- Shown to improve symptoms of Antibiotic Associated Diarrhoea
- Trialled in those with lactose intolerance
- Often studied alongside L. acidophilus Rosell-52
Lactobacillus rhamnosus Rosell-11 is a very well-respected strain from the L. rhamnosus species of Lactobacilli, thought to be one of the most well researched species of probiotic bacteria. This particular strain is sometimes seen referred to as Lactobacillus rhamnosus R0011; it was first isolated in 1976 from a dairy source, though strains from this species are regularly found as natural inhabitants of the vaginal and intestinal microflora (Wasowska-Krolikoeska K. et al., 1997). Lactobacillus rhamnosus Rosell-11 is often studied alongside Lactobacillus acidophilus Rosell-52 in a combination often referred to as ‘Lacidofil’. Both strains are listed on EFSA's Qualified Presumption of Safety (QPS) list.
The potential benefits of this strain have been researched in studies focusing on Helicobacter pylori infection, vaginal health, immune function, lactose intolerance, and anxiety; however, Lactobacillus rhamnosus Rosell-11 has been selected for inclusion in this database of the world's best strains due to the extensive range of studies focusing on its effects for the relief of Irritable Bowel Syndrome (IBS), Clostridium difficile infection, and antibiotic-associated diarrhoea (AAD).
Lactobacillus rhamnosus Rosell-11 – Safety and Survival
L. rhamnosus Rosell-11 was isolated from a dairy starter culture. The ability of Lactobacillus rhamnosus Rosell-11 to survive during transit through the human gastrointestinal tract has been investigated in a randomised double-blind placebo-controlled study including 70 healthy subjects receiving an antibiotic combination of amoxicillin-clavulanic acid (Nagulesapillai, 2015). The results showed that L. rhamnosus Rosell-11 was detected in 87% of the faecal samples using qPCR method. The survival of Lactobacillus rhamnosus Rosell-11 has previously been shown in an open human trial including 14 healthy volunteers assigned to consume 4 capsules daily (each containing 2 billion cfu of L. rhamnosus Rosell-11 in a mixed culture) for a period of 12 days followed by a 12-day washout period. At the end of the capsule consumption period, high levels of Lactobacillus rhamnosus Rosell-11 were detected in faecal samples from all volunteers, reaching a mean value of 7.1 log10 CFU/g of stool (Firmesse el al, 2008).
L. rhamnosus Rosell-11 has been evaluated for its safety. Toxicity studies were completed, and no toxicity was observed (Foster et al, 2011). In clinical studies on L. rhamnosus Rosell-11, there were no undesired outcomes when monitoring for side effects such as allergic reactions or intolerance (Rampengan et al, 2010). Evan et al (2016) demonstrated that safety parameters and adverse events were not significantly different between the intervention and the placebo.
Lactobacillus rhamnosus Rosell-11 and Antibiotic-Associated Diarrhoea (AAD) and Clostridium difficile Infection
In vitro studies using Lactobacillus rhamnosus Rosell-11 have shown its ability to adhere to human intestinal epithelial cells, thereby inhibiting the adhesion of pathogens to the epithelium and assisting with their eradication (Sherman et al., 2005), (Wallace et al., 2003). Building on this research, human clinical trials have been conducted to further explore its potential to help with diarrhoea symptoms caused by antibiotic-associated gut microbiota disruption, and also diarrhoea caused by pathogenic infections by bacteria such as Clostridium difficile.
In one such gold standard, randomised, double-blind and placebo-controlled clinical trial, 146 healthy adults were given Lactobacillus rhamnosus Rosell-11 alongside Lactobacillus acidophilus Rosell-52. The participants were given a broad spectrum antibiotic alongside the probiotic supplement for one week, and then the probiotic was continued for an additional week following the antibiotic treatment. A control group was given a placebo supplement alongside the antibiotics, using the same regime. The results concluded that the group taking the probiotic formula suffered from AAD symptoms for a statistically significant shorter amount of time than those in the control group (Evans et al., 2016).
An earlier trial observed 244 children aged 0-17 years, who were all suffering from acute urinary, digestive or respiratory symptoms. A group of 117 children were given antibiotics together with the Lacidofil probiotic combination, and the other 127 children were given antibiotic therapy only. The results of this study showed that there was both a lower incidence and decreased duration of AAD with the probiotic supplement, as well as a decrease in levels of Clostridium difficile compared to the control group (Maydannik V. et al., 2010).
