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Lactobacillus reuteri DSM 17938

Lactobacillus reuteri DSM 17938 (aus Gründen der einfacheren Leserlichkeit nachfolgend nur als "L. reuteri" bezeichnet) ist ein natürlich vorkommendes Milchsäurebakterium, das aus einer Muttermilchprobe isoliert wurde. L. reuteri begleitet den Menschen schon durch seine gesamte Evolution und kommt auch in vielen anderen Wirbeltierarten vor. Er wird als Nahrungsergänzungsmittel geschätzt und eingesetzt.

Lactobacillus reuteri DSM 17938 = Limosilactobacillus reuteri DSM 17938

Klinische Studien

Antibiotikatherapie

L. reuteri DSM 17938 kann mit vielen Antibiotika eingenommen werden ohne die Wirkung der Antibiotika zu beeinträchtigen und ohne selber zerstört zu werden. Konsultieren Sie Ihren Arzt oder Apotheker.

Menge L. reuteri DSM 17938

Die korrekte tägliche Ration L. reuteri DSM 17938 ist  108 KBE/ml.

  • Betrachten Sie den Verzehr wie eine Kur und nehmen Sie L. reuteri täglich ein.

  • Der L. reuteri wird mit Einstellung des Verzehrs innerhalb von mehreren Wochen aus der Darmflora eliminiert.

  • Eine Kur kann jederzeit verlängert werden. Es gibt keine maximale Einnahmedauer.

Darmgleichgewicht

Die Zusammensetzung der menschlichen Darmflora (Mikrobiota) steht in einem empfindlichen Gleichgewicht. Unter bestimmten Umständen können nützliche Keime durch Pathogene (verschiedene Bakterien, Viren und Pilze) verdrängt werden. L. reuteri kann die Besiedlung mit pathogenen Keimen nachweislich reduzieren und so das Gleichgewicht stabilisieren. L. reuteri konkurriert mit Pathogenen um Nährstoffe und Adhäsionsstellen und verhindert so deren Ansiedlung und Wachstum im Darm. Durch die Produktion von Milchsäure, Essigsäure und Reuterin schafft L. reuteri eine Umgebung, die für nützliche Keime günstig, für Pathogene jedoch ungünstig ist.

Weltweit bekannt

L. reuteri DSM 17938 gehört zu den Laktobazillen, die weltweit am häufigsten untersucht werden.

L. reuteri während des ganzen Lebens

L. reuteri ist ein Bakterium, welches eine Rolle in der Evolution verschiedener Wirbeltiere spielt. Es lebt im Gastro-Intestinal-Trakt von Tieren, wobei jede Art seinen eigenen stammspezifischen L. reuteri hat, der über Generationen weitergegeben wird. Der Mensch und seine Vorfahren haben sich über Millionen von Jahren gemeinsam mit ihren eigenen L. reuteri-Stämmen entwickelt.

Infolge dieses Evolutionsprozesses trägt L. reuteri lebenslang zur menschlichen Gesundheit bei. Menschen werden fast steril geboren und begegnen L. reuteri zum ersten Mal während des natürlichen Geburtsvorgangs im Vaginalkanal und durch das Stillen. Als Schlüsselmitglied der Darmmikrobiota spielt L. reuteri eine wichtige Rolle bei der Unterstützung von Babys bei der Verdauung von Muttermilch und festen Nahrungsmitteln. Während des ganzen Lebens befestigen die Bakterien die Darmschleimhaut, damit Schadstoffe nicht in den Blutkreislauf gelangen können und um die Immunantwort zu verbessern. Sie setzen auch Moleküle frei, die eine gesunde und vielfältige Mikrobiota fördern und das Wachstum von Krankheitserregern verhindern. Die Unterstützung der Darmmikrobiota später im Leben ist besonders wichtig, da ältere Menschen dazu neigen, die Vielfältigkeit ihrer Mikrobiota zu verlieren.

Einige Menschen haben heute noch L. reuteri als Teil ihrer Mikrobiota, aber bei den meisten fehlen diese Stämme aufgrund unseres modernen Lebensstils. Eine ballaststoffarme Ernährung, erhöhte Hygiene, Antibiotikaeinsatz und steigende Anzahl an Kaiserschnittgeburten, die verhindern, dass das Baby während der Geburt dem Bakterium nicht ausgesetzt wird, haben alle dazu beigetragen, L. reuteri aus unserem Magen-Darm-Trakt zu verringern.

