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Volume 3 • Issue 1 • 1000e124
Vitam Miner
ISSN: VMS, an open access journal
Vitamins & Minerals
Eck and Friel, Vitam Miner 2013, 3:1
Editorial Open Access
Should Probiotics be considered as Vitamin Supplements?
Peter Eck and James Friel*
Human Nutritional Sciences, University of Manitoba, Winnipeg, R3T 2N2, Canada
*Corresponding author: James Friel, Human Nutritional Sciences, University of
Manitoba, Winnipeg, R3T 2N2, Canada, Tel: 204-474-8682; Fax: 204-474-7552;
Received October 24, 2013; Accepted October 24, 2013; Published October 27,
Citation: Eck P, Friel J (2013) Should Probiotics be considered as Vitamin
Supplements? Vitam Miner 3: e124. doi:10.4172/vms.1000e124
Copyright: © 2013 Eck P, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Denition of Probiotics
e denition of probiotics that is widely accepted [1] describes
probiotics as “living microorganisms that on ingestion in certain
numbers exert health benets beyond inherent basic nutrition”. e
important aspects of the denition of probiotics are that probiotics need
to be a live microorganism, such as yeast or bacteria, and probiotics
need to have a health benet. erefore, these microorganisms need
to have undergone in vitro and experimental studies in order to
be properly named a benecial strain of probiotics, and to prove its
health benet and safety. An extensive body of evidence demonstrates
that probiotics have a clinical use and can be recommended in the
treatment of certain diseases, such as antibiotic induced diarrhoea,
infectious diarrhoea of adults and children and prevention of atopic
eczema and cow’s milk allergy [2]. Naming the species is important
are there are multiple microorganisms that can be classied under
the general term “probiotics” yet each may have a dierent eect on
metabolism. us, knowledge of which organism is used is crucial in
designing experiments or making claims of function. As they become
more popular and easily available, we need specic knowledge of
function. New sequencing techniques that seem to evolve year by year
are revealing more and more species of bacteria in the human body that
previously we were unaware of.
e Microbiome is a heterogeneous system consisting of millions
of microbes that share our body space, leading some to suggest it is
a “newly discovered organ”. It has been shown that the interaction
between the microbiome and its host play a major role in immune
modulation, as well as in several metabolic functions. Colonization of
the gut starts before birth, and is dependent on known factors such as
mode of delivery, type of feeding and gestational age. Disequilibrium
between the benecial and pathogenic bacteria of the gut will lead to
alteration in the defence barrier mechanisms and in immune functions,
and is associated with a number of acute and chronic conditions, such
as sepsis, NEC, inammatory bowel disease (IBD), type 2 diabetes,
allergy and obesity. Supplemental bacteria have been demonstrated
to modulate a variety of disorders in children and adults, including:
inammatory bowel diseases [3]; bowel cancer [4], ulcerative colitis
[5]; irritable bowel syndrome [6], obesity [7], cholesterol levels [8] and
diarrhea, secondary to oral antibiotics [9].
Microorganisms in the Gut and its Function
Bacteria in the lumen of the digestive system can be classied
accordingly: (a) benecial; (b) potentially pathogenic; and (c)
pathogenic bacteria. Probiotics are within the pool of benecial bacteria.
Two of the most common benecial bacteria are Lactobacillus sp. and
Bidobacter sp. With respect to the gastrointestinal environment,
the benecial microora has three important functions: metabolic,
trophic and protective [10]. For example, bacteria produce short-
chain fatty acids and vitamins and participate in mucosal epithelial cell
proliferation and dierentiation.
Probiotics and VitaminProduction
Vitamins are essential micronutrients that are necessary for vital
reactions in all living cells. We humans are incapable of synthesizing
most vitamins in amounts required to meet our physiological needs,
and so they consequently have to be obtained exogenously. One of
the multiples benets that probiotics have is the capacity to synthesize
vitamins. We have known for some time that commensal bacteria
produce vitamins, particularly B vitamins, and play a major role in
meeting our needs for these essential nutrients. What we now have to
consider with the advent of probiotics as a player in achieving optimal
health is how much of a role do they play as vitamin supplements?
is is uncharted territory and indeed, while we know vitamin K is
produced by bacteria in the gut, recent evidence indicates vitamin D
is as well [11]. In vitro and studies in humans have documented the
capacity of some probiotic strains to synthesize vitamin K, folic Acid,
vitamin B2 and B12. As we are able to identify more and more strains
in the human microbiome, it may be only a matter of time until we
identify new species that produce all the known vitamins, and may I
daresay newly discovered vitamins as well!
