Happy Gut, Healthy Kids!

Achoo! Sniffle, snort! Scratch, scratch, scratch…. Is allergy season here again? Or are we stuck in the dregs of cold and flu season? Wait, is there a season where children aren’t dealing with some kind of infection or allergy? So, what can be done to help support and strengthen our children’s’ immune system, so they are able to enjoy the summer months of outdoor play to come as well as a healthy winter?

The microbiome and children’s health

The microbiome’s influence on health has been studied in all age groups, resulting in the growing popularity of probiotic foods and supplements. In children, healthy and diverse gut microbiome is important for reducing infection and may help reduce the occurrence of common paediatric conditions. Reduced gut microbiota diversity in children has been shown to be associated with allergic disease, asthma and inflammatory bowel disease (IBD).[1],[2],[3]

Probiotics – or “good bacteria” – have been shown in numerous reviews to be safe and effective in people of various ages – infants included.[4],[5],[6],[7],[8] The efficacy of probiotics is perhaps unsurprising, as fermented foods and the lactobacilli and bifidobacteria they contain have been a part of the human diet for a long, long time.[9]

But not all probiotics are equal in their strains and therefore their efficacy. It also figures that our gut microbiome changes with age (and diet) so that the bacteria in a child’s gut is going to be comprised of different strains and base levels compared to that of their future adolescent and adult selves. This means that targeted probiotic supplements may benefit different age groups.

A particular probiotic strain known as Lactobacillus acidophilus DDS®-1 has been found to have superior growth and stability, with a high tolerance to acidic environments such as those found in the digestive tract. This allows it to withstand degradation in the stomach and colonise in the intestines.[10] When combined with a bifidobacterium (known as B. lactis UABla-12) L. acidophilus DDS®-1 has shown great promise in supporting the health of children – particularly so in children with eczema (atopic dermatitis), a condition which often worsens in the spring when other allergies also kick in,[11] and acute respiratory infections (ARIs) like the common cold. Could this be a breakthrough supplement for children this allergy season?

Childhood eczema (atopic dermatitis) and probiotics

Understanding that the microbiome affects so much more than just the gut, researchers have been eager to better understand the role that probiotics and microbial ecology may play in alleviating symptoms of allergic conditions like eczema, which is compounded by seasonal allergies like hayfever.

In one noteworthy study, a combination of L. acidophilus DDS®-1 and B. lactis UABla-12 was assessed in children with eczema. In the randomised, double-blind, placebo-controlled clinical trial, 90 children between the ages of one and three years old with moderate to severe eczema were given either the probiotic blend at a dosage of 5 billion colony-forming units (CFUs) twice daily or placebo.[12]

After eight weeks, the children receiving probiotics had on average a 33.7% decrease in their Scoring of Atopic Dermatitis (SCORAD) scores from baseline, whereas their peers receiving placebo had an average decrease of only 19.4%.

Those in the probiotic group also used an average of 7.7 fewer grammes of steroid cream to manage their eczema symptoms over the course of the eight weeks than those in the placebo group. These improvements in symptom scores and steroid use were also correlated with positive changes in the numbers and types of immune cells found in the blood samples of the participants.

The researchers suggest this shift in immune cell balance may positively help increase the numbers of specific immune cells called T helper-1 (Th1) cells – the types of cells needed to fight off bacteria and viruses – while simultaneously decreasing the number of T helper-2 (Th2) cells – the cells that exacerbate allergic responses.[13],[14]

Those with a history of atopic (allergic) conditions like eczema, asthma, and hay fever (allergic rhinitis) typically respond well to probiotics and other therapies that increase Th1, decrease Th2, or do both.[15] By enhancing Th1, furthermore, probiotics can also help the body fight off bacterial and viral infections – such as those that cause upper respiratory infections.[16]

Acute respiratory infections

Understanding the Th1-boosting potential of this probiotic combination, researchers designed a randomised, double-blind, placebo-controlled clinical trial to see if the same combination of L. acidophilus DDS®-1 and B. lactis UABla-12 could be of value in reducing the incidence and severity of acute respiratory infections (ARIs), such as the common cold. Two-hundred forty healthy children ages three to twelve years old were enrolled and randomised to receive 5 billion CFUs of the probiotic blend per day or placebo, with the treatment beginning on the first day of the appearance of illness in a member of the participant’s household.[17]

By the end of the study, 64 of 113 children in the probiotic group (57%) and 73 of 112 children in the control group (65%) developed ARIs – so the probiotic blend helped only somewhat in lowering ARI incidence. There was, however, a significant difference in the recovery time between the two groups – the children in the probiotic group missed seven days of day care or school due to illness, whereas those taking placebo missed nine days (a 22% difference). Likewise, the caregivers of the children taking probiotics missed five days of work, whereas the parents of the children receiving placebo missed an entire week (a 28.5% difference).

