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Comparison of stool colonization in premature infants by three dose regimes of a probiotic combination: a randomized controlled trial.
Dutta, S, Ray, P, Narang, A
American journal of perinatology. 2015;(8):733-40
Abstract
OBJECTIVE To compare stool colonization among premature infants receiving high-dose probiotics versus standard dose. STUDY DESIGN This blinded, randomized, placebo-controlled trial was conducted in a Level III neonatal unit. Eligibility criteria were gestational age 27-33 weeks, age < 96 hours, tolerating milk ≥ 15 mL/kg/day and availability for follow-up. Gastro-intestinal/life-threatening malformations and necrotizing enterocolitis/sepsis were exclusions. A total of 149 subjects were randomly allocated to groups A through D (received 12-hourly probiotic supplements of 10(10) cells for 21 days, 10(10) cells for 14 days, 10(9) cells for 21 days and placebo, respectively). Key outcome was stool colonization by a probiotic organism at 28 days. RESULTS Colonization with Lactobacillus and Bifidobacterium was significantly higher in groups A, B, and C versus placebo respectively, but groups A through C did not differ from each other. There were trends toward more colony forming unit (cfu) of Lactobacillus and Bifidobacterium per milliliter of stool in group A versus B and B versus C. Groups A and B and spontaneous preterm labor (SPL) independently predicted high Lactobacillus counts on day 28; groups A, B, and C and SPL predicted high Bifidobacterium counts. CONCLUSION Proportion of infants colonized with probiotic species was similar with high-dose and standard dose regimes.
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Acid production in dental plaque after exposure to probiotic bacteria.
Keller, MK, Twetman, S
BMC oral health. 2012;:44
Abstract
BACKGROUND The increasing interest in probiotic lactobacilli in health maintenance has raised the question of potential risks. One possible side effect could be an increased acidogenicity in dental plaque. The aim of this study was to investigate the effect of probiotic lactobacilli on plaque lactic acid (LA) production in vitro and in vivo. METHODS In the first part (A), suspensions of two lactobacilli strains (L. reuteri DSM 17938, L. plantarum 299v) were added to suspensions of supragingival dental plaque collected from healthy young adults (n=25). LA production after fermentation with either xylitol or fructose was analyzed. In the second part (B), subjects (n=18) were given lozenges with probiotic lactobacilli (L. reuteri DSM 17938 and ATCC PTA 5289) or placebo for two weeks in a double-blinded, randomized cross-over trial. The concentration of LA in supragingival plaque samples was determined at baseline and after 2 weeks. Salivary counts of mutans streptococci (MS) and lactobacilli were estimated with chair-side methods. RESULTS Plaque suspensions with L. reuteri DSM 17938 produced significantly less LA compared with L. plantarum 299v or controls (p<0.05). Fructose gave higher LA concentrations than xylitol. In part B, there were no significant differences in LA production between baseline and follow up in any of the groups and no differences between test and placebo were displayed. The salivary MS counts were not significantly altered during the intervention but the lactobacilli counts increased significantly in the test group (p<0.05). CONCLUSION Lactic acid production in suspensions of plaque and probiotic lactobacilli was strain-dependant and the present study provides no evidence of an increase in plaque acidity by the supply of selected probiotic lactobacilli when challenged by fructose or xylitol. The study protocol was approved by The Danish National Committee on Biomedical Research Ethics (protocol no H-2-2010-112). TRIAL REGISTRATION NCT01700712.
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Probiotic and postbiotic activity in health and disease: comparison on a novel polarised ex-vivo organ culture model.
