Consumption of fermented milk product with probiotic modulates brain activity. Gastroenterology. 2013;144:1394–401, 1401.e1.
EFSA Panel on Dietetic Products N, Allergies. Scientific opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion (ID 1143, 2976) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J. 2010;8:1763.
Webbe J, Sinha I, Gale C. Core outcome sets. Arch Dis Child Educ Pract Ed. 2018;103:163–6.
Roberfroid D, Fairon N, San Miguel L, et al. Method – Rapid reviews. Methods Brussels: Belgian Health Care Knowledge Centre (KCE). 2016. KCE Process Notes. D/2017/10.273/01. This document is available on the website of the Belgian Health Care Knowledge Centre.
Depoorter L, Vandenplas Y. Probiotics in pediatrics. A review and practical guide. Nutrients. 2021;13.
Hojsak I. Probiotics in children: what is the evidence? Pediatr Gastroenterol Hepatol Nutr. 2017;20:139–46.