Effects of Lactobacillus reuteri DSM 17938 and vitamin D combination on the level of 25(OH)D in blood serum of young children

Authors

  • M.E. Mamenko Shupyk National Medical Academy of Postgraduate Education, Ukraine
  • M.R. Romanko Shupyk National Medical Academy of Postgraduate Education, Ukraine

Keywords:

vitamin D, Lactobacillus reuteri DSM 17938, young children, supplementation

Abstract

Background. The search for optimal vitamin D levels and supplementation approaches to provide a wide range of preventive effects on the human body remains the focus of the world’s specialists. One of the promising directions is to improve the absorption of vitamin D in the gastrointestinal tract by using probiotics.

Objective: to study the effect of using a combination of Lactobacillus reuteri DSM 17938 with vitamin D on the serum level of 25(OH)D in young children.

Materials and methods. A total of 56 children from 1 to 36 months of age with the signs of functional gastrointestinal disorders were examined; 45 of them were randomized to participate in the comparative efficacy study of using a combination of 400 IU of cholecalciferol and 108 CFU of viable Lactobacillus reuteri DSM 17938 bacteria and an oily vitamin D solution at a dose of 500 IU for 12 weeks. At the start and the end of the study, the indicators of calcium and phosphorus metabolism (25(OH)D, total and ionized calcium, inorganic phosphorus, alkaline phosphatase) and the serum levels of total IgE were determined in all children, and the dynamics of the functional status of the gastrointestinal tract was assessed.

Results. At baseline, the median serum concentration of 25(OH)D in children was 30.3 ng/mL (23.2–41.2); this indicator exceeded 30 ng/mL only in 53.3±7.4% (24/45) of cases. The use of a combination of vitamin D3 with Lactobacillus reuteri DSM 17938 made it possible to reach a statistical difference in the median concentration of 25(OH)D after 12 weeks of use compared to the same indicator at baseline: 37.4 ng/mL (30.2–52.3) versus 28.3 ng/mL (20.8–42.9), p=0.000. The level of 25(OH)D in all these children exceeded 20 ng/mL; the concentration level of 25(OH)D exceeded 30 ng/mL in 75.0±8.8% (18/24) of these. The use of 400 IU of vitamin D supplements in combination with L. reuteri for 12 weeks made it possible to reduce the median concentration of total IgE by almost half — from 64.1 IU/mL (9.2–120.0) to 31.9 IU/mL (6.4–143.6) but with significant individual variability of data. The use of vitamin D supplements in combination with Lactobacillus reuteri DSM 17938 had a positive effect on the functional activity of the gastrointestinal tract in young children and significantly reduced the frequency of parents’ complaints of stool retention and anxiety during defecation in their children.

Conclusions. The use of vitamin D3 supplements at a dose of 400 IU in combination with the probiotic strain Lactobacillus reuteri DSM 17938 has a positive effect on the functional status of the gastrointestinal tract in young children and increases the serum level of 25(OH)D. The effects of vitamin D in combination with L. reuteri in children with a burdened history of allergies require further study.

References

Battault S, Whiting SJ, Peltier SL, Sadrin S, Gerber G, Maixent JM. (2013). Vitamin D metabolism, functions and needs: from science to health claims. European journal of nutrition. 52 (2): 429-441. https://doi.org/10.1007/s00394-012-0430-5; PMid:22886046

Bikle DD. (2016). Extraskeletal actions of vitamin D. Annals of the New York academy of sciences. 1376 (1): 29. https://doi.org/10.1111/nyas.13219; PMid:27649525 PMCid:PMC5031366

Bottcher MF, Abrahamsson TR, Fredriksson M, Jakobsson T, Bjorksten B. (2008). Low breast milk TGF-β2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric allergy and immunology. 19 (6): 497-504. https://doi.org/10.1111/j.1399-3038.2007.00687.x; PMid:18221472

Cirillo Al, Boccia E, Cirillo Ar et al. (2005, abstract) Effectiveness of L. reuteri in patients with atopic dermatitis and cow milk intolerance. Preliminary study. Presented at the Italian Society for Clinical Allergy and Immunology (SIAIC) Congress, Rome, Italy, 4-7 May 2005. Abstract P-08.

