College of Pharmacy, Southwestern Oklahoma State University, Norman Regional Health System, Pharmacy Services, Norman, OK 73070-1308, USA.
American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists (Impact Factor: 1.88). 03/2010; 67(6):449-58. DOI: 10.2146/ajhp090168
Source: PubMed


The pharmacology, uses, dosages, safety, drug interactions, and contraindications of probiotics are reviewed.
Probiotics are live nonpathogenic microorganisms administered to improve microbial balance, particularly in the gastrointestinal tract. They consist of Saccharomyces boulardii yeast or lactic acid bacteria, such as Lactobacillus and Bifidobacterium species, and are regulated as dietary supplements and foods. Probiotics exert their beneficial effects through various mechanisms, including lowering intestinal pH, decreasing colonization and invasion by pathogenic organisms, and modifying the host immune response. Probiotic benefits associated with one species or strain do not necessarily hold true for others. The strongest evidence for the clinical effectiveness of probiotics has been in the treatment of acute diarrhea, most commonly due to rotavirus, and pouchitis. More research is needed to clarify the role of probiotics for preventing antibiotic-associated diarrhea, Clostridium difficile infection, travelers' diarrhea, irritable bowel syndrome, ulcerative colitis, Crohn's disease, and vulvovaginal candidiasis. There is no consensus about the minimum number of microorganisms that must be ingested to obtain a beneficial effect; however, a probiotic should typically contain several billion microorganisms to increase the chance that adequate gut colonization will occur. Probiotics are generally considered safe and well tolerated, with bloating and flatulence occurring most frequently. They should be used cautiously in patients who are critically ill or severely immunocompromised or those with central venous catheters since systemic infections may rarely occur. Bacteria-derived probiotics should be separated from antibiotics by at least two hours.
Probiotics have demonstrated efficacy in preventing and treating various medical conditions, particularly those involving the gastrointestinal tract. Data supporting their role in other conditions are often conflicting.

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    • "Moreover, it is universally recognized that probiotics must be able to colonise the digestive tract [1], [23], On the other hand, it is also currently acknowledged that a strong persistence of probiotics in the GIT could generate dysbiosis via the excessive deconjugation of bile salts and/or degradation of intestinal mucus layer [24]. Anyhow, no serious adverse effects have been described in clinical trials, [25]. Accordingly, adhesion properties have been proposed as a crucial factor for the selection of new probiotic and they could easily be investigated using in vitro models of the intestine. "
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    ABSTRACT: To date, only a few studies have investigated the complex microbiota of table olives in order to identify new probiotic microorganisms, even though this food matrix has been shown to be a suitable source of beneficial lactic acid bacteria (LAB). Two hundred and thirty eight LAB, belonging to Lactobacillus plantarum, Lactobacillus pentosus and Leuconostoc mesenteroides species, and isolated from Nocellara Etnea table olives, have been screened in this survey through an in vitro approach. A simulation of transit tolerance in the upper human gastrointestinal tract, together with autoaggregation and hydrophobicity, have been decisive in reducing the number of LAB to 17 promising probiotics. None of the selected strains showed intrinsic resistances towards a broad spectrum of antibiotics and were therefore accurately characterized on an undifferentiated and 3D functional model of the human intestinal tract made up of H4-1 epithelial cells. As far as the potential colonization of the intestinal tract is concerned, a high adhesion ratio was observed for Lb. plantarum O2T60C (over 9%) when tested in the 3D functional model, which closely mimics real intestinal conditions. The stimulation properties towards the epithelial barrier integrity and the in vitro inhibition of L. monocytogenes adhesion and invasion have also been assessed. Lb. plantarum S1T10A and S11T3E enhanced trans-epithelial electrical resistance (TEER) and therefore the integrity of the polarized epithelium in the 3D model. Moreover, S11T3E showed the ability to inhibit L. monocytogenes invasion in the undifferentiated epithelial model. The reduction in L. monocytogenes infection, together with the potential enhancement of barrier integrity and an adhesion ratio that was above the average in the 3D functional model (6.9%) would seem to suggest the Lb. plantarum S11T3E strain as the most interesting candidate for possible in vivo animal and human trials.
    PLoS ONE 04/2014; 9(4):e94457. DOI:10.1371/journal.pone.0094457 · 3.23 Impact Factor
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    • "A pioneering approach in the dietary treatment of hypercholesterolemia is represented by the utilization of probiotics, i.e. live microbes which, when administered in adequate amounts, confer a health benefit to the host (FAO/WHO working group 2001). Probiotic bacteria, mostly belonging to lactic acid bacteria (LAB) and bifidobacteria which are capable to colonize the intestinal microbiota, have been demonstrated to exert a number of beneficial health effects through a variety of mechanisms (Rossi and Amaretti 2010; Williams 2010; Nagpal et al. 2012) and have recently attracted considerable attention due to potential anti-cholesterol properties. In fact, several in vivo trials report that consumption of probiotics reduced the systemic cholesterol levels and caused a decrease in blood lipids as well (Usman and Hosono 2000; Pereira and Gibson 2002b; Liong and Shah 2006; Jones et al. 2012a, b, 2013). "
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    ABSTRACT: Thirty-four strains of bifidobacteria belonging to Bifidobacterium adolescentis, Bifidobacterium animalis, Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium longum, and Bifidobacterium pseu-docatenulatum were assayed in vitro for the ability to assimilate cholesterol and for bile salt hydrolase (BSH) against glycocholic and taurodeoxycholic acids (GCA and TDCA). Cholesterol assimilation was peculiar characteristic of two strains belonging to the species B. bifidum (B. bifidum MB 107 and B. bifidum MB 109), which removed 81 and 50 mg of cholesterol per gram of biomass, being the median of specific cholesterol absorption by bifidobacteria 19 mg/g. Significant differences in BSH activities were not established among bifidobacterial species. However, the screening resulted in the selection of promising strains able to efficiently deconjugate GCA and TDCA. No relationship was recognized between BSH phenotype and the extent of cholesterol assimilation. On the basis of cholesterol assimilation or BSHGCA and BSHTDCA activities, B. bifidum MB 109 (DSMZ 23731), B. breve MB 113 (DSMZ 23732), and B. animalis subsp. lactis MB 2409 (DSMZ 23733) were combined in a probiotic mixture to be fed to hypercholesterolemic rats. The administration of this probiotic formulation resulted in a significant reduction of total cholesterol and low-density cholesterol (LDL-C), whereas it did not affect high-density cholesterol (HDL-C) and HDL-C/LDL-C ratio.
    Applied Microbiology and Biotechnology 07/2013; 97(18). DOI:10.1007/s00253-013-5088-2 · 3.34 Impact Factor
    • "S. boulardii is contraindicated in patients with a yeast allergy.[2023] However, no contraindications are listed for Bifidobacteria, since most species are considered nonpathogenic and non-toxigenic.[161719] "
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    ABSTRACT: Probiotics are dietary supplements, which have been advocated for the prevention and the treatment of a wide range of diseases. These products consist of beneficial micro-organisms, which stimulate health promoting flora thus, suppressing the pathologic colonization and disease spread. Since, probiotics are now widely used in both medical (such as cancer risk reduction, gastrointestinal tract health, and urinary tract health) and dental specialties (reduction in caries development, in achieving periodontal health, reducing oral malodor, etc.), a thorough understanding of their risks and benefits are essential. This review focuses on the recent trends in use of probiotics in dentistry as well as the potential risks associated with them.
    Dental research journal 03/2013; 10(3):302-306.
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