The probiotic combination Lactobacillus acidophilus Rosell-52 and rhamnosus Rosell-11 was again used in a large clinical trial to assess its efficacy for the prevention of AAD in adults. 214 patients with respiratory tract infections, who had already embarked on antibiotic therapy, were randomly grouped to either receive the probiotic formula, or a placebo, for 14 days. Patients were asked to record their bowel frequency and stool consistency on a daily basis. The results showed that those taking the probiotic maintained their normal bowel habits and function, to a greater extent that those taking the placebo, suggesting that these strains of bacteria help prevent AAD (Song et al., 2010).
Another significant trial monitored 57 children who were taking antibiotics, to see if the addition of a probiotic given alongside the medication could help to reduce the risk of AAD.
The children were split into two groups, with half of them being given the probiotic combination of Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52, and the other half being assigned to a control group in which members were given the antibiotic medication only. It was found that 36.5% of those in the control group went on to develop AAD, whereas only 7.4% of children in the probiotic group developed this side effect (Ivanko O. & Radutnaya E., 2005).
Other Relevant Studies: Aryayev M. & Kononenko N., (2009), Dial S. et al., (2003), Doder R. et al., (2013), D’Souza A. L. et al., (2002), Gnaytenko O. et al., (2009), Jirapinyo, P. et al., (2002), Liskovich, V. et al., (2010), Marushko Y. & Shef G., (2007), Maydannik V. et al., (2008), Patsera M. et al., (2010).
Lactobacillus rhamnosus Rosell-11 and Diarrhoea
Acute or chronic diarrhoea is a common complaint in daily clinical practice, and is often a primary symptom of gastrointestinal tract disorders. It is of particular concern in developing countries where it is a common cause of serious health problems, associated with a high mortality rate in both children and adults. Traveller's diarrhoea. The consumption of probiotics to alleviate or prevent acute episodes of diarrhoea is well-supported with a collection of clinical studies, however more research needs to be carried out to investigate details of methods of action (Simadibrata et al., 2013).
With this focus, a randomised, controlled clinical trial was conducted using 76 adult patients with acute diarrhoea. The subjects were divided into a treatment group, where members received the probiotic combination Lactobacillus rhamnosus Rosell-11 alongside Lactobacillus acidophilus Rosell-52 for 7 days, and a control group that was given a placebo. The study concluded that there was a faster recovery rate in the probiotic group of at least one whole day. A greater improvement in the clinical symptoms (frequency of stools, stool consistency, abdominal pain, nausea, vomiting, bloating, headache, fever and tenesmus) were also observed in the probiotic group, compared to the placebo, though the result was statistically significant in stool consistency changes only (Simadibrata et al., 2013).
Lactobacillus rhamnosus Rosell-11 and Irritable Bowel Syndrome (IBS)
An increasingly common digestive complaint, the precise underlying cause of Irritable Bowel Syndrome (IBS), is not well understood, and conventional treatments attempt merely to ameliorate symptoms. The composition of the intestinal microflora is believed to be a factor, and preliminary studies appear to suggest a positive role for probiotics. To demonstrate this effect, a four month clinical study administered the probiotic formulation (Lactobacillus rhamnosus Rosell-11 alongside Lactobacillus acidophilus Rosell-52) to subjects with IBS. The results illustrated that, of the participants who had suffered with chronic IBS for the last 10 years, 88% showed an overall reduction in IBS related complaints after the study period (Benes Z. et al., 2006).
Further relevant studies: Bruggencate T., (2015), Chayka V. et al., (2006), Firmesse O. et al., (2005), Kocian J. et al., (1994), Rampengan et al., (2010), Skorodumova et al., (2007), Tlaskal P. et al., (1995), Tlaskal et al., (2005), Wasowska-Krolikoeska K. et al., (1997), Zvyagintzeva et al.,(2008).
Lactobacillus rhamnosus Rosell-11 and Helicobacter pylori
Helicobacter pylori is a common resident in the stomach, and in many people, it does not cause any problems; however, if conditions are ripe for its proliferation, it can become a factor in stomach ulcers and associated symptoms such as acid reflux. H. pylori typically lives in the stomach, where it is able to survive the harsh conditions by boring a hole into the stomach lining to ‘hide’ from the acid. Because of this hiding technique, it can be difficult to effectively eradicate this pathogen. The standard medical approach is a ‘triple therapy’ comprising two different antibiotics in combination with a proton pump inhibitor (PPI), typically given for one week. This treatment is not always fully effective and H. pylori infection often recurs. The use of probiotics as an effective natural adjunct to conventional methods is being explored.
