Health & Wellness Blog – EndoMune Probiotic

In the past, I’ve mentioned some of the benefits of probiotics for children. I would now like to discuss how probiotics may lessen childhood allergies like asthma, eczema and hay fever.

Emergence of the Hygiene Theory
Over the last 30 years there has been a two-to-three fold increase in childhood allergies in developed countries. This is significant as compared to the 19th century when hay fever (allergic rhinitis) and asthma were rare.

The rise in allergies like asthma, rhinitis and eczema has not been seen in underdeveloped countries.  This observation has resulted in the “Hygiene Theory”(1).

The theory attributes the rise of allergies to our sanitized lifestyle. In our super-clean world –
vaccinations, anti-bacterial soaps, antibiotics and airtight doors and windows – we are keeping dirt and disease-causing germs at bay.

Seventy percent of our immune system is in the intestines. Since the intestines serve as our window to our environment, it is important that the intestines monitor our exposure to harmful infections and toxins.

The Hygiene Theory explains the rise of allergies to a change in the immune activity of the gut (2). Our bodies no longer need to fight germs as much as they did in the past. As a result, the immune system has shifted away from fighting infection to developing more allergic tendencies.

The lymphocytes (immune cells) in the intestines are of several types:

• Th1 helps to fight infections due to bacteria and viruses
• Th2 responds to infections caused by parasites.

If an infant is not exposed to infectious bacteria and viruses, then Th1 will be less active, causing a shift the balance of activity in favor of the Th2 lymphocytes, producing antibodies to parasites and also to harmless allergens.

The initial theory has been modified some (3).  There is another lymphocyte called a regulatory cell (Treg). This lymphocyte can regulate the activity of both Th1 and Th2 lymphocytes. By adding probiotic bacteria, the (Treg) cells can down regulate the Th2 allergy-mediated immune response.

Probiotics to Regulate Incidence of Eczema
In 2001, a study was done to determine if giving probiotics to mothers prenatally and to infants for the first six months could lessen the frequency of eczema (4). During the first two years of life, eczema occurred 50% less in the group given probiotics compared to the group given placebo.

Subsequent similar studies have had mixed results (5). However, a recent study found that giving a probiotic blend to pregnant women with a family history of allergies was beneficial. The women were given either a placebo or the probiotic starting 4-8 weeks before delivery and then for an additional three months. The infants receiving probiotics had a 55% less involvement with eczema at one year compared to the placebo group (6).

Based on the available studies, probiotics can modify the immune system in infants and lessen the risk of developing eczema and possibly childhood asthma.

There are very few studies that have shown that probiotics can treat existing allergies in children or adults (5). In this regard, it is of interest that a recent study reported probiotics lessened symptoms of nasal allergy in children during the birch pollen season (7).

Much more research is needed to understand how probiotics interact with the intestinal immune cells, but it is really fascinating how our intestinal bacteria play such a major role in our general health.

For women who are allergy prone, taking a probiotic like EndoMune may help prevent eczema in their offspring. In addition, giving EndoMune Junior to your child during infancy may help to lessen the risk of developing allergies. It is always recommended that you talk with your doctor before taking new medications and supplements.

(1) Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989 Nov 18; 299(6710):1259–1260.

(2)Probiotics in children.Kliger B,Hanaway P, Cohrssen A. Pediatr Clin North Am.2007 Dec;54(6): 949 Kligler B, Hanaway P, Cohrssen A.

(3)Hygiene theory and allergy and asthma prevention. Liu AH.Paediatr Perinat Epidemiol. 2007 Nov;21 Suppl 3:2-7.

(4)Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial.Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E.Lancet. 2001 Apr 7;357(9262):1076-9.

(5)Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial.Kim JY, Kwon JH, Ahn SH, Lee SI, Han YS, Choi YO, Lee SY, Ahn KM, Ji GE.Pediatr Allergy Immunol. 2009 Oct 14.

(6)Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence.van der Aa LB, Heymans HS, van Aalderen WM, Sprikkelman ABPediatr Allergy Immunol. 2009 Jul 2.

(7)Specific probiotics alleviate allergic rhinitis during the birch pollen season. Ouwehand AC, Nermes M, Collado MC, Rautonen N, Salminen S, Isolauri E. World J Gastroenterol. 2009 Jul 14;15(26):3261-8.

In the pas, I’ve written about the potential complications of the infection, Clostridium Dificile. Typically the incidence of C. Dificile is within hospitals amongst patients. The intensity and severity of cases outside the hospital seems to be increasing, however:

“Recent reports have shown increasing incidence and severity of C. difficile infection, especially in the older population,” Dr. Darrell Pardi, a Mayo Clinic gastroenterologist and senior author of a study on the situation, said in a Mayo news release. “Our study examines why the cases are on the rise and who is getting the infection.”

C. difficile is a bacterium that can reside in our intestines and generally will not cause harm because the normal, healthy bacteria in our in gut will suppress its growth. The problem arises when we take an antibiotic. The use of antibiotics for illnesses such as respiratory and urinary infections doesn’t only destroy the infection itself, but also the good bacteria within the intestines. Once the good bugs are out of the way, the hostile C. difficile can multiply and take over the intestines.

