Department of Paediatrics, Taiwan Adventist Hospital, Taipei, Taiwan.
J Trop Pediatr. 2009 Oct;55(5):297-301. doi: 10.1093/tropej/fmp001. Epub 2009 Feb 8.
Beneficial effects of probiotics in acute infectious diarrhoea in children are mainly seen in watery diarrhoea and viral gastroenteritis. Lactobacillus rhamnosus, one the most extensively studied probiotic strains, is effective in shortening courses of acute diarrhoea in children. However, the dose-dependent effect of Lactobacillus upon quantification of faecal rotavirus shedding in humans remains little known. Thus, an open-label randomized trial in 23 children with acute rotaviral gastroenteritis was undertaken by randomly allocating patients to receive one of the three regimens for 3 days: daily Lactobacillus rhamnosus 35 (Lcr35) with 0 CFU/day to six patients in the control group, 2 x 10(8) CFU/day to nine patients in the low-dose group, and 6 x 10(8) CFU/day to eight patients in the high-dose group. Faecal samples were collected before and after the 3-day regimen for measurements of rotavirus concentrations by ELISA. There was no statistically significant change in faecal rotavirus concentrations in either the control group (119.2 x 10(5) particles/ml vs. 23.7 x 10(5) particles/ml, p = 0.075) or the low-dose group (36.1 x 10(5) particles/ml vs. 73.5 x 10(5) particles/ml, p = 0.859). However, the high-dose group had a significant reduction of faecal rotavirus concentration (64.2 x 10(5) particles/ml vs. 9.0 x 10(5) particles/ml, p = 0.012). Without any exception, the faecal rotavirus concentrations of all eight patients in the high-dose Lcr35 group declined by 86% after 3 days when compared with those before Lcr35 administration. In conclusion, this is the first report to provide quantitative evidence of the dose-dependent effect of Lactobacillus rhamnosus, a minimal effective dose of 6 x 10(8) CFU for 3 days, upon the faecal rotavirus shedding in paediatric patients.
益生菌对儿童急性感染性腹泻的有益作用主要见于水样腹泻和病毒性胃肠炎。研究最多的益生菌菌株之一鼠李糖乳杆菌（Lactobacillus rhamnosus）可有效缩短儿童急性腹泻的病程。然而，关于人类粪便轮状病毒脱落量与鼠李糖乳杆菌剂量之间的剂量依赖性效应仍知之甚少。因此，一项针对 23 例急性轮状病毒胃肠炎患儿的开放性、随机临床试验，将患者随机分配接受以下三种方案中的一种，连续 3 天：对照组每天给予 35 株鼠李糖乳杆菌（Lcr35），剂量为 0 CFU/天，共 6 例；低剂量组每天给予 2 x 10(8) CFU/天，共 9 例；高剂量组每天给予 6 x 10(8) CFU/天，共 8 例。在 3 天方案前后采集粪便样本，通过 ELISA 测量轮状病毒浓度。对照组（119.2 x 10(5) 个颗粒/ml 与 23.7 x 10(5) 个颗粒/ml，p = 0.075）或低剂量组（36.1 x 10(5) 个颗粒/ml 与 73.5 x 10(5) 个颗粒/ml，p = 0.859）粪便轮状病毒浓度均无统计学显著变化。然而，高剂量组粪便轮状病毒浓度显著降低（64.2 x 10(5) 个颗粒/ml 与 9.0 x 10(5) 个颗粒/ml，p = 0.012）。无一例外，与 Lcr35 给药前相比，高剂量 Lcr35 组的 8 例患儿粪便轮状病毒浓度在 3 天后均下降 86%。总之，这是第一项提供定量证据的报告，表明鼠李糖乳杆菌存在剂量依赖性效应，最小有效剂量为 3 天 6 x 10(8) CFU，可降低儿科患者粪便轮状病毒脱落量。