Although other studies have also shown select probiotic strains to decrease the incidence of upper respiratory infections, L. acidophilus DDS®-1 may be particularly effective in the prevention and treatment of various infections due to its ability to produce acidophilin, a compound with natural anti-pathogenic potential.[18],[19]

It is possible that the therapy didn’t have a positive impact on ARI incidence because it was only initiated when a member of the household already had an infection. By this time, the children were possibly already exposed to the infection as well. Oral probiotic therapies are often taken continuously for a period of several weeks before more systemic benefits are seen due to the time it takes to shift the microbial balance of the gut, and from this the immune system balance. As with the eczema study, there were no clinically significant side events associated with the probiotic blend. Indeed, numerous studies have discovered no significant adverse effects associated with these or related strains.[20],[21],[22],[23]

Happy Gut, Healthy Kids

It’s clear that from skin to the deeper organs, probiotic strains like L. acidophilus DDS®-1 and B. lactis UABla-12 have much to offer our children come allergy season and beyond to the dreaded winter colds and ‘flu. Supplementing L. acidophilus DDS®-1 and B. lactis UABla-12 probiotics as chewable tablets is an easy and safe way for children to get their daily beneficial bacteria dose to enable them to play outside in the summer months and not to live in a bubble avoiding pollen for fear of exacerbating other atopic allergic conditions.

If you’d like more information about the gut microbiome then please view our education partner webinar from nutrihub on Multiple Ways to Support Gut Health.


References

[1]West CE, et al. Gut microbiota and allergic disease: new findings. Curr Opin Clin Nutr Metab Care. 2014 May;17(3):261-6.

[2] Abrahamsson TR, et al. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy. 2014 Jun;44(6):842-50.

[3] Docktor MJ, et al. Alterations in the diversity of the oral microbiome in pediatric inflammatory bowel disease. Inflamm Bowel Dis. 2012 May;18(5):935-42

 [4] Bernardeau M, et al. Beneficial lactobacilli in food and feed: long-term use, biodiversity and proposals for specific and realistic safety assessments. FEMS Microbiology Reviews. 2006;30:487–513.

[5] Adams MR. Safety of industrial lactic acid bacteria. J Biotechnol. 1999;68:171–8.

[6] Borriello SP, et al. Safety of probiotics that contain lactobacilli or bifidobacteria. Clin Infect Dis. 2003;36:775–80.

[7] Ishibashi N, Yamazaki S. Probiotics and safety. Am J Clin Nutr. 2001;73(2 Suppl):465S-70S.

[8] Salminen S, et al. Demonstration of safety of probiotics — a review. Int J Food Microbiol. 1998;44:93–106.

[9] Butel M-J, et al. The developing gut microbiota and its consequences for health. J Dev Orig Health Dis. 2018:1-8.

[10] Frese SA, Hutkins RW, Walter J. Comparison of the colonization ability of autochthonous and allochthonous strains of lactobacilli in the human gastrointestinal tract. Adv Microbiol. 2012;2:399-409.

[11] Krämer U, et al. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005 Mar;124(3):514-23.

[12] Gerasimov SV, et al. Probiotic supplement reduces atopic dermatitis in preschool children: a randomized, double-blind, placebo-controlled, clinical trial. Am J Clin Dermatol. 2010;11:351–61.

[13] Machura E, et al. Staphylococcus aureus skin colonization in atopic dermatitis children is associated with decreased IFN-gamma production by peripheral blood CD4+ and CD8+ T cells. Pediatr Allergy Immunol. 2008;19:37–45.

[14] Bernaldo de Quiros E, et al. The role of regulatory T cells in the acquisition of tolerance to food allergens in children. Allergol Immunopathol (Madr). 2018 Nov – Dec;46(6):612-8.

[15] Peterson JD, et al. Glutathione levels in antigen-presenting cells modulate Th1 versus Th2 response patterns. Proc Natl Acad Sci U S A. 1998 Mar 17;95(6):3071-6.

[16] Torii A, et al. Lactobacillus Acidophilus strain L-92 regulates the production of Th1 cytokine as well as Th2 cytokines. Allergol Int. 2007;56(3):293-301.

[17] Gerasimov SV, et al. Role of short-term use of L. acidophilus DDS-1 and B. lactis UABLA-12 in acute respiratory infections in children: a randomized controlled trial. Eur J Clin Nutr. 2016;70:463–9.

[18] Shahani KM, et al. Natural antibiotic activity of Lactobacillus acidophilus and bulgaricus. II. Isolation of acidophilin from L. acidophilus. Cult Dairy Prod J. 1977;12:8–11.

[19] Goyal N, et al. Int J Microbiol. 2008;5:1277–82. TITLE?

[20] Frese SA, et al. Comparison of the colonization ability of autochthonous and allochthonous strains of lactobacilli in the human gastrointestinal tract. Adv Microbiol. 2012;2:399–409.

[21] Pakdaman MN, et al. The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance – a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutr J. 2016;15:56.

[22] Ayebo AD, et al. Effect of ingesting Lactobacillus acidophilus milk upon fecal flora and enzyme activity in humans. Milchwissenschaft. 1980;35:730–3.

[23] Gerasimov SV. Probiotic prophylaxis in pediatric recurrent urinary tract infections. Clin Pediatr (Phila). 2004;43:95–8.

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