To remind you: ere are two dierent forms of vitamin K,
Phylloquinone or vitamin K1, present in all photosynthetic plants and
menaquinons, or Vitamin K2 which is primarily of bacterial origin
[12]. It has been demonstrated in vitro that strains of Lactobacillus
produce high levels of folate (about 100 µg/L). e same is possible
with bidobacteria strains, which may contribute to folate intake,
due to the synthesis and secretion of folates in the human intestine
by bidobacteria [13]. It has been demonstrated in human and piglet
that the quantity of folate produced in the intestine aects folate status
[14]. e production of vitamin B1 and B2 by bacteria contributes to the
total intake of vitamin B1 and B2 [15]. It was reported that Lactobacillus
reuteri CRL1098 was able to produce B12 [16].
Although it is very clear that microbes can synthesize most likely all
known vitamins, it is far from clear how much they can be a source of
vitamins. Important issues are: a) the microbes might produce vitamins,
but they might not be excreted, or might not survive the challenges of
the other microora, and therefore, be catabolized before they can be
absorbed. b) is raises the second issue, absorption: most transporters
for vitamins are in the duodenum and ileum, not in places where most
of the microbes are found. erefore, it needs to be established if the
vitamins, even if produced in high amounts and not metabolized, are
bioavailable. For example, the special case of Vitamin B12, which needs
intrinsic factor to be absorbed. e vitamin B12 which is produced in
the colon will never be in touch with intrinsic factor, and will never get
in touch with the receptors for intrinsic factors in the ileum.
Clearly residential bacteria and now probiotic supplements play
a role in vitamin production and metabolism. How much of a role
needs to be studied, particularly in vulnerable groups, such as newborn
Eck P, Friel J (2013) Should Probiotics be considered as Vitamin Supplements? Vitam Miner 3: e124. doi:10.4172/vms.1000e124
Page 2 of 2
Volume 3 • Issue 1 • 1000e124
Vitam Miner
ISSN: VMS, an open access journal
infants, premature infants, the elderly and those with chronic or acute
illnesses. e use of vitamin-producing microorganisms may represent
a more natural alternative to fortication using synthesised molecules,
and may permit production of foods with elevated concentrations of
vitamins that are less likely to cause undesirable side-eects.
In conclusion, the possibilities are endless. A whole new
methodology for delivering vitamins to those in need may present
itself in bacteria as a new carrier. Furthermore, once bacteria take up
residence, they keep producing these essential microorganisms, until
they are displaced. A nutrigenetic approach may yield huge benets, if
we can modify bacteria to produce vitamins in quantities that meet our
needs. Instead of vitamin supplements, we can consider seeding the gut
with our new vitamin producing microbes! We even have to change
our denition of “vitamin” and “essential”, if our needs are met by a
healthy microbiome. At the very least those of us in vitamin assessment
must now take into account the potential contributions of probiotics.
1. Guarner F, Schaafsma GJ (1998) Probiotics. Int J Food Microbiol 39: 237-238.
2. Floch MH, Walker WA, Guandalini S, Hibberd P, Gorbach S, et al. (2008)
Recommendations for probiotic use. J Clin Gastroenterol 42: S104-S108.
3. Guandalini S (2010) Update on the role of probiotics in the therapy of pediatric
inammatory bowel disease. Expert Rev Clin Immunol 6: 47-54.
4. de Moreno de Leblanc A, Perdigón G (2010) The application of probiotic
fermented milks in cancer and intestinal inammation. Proc Nutr Soc 69: 421-
5. Sang LX, Chang B, Zhang WL, Wu XM, Li XH, et al. (2010) Remission induction
and maintenance effect of probiotics on ulcerative colitis: A meta-analysis.
World J Gastroenterol 21:1908-1915.
6. Moayyedi P, Ford AC, Quigley EM, Foxx-Orenstein AE, Chey WD, et al.
(2010) The American College of Gastroenterology irritable bowel syndrome
monograph: Translating systematic review data to clinical practice.
Gastroenterology 138: 789-791.
7. Luoto R, Isolauri E, Lehtonen L (2010) Safety of Lactobacillus GG probiotic in
infants with very low birth weight: Twelve years of experience. Clin Infect Dis
50: 1327-1328.
