Lactobacillus Reuteri DSM 17938 in Infantile Colic: A Systematic Review and Meta-Analysis

Background. Infantile colic, defined as paroxysmal, excessive, and consolable crying without an identifiable cause. It is common in the first 3 months of life. There have been many RCT studies conducted. A systematic synthesis is required to summarize the results of these RCTs. This study was aimed to systematically analyze the benefits of Lactobacillus reuteri DSM 17938 for infantile colic. Methods. This systematic review and meta-analysis used keywords: (“infantile colic” OR “abdominal cramps” OR “abdominal cramp” OR “infant colic”) AND “lactobacillus reuteri” AND (placebo OR placebos) AND (“randomized controlled trial” OR RCT). The databases used were: pubmed, science direct, and google scholar. Meta-analysis was conducted to combine the articles. The eligibility criteria were: patient with infantile colic, intervention with L. reuteri DSM 17938, control was placebo, RCT study design, outcome with dichotomous scale, all races, all ethnicities, all countries, all genders, in English, and not limited by year. Results. The search resulted in 800 articles. After reducing duplication, the number of articles was 747. Screening with titles and abstracts resulted in 13 full teks articles. Six articles fitted the eligibility criteria. The results of the meta-analysis were as follows. The forest plot showed that the combined effect of the six articles showed an RR of 0.47 and was statistically significant (p <0.001). Conclusion. Based on the results of this meta-analysis, L. reuteri DSM 17938 is recommended for infants with infantile colic. There were no significant side effects with the use of L. reuteri DSM 17938 on infantile colic.

Probiotic Potential and Functional Properties of Lactobacillus Reuteri, Lactobacillus Rhamnosus and Lactobacillus Helveticus: A Comparative Study

This study was conducted to evaluate and comparethe probiotic propertiesofLactobacillus helveticusNK1, Lactobacillus rhamnosusF and Lactobacillus reuteriLR1lactobacilli strains.Changes in pH, cell growth, proteolytic activity, antioxidantactivity, and angiotensin-converting enzyme(ACE)inhibitoryactivity were monitored during fermentation ofreconstituted skim milk (RSM) by pure cultures of lactobacilli.Among the tested strains, L. helveticusNK1 showed the highest proteolytic, ACE inhibitoryand antioxidantactivitiesduring milk fermentation,followed by L. rhamnosus F and L. reuteriLR1.The promising capability of all of the lactobacilli strains to release bioactivepeptides from the milk proteins was demonstrated. Keywords: Lactobacillus, probiotic, milk fermentation, bioactive peptides

Role of Lactobacillus reuteri DSM 17938 on Crying Time Reduction in Infantile Colic and Its Impact on Maternal Depression: A Real-Life Clinic-Based Study

Background: Infantile colic is characterized by prolonged periods of inconsolable, incessant crying and persistent fussing in an otherwise healthy infant. It is a self-limiting condition, but causes significant stress to mothers. AIM: To observe the role of Lactobacillus reuteriDSM 17938 in reducing crying time in colicky infants in routine clinical practice. Methods: This was a prospective observational multicentric clinic-based study. Each practitioner included approximately 30 infants < 5 months of age with infantile colic who were prescribed L. reuteri DSM 17938 for a period of 21 days. There were four physical consultations and two telephonic consultations. The parents were given a daily diary to record the duration of crying and fussing episodes and a questionnaire was administered during the consultations. Results: A total of 120 infants with a mean age of 56.9 ± 34.2 days were included in this 28-day study. The mean crying time as reported by the parents in the subject diary reduced from 248.2 ± 101.2 min, 95% CI: 229.45, 266.94 at baseline to 45.6 ± 79.1 min 95% CI: 31.02, 60.31 at study end (P < 0.01). The clinical response (defined as reduction of 50% in crying time) was observed in 85% of subjects at study end. The fussiness and parental perception of colic recorded during the consultations were reduced by 66% and 72%, respectively, at study end. The maternal depression scores were reduced to 63% at study end. Conclusion: L. reuteri DSM 17938 was associated with a significant reduction in crying time in colicky infants, and showed improvement in maternal depression.

