Published online September 3, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e795-e803 (doi:10.1542/peds.2006-2930)
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ARTICLE

An Experimental Study and a Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Antisecretory Activity of Lactobacillus acidophilus Strain LB Against Nonrotavirus Diarrhea

Vanessa Liévin-Le Moal, PhDa,b, Luis E. Sarrazin-Davila, MDc and Alain L. Servin, PhDa,b

a Faculté de Pharmacie, Institut National de la Santé et de la Recherche Médicale, Université Paris XI, UMR-S 756 Signalisation et Physiopathologie des Cellules Epithéliales, Châtenay-Malabry, France
b Faculté de Pharmacie, Université Paris-Sud 11, Châtenay-Malabry, France
C Department of Pediatrics, Hospital Clinica Kennedy, Guayaquil, Ecuador

OBJECTIVE. Previous studies have shown that selected strains of Lactobacillus have the capacity to antagonize rotavirus-induced diarrhea. However, only a few reports have documented their efficacy against nonrotavirus diarrhea. This study involved an experimental investigation and a clinical trial of the antisecretory activity of Lactobacillus acidophilus strain LB in the context of nonrotavirus diarrhea.

METHODS. The activity of a culture of L acidophilus LB or of the lyophilized, heat-killed L acidophilus LB bacteria plus their spent culture medium was tested in inhibiting the formation of fluid-formed domes in cultured human intestinal Caco-2/TC7 cell monolayers infected with diarrheagenic, diffusely adhering Afa/Dr Escherichia coli C1845 bacteria. A randomized, double-blind, placebo-controlled clinical trial of male or female children who were 10 months of age and presented with nonrotavirus, well-established diarrhea was conducted to evaluate the therapeutic efficacy of a pharmaceutical preparation that contains 10 billion heat-killed L acidophilus LB plus 160 mg of spent culture medium.

RESULTS. Infection of the cells with C1845 bacteria that were treated with L acidophilus LB culture or the lyophilized, heat-killed L acidophilus LB bacteria plus their culture medium produced a dosage-dependent decrease in the number of fluid-formed domes as compared with cells that were infected with untreated C1845 bacteria. The clinical results show that in selected and controlled homogeneous groups of children with well-established, nonrotavirus diarrhea, adding lyophilized, heat-killed L acidophilus LB bacteria plus their culture medium to a solution of oral rehydration solution shortened by 1 day the recovery time (ie, the time until the first normal stool was passed) as compared with children who received placebo oral rehydration solution.

CONCLUSIONS. Heat-killed L acidophilus LB plus its culture medium antagonizes the C1845-induced increase in paracellular permeability in intestinal Caco-2/TC7 cells and produces a clinically significant benefit in the management of children with nonrotavirus, well-established diarrhea.

Key Words: children • nonrotavirus diarrhea • Lactobacillus • anti-secretory activity

Abbreviations: ORS—oral rehydration solution • DAEC—diffusely adhering Escherichia coli • PBS—phosphate-buffered saline • Sat—secreted autotransporter toxin • MRS—De Man, Rogosa, Sharpe • CFCS—cell-free culture supernatant • CFU—colony-forming units • LDH—lactate dehydrogenase

Accepted Feb 23, 2007.


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[Abstract] [PDF]