8. Ramasamy K, Abdullah N, Wong MC, Karuthan C, Ho YW (2010) Bile salt
deconjugation and cholesterol removal from media by Lactobacillus as
probiotics in chickens. J Sci Food Agric 90: 65-69.
9. Kale-Pradhan PB, Jassal HK, Wilhelm SM (2010) Role of Lactobacillus in the
prevention of antibiotic-associated diarrhea: A meta-analysis. Pharmacotherapy
30: 119-126.
10. Guarner F, Malagelada JR (2003) Gut ora in health and disease. Lancet 361:
11. Jones ML, Martoni CJ, Prakash S (2013) Oral supplementation with probiotic
L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: A
post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab 98:
12. Thijssen HH, Vervoort LM, Schurgers LJ, Shearer MJ (2006) Menadione is a
metabolite of oral vitamin K. Br J Nutr 95: 260-266.
13. Strozzi GP, Mogna L (2008) Quantication of folic acid in human feces after
administration of Bidobacterium probiotic strains. J Clin Gastroenterol 42:
14. Kim TH, Yang J, Darling PB, O’Connor DL (2004) A large pool of available
folate exists in the large intestine of human infants and piglets. J Nutr 134:
15. Fabian E, Majchrzak D, Dieminger B, Meyer E, Elmadfa I (2008) Inuence of
probiotic and conventional yoghurt on the status of vitamins B1, B2 and B6 in
young healthy women. Ann Nutr Metab 52: 29-36.
16. Taranto MP, Vera JL, Hugenholtz J, De Valdez GF, Sesma F (2003)
Lactobacillus reuteri CRL1098 produces cobalamin. J Bacteriol 185: 5643-
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Citation: Eck P, Friel J (2013) Should Probiotics be considered as Vitamin
Supplements? Vitam Miner 3: e124. doi:10.4172/vms.1000e124
... Generally, it is acknowledged that the fermentation process replenishes the food substrate with vitamins and improves protein availability besides reducing antinutritional content (Sahlin, 1999). In vitro experiments and studies on humans have documented the capacity of some probiotic strains to synthesize vitamin K, folic Acid (vitamin B 9 ), vitamin B 2, and B 12 (Eck and Friel, 2013). Therefore, including fermented foods in vegetarian diets, will help in overcoming vitamin deficiencies, specially vitamin B 12 being the limiting micronutrient (Agnoli et al., 2017) provided the right microorganisms are used in their fermentation. ...
... Vitamin B 12 being one of the heat stable B group vitamins, it is likely that it will be available even in cooked fermented foods provided that the right microorganisms are there. For instance, at least one strain of the probiotic species Lactobacillus reuteri is known to produce vitamin B 12 (Eck and Friel, 2013). Harnessing this effect in cooked fermented foods will be useful for a primarily vegetarian diet. ...
Full-text available
The Sri Lankan diet of which the staple is rice, has unacceptable levels of antinutritional substances, particularly phytic acid, which is associated with fibre, a dietary component originating from plant sources of food. Low anthropometric indicators among preschool children suggestive of undernutrition have remained static over several years. Some microbes that ferment food are known to produce phytase that metabolize phytic acid in addition to providing other benefits. Some of these microbes in fermented foods serve as probiotics, which help maintain homeostasis within the gut microbiota, thus providing a wide range of health benefits. At present, it is a worldwide trend to incorporate probiotics to the daily diet in fermented foods, while a market for novel probiotic foods is catching on. In the gut, probiotics can thrive on indigestible carbohydrates (fibre) serving as prebiotics. Therefore, designing synbiotic foods having both probiotics and prebiotics with enhanced benefits is also becoming popular globally. This review evaluates the feasibility of introducing a wide range of fermented foods to the Sri Lankan diet. Such a move is envisaged to diversify the local diet thus helping to alleviate certain nutritional shortcomings. This can subsequently help in the introduction of specific probiotics with beneficial effects.
... These vitamins are essential micronutrients and play an important role in growth and reproduction. However, it is unclear if these bacterially produced vitamins are absorbed in the GIT [69]. ...