In order to assess their potential, a study was conducted which used the probiotic combination, Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52, alongside the standard triple therapy. The trial monitored 152 patients who had tested positive for Helicobacter pylori and who were suffering from typical symptoms. The subjects were divided into groups, where members were assigned to be given the probiotic combination alongside the 10 day triple therapy, or the triple therapy alone (control group). After 6 weeks, the participants were tested and it was found that, 72% of patients in the control group achieved a total eradication of the pathogen. In the probiotic group, however, the H. pylori eradication rate increased up to 92% (Bielanski W. et al., 2002).
Further relevant studies: Abaturov et al., 2014, Babak O., (2007), Gnaytenko et al., 2009, Plewinska E., (2006), Vdovychenko V., (2008), Ziemniak W., (2006).
Lactobacillus rhamnosus Rosell-11 and Lactose Intolerance
Lactose intolerance is described as an inability to digest significant amounts of lactose, which is the primary sugar found in milk and other dairy products. Lactose intolerance usually develops from an insufficiency of the enzyme lactase, which breaks down lactose into simpler molecular forms that can be more easily absorbed into the bloodstream. Many probiotics are B-galactosidase positive, giving them a lactase-like action which helps with the digestion lactose in the intestines. There has been a small amount of research to indicate that probiotics may help to improve lactose tolerance, and the strain Lactobacillus rhamnosus Rosell-11 is one of the probiotics which has been investigated for this purpose (Maladkar et al, 2009).
A related study used 19 patients with lactose intolerance giving them the probiotic supplement, Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52, to take at the same time as consuming a variety of different dairy products including milk, cottage cheese and Edam cheese. Lactose tolerance as well as stool consistency was measured both before, and after, the two week study period. The results indicated that taking the probiotic supplement increased tolerance of the dairy foods by a third. The improvement in lactose intolerance was particularly significant when the subject were consuming milk (Kocian J., 1994).
Kocian J., 1994 - is indicative of how specific strains can help with lactose intolerance
Further relevant studies: Chernyshov, (2009a), Chernyshov, (2009b), Kocian J., (1996), Rampengan et al., (2010).
Lactobacillus rhamnosus Rosell-11 and Vaginal Dysbacteriosis
There is a growing interest in the use of probiotics to help rebalance the microflora in areas outside of the intestines, including the uro-genital area. Populations of the delicate bacteria in the intimate area can become unbalanced due to a variety of different factors, including menstruation, sexual activity, hormonal changes, and medication such as antibiotics. Although you will see from the other database entries that other strains have been more extensively researched for genito-urinary health, there has been some limited clinical research using the Lacidofil combination for this purpose. In order to try to demonstrate the efficacy of these probiotics in maintaining the natural balance of the vaginal microbiota, a group of women were recruited to take part in a small trial. The women were all taking antibiotics following a caesarian procedure. Alongside their antibiotics, a total of 56 women were given the probiotic supplement, Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52, and 40 were given a placebo supplement. The results showed that 89.3% of those women in the probiotic group had no negative changes in composition of their vaginal flora compared to the placebo group who all did. Additionally none of them experienced antibiotic associated diarrhoea compared to the control group, where 10% of the women experienced AAD (Liskovich et al., 2010).
Further relevant study: Chayka et al., (2006).
Lactobacillus rhamnosus Rosell-11 and Immunity
Whilst, to date, no significant clinical trials have been conducted to demonstrate this effect, there is some promising evidence resulting from a collection of in-vivo studies which suggest that the combination of strains Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52 could help to support immune function.
Further relevant studies: Gareau et al., (2007), Zareie et al., (2006), Verdu et al., (2008), Gareau et al., (2010), Huynh et al., (2015), Smith et al., (2014).
Lactobacillus rhamnosus Rosell-11 and Anxiety
Another interesting area of study is the gut-brain-microbiome connection. Again, more research needs to be carried out, but a murine study indicated that the Lacidofil probiotic helped to normalise anxious behaviour and memory impairments in immune-deficient mice with HPA axis dysfunction. Corticosteroid hormone levels were used as the measure of HPA axis activation, and statistically significant levels of the hormone were observed in the probiotic group of mice compared to the control group (Smith C.J. et al., 2014).
Further relevant studies: Callaghan B. et a.,l (2016), Cowan C et al., (2016)
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Information on this strain was gathered by Joanna Scott-Lutyens BA (hons), DipION, Nutritional Therapist; and Kerry Beeson, BSc (Nut.Med) Nutritional Therapist.
Last updated - 19th February, 2019