Menschen können den L. reuteri durch den Einsatz von Probiotika wieder einführen, müssen dies jedoch häufig wiederholen, da die Bakterien kontinuierlich aus dem Gastrointestinal-Trakt ausgeschieden werden.

Lactobacillus reuteri DSM 17938 während des ganzen Lebens
Lactobacillus reuteri DSM 17938 menschlichen Ursprungs

Lactobacillus reuteri DSM 17938 – Menschlichen Ursprungs

Dieses Bakterium ist das Einzige, welches im ganzen menschlichen Magen-Darm-Trakt mittels Biopsie untersucht und publiziert wurde.

Es ist robust, hält der rauen Umgebung des Magens stand und haftet leicht an der Darmwand.

L. reuteri DSM 17938 ist das einzige Bakterium der Welt, welches in veröffentlichten, klinischen Studien gezeigt hat, dass es den Magen, das Duodenum und das Ileum gesunder Menschen vorübergehend in-situ signifikant besiedelt.

L. reuteri DSM 17938 wurde beim Menschen isoliert aus:

  • Speichel
  • Muttermilch
  • Magen
  • Dünndarm
  • Dickdarm
  • Fäkalien
  • Vagina

Sicherheit des L. reuteri DSM 17938

  • L. reuteri DSM 17938 ist eines der wissenschaftlich am besten dokumentierten Probiotika, sowohl was die Wirksamkeit als auch die Sicherheit betrifft.
  • L. reuteri DSM 17938 ist menschlichen Ursprungs und wird unter kontrollierten Bedingungen hergestellt, um eine Kontamination mit anderen Mikroben oder Substanzen auszuschliessen.
  • Die Sicherheit wurde gründlich evaluiert und dokumentiert. Es wurden mehr als 30 Sicherheitsstudien durchgeführt und veröffentlicht, davon die meisten bei Kleinkindern, aber auch bei schwer kranken Patienten, immungeschwächten Erwachsenen und sogar bei Frühgeborenen.
  • Es hat sich gezeigt, dass der L. reuteri DSM 17938 nicht transloziert. Im Gegenteil haben Studien gezeigt, dass der L. reuteri DSM 17938  die Magen-Darm-Schleimhaut unterstützt, indem er die Produktion neuer Epithelzellen und die Heilung der Tight Junctions fördert.

Klinische Studien / Artikel

177 klinische Studien mit L. reuteri DSM 17938 bei 17'219 Studienteilnehmer!

Guidelines

Koliken

Akute Gastroenteritis

Funktionelle Bauchschmerzen

Obstipation

Schutz vor Infektionen

Guidelines Supporting the Use of L. reuteri

L. reuteri in Infants and Children

  • 7 guidelines supporting the use for acute gastroenteritis (AGE)
  • 6 guidelines supporting the use for colic
  • 2 guidelines supporting the use for functional abdominal pain (FAP)
  • 1 guideline supporting the use for infection protection

L. reuteri in Adults

  • 1 guideline supporting the use for antibiotic-associated diarrhoea
  • 1 guideline supporting the use for helicobacter pylori (HP) eradication
  • 1 guideline supporting the use for constipation

Koliken

15 klinische Studien und 13 Meta-Analysen. Es folgen einige Artikel.


  • Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938

    Chau K. et al., J Pediatr. 2015 Jan;166(1):74-8. doi: 10.1016/j.jpeds.2014.09.020.

    Study Objectives: Investigate the efficacy of L. reuteri DSM 17938 for the treatment of infant colic in breastfed infants ≤ 6 months.

    Study Design: R, DB, PC, 21 days

    Subjects and daily dose: 24 patients L. reuteri DSM 17938 (1x108 CFU), 28 patients Placebo

    Results:

    Compared to placebo:

    • L. reuteri significantly improved colic symptoms by reducing median crying and fussing times at days 7, 14 and 21.
    • The rate of responders (50% reduction in daily crying time) was significantly higher in the L. reuteri group compared with the control group at day 21.
  • Effectiveness of Lactobacillus reuteri in infantile colic and colicky induced maternal depression: a prospective single blind randomized trial

    Mi G.-L. et al., Antonie Van Leeuwenhoek. 2015 Jun;107(6):1547-53. doi: 10.1007/s10482-015-0448-9

    Study Objectives: Evaluate the effects of L. reuteri DSM 17938 on colicky infants < 4 months old, exclusively or predominantly breastfed: on rate of treatment success, reduction in daily crying time, parent satisfaction and maternal depression.