Full-text available
Pathogens develop resistance to antibiotics at a rate much faster than the discovery of new antimicrobial compounds. Reports of multidrug-resistant bacteria isolated from broilers, and the possibility that these strains may spread diseases amongst humans, prompted many European countries to ban the inclusion of antibiotics in feed. Probiotics added to broiler feed controlled a number of bacterial infections. A combination of Enterococcus faecium, Pediococcus acidilactici, Bacillus animalis, Lactobacillus salivarius and Lactobacillus reuteri decreased the colonisation of Campylobacter jejuni and Salmonella Enteritidis in the gastro-intestinal tract (GIT) of broilers, whereas Bacillus subtilis improved feed conversion, intestinal morphology, stimulated the immune system and inhibited the colonisation of Campylobacter jejuni, Escherichia coli and Salmonella Minnesota. Lactobacillus salivarius and Pediococcus parvulus improved weight gain, bone characteristics, intestinal morphology and immune response, and decreased the colonisation of S. Enteritidis. Lactobacillus crispatus, L. salivarius, Lactobacillus gallinarum, Lactobacillus johnsonii, Enterococcus faecalis and Bacillus amyloliquefaciens decreased the Salmonella count and led to an increase in lysozyme and T lymphocytes. Probiotics may also improve feed digestion through production of phytases, lipases, amylases and proteases or stimulate the GIT to secrete digestive enzymes. Some strains increase the nutritional value of feed by production of vitamins, exopolysaccharides and antioxidants. Bacteriocins, if produced, regulate pathogen numbers in the GIT and keep pro-inflammatory and anti-inflammatory reactions in balance.
... 6 However, it has been known that commensal bacteria produce vitamins, particularly B vitamins, thus it plays a major role in meeting the needs, as some studies have documented that some probiotic strains can synthesize vitamin K, folate, vitamin B2 and B12. 7 This study aims to compare plasma folate, vitamin B6 and B12 levels in relation to the existence of fecal probiotic strain Bifidobacterium animalis subsp. lactis HNO19 (DR10 TM ) among pregnant women in Indonesia. ...
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Introduction Vitamin B12 plays a role during pregnancy in maintaining folate metabolism. Together with folate and vitamin B6, B12 is involved as a coenzyme in DNA synthesis and various methylation reactions in developing embryos. This study aims to compare plasma folate, vitamin B6 and B12 blood levels with respect to the presence of probiotic strain Bifidobacterium animalis subsp. lactis HNO19 (DR10TM) among pregnant women in Indonesia. Methods: This study is part of a larger study entitled “Effects of Bifidobacterium animalis subsp. lactis HNO19 (DR10TM), inulin, and micronutrient fortified milk on fecal DR10TM, immune markers, and maternal micronutrients among Indonesian pregnant women.” Further analyses were performed using independent-t test or Mann Whitney test, GLM-repeated measures and chi-square test, to compare folate, vitamin B6 and B12 intake and blood concentration during pregnancy with presence (n=22) and absence (n=55) subjects of fecal DR10TM at third trimester. Results: At the first trimesters there was no difference in plasma vitamin B6 and vitamin B12 levels between the two groups, based on the presence or absence of fecal DR10TM. However, at the second and third trimester, vitamin B6 blood concentration (p=0.034 and p=0.001) and vitamin B12 blood concentrations at the third trimester (p=0.035) were significantly higher in the fecal DR10TM positive group, while having a similar vitamin B6 and B12 intake. Conclusion: Consumption of pre- and probiotics during the periconceptional period may be a useful strategy for improving maternal vitamin B’s vitamins, especially vitamin B6 and B12 status and therefore provide benefits for the offspring’s quality of life.
... Other nutritional effects of probiotics relate to the production of vitamins. They play a major role in helping humans to meet their needs for these essential nutrients (Eck and Friel, 2013). In vitro studies have documented the capacity of some probiotic strains to synthesize vitamin K, folic acid, vitamin B2, and B12 (Pompei et al., 2007). ...
