ArticleLiterature Review

The effects of probiotics in lactose intolerance: A systematic review

Taylor & Francis
Critical Reviews In Food Science and Nutrition
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Abstract

Over 60 percent of the human population has a reduced ability to digest lactose due to low levels of lactase enzyme activity. Probiotics are live bacteria or yeast that supplements the gastrointestinal flora. Studies have shown that probiotics exhibit various health beneficial properties such as improvement of intestinal health, enhancement of the immune responses, and reduction of serum cholesterol. Accumulating evidence has shown that probiotic bacteria in fermented and unfermented milk products can be used to alleviate the clinical symptoms of lactose intolerance (LI). In this systematic review, the effectiveness of probiotics in the treatment of LI was evaluated using 15 randomized double-blind studies. Eight probiotic strains with the greatest number of proven benefits were studied. Results showed varying degrees of efficacy but an overall positive relationship between probiotics and lactose intolerance.

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... The population of Jazan appears to be less aware of lactose intolerance than reported in similar studies from India, where awareness levels reached 71.6 percent [50], when compared to studies conducted in other regions. These results point to the necessity of focused public health campaigns in Jazan to increase understanding and awareness of lactose intolerance. ...
... This study's awareness of lactose intolerance was noticeably lower than that of studies carried out in other places, like India, where more than 70% of participants showed adequate knowledge [50]. Differences in public health education and cultural views on dairy consumption may be the cause of this discrepancy. ...
... [49], who found that approximately onethird of Saudi Arabians are aware of lactose intolerance and how to treat it. On the other hand, Diandra and Patil [50] discovered that awareness levels were higher in India, where 71.6% of participants showed that they were aware of the condition. The low level of awareness in this study may be related to participants' reliance on unreliable information sources, with 491 percent citing friends and family and 258 percent using the internet. ...
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Background: Lactose intolerance is a frequent disorder characterized by gastrointestinal symptoms (such as nausea, bloating, and discomfort) following dairy product consumption. LI can be considerably decreased with simple understanding of symptoms and the use of milk substitutes. Aim: The goal of this study was to look into the prevalence of lactose intolerance and its relationship to nutrition and dietary habits in Jazan, Saudi Arabia. Methods: This study used a cross-sectional descriptive design with a sample of 283 participants who met the qualifying requirements. A questionnaire was used to collect the data, which was then analyzed using statistical tools for social sciences (SPSS) and Microsoft Excel. Results: Dairy/dairy products were highly consumed on daily basis (64.7%) accompanied by abdominal distention and gases (18%), yet, only 13.8% had been diagnosed with lactose intolerance. The magnitude of lactose intolerance was mainly in late childhood (11-20 years) and emerging adulthood (21-30 years) (56.4%). only 36% had good knowledge about the disorder, with females had significantly higher levels of awareness compared to males (p<0.05). Conclusion: Almost one-third of the population in Jazan had good knowledge on lactose intolerance with females having significantly higher levels.
... Studies have shown that probiotics such as Lactobacillus spp., B. longum, and B. animalis possess a beneficial influence on people suffering from lactose intolerance when they consume a probiotic yogurt comprising L. acidophilus and Bifidobacterium spp. [74]. Another study proved that probiotic yogurt supplemented with L. acidophilus and Bifidobacterium spp. ...
... Another study also demonstrated that the consumption of ice cream containing high or low concentrations of B. bifidum 900,791 improves lactose tolerance in hypolactasic subjects [84]. Accumulating evidence has indicated that probiotic bacteria present in milk products can be used to reduce the clinical signs of lactose intolerance [74,85]. Another study highlighted the importance of selected probiotics and vitamin B6 to alleviate symptoms and gut dysbiosis in lactoseintolerant patients with persistent functional gastrointestinal symptoms [86]. ...