Tsilingiri, K, Barbosa, T, Penna, G, Caprioli, F, Sonzogni, A, Viale, G, Rescigno, M
Gut. 2012;(7):1007-15
Abstract
BACKGROUND AND AIMS Probiotics and their metabolic products, here called postbiotics, have been proposed as food supplements for a healthier intestinal homeostasis, but also as therapeutic aids in inflammatory bowel disease (IBD) with, however, very little clinical benefit. This may be due to the lack of reliable preclinical models for testing the efficacy of different strains. METHODS The activity of three probiotic strains of Lactobacillus (or a postbiotic) was analysed and compared with a pathogenic strain of Salmonella on a novel organ culture system of human healthy and IBD intestinal mucosa developed in our laboratory. The system maintains an apical to basolateral polarity during stimulation due to the presence of a glued cave cylinder. The cylinder is detached at the end of the experiment and the tissue is processed for histology and immunohistochemistry. Cytokines released from the basolateral side are analysed. RESULTS The model system provides several physiological characteristics typical of a mucosal microenvironment including the presence of an organised mucus layer and an apical to basolateral polarity. Polarised administration of bacteria is critical to control the ensuing immune response as it mimics the physiological entrance of bacteria. The authors show that probiotics are not always beneficial for the healthy host and can also be detrimental in inflamed IBD. This study shows that a potent postbiotic can protect against the inflammatory properties of invasive Salmonella on healthy tissue and also downregulate ongoing inflammatory processes in IBD tissue. CONCLUSIONS Probiotics can have inflammatory activities in both healthy and IBD tissue. Valid preclinical data on proper model systems should therefore be obtained before specific probiotic strains enter the clinics, especially if administered during acute inflammatory responses. Postbiotics may be a safe alternative for the treatment of patients with IBD in the acute inflammatory phase.
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Immune-stimulating effects of lactic acid bacteria in vivo and in vitro.
Elmadfa, I, Klein, P, Meyer, AL
The Proceedings of the Nutrition Society. 2010;(3):416-20
Abstract
The health-promoting effects of lactic acid bacteria (LAB) are well recognised, making them a popular functional food ingredient. Commercially available probiotic products are often promoted as capable of improving immune defences also in healthy subjects. However, while strain-specific differences exist in the effects of LAB, conventional yoghurt bacteria have proved beneficial as well. For comparing the immunological effects of conventional and probiotic LAB, young healthy women received either a commercially available probiotic fermented milk product or a conventional yoghurt for four weeks. Both treatments showed comparable effects resulting in a stronger immunological reaction to stimuli (natural cytotoxicity against cancer cells, mitogen-induced T-lymphocyte activation and stimulated cytokine production). To study the mechanisms behind these effects, conventional (Lactobacillus delbrueckii) and probiotic (Lactobacillus rhamnosus GG), LAB were compared in vitro at the cellular level. Interestingly, L. rhamnosus GG was more potent in inducing maturation of dendritic cells (DC) that play a substantial role in directing the immune response to stimuli. In turn, L. delbrueckii provoked a higher secretion of proinflammatory cytokines as well as IL-10. These effects were, however, observed only after direct incubation of DC and LAB, not when both were separated by a layer of enterocyte-like Caco-2 cells. LAB also induced cytokine secretion in peripheral blood mononuclear cells in a similar manner and this effect was reduced in a Caco-2 cell model, suggesting a modulating influence of gut epithelial cells. While both conventional and probiotic strains modulate the immune response, specific properties may offer therapeutic options in the treatment of certain diseases.
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Clinical trial on the efficacy of a new symbiotic formulation, Flortec, in patients with acute diarrhea: a multicenter, randomized study in primary care.
Grossi, E, Buresta, R, Abbiati, R, Cerutti, R, ,
Journal of clinical gastroenterology. 2010;:S35-41
Abstract
OBJECTIVES Few randomized studies have been carried out on adult patients affected by acute diarrhea especially in primary care, which is the natural context for this kind of disorder. Lactobacillus paracasei B 21060 is a novel strain of lactobacillus, which has been shown to be effective in relieving symptoms associated with diarrhea of irritable bowel syndrome subtype and in shortening diarrhea duration. In this study, we compared the therapeutic efficacy, safety, and tolerability of a new symbiotic formulation, Flortec, containing L. paracasei B-21060, with lactobacillus GG (FlorVis GG) in the treatment of acute presumed infectious diarrhea. METHODS Fourteen general practitioners working in the Perugia health authority district carried out a randomized controlled, parallel-group, open trial in 174 adult patients suffering from acute diarrhea (87 enrolled in the Flortec group and 87 in the FlorVis group). Both the products were administered according to their standard recommended dosage. The main efficacy criterion was the duration of diarrhea after beginning treatment. Treatment duration was 10 days. Enrolled patients kept a careful track of their symptoms noting them in a personal diary for 12 days. RESULTS The 2 groups resulted to be homogeneous at baseline with regard to prognostic variables. The mean duration of diarrhea from the start of treatment in the Flortec group was 4.24 (2.73 SD) days versus 5.09 (3.72 SD) days in the FlorVis group (P=0.09).Clinical success rates in terms of absence of abdominal pain and absence of diarrhea (defined as <2 bowel movements of watery or loose stool consistency) recorded at different time-points were statistically superior in the Flortec group (Kaplan-Meyer P=0.05 for both the symptoms). The physician judged that overall efficacy was good or very good in 91.8% of the patients in the Flortec group. The corresponding value in the FlorVis group was 83.7% (P=0.003). The 2 treatments showed a very good tolerability profile, with negligible and similar adverse event rates and similar concomitant medication usage rates. CONCLUSIONS Oral therapy with Flortec proved to be more effective than FlorVis GG in the treatment of acute diarrhea in adults treated at a primary care setting.