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Over the past decades the food industry has been revolutionized toward the production of functional foods due to an increasing awareness of the consumers on the positive role of food in wellbeing and health. By definition probiotic foods must contain live microorganisms in adequate amounts so as to be beneficial for the consumer's health. There are numerous probiotic foods marketed today and many probiotic strains are commercially available. However, the question that arises is how to determine the real probiotic potential of microorganisms. This is becoming increasingly important, as even a superficial search of the relevant literature reveals that the number of proclaimed probiotics is growing fast. While the vast majority of probiotic microorganisms are food-related or commensal bacteria that are often regarded as safe, probiotics from other sources are increasingly being reported raising possible regulatory and safety issues. Potential probiotics are selected after in vitro or in vivo assays by evaluating simple traits such as resistance to the acidic conditions of the stomach or bile resistance, or by assessing their impact on complicated host functions such as immune development, metabolic function or gut-brain interaction. While final human clinical trials are considered mandatory for communicating health benefits, rather few strains with positive studies have been able to convince legal authorities with these health claims. Consequently, concern has been raised about the validity of the workflows currently used to characterize probiotics. In this review we will present an overview of the most common assays employed in screening for probiotics, highlighting the potential strengths and limitations of these approaches. Furthermore, we will focus on how the advent of omics technologies has reshaped our understanding of the biology of probiotics, allowing the exploration of novel routes for screening and studying such microorganisms.
The applications of probiotics are significant and thus resulted in need of genome analysis of probiotic strains. Various omics methods and systems biology approaches enables us to understand and optimize the metabolic processes. These techniques have increased the researcher's attention towards gut microbiome and provided a new source for the revelation of uncharacterized biosynthetic pathways which enables novel metabolic engineering approaches. In recent years, the broad and quantitative analysis of modified strains relies on systems biology tools such as in silico design which are commonly used methods for improving strain performance. The genetic manipulation of probiotic microorganisms is crucial for defining their role in intestinal microbiota and exploring their beneficial properties. This review describes an overview of gene editing and system biology approaches, highlighting the advent of omics methods which allows the study of new routes for studying probiotic bacteria. We have also summarized gene editing tools like TALEN, ZFNs and CRISPR-Cas that edits or cleave the specific target DNA. Furthermore, in this review an overview of proposed design of advanced customized probiotic is also hypothesized to improvise the probiotics.
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Context: Low serum 25-hydroxyvitamin D is a risk factor for osteoporosis, cardiovascular disease, diabetes, and cancer. Disruption of noncholesterol sterol absorption due to cholesterol-lowering therapies may result in reduced fat-soluble vitamin absorption. Objective: We have previously reported on the cholesterol-lowering efficacy and reduced sterol absorption of probiotic bile salt hydrolase active Lactobacillus reuteri NCIMB 30242; however, the effects on fat-soluble vitamins was previously unknown and the objective of the present study. DESIGN, SETTINGS, PATIENTS, AND INTERVENTION: The study was double-blind, placebo-controlled, randomized, parallel-arm, multicenter lasting 13 weeks. A total of 127 otherwise healthy hypercholesterolemic adults with low-density lipoprotein-cholesterol >3.4 mmol/L, triglycerides <4.0 mmol/L, and body mass index of 22 to 32 kg/m² were included. Subjects were recruited from 6 private practices in Prague, Czech Republic, and randomized to consume L. reuteri NCIMB 30242 or placebo capsules over a 9-week intervention period. Outcome measures: The primary outcome measure was the change in serum low-density lipoprotein-cholesterol over the 9-week intervention. Analysis of fat-soluble vitamins at weeks 0 and 9 were performed post hoc. Results: There were no significant differences between L. reuteri NCIMB 30242 and placebo capsule groups in serum vitamin A, vitamin E, or β-carotene or dietary intake over the intervention period (P > .05). L. reuteri NCIMB 30242 increased serum 25-hydroxyvitamin D by 14.9 nmol/L, or 25.5%, over the intervention period, which was a significant mean change relative to placebo of 17.1 nmol/L, or 22.4%, respectively (P = .003). Conclusions: To our knowledge, this is the first report of increased circulating 25-hydroxyvitamin D in response to oral probiotic supplementation.
Full-text available
To evaluate the induction of remission and maintenance effects of probiotics for ulcerative colitis. Information was retrieved from MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The induction of remission and promotion of maintenance were compared between probiotics treatment and non-probiotics treatment in ulcerative colitis. Thirteen randomized controlled studies met the selection criteria. Seven studies evaluated the remission rate, and eight studies estimated the recurrence rate; two studies evaluated both remission and recurrence rates. Compared with the non-probiotics group, the remission rate for ulcerative colitis patients who received probiotics was 1.35 (95% CI: 0.98-1.85). Compared with the placebo group, the remission rate of ulcerative colitis who received probiotics was 2.00 (95% CI: 1.35-2.96). During the course of treatment, in patients who received probiotics for less than 12 mo compared with the group treated by non-probiotics, the remission rate of ulcerative colitis was 1.36 (95% CI: 1.07-1.73). Compared with the non-probiotics group, the recurrence rate of ulcerative colitis patients who received probiotics was 0.69 (95% CI: 2.47-1.01). In the mild to moderate group who received probiotics, compared to the group who did not receive probiotics, the recurrence rate was 0.25 (95% CI: 0.12-0.51). The group who received Bifidobacterium bifidum treatment had a recurrence rate of 0.25 (95% CI: 0.12-0.50) compared with the non-probiotics group. Probiotic treatment was more effective than placebo in maintaining remission in ulcerative colitis.