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Background/Objectives: There is scattered information in the scientific literature regarding the characterization of probiotic bacteria found in fermented milk beverages and the beneficial effects of probiotic bacteria on human health. Our objective was to gather the available information on the use of probiotic bacteria in the prevention of civilization diseases, with a special focus on the prevention of obesity, diabetes, and cancer. Methods: We carried out a literature review including the following keywords, either individually or collectively: lactic acid bacteria; probiotic bacteria; obesity; lactose intolerance; diabetes; cancer protection; civilization diseases; intestinal microbiota; intestinal pathogens. Results: This review summarizes the current state of knowledge on the use of probiotic bacteria in the prevention of civilization diseases. Probiotic bacteria are a set of living microorganisms that, when administered in adequate amounts, exert a beneficial effect on the health of the host and allow for the renewal of the correct quantitative and qualitative composition of the microbiota. Probiotic bacteria favorably modify the composition of the intestinal microbiota, inhibit the development of intestinal pathogens, prevent constipation, strengthen the immune system, and reduce symptoms of lactose intolerance. As fermented milk beverages are an excellent source of probiotic bacteria, their regular consumption can be a strong point in the prevention of various types of civilization diseases. Conclusions: The presence of lactic acid bacteria, including probiotic bacteria in fermented milk beverages, reduces the incidence of obesity and diabetes and serves as a tool in the prevention of cancer diseases.
... Research has demonstrated that probiotics have a number of advantageous health effects, including bettering immune function, lowering blood cholesterol, and enhancing intestinal health. Probiotic bacteria found in fermented and unfermented milk products have been linked to a reduction in the clinical symptoms of Lactose Intolerance (LI), according to mounting data (Oak et al., 2019) [21] . ...
... Research has demonstrated that probiotics have a number of advantageous health effects, including bettering immune function, lowering blood cholesterol, and enhancing intestinal health. Probiotic bacteria found in fermented and unfermented milk products have been linked to a reduction in the clinical symptoms of Lactose Intolerance (LI), according to mounting data (Oak et al., 2019) [21] . ...
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Consumption of probiotic functional foods, i.e., foods with probiotic effects and special dietary effects with health impacts are getting an increased demand day by day. In this progression, it may be noted that chocolate. The most delicious desert to be known worldwide is also getting evolved and becoming well known for its functional values. Live microorganisms i.e. probiotics are being used in chocolate preparations along with other conventional ingredients. The main aim of this evolution in the dairy industry is to impart several healthcare benefits to local mass of population and to popularize this probiotic product for improvement of health. In this systematic review, the effectiveness of probiotics functional chocolate in the treatment of different diseases and disorders was evaluated using different double-blind studies. This systematic review will be presented with multiple healthful effects of chocolates containing probiotics and functional foods.
... Due to decreased production of the lactose disaccharide, lactose intolerance has been found in over 60% of the world's population. In the presence of the enzyme lactase, glucose and galactose combine to form lactose in the intestine [69]. Clinical effects of abnormal lactose production include bloating, cramping in the abdomen, nausea, diarrhea, and more [70,71]. ...
... Probiotics are a good source of lactase, which is provided externally to promote lactose fermentation, and they also assist in increasing the amount of gut microbeam in the intestine [72]. Probiotics also have an antagonistic effect on the bacteria in the gastrointestinal tract lining that produce a lot of CO 2 and methane [69,73]. In the absence of the lactase enzyme, β-galactosidase contributes to the breakdown and transgalactosulation of lactose. ...
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Microorganisms are ubiquitous and have been exploited for centuries to generate primary and secondary metabolites essential for human welfare and environmental sustainability. Microorganisms occupy a prominent position in the industrial sector due to their unique properties, such as the limited time and space required for their growth and proliferation, as well as their easy manipulation of the genetic material. Among all the microorganisms, probiotics have grabbed the attention of researchers because of their nonpathogenic nature and immersive application in treating digestive ailments and vitamin deficiency, boosting immunity, and detoxifying harmful chemicals. Furthermore , probiotics are widely used to treat various diseases such as constipation, colon cancer, type 2 diabetes mellitus, and obesity, as well as a range of intestinal disorders, including inflammatory bowel disease, among others. The updated information on these diseases and the role of probiotics has not been updated in the past few years. The present review covers updated information on the role of probiotics in these topics. The growth of populations around the globe has attracted the attention of scientists, primarily investigating diverse technologies to meet the gap between probiotic production and demand. With the support of standardized tools and techniques, researchers have explored the potent probiotic strains feasible for industrial production and treating health ailments. In the current review, we have curated the potential information essential for the screening, strain selection, production, and application necessary for probiotic researchers.
