L.rhamnosus may improve acute diarrhea in children

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The probiotic strain Lacticaseibacillus rhamnosus LRa05 may reduce the severity of diarrhea in children by reshaping gut microbiota and enhancing immunity, according to a new study.

Writing in the journal Frontiers in Nutrition, researchers in China assessed the LRa05 strain which is marketed to treat diarrhea, constipation and eczema and has been found to reshape intestinal microflora by boosting short-chain fatty acids (SCFA)-producing bacteria and reducing pro-inflammatory bacteria.

Can probiotics help treat diarrhea in children?

Diarrhea can lead to malnutrition, stunted growth and even child mortality, particularly in developing countries.

Probiotic supplementation has recently emerged as a complementary treatment for acute diarrhea, however, the effectiveness of probiotics depends heavily on specific strains.

The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHN) recommends using only clinically proven probiotic strains in appropriate doses for treating acute gastroenteritis in children.

The Lacticaseibacillus rhamnosus LRa05 strain is isolated from infant feces. Previous research has demonstrated its ability to improve acid and bile tolerance, as well as its immunomodulatory, cholesterol-lowering, and antioxidant effects in vivo.

However, whether LRa05 can effectively colonize and become a dominant flora to enhance immunity in children with diarrhea has been unexplored until now. 

Probiotics reduce diarrhea duration in children

The randomized controlled trial recruited 60 children between the ages of 0 and 3 years with diarrhea and randomly assigned them to an intervention group (IG) or a control group (CG). IG children received daily oral probiotics (5×10⁹ CFU of LRa05) for seven days alongside standard therapy, while CG received standard care plus placebo sachets.

Clinical data, including Bristol fecal scores, adverse events and secondary outcomes such as fecal biochemical and microbiome analyses, were systematically documented and analyzed.

Results showed that LRa05 significantly reduced diarrhea duration and fecal frequency in children with acute watery diarrhea. By day two, improvements were evident, and by day five, daily fecal frequency had dropped by 1.23 times compared to controls.

LRa05 was found to alter gut microbiota by increasing ActinobacteriaBifidobacterium and Bifidobacterium longum while decreasing harmful bacteria like Enterococcus faecium.

The microbial shift correlated with symptom improvement. Additional functional gene analysis revealed significant changes in the relative abundance of 108 sub-functional genes in the gut microbiome after LRa05 treatment, particularly in pathways related to DNA repair, metabolism, ribosome function and amino acid-related enzymes.

The researchers concluded that this dose and duration of LRa05 effectively shortened diarrhea duration, improved fecal consistency and positively influenced gut microbiome composition and function, without adverse effects in infants.

However, they noted that further studies should detect the possible viral and bacterial pathogens that caused the diarrhea to further explore the different responses of specific pathogens to the LRa05 administration.

They added that as the intervention lasted only one week, the possible long-term effects of LRa05 on children’s health and gut microbiome could not be observed.

Journal: Frontiers in Nutrition 

“Lacticaseibacillus rhamnosus LRa05 in the treatment of acute diarrhea in children: a randomized controlled trial.”

doi: doi.org/10.3389/fnut.2024.1479186

Authors: Chen, K. et al.