PROBIOTIC STRAINS OF LACTOBACILLI AS IMMUNOMODULATORS: FOCUS ON LACTOBACILLUS RHAMNOSUS GG

Probiotics have long been considered not only as a way of correcting intestinal dysbiosis but also as a promising immunomodulatory solution. Over the past years, the evidence base for their effectiveness in the prevention and treatment of immuneassociated human diseases has substantially increased, the previously described mechanisms were specified and new components of the immunocorrective effect of probiotic bacteria, including those belonging to the genus Lactobacillus, have been deciphered. The meta-analytical findings and systematic reviews leave no doubt about the advisability of using certain probiotics, primarily Lactobacillus rhamnosus GG (LGG), in children for the treatment and prevention of various forms of acute diarrhea, including those associated with the administration of antibacterial agents, as well as for the prevention of respiratory infections. The results of testing the strain to be used as an adjuvant vaccine and a way of preventing atopic dermatitis are encouraging. The review analyzes the specific characteristics of present-day children who are more susceptible to allergic and infectious diseases, effector molecules of lactobacilli and signaling pathways that ensure their immunomodulatory effect, the main areas of therapeutic and preventive application and safety of probiotics, with a focus on LGG as one of the most studied and tested strains. In addition, the clinical efficacy of the synbiotic Normobakt L, a combination of LGG (4 × 109) plus fructooligosaccharides (800 mg),which has been approved in Russia for use in children with rotavirus infection against a background of atopic dermatitis, is demonstrate