Postbiotics for Preventing and Treating Common Infectious Diseases in Children: A Systematic Review

Abstract

Postbiotics have recently been tentatively defined as bioactive compounds produced during a fermentation process (including microbial cells, cell constituents and metabolites) that supports health and/or wellbeing. Postbiotics are currently available in some infant formulas and fermented foods. We systematically reviewed evidence on postbiotics for preventing and treating common infectious diseases among children younger than 5 years. The PubMed, Embase, SpringerLink, and ScienceDirect databases were searched up to March 2019 for randomized controlled trials (RCTs) comparing postbiotics with placebo or no intervention. Seven RCTs involving 1740 children met the inclusion criteria. For therapeutic trials, supplementation with heat-killed Lactobacillus acidophilus LB reduced the duration of diarrhea (4 RCTs, n = 224, mean difference, MD, −20.31 h, 95% CI −27.06 to −13.57). For preventive trials, the pooled results from two RCTs (n = 537) showed that heat-inactivated L. paracasei CBA L74 versus placebo reduced the risk of diarrhea (relative risk, RR, 0.51, 95% CI 0.37–0.71), pharyngitis (RR 0.31, 95% CI 0.12–0.83) and laryngitis (RR 0.44, 95% CI 0.29–0.67). There is limited evidence to recommend the use of specific postbiotics for treating pediatric diarrhea and preventing common infectious diseases among children. Further studies are necessary to determine the effects of different postbiotics.

Impact of Heat-Killed Lactobacillus casei Strain IMAU60214 on the Immune Function of Macrophages in Malnourished Children

“…Based on the above, we consider that the administration of heat-killed Lactobacillus casei IMAU60214 by adjuvant therapy, together with oral hydration solutions, could help malnourished patients with conditions complicated by diarrhea, who represent a high risk of mortality with respect to malnourished patients without diarrhea during their stay in Hospital. These conditions are in agreement with the previous reports that suggested that heat-killed bacteria retain immunostimulatory properties [ 63 , 64 ] and their function as potential bioactive foods in the prevention of infectious diseases in children [ 65 ]. However, further research is necessary to extend these observations with well-controlled clinical studies before their acceptance as a recommendation for alternative therapy.…”

Postbiotics—A Step Beyond Pre- and Probiotics

“…Indeed, combining postbiotics and probiotics effectively prevented rotavirus-associated diarrhea in a preclinical model [84]. Furthermore, randomized clinical trials conducted in a group of children aged 12-48 months showed that daily intake of products containing L. paracasei postbiotic led to a reduction in the incidence of diarrhea [85,86], acute gastroenteritis, pharyngitis, laryngitis, and tracheitis [86,87]. Butyrate (a SCFA), was found to support the regeneration of the intestinal epithelium [88].…”

Exploring the Effect of Probiotics, Prebiotics, and Postbiotics in Strengthening Immune Activity in the Elderly

“…Similar to probiotics and prebiotics, postbiotics have recently been tentatively defined as bioactive compounds produced during a fermentation process (including inactive microbial cells, cell constituents, and metabolites) that support health and/or well-being [ 52 ]. Postbiotics, particularly heat-killed bacteria, have been widely used in various applications, including foods, cosmetics, and pharmaceuticals.…”