Treatment of Hyperammonemia by Transplanting a Symbiotic Pair of Intestinal Microbes

Hyperammonemia is a deleterious and inevitable consequence of liver failure. However, no adequate therapeutic agent is available for hyperammonemia. Although recent studies showed that the pharmabiotic approach could be a therapeutic option for hyperammonemia, its development is clogged with poor identification of etiological microbes and low transplantation efficiency of candidate microbes. In this study, we developed a pharmabiotic treatment for hyperammonemia that employs a symbiotic pair of intestinal microbes that are both able to remove ammonia from the surrounding environment. By a radioactive tracing experiment in mice, we elucidated how the removal of ammonia by probiotics in the intestinal lumen leads to lower blood ammonia levels. After determination of the therapeutic mechanism, ammonia-removing probiotic strains were identified by high-throughput screening of gut microbes. The symbiotic partners of ammonia-removing probiotic strains were identified by screening intestinal microbes of a human gut, and the pairs were administrated to hyperammonemic mice to evaluate therapeutic efficacy. Blood ammonia was in a chemical equilibrium relationship with intestinal ammonia. Lactobacillus reuteri JBD400 removed intestinal ammonia to shift the chemical equilibrium to lower the blood ammonia level. L. reuteri JBD400 was successfully transplanted with a symbiotic partner, Streptococcus rubneri JBD420, improving transplantation efficiency 2.3×103 times more compared to the sole transplantation while lowering blood ammonia levels significantly. This work provides new pharmabiotics for the treatment of hyperammonemia as well as explains its therapeutic mechanism. Also, this approach provides a concept of symbiotic pairs approach in the emerging field of pharmabiotics.

Antagonistic Activity of Bacteriocins Produced by Lactobacillus Isolates against Multidrug Resistant Pathogens

Background: Multi drug-resistance pose a great threat to public health and are responsible for various life-threatening ailments. There is a crucial need to control the outbreaks by finding alternatives to the conventional drugs available. Over the last few years, the usage of probiotics, including Lactobacillus spp. and their bacteriocins has gained much attention to ward off various diseases. Methods: This study was focused on characterizing bacteriocins extracted from Lactobacillus spp. and assessing their antagonistic effect against multi-drug resistant bacteria. Fifteen Lactobacillus spp. were isolated and identified from Pakistani dairy and fermented products (raw milk, cheese, butter milk, pickle and yoghurt). All the isolates were preliminarily screened by the antagonism method of agar well diffusion method, and the bacteriocins were isolated by ammonium sulphate method. Afterwards, to evaluate the release of bacteriocin in liquid medium, the Cell-Free Supernatant Fluid (CFSF) of the best producer strains were tested by agar well diffusion assay. To assess the thermostability of the bacteriocins, they were subjected to temperatures of 40ᴼC, 60ᴼC, 80ᴼC and 100ᴼC. Results: The study allowed the selection of five bacteriocin producing strains Lactobacillus acidophilus KAL1, Lactobacillus casei KAL3, Lactobacillus plantarum KAL5, Lactobacillus reuteri KAL6 and Lactobacillus spp. delbrukei KAL7, endowed with the strongest and broadest inhibitory ability against both Gram-positive (Methicillin Resistant Staphylococcus aureus) and Gram-negative (Pseudomonas aeruginosa) bacteria. Bacteriocins isolated were significantly thermostable with activity at 80ᴼC (30, 20 min) respectively. Moreover, all the bacteriocins were considerably stable at a range of pH (4–8) but all the activity was eliminated against proteolytic enzyme Proteinase K. Conclusion: From this study, it was concluded that bacteriocin extracts from five isolated Lactobacillus spp. can be considered a preferable candidate against multi-drug resistant pathogens. These partially purified bacteriocins should be further processed to attain purified product that could be useful for further studies for the control of pathogens, food spoilage and preservation purposes.

A Novel Effective Formulation of Bioactive Compounds for Wound Healing: Preparation, In Vivo Characterization, and Comparison of Various Postbiotics Cold Creams in a Rat Model

The wound is a break in the integrity of the skin produced by injury, illness, or operation. Wound healing is an essential dynamic biological/physiological process that occurs in response to tissue damage. The huge health, economic, and social effects of wounds on patients and societies necessitate the research to find novel potential therapeutic agents in order to promote wound healing. Postbiotics, the newest member of the biotics family, are valuable functional bioactive substances produced by probiotics through their metabolic activity, which have several beneficial properties, including immunomodulatory, anti-inflammatory, antimicrobial, and angiogenesis characteristics, resulting in acceleration of wound healing. In the current study, three topical cold cream formulations containing postbiotics obtained from Lactobacillus fermentum, Lactobacillus reuteri, or Bacillus subtilis sp. natto probiotic strains were prepared. The effectiveness and wound healing activity of the developed postbiotics cold cream formulations were investigated compared to cold cream without postbiotics and no treatment via wound closure investigation, hydroxyproline content assay, and histological assessment in 25 Sprague Dawley rats divided into five groups. Interestingly, analysis of the results revealed that all three formulations containing postbiotics significantly accelerated the wound healing process. However, in general, the Bacillus subtilis natto cold cream manifested a better wound healing property. The pleasing wound healing characteristics of the topical postbiotics cold creams through the in vivo experiment suggest that formulations containing postbiotics can be considered as a promising nominee for wound healing approaches.