Abstract
Background/Objectives:
Evidence suggests that the long-term consumption of probiotics may help in reducing the incidence of or modifying acute respiratory infection (ARI). We assessed the role of the short-term use of probiotics in ARI in children.
Subjects/Methods:
This was a randomized, double-blind, controlled study that enrolled 315 children with 90 dropouts. On the first day of appearance of a sick household member, otherwise healthy children of both sexes aged 3–12 years were allocated to receive Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABLA-12 (Up4-Junior) in a dose of 5 billion colony-forming units daily with 50 mg of fructooligosaccharide (the probiotic group) or rice maltodexrin (the control group). Test supplementation and follow-up lasted for 2 weeks or until the end of the secondary ARI in a child. The primary outcome measure was the incidence of ARI. Time to resolution and the severity of ARI served the secondary outcome measures.
Results:
In all, 64 of 113 children in the probiotic group (57%) and 73 of 112 children in the control group (65%) developed ARI (P=0.261). Time to resolution of the secondary ARI was shorter in the probiotic group (5.0 (interquartile range (IQR): 4.0–6.0) vs 7.0 (IQR: 6.0–8.0) days, P<0.001). The median severity of ARI was 240 (IQR: 163–350) score-days in the probiotic vs 525 (IQR: 364–736) score-days in the control group (P<0.001).
Conclusions:
The short-term use of probiotics does not reduce the incidence, but shortens ARI in preschool and elementary school children.
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References
Chonmaitree T, Revai K, Grady JJ, Clos A, Patel JA, Nair S et al. Viral upper respiratory tract infection and otitis media complication in young children. Clin Infect Dis 2008; 46: 815–823.
Haskins R, Kotch J . Day care and illness: evidence, costs and public policy. Pediatrics 1986; 77: 951–982.
Nicholson KG, McNally T, Silverman M, Simons P, Stockton JD, Zambon MC . Rates of hospitalisation for influenza, respiratory syncytial virus and human metapneumovirus among infants and young children. Vaccine 2006; 24: 102–108.
Massin MM, Montesanti J, Gerard P, Lepage P . Spectrum and frequency of illness presenting to a pediatric emergency department. Acta Clin Belg 2006; 61: 161–165.
Olszewska W, Zambon M, Openshaw PJM . Development of vaccines against common colds. Br Med Bull 2002; 62: 99–111.
Sauro A, Barone F, Blasio G, Russo L, Santillo L . Do influenza and acute respiratory infective diseases weigh heavily on general practitioners’ daily practice? Eur J Gen Pract 2006; 12: 34–36.
Lambert SB, Allen KM, Carter RC, Nolan TM . The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children. Respir Res 2008; 9: 11.
Ehlken B, Ihorst G, Lippert B, Rohwedder A, Petersen G, Schumacher M et al. Economic impact of community-acquired and nosocomial lower respiratory tract infections in young children in Germany. Eur J Pediatr 2005; 164: 607–615.
Winkler P, de Vrese M, Laue Ch, Schrezenmeir J . Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Int J Clin Pharmacol Ther 2005; 43: 318–326.
Berggren A, Lazou Ahron I, Larsson N, Onning G . Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. Eur J Nutr 2011; 50: 203–210.
Hojsak I, Abdovic S, Szajewska H, Milosevic M, Krznaric Z, Kolacek S . Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics 2010; 125: e1171–e1177.
Guillemard E, Tanguy J, Flavigny A, de la Motte S, Schrezenmeir J . Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial. J Am Coll Nutr 2010; 29: 455–468.
West NP, Horn PL, Pyne DB, Gebski VJ, Lahtinen SJ, Fricker PA et al. Probiotic supplementation for respiratory and gastrointestinal illness symptoms in healthy physically active individuals. Clin Nutr 2014; 33: 581–587.
Luoto R, Ruuskanen O, Waris M, Kalliomäki M, Salminen S, Isolauri E . Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized, placebo-controlled trial. J Allergy Clin Immunol 2014; 133: 405–413.
de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C et al. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: a double blind, randomized, controlled trial. Clin Nutr 2005; 24: 481–491.
Haywood BA, Black KE, Baker D, McGarvey J, Healey P, Brown RC . Probiotic supplementation reduces the duration and incidence of infections but not severity in elite rugby union players. J Sci Med Sport 2014; 17: 356–360.
Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC . Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009; 124: e172–e179.
Hojsak I, Snovak N, Abdovic 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: 312–316.
Garaiova I, Muchová J, Nagyová Z, Wang D, Li JV, Országhová Z et al. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomized controlled pilot study. Eur J Clin Nutr 2014; 69: 373–379.
Kang EJ, Kim SY, Hwang IH, Ji YJ . The effect of probiotics on prevention of common cold: a meta-analysis of randomized controlled trial studies. Korean J Fam Med 2013; 34: 2–10.
King S, Glanville J, Sanders ME, Fitzgerald A, Varley D . Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis. Br J Nutr 2014; 112: 41–54.
Jacobs B, Young NL, Dick PT, Ipp MM, Dutkowski R, Davies HD et al. Canadian Acute Respiratory Illness and Flu Scale (CARIFS). Development of a valid measure for childhood respiratory infections. J Clin Epidemiol 2000; 53: 793–799.
