Lactobacillus Rhamnosus Lysate
Also known as: LGG, Lactobacillus rhamnosus lysate, Lactobacillus rhamnosus GG
Overview
Lactobacillus rhamnosus GG (LGG) is a well-researched probiotic strain, originally isolated from the human gut, known for its beneficial effects on gastrointestinal and immune health. The 'lysate' form refers to non-viable bacterial components that exert immunomodulatory effects without containing live bacteria. LGG is widely used for the prevention and treatment of various gastrointestinal disorders, including antibiotic-associated diarrhea and acute pediatric diarrhea. It also plays a significant role in promoting immune tolerance in children with food allergies, such as cow's milk allergy. Key characteristics of LGG include its robust ability to survive the acidic environment of the stomach, adhere effectively to the intestinal lining, modulate immune responses, and inhibit the growth of pathogenic bacteria. Research on LGG is extensive, with numerous randomized controlled trials, systematic reviews, and meta-analyses supporting its efficacy in specific indications, particularly in pediatric populations. While generally safe, caution is advised for immunocompromised individuals.
Benefits
Lactobacillus rhamnosus GG offers several evidence-based benefits, particularly in pediatric populations. A meta-analysis of 5 randomized controlled trials (n=565) demonstrated that LGG significantly increased the acquisition of immune tolerance in children with cow's milk allergy, showing a relative risk of 2.22 (95% CI 1.86–2.66, p<0.00001) over 12-36 months. This suggests a strong effect in promoting long-term tolerance. For the prevention of antibiotic-associated diarrhea, a systematic review and meta-analysis found that LGG significantly reduces the incidence in both children and adults (p<0.05). In the treatment of acute pediatric diarrhea, meta-analyses of RCTs indicate that high-dose LGG can reduce the duration of diarrhea and stool frequency, especially when administered early, with effects observed within days. Beyond these primary effects, LGG also exhibits antimicrobial activity against various pathogens like Salmonella and E. coli, as shown in in vitro and animal studies. The strength of evidence for these benefits ranges from moderate to high, with strong effect sizes reported for allergy tolerance and a reduction in diarrhea duration by approximately 24-48 hours.
How it works
Lactobacillus rhamnosus GG exerts its beneficial effects through multiple mechanisms. It modulates the composition of the gut microbiota, promoting a healthier balance of microorganisms. LGG enhances the integrity of the intestinal mucosal barrier, which is crucial for preventing the translocation of harmful substances and pathogens. Furthermore, it significantly influences immune cell responses, helping to promote immune tolerance and reduce inflammation within the gut. At a molecular level, LGG produces bacteriocins and microcin-like substances, which are antimicrobial peptides that directly inhibit the growth of pathogenic bacteria. While live LGG colonizes the gut, the lysate form provides bacterial components that can stimulate immune receptors without requiring the bacteria to be viable, offering immunomodulatory benefits. Its ability to survive gastric acidity is key to its local action in the gut.
Side effects
Lactobacillus rhamnosus GG is generally considered safe and well-tolerated in healthy individuals, including pediatric and adult populations. Mild gastrointestinal symptoms, such as bloating or gas, are occasionally reported but typically do not differ significantly from placebo groups. However, rare but serious adverse events have been documented, primarily in vulnerable populations. These include cases of bacteremia, sepsis, and endocarditis, predominantly observed in immunocompromised individuals, critically ill patients, or those with central venous catheters. Therefore, caution is strongly advised for individuals with immunodeficiency, severe underlying illnesses, or compromised gut barrier function, as these conditions may increase the risk of adverse effects. There are no major known drug interactions, but careful consideration is warranted when LGG is used concurrently with immunosuppressants. Contraindications include severe immunodeficiency, critical illness, or conditions that significantly impair gut barrier integrity, as these factors can elevate the risk of systemic infection.
Dosage
Recommended dosages for Lactobacillus rhamnosus GG vary depending on the intended use, but studies commonly employ doses ranging from 10^9 to 10^10 Colony Forming Units (CFU) per day for both diarrhea and allergy management. For the treatment of acute diarrhea, higher doses, specifically ≥10^10 CFU/day, appear to be more effective. While there is no established upper limit for safety, doses up to 10^11 CFU/day have been used safely in clinical trials. For optimal efficacy in acute diarrhea, early intervention within 48 hours of symptom onset is crucial. Live probiotic preparations are generally preferred for gut colonization and their full range of benefits, whereas lysate forms are utilized for their immunomodulatory effects without requiring live bacterial presence. LGG's natural acid resistance ensures its survival through gastric acid, allowing it to reach the intestines. Although prebiotics may enhance probiotic effects, they are not strictly required for LGG's efficacy.
FAQs
Is LGG lysate as effective as live LGG?
LGG lysate can provide immune benefits without live bacteria, but the evidence for treating diarrhea and allergies is stronger for live LGG due to its colonization and broader mechanisms.
Can LGG be used in infants?
Yes, LGG has demonstrated safety and efficacy in pediatric populations, including infants, for conditions like acute diarrhea and cow's milk allergy.
How soon will benefits appear?
Benefits for acute diarrhea can be observed within days, while immune tolerance for allergies may require months to years of consistent supplementation.
Are there risks for healthy adults?
For healthy adults, the risks are minimal. Adverse events are rare and primarily occur in vulnerable populations such as the immunocompromised or critically ill.
Research Sources
- https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.727127/full – This meta-analysis of 5 RCTs (n=565) investigated LGG's role in cow's milk allergy in children, finding a significant increase in immune tolerance acquisition (RR 2.22; p<0.00001) over 12-36 months, with moderate-quality evidence and no heterogeneity.
- https://www.wjgnet.com/1007-9327/full/v25/i33/4999.htm – This systematic review and meta-analysis on LGG for acute pediatric diarrhea concluded that high-dose LGG significantly reduces diarrhea duration and stool frequency, especially with early treatment. It also noted generally good safety but advised caution in immunocompromised individuals.
- https://pubmed.ncbi.nlm.nih.gov/26365389/ – This systematic review and meta-analysis focused on LGG's efficacy in preventing antibiotic-associated diarrhea in children and adults. It included RCTs demonstrating a significant reduction in diarrhea incidence with LGG (p<0.05) and a favorable safety profile.
- https://www.nmi.health/lactobacillus-rhamnosus-gg-a-review-of-clinical-use-and-efficacy/ – This review provides a comprehensive overview of Lactobacillus rhamnosus GG, detailing its clinical uses, efficacy, and mechanisms of action, including its antimicrobial properties against various pathogens.
- https://pubmed.ncbi.nlm.nih.gov/31543689/ – This study, likely a meta-analysis or systematic review, reinforces the findings regarding high-dose LGG's effectiveness in reducing the duration of acute pediatric diarrhea, emphasizing the importance of early administration for improved outcomes.
Supplements Containing Lactobacillus Rhamnosus Lysate
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