    Study Design: R, DB, PC, 4 weeks

    Subjects and daily dose: 20 patients L. reuteri DSM 17938 (1x108 CFU), 19 patients Placebo

    Results:

    Significant effects compared to placebo:

    • Treatment success (≥ 50% reduction of crying time vs. baseline) was 100% in the L. reuteri group vs. 16% in the placebo group.
    • Reduction in mean daily crying time (from 201 to 32 min/d in the L. reuteri group vs. 201 to 121 min/d in the placebo group). Differences were significant at each weekly evaluation.
    • Parental satisfaction (100% vs 16% in the placebo group). 
    • Improved maternal depression scores throughout the study period (Edinburgh postnatal depression scale).
    • No report of adverse effects in any of the groups.
  • Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial

    Indrio F. et al., JAMA Pediatr. 2014 Mar;168(3):228-33. doi: 10.1001/jamapediatrics.2013.4367.

    Study Objectives: Investigate if oral supplementation with L. reuteri DSM 17938 during the first 3 months of life can reduce the onset of colic, gastroesophageal reflux, and constipation in term newborns, and in addition reduce the socio-economic impact of these conditions.

    Study Design: R, DB, PC, 90 days, Multicentre study

    Subjects and daily dose: 238 patients L. reuteri DSM 17938 (1x108 CFU), 230 patients Placebo

    Results:

    Compared to placebo:

    • Daily administration of L. reuteri early in life reduced the duration of daily inconsolable type of crying, frequency of regurgitation, and incidence of functional constipation in the first 3 months of life
    • Private and public costs for the management of these conditions were significantly reduced for infants receiving L. reuteri
  • Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trial

    Szajewska H. et al., J Pediatr. 2013 Feb;162(2):257-62. doi: 10.1016/j.jpeds.2012.08.004

    Study Objectives: Efficacy of L. reuteri DSM 17938 on infant colic in infants younger than 5 months, exclusively or pre-dominantly breastfed. Effect on screaming intensity and family quality of life. The trial included follow-up one week after termination of ingestion of the study product.

    Study Design: R, DB, PC, 21 days + 7 days follow-up

    Subjects and daily dose: 40 patients L. reuteri DSM 17938 (1x108 CFU), 40 patients Placebo

    Results:

    • L. reuteri significantly reduced daily crying time compared to placebo
    • Significantly more responders on day 7, 14, 21 and 28 (follow-up) compared to placebo
    • Parents’ rating of screaming intensity and family quality of life was significantly decreased and increased, respectively, at all time points
  • Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial

    Savino F. et al., Pediatrics. 2010 Sep;126(3):e526-33. doi: 10.1542/peds.2010-0433

    Study Objectives: To study the effect of L. reuteri DSM 17938 on infant colic in infants 2-16 weeks old, and investigate changes in the faecal microbiota.

    Study Design: R, DB, PC, 21 days

    Subjects and daily dose: 25 patients L. reuteri DSM 17938 (1x108 CFU), 21 patients Placebo

    Results:

    • L. reuteri significantly reduced daily crying time compared to placebo
    • Significantly more responders on day 7, 14 and 21 compared to placebo
    • Reduced faecal E. coli and increased counts of lactobacilli in the L. reuteri group only

Akute Gastroenteritis

10 klinische Studien und 1 Meta-Analyse. Es folgen einige Artikel.


  • Lactobacillus reuteri DSM 17938 effectively reduces the duration of acute diarrhoea in hospitalised children

    Dinleyici E. et al., Acta Paediatr. 2014 Jul;103(7):e300-5. doi: 10.1111/apa.12617. Epub 2014 Mar 24.

    Study Objectives: The efficacy of L. reuteri DSM 17938 in children aged 3 – 60 mo, and hospitalized for acute diarrhoea. Both groups of children received conventional rehydration therapy, but the control group received no probiotic.

    Study Design: R, single blinded (effects analyst) 5 days

    Subjects and daily dose: 64 patients L. reuteri DSM 17938 (1x108 CFU), 63 patients control

    Results:

    Compared to controls:

    • L. reuteri significantly reduced the duration of diarrhoea
    • The proportion of children with watery diarrhoea after 48h and 72h was significantly reduced
    • Duration of hospital stay was significantly reduced
    • Prolonged diarrhoea was only reported in the control group of children
  • Diarrhea in preschool children and Lactobacillus reuteri: a randomized controlled trial

    Gutierrez-Castrellon P. et al., Pediatrics. 2014 Apr;133(4):e904-9. doi: 10.1542/peds.2013-0652. Epub 2014 Mar 17.