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Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli.
Caglar, E, Kavaloglu, SC, Kuscu, OO, Sandalli, N, Holgerson, PL, Twetman, S
Clinical oral investigations. 2007;(4):425-9
Abstract
The aim was to evaluate the effect of xylitol and probiotic chewing gums on salivary mutans streptococci (MS) and lactobacilli (LB). The material consisted of 80 healthy young adults (21-24 years) who volunteered after informed consent. They were assigned by random into one of four parallel study groups: A, probiotic gum group; B, xylitol gum group; C, probiotic + xylitol gum group; and D, placebo gum group. The gums were taken three times daily after meals, and the intervention period was 3 weeks. The probiotic gums contained two strains of Lactobacilli reuteri (ATCC 55730 at a dose of 1 x 10(8) CFU/gum and ATCC PTA 5289 at a dose of 1 x 10(8) CFU/gum), and each pellet of the xylitol gum contained approximately 1.0 g xylitol as single sweetener. Pretreatment and posttreatment samples of stimulated whole saliva were collected and quantified for MS and LB with chair-side kits. A statistically significant reduction (p < 0.05) of salivary MS was displayed in group A and B after the intervention when compared with baseline. A similar but nonsignificant tendency was seen in group C. No alterations of salivary LB was demonstrated in any group. In conclusion, daily chewing on gums containing probiotic bacteria or xylitol reduced the levels of salivary MS in a significant way. However, a combination of probiotic and xylitol gums did not seem to enhance this effect.
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Antagonistic activity of probiotic lactobacilli and bifidobacteria against entero- and uropathogens.
Hütt, P, Shchepetova, J, Lõivukene, K, Kullisaar, T, Mikelsaar, M
Journal of applied microbiology. 2006;(6):1324-32
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Abstract
AIM: To develop in vitro assays for comparing the antagonistic properties and anti-oxidative activity of probiotic Lactobacillus and Bifidobacterium strains against various entero- and urinary pathogens. METHODS AND RESULTS The antagonistic activity of five probiotic lactobacilli (Lactobacillus rhamnosus GG, Lactobacillus fermentum ME-3, Lactobacillus acidophilus La5, Lactobacillus plantarum 299v and Lactobacillus paracasei 8700:2) and two bifidobacteria (Bifidobacterium lactis Bb12, Bifidobacterium longum 46) against six target pathogens was estimated using different assays (solid and liquid media, anaerobic and microaerobic cultivation) and ranked (low, intermediate and high). Bacterial fermentation products were determined by gas chromatography, and the total anti-oxidative activity of probiotics was measured using linolenic acid test. Pyelonephritic Escherichia coli was highly suppressed by GG and both bifidobacteria strains. Lactobacilli strains 8700:2, 299v and ME-3 were the most effective against Salmonella enterica ssp. enterica in microaerobic while ME-3 and both bifidobacteria expressed high activity against Shigella sonnei in anaerobic milieu. Lact. paracasei, Lact. rhamnosus and Lact. plantarum strains showed intermediate antagonistic activity against Helicobacter pylori under microaerobic conditions on solid media. The highest anti-oxidative activity was characteristic for Lact. fermentum ME-3 (P < 0.05). No efficient antagonist against Clostridium difficile was found. The positive correlations between the pH, lactic acid production and anti-microbial activity for all tested probiotics were assessed. CONCLUSIONS Developed experimental assays enable to compare the anti-microbial and -oxidative activity of Lactobacillus and/or Bifidobacterium probiotics, which have been claimed to possess the ability of suppressing the growth of various enteric and urinary pathogens. SIGNIFICANCE AND IMPACT OF THE STUDY Screening Lactobacillus and Bifidobacterium sp. strains according to their activity in various environmental conditions could precede the clinical efficacy studies for adjunct treatment with probiotics in cure of different gastrointestinal and urinary tract infections.
