The L. reuteri strains DSM 17938 and ATCC PTA 5289 have the ability to produce reuterin, a substance with both antiviral and antimicrobial activity (Ang et al., 2016; Spinler et al., 2008).
L. reuteri strains have also been reported to increase the concentration of secretory immunoglobulin (Ig)A (Mu et al., 2018), which could be an important factor in the defence against pathogens. Finally, different strains of L. reuteri have been shown to protect integrity of cultivated intestinal epithelial cells from the detrimental effect of enterotoxigenic Escherichia coli by increasing the expression of the longer isoform of zonulin (ZO)-1, maintaining E-cadherin expression and downregulating induction of interleukin (IL)-6 and umour necrosis factor (TNF)-α (Karimi et al., 2018).
The present study, sponsored by BioGaia AB, Sweden, aimed to evaluate the safety and efficacy of L. reuteri ATCC PTA 5289 combined with L. reuteri DSM 17938 as an adjuvant to non-steroidal anti-inflammatory drug (NSAID), twice daily for 10 days in children with URTIs.
A total of 70 children, aged six months to five years, were randomised into an active or placebo group.
L. reuteri (DSM 17938 and ATCC PTA 5289) oil drops were administered orally in a total daily dose of 4×10 8 cfu for 10 days. The active study product consisted of freeze-dried L. reuteri suspended in a mixture of pharmaceutical grade medium chain triglyceride and sunflower oils while the placebo group received the same treatment, without the bacterial strain.
At the end of the study, significant differences were observed in relation to the duration of respiratory symptoms (3.1±0.8 vs 5.2±1.4,P<0.05), days with fever (1.8±0.4 vs 3.6±0.6, P<0.05), severity of sore throat (FLACC score 5±1.2 vs 8±3.4, P<0.05), runny nose, nasal congestion, days of non-programmed visits to medical office or emergency department and related costs in favour to L. reuteri group.There was no fever on day 2 and subsequent days in the L. reuteri droup. Significant differences were also identified for TNF-α in favour to the L. reuteri Group (3.8±0.7 vs 5.9±0.4 pg/ml, P<0.05).
The report concludes that the two strains of probiotics can be used as an adjuvant to reduce the duration and severity of clinical symptoms in children with pharyngitis or tonsillitis.
“The importance of this study lies not only in the clinical impact observed but also in the reduction of related costs, which undoubtedly adds a significant value from a public health point of view, considering the frequency of acute respiratory infections observed in young children and the impact on their quality of life,” says researcher Pedro Gutiérrez-Castrellón. MD, MSc, DSc, Centre for Translational Research on Mother and Child Health, Hospital General Dr. Manuel Gea González, Mexico City, Mexico.
The researchers advise a second clinical trial is needed with a larger sample size, to allow evaluation of the impact of some covariates that could generate different impacts on the outcome variables.
Source: Beneficial Microbes
Maya-Barrios. A., et al
"Limosilactobacillus reuteri ATCC PTA 5289 and DSM 17938 as adjuvants to improve evolution of pharyngitis/tonsillitis in children: randomised controlled trial"