    Study Objectives: Evaluate if daily administration of L. reuteri DSM 17938 reduces the frequency and duration of diarrhoea episodes and respiratory tract infections (RTI) in Mexican day school children aged 6-36 months. A cost-effectiveness analysis was also made

    Study Design: R, DB, PC, 3 months of intervention, follow-up at 6 months

    Subjects and daily dose: 168 patients L. reuteri DSM 17938 (1x108 CFU), 168 patients Placebo

    Results:

    Compared to placebo:

    • L. reuteri significantly reduced the frequency and duration of episodes of diarrhoea and respiratory tract infection at both 3 and 6 months
    • The number of doctor visits, antibiotic use, absenteeism from day school and parental absenteeism from work were significantly reduced
    • The use of L. reuteri was associated with a reduction of costs by 36 US dollars (USD) for each case of diarrhoea, and by 37 USD for each case of RTI
  • Randomised clinical trial: Lactobacillus reuteri DSM 17938 vs. placebo in children with acute diarrhoea-a double-blind study

    Francavilla R. et al., Aliment Pharmacol Ther. 2012 Aug;36(4):363-9. doi: 10.1111/j.1365-2036.2012.05180.x. Epub 2012 Jun 11.

    Study Objectives: Effect on acute gastroenteritis caused by rotavirus in children 6-36 months old, and hospitalized due to clinical signs of mild to moderate dehydration.

    Study Design: R, DB, PC, 7 days

    Subjects and daily dose: 35 patients L. reuteri DSM 17938 (2x108 CFU), 34 patients Placebo

    Results:

    Compared to placebo L. reuteri significantly:

    • reduced the duration of diarrhoea by 1.2 days
    • the frequency of watery diarrhoea was significantly reduced on treatment days 2 and 3
    • the number of children with normal stool consistency was significantly higher on days 2 and 3
  • Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents

    Weizman Z. et al., Pediatrics. 2005 Jan;115(1):5-9. doi: 10.1542/peds.2004-1815.

    Study Objectives: Prevention of common infections in day-care children 4–10 months old.

    Study Design: R, DB, PC, 12 weeks

    Subjects and daily dose: 68 patients L. reuteri DSM 17938 (1,2x109 CFU), 73 patients Bb-12 (1,2x109 CFU), 60 patients control

    Results:

    L. reuteri significantly reduced (compared to Bb-12 and control):

    • Days with fever
    • Need to consult doctor and need of antibiotics
    • Absence from day-care

    Both probiotics significantly reduced:

    • Episodes with fever
    • Episodes and days with diarrhoea
  • Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis

    Shornikova A. et al., Pediatr Infect Dis J. 1997 Dec;16(12):1103-7. doi: 10.1097/00006454-199712000-00002.

    Study Objectives: Treatment of children hospitalized for acute rotavirus gastroenteritis and aged 6 mo – 3y.

    Study Design: R, DB, PC, 5 days or until discharged

    Subjects and daily dose: 21 patients L. reuteri DSM 17938 (1x108 CFU), 20 patients L. reuteri (1x107 CFU), 25 patients Placebo

    Results:

    L. reuteri in the high dose significantly reduced:

    • duration of watery diarrhoea
    • frequency of diarrhoea

    Positive, but non-significant, effects were seen also in the low dose group compared to placebo

Funktionelle Bauchschmerzen

7 klinische Studien und 1 Meta-Analyse. Es folgen einige Artikel.


  • Lactobacillus reuteri DSM 17938 is effective in the treatment of functional abdominal pain in children: Results of the double-blind randomized study

    Jadrešin O. et al., Clin Nutr. 2020 Dec;39(12):3645-3651. doi: 10.1016/j.clnu.2020.04.019. Epub 2020 Apr 21.

    Study Objectives: To investigate the effect of L. reuteri DSM 17938 in the treatment of functional abdominal pain (FAP) in children aged 4-18 years. This study was performed after interim analysis of Jadrešin 2017 in order reach the initial targeted sample size.