Gerasimov SV, Belova HA, Pavuk HL, Seniuk ІM, Strekalina YI . The Ukrainian version of the pediatric Canadian acute respiratory illness and flu scale: a linguistic validation study. Patient Relat Outcome Meas 2014; 5: 111–117.
Gerasimov SV, Vasjuta VV, Myhovych OO, Bondarchuk LI . Probiotic supplement reduces atopic dermatitis in preschool children: a randomized, double-blind, placebo-controlled, clinical trial. Am J Clin Dermatol 2010; 11: 351–361.
Pang IK, Iwasaki A . Control of antiviral immunity by pattern recognition and the microbiome. Immunol Rev 2012; 245: 209–226.
Taipale T, Pienihäkkinen K, Isolauri E, Larsen C, Brockmann E, Alanen P et al. Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in infancy. Br J Nutr 2011; 105: 409–416.
de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C et al. Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial. Vaccine 2006; 24: 6670–6674.
Hao Q, Dong BR, Wu T . Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev 2015; (2), CD006895.
Agustina R, Kok FJ, van de Rest O, Fahmida U, Firmansyah A, Lukito W et al. Randomized trial of probiotics and calcium on diarrhea and respiratory tract infections in Indonesian children. Pediatrics 2012; 129: e1155–e1164.
Smith TJ, Rigassio-Radler D, Denmark R, Haley T, Touger-Decker R . Effect of Lactobacillus rhamnosus LGG® and Bifidobacterium animalis ssp. lactis BB-12® on health-related quality of life in college students affected by upper respiratory infections. Br J Nutr 2012; 1: 1–9.
Hatakka K, Savilahti E, Ponka A, Meurman JH, Poussa T, Nase L 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: 1–5.
Weizman Z, Asli G, Alsheikh A . Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005; 115: 5–9.
Schwarze J, Mackenzie KJ . Novel insights into immune and inflammatory responses to respiratory viruses. Thorax 2013; 68: 108–110.
Heymann DL Influenza. In: Heymann DL (ed.) Control of Communicable Diseases Manual, 19th edn. American Public Health Association Press: Washington, DC, USA, 2008, pp 315–322.
Peltola V, Waris M, Osterback R, Susi P, Ruuskanen O, Hyypiä T . Rhinovirus transmission within families with children: incidence of symptomatic and asymptomatic infections. J Infect Dis 2008; 197: 382–389.
Turchet P, Laurenzano M, Auboiron S, Antoine JM . Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study. J Nutr Health Aging 2003; 7: 75–77.
König R, Stertz S, Zhou Y, Inoue A, Hoffmann HH, Bhattacharyya S et al. Human host factors required for influenza virus replication. Nature 2010; 463: 813–817.
Miller EK, Williams JV, Gebretsadik T, Carroll KN, Dupont WD, Mohamed YA et al. Host and viral factors associated with severity of human rhinovirus-associated infant respiratory tract illness. J Allergy Clin Immunol 2011; 127: 883–891.
Kawase M, He F, Kubota A, Yoda K, Miyazawa K, Hiramatsu M . Heat-killed Lactobacillus gasseri TMC0356 protects mice against influenza virus infection by stimulating gut and respiratory immune responses. FEMS Immunol Med Microbiol 2012; 64: 280–288.
Villena J, Chiba E, Tomosada Y, Salva S, Marranzino G, Kitazawa H et al. Orally administered Lactobacillus rhamnosus modulates the respiratory immune response triggered by the viral pathogen-associated molecular pattern poly(I:C). BMC Immunol 2012; 13: 53.
Salva S, Villena J, Alvarez S . Immunomodulatory activity of Lactobacillus rhamnosus strains isolated from goat milk: impact on intestinal and respiratory infections. Int J Food Microbiol 2010; 30: 82–89.
Gill HS, Rutherfurd KJ, Cross ML . Dietary probiotic supplementation enhances natural killer cell activity in the elderly: an investigation of age-related immunological changes. J Clin Immunol 2001; 21: 264–271.
Sheih YH, Chiang BL, Wang LH, Liao CK, Gill HS . Systemic immunity-enhancing effects in healthy subjects following dietary consumption of the lactic acid bacterium Lactobacillus rhamnosus HN001. J Am Coll Nutr 2001; 20: 149–156.
Pulendran B, Maddur MS . Innate immune sensing and response to influenza. Curr Top Microbiol Immunol 2015; 386: 23–71.
Merenstein D, Murphy M, Fokar A, Hernandez RK, Park H, Nsouli H et al. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study. A patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial. Eur J Clin Nutr 2010; 64: 669–677.
West NP, Pyne DB, Cripps AW, Hopkins WG, Eskesen DC, Jairath A et al. Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes. Nutr J 2011; 10: 30.
Acknowledgements
We thank the family and pediatric physicians who helped to recruit children into this study, and the caregivers and children for taking part. The study was supported as a part of the program ‘Optimization of the prognosis, prophylaxis and treatment of the most common pediatric illnesses and functional disorders’ approved by the Health Ministry of Ukraine (0113U000209).
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Gerasimov, S., Ivantsiv, V., Bobryk, L. et al. Role of short-term use of L. acidophilus DDS-1 and B. lactis UABLA-12 in acute respiratory infections in children: a randomized controlled trial. Eur J Clin Nutr 70, 463–469 (2016). https://doi.org/10.1038/ejcn.2015.171
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DOI: https://doi.org/10.1038/ejcn.2015.171
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