HLC Multi Strain is a 15 billion CFU probiotic formula, providing four strains of proprietary
human-sourced Lactobacillus acidophilus (CUL-60 & CUL-21), Bifidobacterium
bifidum and Bifidobacterium animalis subsp. lactis that temporarily modify gut flora,* and have
been tested in various human clinical trials. The capsules are 100% pure vegetable-sourced
which makes the product ideal for vegans.
Additional product info: The microbiota ensures intestinal structure and function and the
homeostasis of the gut microbiota also maintains various functions, which are vital to the
maintenance of human health. In fact, disruption of the intestinal ecosystem equilibrium (gut
dysbiosis) is associated with a plethora of human diseases, including autoimmune and allergic
diseases, and bacterial infections.(1)
Colonic infection with Clostridium difficile, leading to pseudomembranous colitis, is a common
complication of antibiotic therapy, especially in elderly patients. It has been suggested that nonpathogenic probiotic bacteria might prevent the development and recurrence of C.
difficile infection. A double-blind, placebo-controlled study examined the role of probiotic
administration in the prevention of C. difficile-associated diarrhoea (CDAD) in elderly patients
receiving antibiotic therapy. Consecutive patients (150) receiving antibiotic therapy were
randomised to receive either a probiotic containing both Lactobacillus and Bifidobacterium or
placebo for 20 days. Each patient received one capsule/day for 20 days. The probiotic product
(provided by Cultech, Swansea) comprised 2 x 1010 CFU Lactobacillus
acidophilus and Bifidobacterium bifidum/capsule; the placebo comprised the inactive carrier.
Upon admission to hospital, bowel habit was recorded and a faecal sample taken. Trial probiotic
or placebo was taken within 72 h of prescription of antibiotics, and a second stool sample was
taken in the event of development of diarrhoea during hospitalisation or after discharge. Of the
randomised patients, 138 completed the study, 69 with probiotics in conjunction with antibiotics
and 69 with antibiotics alone. On the basis of development of diarrhoea, the incidence of samples
positive for C. difficile-associated toxins was 2.9% in the probiotic group compared with 7.25%
in the placebo-control group. Toxin testing of the C. difficile-positive patients indicated that five
of the 11 probiotic patients (46%) were toxin-positive with two of the five toxin-positive patients
showing signs of diarrhoea. Seven of the nine placebo patients carrying C. difficile (78%) were
toxin-positive, and six of these seven had diarrhoeal symptoms.(2)
The effects of probiotic supplementation on the intestinal re-growth microbiota following
antibiotic therapy were studied in another double-blind placebo-controlled study. The probiotic
product (Cultech Ltd., Port Talbot, UK) comprised two strains of Lactobacillus
acidophilus (CUL60 and CUL21) and two strains of Bifidobacterium spp. at a total of 2.5 X
1010 colony-forming units (CFU)/capsule, and the placebo comprised an inactive carrier
(maltodextrin). Patients received one capsule daily. In the placebo group, numbers of facultative
anaerobes and enterobacteria increased significantly, and at day 35 the numbers were
significantly higher in the placebo group than in the active group; in the active group, the
numbers of bacteroides increased significantly. Although the numbers of enterococci in both
groups did not change, in the placebo group the number of patients harbouring antibioticresistant enterococci post therapy increased significantly. From this study, it would appear that
daily supplementation with viable probiotic bacteria during and post antibiotic therapy reduces
the extent of disruption to the intestinal microbiota as well as the incidence and total numbers of
antibiotic-resistant strains in the re-growth population.(3)
In a pilot-scale, double-blind, placebo-controlled trial, 30 patients with Helicobacter
pylori infection were randomised into three groups prior to their 7 days eradication therapy, to
study the effects of probiotic supplement comprising Lactobacillus
acidophilusand Bifidobacterium bifidum on the intestinal microflora in response to antibiotic
therapy. Group I received the placebo product from day 1 to day 15, Group II received placebo
from day 1 to day 7 and probiotics from day 8 to day 15 and Group III received probiotics from
day 1 to day 15. Patients took one probiotic or placebo capsule daily with food, according to
their group. A commercially available probiotic product was provided by Cultech Ltd (Swansea,