    Study Design: R, DB, PC, 3 months + 1 month follow up

    Subjects and daily dose: 24 patients L. reuteri DSM 17938 (1x108 CFU), 22 patients Placebo

    Results:

    Compared to placebo, L. reuteri significantly:

    • increased days without pain
    • reduced intensity of pain at 4 months

    Pooled data from both studies confirmed increased days without pain and reduced severity of pain.

  • Lactobacillus reuteri DSM 17938 in the Treatment of Functional Abdominal Pain in Children: RCT Study

    Jadrešin O. et al., J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):925-929. doi: 10.1097/MPG.0000000000001478.

    Study Objectives: To investigate the effect of L. reuteri DSM 17938 in the treatment of functional abdominal pain (FAP) and irritable bowel syndrome (IBS) in children aged 4-18 years.

    Study Design: R, DB, PC, 3 months + 1 month of follow-up

    Subjects and daily dose: 26 patients L. reuteri DSM 17938 (1x108 CFU), 29 patients Placebo

    Results:

    Results of interim analysis of the study:

    • Significant increase in days free of pain in the L. reuteri group compared to placebo: 80% vs. 46% of study days.
    • Both groups showed significant reduction in severity of pain compared to baseline.
    • Results suggest an effect of L. reuteri also in children with IBS.
  • Lactobacillus reuteri DSM 17938 for the Management of Functional Abdominal Pain in Childhood: A Randomized, Double-Blind, Placebo-Controlled Trial

    Weizman Z. et al., J Pediatr. 2016 Jul;174:160-164.e1. doi: 10.1016/j.jpeds.2016.04.003. Epub 2016 May 4.

    Study Objectives: To assess the efficacy of L. reuteri DSM 17938 on functional abdominal pain (FAP) in children aged 6-15 years, with the primary outcomes frequency and intensity of abdominal pain. Intensity measured by Hicks face scoring system, ranking 0=no pain and 10=very severe pain.

    Study Design: R, DB, PC, 4 weeks + 4 weeks of follow-up

    Subjects and daily dose: 47 patients L. reuteri DSM 17938 (1x108 CFU), 46 patients Placebo

    Results:

    Compared to placebo:

    • Frequency of pain was significantly reduced at 4 weeks with 1.9 vs. 3.6 episodes/week in the L. reuteri and placebo group, respectively.
    • Intensity of pain was significantly reduced during the supplementation: 4.3 vs. 7.2 on Hicks scale. This effect that was sustained at the follow-up at 8 weeks: 4.8 vs. 6.4.
    • For other GI symptoms there was a significant reduction in the incidence of abdominal distention and bloating in the L. reuteri group.
  • Lactobacillus reuteri in children with functional abdominal pain (FAP)

    Romano C. et al., J Paediatr Child Health. 2014 Oct;50(10):E68-71. doi: 10.1111/j.1440-1754.2010.01797.x. Epub 2010 Jul 8.

    Study Objectives: To study if L. reuteri DSM 17938 affect functional abdominal pain in children aged 6-16 years.

    Study Design: R, DB, PC, 4 weeks supplementation + 4 weeks follow-up

    Subjects and daily dose: 30 patients L. reuteri DSM 17938 (2x108 CFU), 26 patients Placebo

    Results:

    • Significantly reduced severity of abdominal pain during L. reuteri intake
    • Reduction in pain sustained up to 4 weeks after cessation of L. reuteri
    • Pain frequency decreased significantly during the 8 weeks in both groups

Obstipation

13 klinische Studien. Es folgen einige Artikel.


  • Lactobacillus reuteri DSM 17938 and Magnesium Oxide in Children with Functional Chronic Constipation: A Double-Blind and Randomized Clinical Trial

    Kubota M. et al., Nutrients. 2020 Jan 15;12(1):225. doi: 10.3390/nu12010225.

    Study Objectives: To evaluate the efficacy of L. reuteri DSM 17938 and MgO on chronic functional constipation in children 6 months to 6 years.

    Study Design: R, DB, PC parallel-group, 4 weeks

    Subjects and daily dose: 20 patients L. reuteri DSM 17938 + MgO placebo, 19 L. reuteri DSM 17938 + MgO, 21 patients MgO + L. reuteri placebo

    L. reuteri: 2 x 108 CFU
    MgO: 30 mg/kg bw

    Results: All groups experienced a significant improvement in defecation frequency at week 4. L. reuteri and MgO were equally effective in the management of functional constipation in young children.