The C. difficile bacteria produce toxins that damage the lining of the colon and cause diarrhea or even severe colitis. The infection can be life threatening, especially in elderly patients with other health issues. The frequency of having to surgically remove an inflamed colon has become an increasing occurrence.

In the meantime, be aware of this significant, potentially serious side effect of taking an antibiotic. You may want to consider taking a probiotic like EndoMune if an antibiotic is prescribed.

For more information about recent findings presented by the American College of Gastroenterology, visit:
http://news.yahoo.com/s/hsn/20091104/hl_hsn/deadlystomachbug…

We have spent the last year researching and developing a new high quality probiotic for infants and children – EndoMune jr. This product will be available later in the month.

You may ask why create a probiotic for kids – why not use the existing EndoMune?

EndoMune jr is a high quality probiotic consisting of bacteria that have been selected based on their benefits for children and have been combined to make a special proprietary blend. Each serving size provides 10 billon of these bacteria in a powder form that can easily be sprinkled on food or added to liquids. Recent reports suggest that doses in the range of “5 to 10 billon CFUs per day or higher are appropriate for most clinical indications in children” (1).

There are important questions associated with the use of probiotics for children. A few of those include:

Q: Can taking probiotics during the flu and cold season lessen the symptoms of fever, cough and runny nose?
A: Yes. Lactobacillus acidophilus strains in combination with a Bifidobacterium lactis strain —  like in EndoMune jr — have been shown to lessen the symptoms of cold and flu in children (2).

Q: Should children take probiotics when prescribed antibiotics in order to lessen the risk of developing diarrhea?
A: Yes. Bifidobacterium longum strains comparable to EndoMune jr have shown benefit in lessening antibiotic associated diarrhea in children (3).

Q: What about taking probiotics to lessen infectious diarrhea.
A: Yes. Lactobacillus acidophilus strains have been found to lessen episodes of community-acquired diarrhea (4).

Q: Can probioitcs  lessen the risk of allergies like eczema?
A: Probably yes. The combination of bacterial strains like those in EndoMune jr have been shown to alter the risk of developing childhood eczema (2).

Over the next year I will discuss the studies that answer the above questions, and also other clinical trials that have looked at whether probiotics given to children can improve disorders such as: Irritable bowel syndrome symptoms, constipation, infantile colic and inflammatory bowel disease.

The most important consideration when deciding on a probiotic is whether it is safe. Fortunately, in healthy children, there are no reports of any serious illness due to probiotics. Extensive reviews of clinical trials published in the medical literature have reported only a few episodes of infection due to the probiotic. However, these episodes occurred in severely immunocompromised children and adults (1).

All the bacteria in EndoMune jr have been tested for their safety. In addition, EndoMune meets and exceeds the “Good Manufacturing Practices” established by the FDA. Packaging EndoMune jr in dark glass bottles exceeds guidelines, ensuring the bacteria are not destroyed by exposure to sunlight and oxygen during distribution and storage.

Probiotics have been shown to be beneficial for children and are safe. Depending on the disorder, parents should consider giving a probiotic like EndoMune Junior to their children.

(1) Probiotics in children.Kligler B, Hanaway P, Cohrssen A.Pediatr Clin North Am. 2007 Dec;54(6):949-67; xi. Review

(2) Probiotic effects on cold and influenza-like symptom incidence and duration in children.Leyer GJLi S, Mubasher ME, Reifer C, Ouwehand AC. Pediatrics. 2009 Aug;124(2):e172-9.

(3) Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Johnston BC, Supina AL, Ospina M, Vohra S. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004827. Review.

(4) Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations.Canani RB, Cirillo P, Terrin G, Cesarano L, Spagnuolo MI, De Vincenzo A, Albano F, Passariello A, De Marco G, Manguso F, Guarino A.BMJ. 2007 Aug 18;335(7615):340.

(5) The effects of selected probiotic strains on the development of eczema (the PandA study).Niers L, Martín R, Rijkers G, Sengers F, Timmerman H, van Uden N, Smidt H, Kimpen J, Hoekstra M. Allergy. 2009 Sep;64(9):1349-5.

Everyday in the news there are updates about this year’s flu season, especially about the H1N1 virus (Swine flu).  By all accounts, the infectivity rate is going to be very high.

We have all heard the recommendations:
1) Get the vaccine
2) Wash your hands
3) Avoid crowds
4) Don’t sneeze or cough into your hands
5) Drink lots of fluid, eat lots of fruits and vegetables, exercise and get 7 hours of sleep

Is there any other preventive therapy that is over the counter and without any adverse effects? You guessed it, PROBIOTICS!!

This month in the medical journal, Pediatrics, a study was published: “Probiotics Effects on Cold and Influenza-like Symptom Incidence and Duration in Children” (1).

Method: Healthy children ages 3-5 were randomly placed in one of three groups: 104 received a placebo; 110 received a probiotic containing Lactobacillus acidophilus; 112 received a probiotic containing L acidophilus in combination with Bifidobacterium lactis. The children were given the probiotics daily for 6 months and monitored for cold and influenza-like symptoms.