... Plant-based cheese alternatives, in particular, offer significant opportunities for addressing consumer dietary needs and sustainability challenges (Monga, Dev, and Singhal 2022;Zhang et al. 2024). Around 75% of the global population suffers from lactose intolerance (lactose malabsorption), with prevalence rates ranging from 50% to 90% in regions like Africa, South America, and Asia, and 5% to 15% in North America and Europe, which means they should avoid consuming lactose-containing products and replace them with milk-free alternative products (e.g., vegetable milks) (Goh, Mohd Said, and Goh 2018;Oak and Jha 2019). In addition, milk proteins (i.e., casein and whey protein) can cause allergic reactions in some consumers, with cow's milk protein allergy affecting about 4% to 6% of children, a public health concern in developed countries, which may also drive the choice plant-based milk substitutes (Santalha et al. 2013;Silva, Silva, and Ribeiro 2020). ...
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in response to population growth, ethical considerations, and the environmental impacts of animal proteins, researchers are intensifying efforts to find alternative protein sources that replicate the functionality and nutritional profile of animal proteins. in this regard, plant-based cheese alternatives are becoming increasingly common in the marketplace, as one of the emerging dairy-free products. However, the dairy industry faces challenges in developing dairy-free products alternatives that meet the demands of customers with specific lifestyles or diets, ensure sustainability, and retain traditional customers. these challenges include food neophobia, the need to mimic the physicochemical, sensory, functional, and nutritional properties of dairy products, the inefficient conversion factor of plant-based proteins into animal proteins, and high production expenses. Given the distinct nature of plant-based milks, understanding their differences from cow's milk is crucial for formulating alternatives with comparable properties. Designing dairy-free cheese analogs requires overcoming electrostatic repulsion energy barriers among plant proteins to induce gelation and curd formation. innovative approaches have substantially enhanced the physicochemical and sensory properties of these alternatives. Researchers are exploring the application of microalgae as a plant protein source and investigating new microbial fermentation methods to increase protein content in dairy-free products.
... Probiotics have been proven to not only improve general health conditions such as lactose intolerance and constipation but also have specific beneficial effects on certain disease states. These include conditions such as irritable bowel syndrome (IBS), obesity, atopic dermatitis, type II diabetes (T2D), Alzheimer's disease and various types of cancer [4][5][6][7][8][9][10][11]. Diverse probiotic strains confer health benefits to humans through distinct mechanisms [5] The complex interplay of these mechanisms can be broadly categorized into critical areas, which include but are not limited to the modulation of gut microbiota [12], improvement in gut barrier function, prevention of pathogenic translocation, elevation of beneficial short-chain fatty acids, regulation of aquaporin protein expression for improved hydration [13], adjustment of neurotransmitter levels for enhanced nervous system signaling [14] and reduction in inflammation [15] Due to the aforementioned benefits, probiotics have become increasingly popular in recent years. ...
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Probiotics are an essential dietary supplement for intestinal flora balance, inhibition of pathogenic bacteria and immune regulation. However, probiotic inactivation during gastrointestinal transportation remains a big challenge for oral administration. Hence, oral delivery systems (ODSs) based on polysaccharides have been constructed to protect probiotics from harsh environments. Cellulose, chitosan, alginate and their derivates have been used to form a protective layer for probiotics. This review summarizes the superiority and application of polysaccharides in forming protective layers for probiotics. Meanwhile, ODS processes including extrusion, emulsion and spray drying are also summarized. The preparation technique mechanism, the microparticle formation process and especially the role polysaccharides serve in the preparation process are overviewed. Lastly, the need for cell viability retention during the dehydration and construction of core-shell ODS microparticles is emphasized in this review.
... This finding highlights the changing trend in the development of probiotic food for lactoseintolerant individuals, vegetarians, and vegans, who do not consume any dairy products [34]. Approximately 60% of the global population has lactose digestion problems [35]. Moreover, 5% follow a vegetarian diet, with 3.7% identifying as vegans in the USA. ...