  • Effects of long-term administration of Lactobacillus reuteri DSM-17938 on circulating levels of 5-HT and BDNF in adults with functional constipation

    Riezzo G. et al., Benef Microbes. 2019 Mar 13;10(2):137-147. doi: 10.3920/BM2018.0050. Epub 2018 Dec 21.

    Study Objectives: To evaluate pathophysiological aspects = serum concentrations of GI neuropeptides serotonin (5-HT) and brain-derived neurotrophic factor (BDNF) and their association with changes in symptoms and quality-of-life scores during intake of L. reuteri DSM 17938 or placebo in adults with chronic functional constipation (FC). Results on symptoms and quality of life (QoL) in this cohort of patients are previously published in Riezzo et al., 2018.

    Study Design: R, DB, PC, 105 days

    Subjects and daily dose: 28 patients L. reuteri DSM 17938 (Induction period, 15 days: 4x108 CFU = 4 tablets Standard dose, 90 days: 2x108 CFU = 2 tablets), 28 patients Placebo.

    Additional group of 20 healthy control patients, for comparison of serum levels of 5-HT and BDNF

    Results: 

    • Baseline serum levels of 5-HT were significantly higher in FC subjects compared to healthy controls
    • 5-HT and BDNF were significantly reduced compared to placebo at the end of intervention (day 105)
    • 5-HT in the Lr group was reduced by 24% (p<0.008) to a level non-significant from that of healthy controls, and significantly different from placebo (p<0.04), on day 105
    • Neither 5-HT nor BDNF serum levels showed correlation with the symptoms or QoL scores
  • Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation

    Riezzo G. et al., Benef Microbes. 2018 Jan 29;9(1):51-60. doi: 10.3920/BM2017.0049. Epub 2017 Oct 12.

    Study Objectives: To study the effect of a 15-week supplementation of L. reuteri DSM 17938 in adults with chronic functional constipation and normal colonic transit time. Primary outcome was change in Constipaq score (constipation symptoms and quality of life). Secondary outcomes were constipation symptom item’s scores. Mean age 44 years.

    Study Design: R, DB, PC, 105 days

    Subjects and daily dose: 28 patients L. reuteri DSM 17938 (Induction period, 15 days: 4x108 CFU = 4 tablets Standard dose, 90 days: 2x108 CFU = 2 tablets), 28 patients Placebo

    Results: 

    Compared to the placebo group at day 105, L. reuteri significantly:

    • Reduced the Constipaq score, which includes quality-of-life evaluation (p<0.0001)
    • Reduced symptoms related to gas production and dysbiosis (incomplete defecation, abdominal discomfort, pain, and bloating)
    • Reduced the need of laxatives

    L. reuteri had no effect on stool consistency.

  • Effect of Lactobacillus reuteri (DSM 17938) on methane production in patients affected by functional constipation: a retrospective study

    Ojetti V. et al., Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1702-1708.

    Study Objectives: The effect of L. reuteri DSM 17938 on production of methane (CH4) in adults with functional constipation. Methane production of >5 ppm during a H2/CH4 lactulose breath test (LBT). Mean age 36y.

    Study Design: Open, no control group 4 weeks

    Subjects and daily dose: 20 patients L. reuteri DSM 17938 (2x108 CFU)

    Results: 

    • Compared to baseline, there was a significant reduction in the CH4 production by L. reuteri: 8.9 ± 8.6 ppm vs. 20.8 ± 15 ppm, and on AUC value (Area Under the Curve): 2128.4 vs. 5101.5
    • 11 patients (55%) ceased to produce methane (<5 ppm)
    • Bowl movements/week were significantly increased compared to baseline: 6.4 ± 0.7 vs. 4.1 ± 1.2
  • The effect of Lactobacillus reuteri supplementation in adults with chronic functional constipation: a randomized, double-blind, placebo-controlled trial

    Ojetti V. et al., J Gastrointestin Liver Dis. 2014 Dec;23(4):387-91. doi: 10.15403/jgld.2014.1121.234.elr.

    Study Objectives: The effect of L. reuteri DSM 17938 on functional constipation in adults of mean age 35.6 (± 15) years

    Study Design: R, DB, PC, 4 weeks

    Subjects and daily dose: 20 patients L. reuteri DSM 17938 (2x108 CFU), 20 patients Placebo.

    Results: 

    • Frequency of defecation per week was significantly increased at week 4 compared to placebo
    • Stool consistency was somewhat improved but without significant difference compared to baseline or compared to placebo
  • Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study

    Coccorullo P. et al., J Pediatr. 2010 Oct;157(4):598-602. doi: 10.1016/j.jpeds.2010.04.066. Epub 2010 Jun 12.