Grossman Z, Hadjipanayis A, Stiris T, Del Torso S, Mercier JC, Valiulis A, Shamir R. (2017). Vitamin D in European children-statement from the European Academy of Paediatrics (EAP). European Journal of Pediatrics. 176 (6): 829-831. https://doi.org/10.1007/s00431-017-2903-2; PMid:28401345

Holick MF, Chen TC. (2008). Vitamin D deficiency: a worldwide problem with health consequences. The American journal of clinical nutrition. 87 (4): 1080S-1086S. https://doi.org/10.1093/ajcn/87.4.1080S; PMid:18400738

Holick MF. (2007). Vitamin D deficiency. New England Journal of Medicine. 357 (3): 266-281. https://doi.org/10.1056/NEJMra070553; PMid:17634462

Jones ML, Martoni CJ, Prakash S. (2012). Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial. European journal of clinical nutrition. 66 (11): 1234-1241. https://doi.org/10.1038/ejcn.2012.126; PMid:22990854

Jones ML, Martoni CJ, Prakash S. (2013). Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. The Journal of Clinical Endocrinology&Metabolism. 98 (7): 2944-2951. https://doi.org/10.1210/jc.2012-4262; PMid:23609838

Kvashnina LV. (2017). Vitamin D v rizni periody dytynstva: shcho my znaiemo, shcho neobkhidno pam'iataty i shcho zabuly. Zdorov'ia Ukrainy. 4 (43): 29-31.

Ly NP, Litonjua A, Gold DR, Celedon JC. (2011). Gut microbiota, probiotics, and vitamin D: interrelated exposures influencing allergy, asthma, and obesity? Journal of Allergy and Clinical Immunology. 127 (5): 1087-1094. https://doi.org/10.1016/j.jaci.2011.02.015; PMid:21419479 PMCid:PMC3085575

Maidannyk VH. (2017). Vitamin D, imunna systema i profilaktyka hostrykh respiratornykh infektsii. Mizhnarodnyi zhurnal pediatrii, akusherstva ta hinekolohii. 11 (4): 38-53.

Miyamoto KI, Kesterson RA, Yamamoto H, Taketani Y, Nishiwaki E, Tatsumi S, Pike JW. (1997). Structural organization of the human vitamin D receptor chromosomal gene and its promoter. Molecular Endocrinology. 11 (8): 1165-1179. https://doi.org/10.1210/mend.11.8.9951; PMid:9212063

Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, Ramos-Abad L. (2016). Global consensus recommendations on prevention and management of nutritional rickets. Hormone research in paediatrics. 85 (2): 83-106. https://doi.org/10.1159/000443136; PMid:26741135

Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, Rudenka E. (2018). Vitamin D supplementation guidelines. The Journal of steroid biochemistry and molecular biology. 175: 125-135. https://doi.org/10.1016/j.jsbmb.2017.01.021; PMid:28216084

Povorozniuk VV, Pludovski P. (2014). Defitsyt ta nedostatnist vitaminu D: epidemiolohiia, diahnostyka, profilaktyka ta likuvannia. Donetsk: Vydavets Zaslavskyi OIu.

Savino F, Ceratto S, Poggi E, Cartosio ME, Cordero di Montezemolo L, Giannattasio A. (2015). Preventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938. Beneficial microbes. 6 (3): 245-251. https://doi.org/10.3920/BM2014.0090; PMid:25488262

Trochoutsou A, Kloukina V, Samitas K, Xanthou G. (2015). Vitamin-D in the immune system: genomic and non-genomic actions. Mini reviews in medicinal chemistry. 15 (11): 953-963. https://doi.org/10.2174/1389557515666150519110830; PMid:25985946

Wacker M, Holick MF. (2013). Vitamin D-effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 5 (1): 111-148. https://doi.org/10.3390/nu5010111; PMid:23306192 PMCid:PMC3571641

Wagner CL, Greer FR. (2008). Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 122 (5): 1142-1152. https://doi.org/10.1542/peds.2008-1862; PMid:18977996

Published

2020-09-28

Issue

Section

Practical doctor school