Results: Compared to the placebo group, single and combination probiotics reduced the following symptoms, antibiotic usage, and reduction in days missed from school:

Conclusion:
Daily intake of a probiotic supplement for 6 months during the cold and flu season was a safe and effective way to reduce the frequency of symptoms of colds and flu, reduce antibiotic usage and lessen missed days from school. A two strain probiotic in a dosage of 10 billon colonies is very beneficial.

Discussion:
So I imagine you are all saying, “that is very interesting, but I am not a 3 year old.”

Well, there have been a number of studies (2,3,4,5,6) done over the last 4-5 years to determine if probiotics can lessen or prevent viral upper respiratory infections in not only children but also healthy adults, young and old.

One study done on healthy adults investigated the effect of long-term consumption of probiotics on viral respiratory infections during two winter/spring periods (4). The combination of a probiotic containing lactobacilli and bifidobacteriaa successfully shortened the duration of cold infections by two days and reduced the severity of symptoms. The incidence of infections, however, was not affected.

Another published paper did a systematic review of probiotics efficacy in preventing respiratory tract infections (5). Twelve controlled trials were reviewed, half reviewed adults and the other half reviewed children and infants. While the trials varied in duration of probiotic taken, dosage and type of bacterial strain, most of the trials noted a significant reduction in the severity of symptoms, but not the incidence of infection. A few did report a decrease in the frequency of infections.

There is a considerable amount of research being directed toward the mechanisms by which orally ingested probiotics can affect the immune system to lessen viral respiratory infections. Studies have shown that use of probiotics can stimulate the immune system in the gastrointestinal tract, producing more immune cells. In turn, those immune cells can stop inflammation and can also attack the viruses as they invade the lining of the respiratory tract (4, 7, 8, 9). The stimulated immune cells can migrate from the GI tract to other areas of the body…including the respiratory tract.

With these kinds of study results, it seems reasonable during the flu season to take a daily probiotic that contains a combination of lactobacilli and bifidobacteria in a serving size or dosage of 10 billon colonies or more — like EndoMune.

(1)Probiotic effects on cold and influenza-like symptom incidence and duration in children.Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC; Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27

(2) Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Winkler P, de Vrese M, Laue Ch, Schrezenmeir J; Int J Clin Pharmacol Ther. 2005 Jul;43(7):318-26.

(3)A new chance of preventing winter diseases by the administration of synbiotic formulations.Pregliasco F, Anselmi G, Fonte L, Giussani F, Schieppati S, Soletti L; J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S224-33.

(4) Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial.de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, Ott S, Hampe J, Schreiber S, Heller K, Schrezenmeir J; Vaccine. 2006 Nov 10;24(44-46):6670-4. Epub 2006 Jun 6.

(5) Probiotics for the prevention of respiratory tract infections: a systematic review. Vouloumanou EK, Makris GC, Karageorgopoulos DE, Falagas ME; Int J Antimicrob Agents. 2009 Sep;34(3):197.e1-10. Epub 2009 Jan 28.
Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence.
Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

(6) Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study.Turchet P, Laurenzano M, Auboiron S, Antoine JM; J Nutr Health Aging. 2003;7(2):75-7.

(7) Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence. Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

(8) Molecular and cellular basis of microflora-host interactions.Winkler P, Ghadimi D, Schrezenmeir J, Kraehenbuhl JP; J Nutr. 2007 Mar;137(3 Suppl 2):756S-72S. Review.

(9) Probiotic and prebiotic influence beyond the intestinal tract. Lenoir-Wijnkoop I, Sanders ME, Cabana MD, Caglar E, Corthier G, Rayes N, Sherman PM, Timmerman HM, Vaneechoutte M, Van Loo J, Wolvers DA; Nutr Rev. 2007 Nov;65(11):469-89. Review

“When given preventively over the winter months, probiotics reduce fever, cough, and runny noses in children, researchers said.”

This is very exciting news for parents across the country. Many parents deal with the frustration of sick children during the winter months and the many associated problems including missed school, missed work and restless nights.

A recent study evaluated 326 children ages 3 to 5 years. Two groups of these children in a childcare center in China were given “twice-daily doses of L. acidophilus or L. acidophilus in combination with Bifidobacterium animalis for six months from November 2005 to May 2006.” The third group was given a placebo.

Both the single strain and the multi-strain probiotic doses were effective at reducing fever, cough, and rhinorrhea; the combination strain, however, had a more profound, positive impact. This seems to imply multi-strain, multi-species probiotics continue to prove more efficacy for prevention rather than their single-strain counterparts.

With profound research studies, such as this study in China, physicians may be able to begin moving away from antibiotics toward other forms of prevention like probiotics. While more studies are necessary, probiotic research continues to move forward in a very exciting direction.

For the article in its entirety, visit:
http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/15251

Source reference:
Leyer GJ, et al “Probiotic effects on cold and influenza-like symptom incidence and duration in children” Pediatrics 2009; DOI: 10.1542/peds.2008-2666.