    Study Objectives: To evaluate the effect of L. reuteri DSM 17938 in 6-12 months old infants with chronic functional constipation.

    Study Design: R, DB, PC, 8 weeks

    Subjects and daily dose: 22 patients L. reuteri DSM 17938 (1x108 CFU), 22 patients Placebo

    Results:

    L. reuteri significantly improved:

    • Defecation frequency compared to placebo
    • Faecal consistency compared to baseline

Schutz vor Infektionen

16 klinische Studien. Es folgen einige Artikel.


  • L. reuteri DSM 17938 erhöht die Immunantwort gegen SARS-CoV-2 bei Erwachsenen

    Forsgård R. A. et al., Gut Microbes. 2023 Jan-Dec;15(1):2229938. doi: 10.1080/19490976.2023.2229938.

    Eine randomisierte, dreifach-blinde, placebokontrollierte Studie mit L. reuteri DSM 17938 zeigte eine Zunahme der Antikörpertiter gegen SARS-CoV-2 bei gesunden Probanden nach 28 Tagen oder länger nach der Impfung. Die Studie legt nahe, dass die Supplementation mit Probiotika den langfristigen Schutz vor viralen Infektionen erhöhen kann.

    Die Studie umfasste 159 gesunde Erwachsene, die weder zuvor mit SARS-CoV-2 infiziert waren noch gegen COVID-19 geimpft wurden. Die Teilnehmer erhielten entweder L. reuteri DSM 17938 + 10 Mikrogramm Vitamin D3 oder ein Placebo, das nur Vitamin D3 enthielt, über einen Zeitraum von 6 Monaten. Während des Interventionszeitraums wurden 12 Probanden infiziert und 17 wurden vollständig geimpft.

    Das Ziel der Studie war es, die Auswirkungen der Supplementation mit L. reuteri DSM 17938 auf die spezifischen Antikörperantworten gegen SARS-CoV-2 nach einer natürlichen Infektion oder Impfung zu untersuchen. Obwohl der primäre Endpunkt, basierend auf den infizierten Personen, keine statistisch signifikante Unterschiede zwischen den beiden Gruppen zeigte, wiesen die geimpften Personen, die L. reuteri DSM 17938 einnahmen, 28 Tage oder länger nach der Impfung signifikant höhere IgA-Antikörper-Titer auf als die Placebo-Gruppe.

    Die Studie wurde am Forschungszentrum für Ernährung-Darm-Gehirn-Interaktionen der Universität Örebro in Schweden durchgeführt.

    "Unseres Wissens ist dies die erste Studie, die die Auswirkungen einer Probiotika-Supplementation auf die verschiedenen Klassen von Antikörpern gegen SARS-CoV-2, einschliesslich der neutralisierenden Antikörper gegen das Virus, in einer Antikörper-naiven Kohorte untersucht", sagte Professor Robert Brummer, einer der Forscher und Autoren der Studie.

    Die Ergebnisse deuten darauf hin, dass L. reuteri DSM 17938 den langfristigen Schutz vor viralen Infektionen nach der Impfung verbessern kann.

    Bereits Bekanntes zu diesem Thema

    Es wurde gezeigt, dass Probiotika vor Atemwegsinfektionen schützen1 und die Wirksamkeit bestimmter Impfungen erhöhen.2 Eine frühere klinische Studie hat gezeigt, dass L. reuteri DSM 17938 Arbeitsabwesenheiten aufgrund häufig auftretender Infektionen reduziert.3

    1) Maya-Barrios et al., Benef. Microbes 12 (2021). 2) Zimmermann P. and Curtis N. Vaccine, 36 (2018). 3) Gutiérrez-Castrellón P. et al., Pediatrics 133 (4) e904-9 (2014).

  • Effects of the regular intake of the probiotic Lactobacillus reuteri (DSM 17938) on respiratory and gastrointestinal infections in a workplace setting: a double-blind randomized placebo-controlled trial

    Schröder C. et al., BMC Nutrition, 2015 1:3. doi: 10.1186/2055-0928-1-3.

    Study Objectives: The effect of regular intake of L. reuteri DSM 17938 on the number of days of sick leave caused by respiratory and/or gastrointestinal diseases among male steelworkers.

