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Lactobacillus reuteri LRE02

Also known as: Lactobacillus reuteri, L. reuteri LRE02, Limosilactobacillus reuteri LRE02, Limosilactobacillus reuteri

Overview

Limosilactobacillus reuteri (formerly Lactobacillus reuteri) is a naturally occurring lactic acid bacterium found in the human gastrointestinal tract. It is widely utilized as a probiotic supplement, primarily for its beneficial effects on gastrointestinal health, particularly in the prevention and treatment of various forms of diarrhea, including antibiotic-associated diarrhea (AAD) and acute gastroenteritis. The specific strain LRE02 is notable for being a microencapsulated form, a technological advancement designed to significantly enhance its survival through the harsh conditions of the gastrointestinal tract, thereby increasing the number of viable bacteria reaching the intestines. Research on L. reuteri is extensive, with numerous randomized controlled trials (RCTs) and meta-analyses supporting its efficacy, especially for well-studied strains like DSM 17938 and ATCC 55730. While LRE02 is a newer strain, it is supported by its own RCT data, demonstrating moderate to high-quality evidence for its role in diarrhea reduction.

Benefits

Limosilactobacillus reuteri, particularly strains like LRE02, offers significant evidence-based benefits primarily in gastrointestinal health. It has been shown to significantly reduce the incidence and duration of antibiotic-associated diarrhea (AAD) in adults, with studies reporting a relative risk reduction of approximately 65% for strains like ATCC 55730. For children, L. reuteri effectively reduces the duration and severity of acute diarrhea, with notable improvements observed as early as day 4 of treatment, and a relative risk reduction of about 39% by day 2. These benefits include improvements in diarrhea severity scores, fewer days of watery stools, and reduced hospitalization duration. The populations benefiting most are children with acute gastroenteritis and adults at risk of AAD. While less established, some research suggests L. reuteri may also contribute to improved lipid profiles by reducing total cholesterol and LDL cholesterol, though this secondary effect requires further investigation to confirm clinical relevance.

How it works

Limosilactobacillus reuteri exerts its probiotic effects through several key mechanisms. It colonizes the gut mucosa, creating a competitive environment that inhibits the growth of pathogenic bacteria. A unique aspect of its action is the production of antimicrobial substances, such as reuterin, which directly combat harmful microorganisms. Furthermore, L. reuteri modulates the host immune response, helping to reduce inflammation within the gut. The LRE02 strain specifically benefits from microencapsulation, a process that significantly enhances its survival through the acidic environment of the stomach and the presence of bile salts, increasing the delivery of viable bacteria to the intestines by up to five-fold. This improved survival ensures more active bacteria reach their target site, maximizing their therapeutic potential. The LRE02 strain is also plasmid-free for antibiotic resistance, minimizing the risk of horizontal gene transfer.

Side effects

Limosilactobacillus reuteri, including the LRE02 strain, is generally considered safe for consumption, with clinical trials reporting no serious adverse events. Side effects are rare, mild, and typically transient, primarily involving minor gastrointestinal discomfort such as bloating or gas. There are no significant drug interactions documented for L. reuteri. Contraindications are minimal; however, caution is advised for severely immunocompromised individuals due to the theoretical risk of bacteremia, although this is extremely rare with probiotic strains. The microencapsulation technology used for LRE02 may further enhance tolerability and potentially reduce allergen exposure, making it a well-tolerated supplement for most individuals. Overall, its safety profile is robust, supported by extensive research in both adult and pediatric populations.

Dosage

The effective dosage of Limosilactobacillus reuteri, including the LRE02 strain, typically ranges from 1 × 10^8 to 1 × 10^9 Colony Forming Units (CFU) per day in clinical trials. For the LRE02 strain specifically, efficacy has been demonstrated at a dose of 2 × 10^8 CFU, particularly when used in combination formulations for the prevention of antibiotic-associated diarrhea. The duration of supplementation varies depending on the condition; for acute diarrhea, a typical course is 4–7 days, while for preventive measures, longer durations may be recommended. The microencapsulation of the LRE02 strain is a critical factor, as it significantly improves the bioavailability and gut colonization of the probiotic, ensuring that a higher number of viable bacteria reach the intestines. This enhanced delivery means that even at seemingly lower CFU counts, the effective dose reaching the target site is optimized. No specific cofactors are required for its absorption or efficacy.

FAQs

Is LRE02 effective alone or only in combination?

Evidence supports the efficacy of LRE02 both as a standalone supplement and when used in combination with other probiotics, particularly for conditions like antibiotic-associated diarrhea.

How soon will benefits appear?

For diarrhea reduction, the beneficial effects of L. reuteri often become noticeable within 1 to 4 days of consistent supplementation.

Is it safe for children?

Yes, numerous pediatric randomized controlled trials have confirmed the safety and efficacy of L. reuteri strains, including LRE02, for use in children.

Does it help beyond diarrhea?

While primarily known for its benefits in diarrhea, some research suggests L. reuteri may offer improvements in lipid profiles, though more studies are needed to confirm this secondary benefit.

Research Sources

https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2018.00124/full – This meta-analysis of three randomized controlled trials investigated the effect of L. reuteri ATCC 55730 on antibiotic-associated diarrhea (AAD) in adults. It found a significant reduction in AAD incidence (RR = 0.35), with low heterogeneity, indicating a consistent and high-quality evidence base for its preventive effect.
https://www.springermedizin.de/a-systematic-review-and-meta-analysis-the-therapeutic-and-preven/25324294 – This systematic review and meta-analysis focused on L. reuteri DSM 17938 in children with diarrhea. It demonstrated a significant reduction in diarrhea episodes by day 2 (RR = 0.61), with effects stable after 4 days, supporting its therapeutic use in pediatric populations despite some heterogeneity.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7650601/ – This randomized, double-blind, placebo-controlled trial evaluated microencapsulated L. reuteri LRE02 and L. rhamnosus for AAD prevention. It showed that microencapsulation improved probiotic survival and colonization, leading to reduced AAD incidence, confirming the efficacy and enhanced delivery of the LRE02 strain.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6893691/ – This systematic review and meta-analysis assessed L. reuteri DSM 17938 for acute gastroenteritis in pediatric patients. It confirmed a reduction in both the duration and severity of diarrhea, providing moderate confidence for its clinical use based on a robust analysis of multiple RCTs.
https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0178868 – This meta-analysis investigated the effects of various Lactobacillus probiotics, including L. reuteri, on lipid profiles. It reported significant reductions in total cholesterol and LDL-C, suggesting a potential secondary benefit, though the clinical relevance and specific strain effects require further dedicated research.