Recommendations for the clinical use of probiotics were published after a Yale University Workshop in 2005. A similar workshop was held in 2007, and the recommendations were updated and extended into other areas. The recommendations are graded into an "A," "B," "C" or no category based on the expert's opinion and review by the workshop participants. An "A" recommendation is made for acute childhood diarrhea, prevention of antibiotic-associated diarrhea, preventing and maintaining remission in pouchitis, and in an immune response for the treatment and prevention of atopic eczema associated with cow's milk allergy. The group maintained several "B" recommendations in other areas of treating inflammatory bowel disease and irritable bowel syndrome. Although there are significant studies in the "B" group, most "B" recommendations did not reach an "A" level because of some negative studies or a limited number of studies. Many reports in the "C" recommendations were significant but fell short of receiving stronger ratings because of the size of reported patient studies, and also the factors that limited categories to the "B" rating.
Lactic acid bacteria are present in many foods such as yoghurt and are frequently used as probiotics to improve some biological functions of the host. Many researchers have evaluated the effects of yoghurt and lactic acid bacteria against diseases such as cancer and intestinal inflammation. The preventive effect of probiotics on intestinal carcinogenesis may be associated with changes in the intestinal microbiota, suppressing the growth of bacteria that convert procarcinogens into carcinogens. Other mechanisms could be related to the immune response modulation and have been evaluated using milks fermented with lactic acid bacteria in chemically induced colon cancer and hormone-dependent breast cancer models. We demonstrated, using a murine colon cancer model, that yoghurt consumption inhibited tumour growth by decreasing the inflammatory response by increasing IL-10-secreting cells, cellular apoptosis and diminishing procarcinogenic enzymes. Milk fermented with Lactobacillus helveticus R389 delayed breast tumour growth by decreasing IL-6 and increasing IL-10 in serum and in the mammary glands and tumour-infiltrating immune cells. Previous results obtained with yoghurt administration in a colon cancer model led us to analyse its effect on a trinitrobenzenesulfonic acid-induced intestinal inflammation model in mice. Yoghurt was able to attenuate the symptoms of acute inflammation by reducing inflammatory cytokines, and increasing regulatory cytokine IL-10-producing cells, leading to desirable changes of the intestinal microbiota. It was demonstrated, by using murine models, that the consumption of fermented milks can modulate the immune system and can maintain it in a state of surveillance, which could affront different pathologies such as cancer and intestinal inflammation.
Probiotics have had many applications in the past few years, and inflammatory conditions of the GI tract--including chronic disorders such as inflammatory bowel disease (IBD)--have received the most attention by investigators. In fact, the experimental basis to expect clinical efficacy of probiotics in IBD is quite robust. In spite of this however, only minimal evidence of benefit by any probiotic is currently available in Crohn's disease, either in adult or in pediatric populations. In ulcerative colitis, on the other hand, several probiotic formulations and especially the proprietary preparation VSL#3 (a high-concentration mixture) have been found effective as adjuvant therapy, both in inducing and maintaining remission.
Bile salt deconjugation by Lactobacillus strains is often closely linked to bile tolerance and survival of the strains in the gut and lowering of cholesterol in the host. The present study investigated the deconjugation of bile salts and removal of cholesterol by 12 Lactobacillus strains in vitro. The 12 strains were previously isolated from the gastrointestinal tract of chickens. The 12 Lactobacillus strains could deconjugate sodium glycocholate (GCA, 16.87-100%) and sodium taurocholate (TCA, 1.69-57.43%) bile salts to varying degrees, with all strains except L. salivarius I 24 having a higher affinity for GCA. The 12 Lactobacillus strains also showed significant (P < 0.05) differences in their ability to remove cholesterol from the growth medium (26.74-85.41%). Significant (P < 0.05) correlations were observed between cholesterol removal and deconjugation of TCA (r = 0.83) among the L. reuteri strains (C1, C10 and C16) and between cholesterol removal and deconjugation of TCA (r = 0.38) and GCA (r = 0.70) among the L. brevis strains (I 12, I 23, I 25, I 211 and I 218). In contrast, although L. gallinarum I 16 and I 26 and L. panis C 17 showed high deconjugating activity, there was no correlation between cholesterol removal and deconjugation of bile salts in these strains. The results showed that the 12 Lactobacillus strains were able to deconjugate bile salts and remove cholesterol in vitro, but not all strains with high deconjugating activity removed cholesterol effectively.