    Study Design: R, DB, PC, 90 days

    Subjects and daily dose: 79 patients L. reuteri DSM 17938 (1x108 CFU), 80 patients placebo, 242 patients randomized

    Results: 

    L. reuteri significantly reduced the incidence of diarrhoea, which was reported on 0.60 days for subjects of the L. reuteri group vs. 1.33 days in the placebo group. There was no difference in primary outcome of number of sick days due to respiratory or gastrointestinal symptoms. The dropout rate of randomized subjects was 34%.

  • Diarrhea in preschool children and Lactobacillus reuteri: a randomized controlled trial

    Gutierrez-Castrelon P. et al., Pediatrics. 2014 Apr;133(4):e904-9. doi: 10.1542/peds.2013-0652. Epub 2014 Mar 17.

    Study Objectives: Evaluate if daily administration of L. reuteri DSM 17938 reduces the frequency and duration of diarrhoea episodes and respiratory tract infections (RTI) in Mexican day school children aged 6-36 months. A cost-effectiveness analysis was also made.

    Study Design: R, DB, PC, 3 months of intervention, follow-up at 6 months

    Subjects and daily dose: 168 patients L. reuteri DSM 17938 (1x108 CFU), 168 patients Placebo

    Results: 

    Compared to placebo:

    • L. reuteri significantly reduced the frequency and duration of episodes of diarrhoea and respiratory tract infection at both 3 and 6 months
    • The number of doctor visits, antibiotic use, absenteeism from day school and parental absenteeism from work were significantly reduced
    • The use of L. reuteri was associated with a reduction of costs by 36 US dollars (USD) for each case of diarrhoea, and by 37 USD for each case of RTI
  • Randomized trial of probiotics and calcium on diarrhea and respiratory tract infections in Indonesian children

    Augustina R. et al., Pediatrics. 2012 May;129(5):e1155-64. doi: 10.1542/peds.2011-1379. Epub 2012 Apr 9.

    Study Objectives: To investigate milk with low and regular calcium content, respectively, and the addition of probiotics (L. reuteri DSM 17938 or L. casei CRL431) to milk with regular calcium content, on the incidence and duration of diarrhoea and acute respiratory infections in healthy Indonesian children, 1-6y old.

    Study Design: R, DB, PC, 6 months

    Subjects and daily dose: 124 patients L. reuteri DSM 17938 (5x108 CFU), 120 patients L. casei (5x108 CFU), 124 patients low calcium milk, 126 patients regular calcium milk

    Results: 

    Only L. reuteri significantly reduced:

    • Incidence of diarrhoea in children with lower nutritional status, irrespective of definition of diarrhoea
    • Incidence of diarrhoea in all children when diarrhoea was defined as ≥ 2 loose/liquid stools/24h instead of ≥ 3 loose/liquid stools/24h

    The interventions had no effect on incidence or duration of acute respiratory infection

  • Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents

    Weizman Z. et al., Pediatrics. 2005 Jan;115(1):5-9. doi: 10.1542/peds.2004-1815.

    Study Objectives: Prevention of common infections in day-care children 4–10 months old.

    Study Design: R, DB, PC, 12 weeks

    Subjects and daily dose: 68 patients L. reuteri DSM 17938 (1,2x109 CFU), 73 patients Bb-12 (1,2x109 CFU), 60 patients control

    Results: 

    L. reuteri significantly reduced (compared to Bb-12 and control):

    • Days with fever
    • Need to consult doctor and need of antibiotics
    • Absence from day-care

    Both probiotics significantly reduced:

    • Episodes with fever
    • Episodes and days with diarrhoea
  • Increasing work-place healthiness with the probiotic Lactobacillus reuteri: a randomised, double-blind placebo-controlled study

    Tubelius P. et al., Environ Health. 2005 Nov 7;4:25. doi: 10.1186/1476-069X-4-25.

    Study Objectives: To study prevention of short-term illness, cold or GI infection, in healthy adults at a work place.

    Study Design: R, DB, PC, 80 days

    Subjects and daily dose: 94 patients L. reuteri DSM 17938 (1x108 CFU), 87 patients placebo

    Results: 

    L. reuteri significantly reduced short-term sick leave due to cold or GI infection compared to placebo: 10.6% and 26.4%, respectively, reported sick-leave. Among the in total 53 shift-workers, the frequency was 0 vs. 33%.

R = Randomized; DB = Double blind; PC = Placebo controlled

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