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Lactobacillus rhamnosus induces peripheral hyporesponsiveness in stimulated CD4+ T cells via modulation of dendritic cell function.
Braat, H, van den Brande, J, van Tol, E, Hommes, D, Peppelenbosch, M, van Deventer, S
The American journal of clinical nutrition. 2004;(6):1618-25
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Abstract
BACKGROUND Although it is widely recognized that the intake of so-called probiotic microorganisms is beneficial in chronic mucosal inflammation and topical allergic disease, the immunologic details explaining how such bacteria can exert these effects remain obscure. OBJECTIVE We determined whether Lactobacillus rhamnosus can modulate T cell responses in vitro and in vivo. DESIGN In vitro, human monocyte-derived dendritic cells (DCs) matured in the presence of L. rhamnosus were used to instruct naive CD4+ T cells; subsequently, the T cell response was assessed with the use of CD3/CD28 and interleukin (IL) 2. Cytokine production by ex vivo-stimulated naive cells and memory T cells was measured before and after oral supplementation with L. rhamnosus in 6 healthy volunteers and 6 patients with Crohn disease. RESULTS A decreased T cell proliferation and cytokine production, especially of IL-2, IL-4, and IL-10, was observed in CD3/CD28-stimulated T cells derived from L. rhamnosus-matured DCs. This T cell hyporesponsiveness was associated with enhanced DC-T cell interaction and normal responsiveness of T cells for IL-2. In vivo oral supplementation of L. rhamnosus for 2 wk induced a similar T cell hyporesponsiveness, including impaired ex vivo T helper subsets 1 and 2 responses without up-regulation of immunoregulatory cytokines in cohorts of both healthy volunteers and patients with Crohn disease. CONCLUSIONS We propose that L. rhamnosus modulates DC function to induce a novel form of T cell hyporesponsiveness; this mechanism might be an explanation for the observed beneficial effects of probiotic treatment in clinical disease.
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Use of pro-, pre- and synbiotics in the ICU--future options.
Bengmark, S, García de Lorenzo, A, Culebras, JM
Nutricion hospitalaria. 2001;(6):239-56
Abstract
Although the word synbiotics was coined to describe the combined action of pre- and probiotics, the ability to, like antibiotics, control infection, the term is now increasingly used in a wider sense, as a name for all the substances released by microbial fermentation in the lower gut. One obvious reason is that most of the substances released seem to influence the immune defense, increase resistance to disease, and, most important, prevent complications to surgery such as infections and thrombosis. Protection layer of lactobacillus does not exist only on the GI tract mucosa, it is important at all exterior body surfaces including those of the eye, the nose, the mouth, the respiratory tract, the vagina, not to forget the skin. It is clearly reduced at all sites when the patient is in the settings of ICU. Each human being has his/her own unique microbial collection, especially of strains of Bifidobacterium and Lactobacillus, and it should be possible to identify an individual on the basis of his/her personal intestinal microflora. The flora seems always to be significantly reduced in the sick, especially in connection with severe disease, care in ICU, and in patients with little food intake or on parenteral nutrition. Supply of both pre- and probiotics can modify functions such as appetite, sleep, mood and circadian rhythm, and this most likely through metabolites produced by microbial fermentation in the gut. Supply of lactic acid bacteria (LAB) can also significantly reduce serum levels of a variety of toxins such as endotoxin. An umbrella of supplemented probiotics could provide to the patients with liver cirrhosis a tool to reduce septic manifestations and the incidence of bleeding. LAB are effective in controlling diarrhea of both bacterial and viral origin. A series of experimental studies and several uncontrolled clinical studies support the idea of using probiotics in patients with IBD. Ecoimmunonutrition with pre- pro- and synbiotics offer to be suitable tools in the new millennium.