To evaluate the efficacy of a Lactobacillus probiotic single-agent regimen in preventing antibiotic-associated diarrhea (AAD). Meta-analysis of 10 randomized, blinded, placebo-controlled trials. Patients. A total of 1862 pediatric and adult patients who received a Lactobacillus single-agent regimen or placebo for the prevention of AAD. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched from inception through May 2008 by two investigators independently using the following key words: probiotic, Lactobacillus, antibiotic-associated diarrhea. Full reports published in English were included if the studies were randomized, blinded, and placebo-controlled trials that evaluated the efficacy of Lactobacillus single-agent regimens versus placebo in the prevention of AAD. Bibliographies of recent review articles and systematic reviews were hand searched. Quality of the studies was assessed by using the Jadad scoring system. Number of subjects, age, Lactobacillus regimen, follow-up period, and occurrence of AAD were extracted into a standardized data collection form. Overall impact of Lactobacillus on AAD was compared with placebo by using a random-effects model. Ten studies with a total of 1862 patients (50.4% male) met all criteria. Six studies included patients aged 18 years or older, whereas four included patients younger than 18 years (range 2 wks-14 yrs). Jadad scores ranged from 2-5 (out of 5). The total daily dose of Lactobacillus ranged from 2 x 10(9)-4 x 10(10) colony-forming units and was administered throughout the entire antibiotic treatment (5-14 days) for all patients. The follow-up period varied from 2 days-3 months after the end of the probiotic regimen. The combined risk ratio (RR) of developing AAD was significantly lower with Lactobacillus compared with placebo (RR 0.35, 95% confidence interval [CI] 0.19-0.67). In a subgroup analysis, this held true for adults but not pediatric patients (RR 0.24, 95% CI 0.08-0.75 and RR 0.44, 95% CI 0.18-1.08, respectively). Administration of a Lactobacillus single-agent regimen as a prophylactic agent during antibiotic treatment reduced the risk of developing AAD compared with placebo in adults but not pediatric patients.
Folic acid, or vitamin B9, is involved in appropriate regulation of DNA replication, synthesis of purines and deoxythymidine (dTMP), conversion of homocysteine to methionine, histidine catabolism, and correct differentiation of the neural tube during fetal organogenesis. Folic acid from food sources is almost completely absorbed in the small intestine, mostly in the jejunum, and does not reach the large intestine. The administration of probiotic strains able to synthesize folates de novo and release them in the extracellular space may provide an additional, constant endogenous source of this important vitamin in the intestinal lumen of humans. A pilot study involving 23 healthy volunteers was conducted to evaluate the ability of 3 probiotic strains, Bifidobacterium adolescentis DSM 18350, B. adolescentis DSM 18352, and Bifidobacterium pseudocatenulatum DSM 18353, to produce folates in the human intestine. Volunteers were randomly assigned to 1 of 3 groups for treatment with a specific probiotic strain (5 x 10(9) colony forming units/d). Strain effectiveness was evaluated by determination of the folate concentration in feces evacuated within 48 hours before and after administration of the probiotics. Quantification of microorganisms belonging to the genus Bifidobacterium was performed in parallel to folate analysis. Ingestion of these probiotic strains resulted in a significant increase of folic acid concentration in human feces in all treated groups. Analysis of the fecal Bifidobacteria confirmed the potential of all strains, especially B. adolescentis DSM 18352, to colonize the intestinal environment. The demonstrated ability of the probiotic microorganisms B. adolescentis DSM 18350, B. adolescentis DSM 18352, and B. pseudocatenulatum DSM 18353 to synthesize and secrete folates in the human intestinal environment may provide a complementary endogenous source of such molecules, which is especially useful for the homeostasis of mucosal enterocytes of the colon and, unlike oral administration of the vitamin, ensures its constant bioavailability.