UK) and comprised two strains of Lactobacillus acidophilus (CLT60 and CUL21) and two
strains of Bifidobacterium bifidum (CUL17 and B. bifidum Rhodia, New Jersey, USA) at a total
of 2.5 x 1010 colony forming units (CFU)/capsule. The placebo comprised an inert carrier
(maltodextrin, Cultech Ltd). Patients provided stool samples for analysis on days 1, 7, 12, 17 and
27. For patients in Groups I and II, significant increases in the facultative anaerobe component of
the microflora occurred between days 1 and 7. In Group I, the numbers remained elevated to day
27 but in Group II, the numbers decreased significantly between days 7 and 27 back to the
starting levels. In Group III, the facultative anaerobe population remained stable throughout. The
total anaerobe numbers increased significantly at day 27 than at day 1 for Group I, were
unchanged throughout for Group II and decreased significantly for the patients in Group III
between days 1 and 7 before reverting to the starting levels by day 27. From these results, it can
be seen that probiotic supplementation modulates the response of the intestinal microflora to the
effects of antibiotic therapy. (4)
The efficacy of probiotics in alleviating the symptoms of irritable bowel syndrome (IBS) appears
to be both strain- and dose-related. The aim of a study was to investigate the effect of a
multistrain probiotic preparation on symptoms of IBS. This probiotic preparation has not
previously been assessed in IBS. Fifty-two participants with IBS, as defined by the Rome II
criteria, participated in this double blind, randomized, placebo-controlled study. Participants
were randomized to receive either a probiotic preparation comprising two strains
of Lactobacillus acidophilus CUL60 and CUL21, Bifidobacterium lactis CUL34
and Bifidobacterium bifidumCUL20 at a total of 2.5 × 1010 cfu/capsule or a placebo for 8 weeks.
Subjects were asked to complete a validated questionnaire to assess IBS symptoms at baseline
and fortnightly throughout the 8 weeks study period. The questionnaire assessed severity and
duration of abdominal pain (abdominal pain, days with pain), abdominal distension (bloating),
satisfaction with bowel habits and quality of life. The following results were noted:
1. The number of days with pain improved significantly by week 2 in the probiotic group, but did
not reduce significantly for the placebo group until 4 weeks into the study.
2. The severity of abdominal pain reduced significantly in both groups from week 4 onwards.
3. Significant improvements in quality of life were recorded for those receiving the probiotic at
the end of the intervention period and this was associated with significantly improved
satisfaction with bowel habit for the probiotic subjects over the placebo group at 6 weeks.
Significant improvements from baseline for symptoms severity score were seen throughout the
intervention period in both active and placebo groups from weeks 2. Comparison of the
effectiveness of the probiotic in the presence of significant placebo effect in this study showed a
significant difference in the Symptom Severity Score in favour of the probiotic at 6 weeks and 8
weeks but by 2 weeks after the 8 weeks of the intervention, no significant difference could be
detected between the probiotic and placebo group. LAB4 multistrain probiotic supplement may
benefit subjects with IBS.(4)
References: 1. Prakash S, Rodes L, Coussa-Charley M, Tomaro-Duchesneau C. Gut
microbiota: next frontier in understanding human health and development of biotherapeutics.
Biologics. 2011;5:71-86.
2. Plummer, S., Weaver, M.A., Harris, J.C., Dee, P. and Hunter, J. “ Clostridium difficile pilot
study: effects of probiotics supplementation on the incidence of C.difficile diarrhea.”
International Microbiology. 2004; 7(1):59-62.
3. Plummer SF, Garaiova I, Sarvotharn T, Cottrell SL, LeScouiller S, Weaver MA et al. Effects
of probiotics on the composition of the intestitinal microbiota following antibiotic therapy. Int J
Antimicrob Agents. 2005; 26(1):69-74.
4. Madden JA, Plummer SF, Tang J, Garaiova I, Plummer NT, Herbison T, et al. Effects of
probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: a
double-blind, placebo-controlled pilot study. Int Immunopharmacol. 2005; (6): 1091-7.
5. Williams EA, Stimpson J, Wang D, Plummer S, Garaiova I, Barker ME, Corfe BM. “Clinical
trial: a multistrain probiotic preparation significantly reduces the symptoms of irritable bowel
syndrome in a double-blind placebo-controlled trial.” Alimentary Pharmacology & Therapeutics.
2009. 29(1):97-103.
6. NHPD Abbreviated Labelling Standard – Live Microorganisms. August 30, 2011