Article
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Probiotics are microorganisms that provide health benefits at adequate doses and exhibit notable antioxidant and antimicrobial activities. These properties play crucial roles in combating chronic diseases linked to oxidative stress and antimicrobial resistance. This review aimed to summarize the antioxidant and antimicrobial properties of probiotics determined in in vitro studies and discuss mechanistic actions and analysis methods. The MEDLINE (PubMed), Web of Science, Scopus, Science Direct, and Embase databases were utilized. The included articles demonstrated the antioxidant and antimicrobial activities of both isolated and food matrix-associated probiotics, with the most common genera being Lactobacillus, Bifidobacterium, Saccharomyces, and Streptococcus. Antioxidant activity was the most studied property, yielding varied results attributed to evaluation tests and probiotic strain. Antibacterial activity was consistently reported in all studies. Additionally, fermentation with probiotic microorganisms improved the content and bioaccessibility of bioactive compounds. In conclusion, analysis results highlight the antioxidant and antimicrobial activity of probiotics reported in in vitro studies. They enhance bioactive content and bioaccessibility and produce novel beneficial metabolites during fermentation. These results reinforce the therapeutic promise of probiotics associated with plant matrices and indicate the need for clinical studies to confirm their efficacy in improving human health.
... Probiotics are not limited to bacteria but also include yeasts such as Saccharomyces, Pichia, Kluyveromyces, and Torulaspora (Rad et al., 2020a, b, c). Several studies have revealed the potential of probiotics to treat several groups of diseases, such as lactose intolerance (Oak & Jha, 2019), cancer (Mi et al., 2017), irritable bowel syndrome (IBS) (Dale et al., 2019;, heart disease, and COVID-19 (Nayebi et al., 2022). Moreover, these beneficial microorganisms can be applied in the food industry and improve nutritional value, shelf life, quality, and safety. ...
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Postbiotics represent an innovative group of bioactive compounds generated through the fermentation of probiotics. Postbiotics are nonviable bacterial constituents, such as cell wall fragments, teichoic acids, peptidoglycans, and probiotic metabolites, such as exopolysaccharides, short chain fatty acids, and enzymes, which are soluble in cell-free supernatant. They are safe and efficient alternatives to probiotics. Studies have demonstrated their health benefits on different parts of the body, such as the gastrointestinal, neurological, and cardiovascular systems. The extraction of postbiotics can be achieved using either synthetic culture media or sustainable resources such as sugarcane straw. The extraction and identification of postbiotics involve techniques such as centrifugation, ultrafiltration, chromatography, and mass spectrometry. The production process typically includes the fermentation of probiotics, treatment to alter the nature of postbiotics, and subsequent harvesting and concentration. The efficacy of postbiotics in various applications, including food preservation, packaging, and as biofilm control agents, highlights their potential to replace chemical preservatives and enhance food quality. Despite their promising benefits, the application of postbiotics faces challenges, and they need further research to understand their mechanisms and establish safety standards. Graphical Abstract
... The increase in veganism, lactose intolerance, and/or hypercholesterolemic individuals have been demanding changes to products with probiotics and dairy products (yogurt and other fermented products) (Nguyen et al., 2019). Lactose intolerance is a genetically determined β-galactosidase deficiency resulting in the incapacity to hydrolyze lactose into glucose and galactose monosaccharides (Oak & Jha, 2019). Thus, the avoidance of products derived from animals has become an increasing trend in modern lifestyles. ...
Article
Functional foods within a varied diet at effective dosages may confer health benefits that surpass the scope of basic nutrition, with probiotics assuming a significant role in this domain. The use of sorbet enriched with probiotics is an alternative to dairy products. However, the viable bioprocessing for probiotic production presents substantial challenges. The aim of this study was to optimize the bioprocesses of Lactiplantibacillus plantarum UFSJP2 and to evaluate its antioxidant activity and viability in graviola (Annona muricata) sorbet. The optimized production of UFSJP2 biomass was 787% greater than non-optimized processes, resulting in a yield of 3.7 x 1010 CFU.mL-1 under conditions comprising 10.55 g.L-1 yeast extract, 10 g.L-1 peptone, and 0.16 g.L-1 manganese sulfate. The aggregated spherical structure observed in SEM may have a certain protective effect. Antioxidant activity assays revealed efficacies of 79% and 46% for intact and lysed cells, respectively. The survival rate of the UFSJP2 strain in the presence of hydrogen peroxide was observed at 77.5% (1.0 mM for 8 h). Notably, there was no diminution in the number of viable cells of UFSJP2 in graviola sorbet in 30 days. These results underscore a cost-effective strategy for probiotic production and for enhancing viability within plant-based matrices.
... In our opinion, the use of probiotics based on lactobacilli in women with lactose intolerance is logically questionary. The latest data suggest that the use of probiotics containing lactobacilli (Lactobacillus reuteri DSM 17938 and Lactobacillus acidophilus DDS-1, etc.) has a positive effect on the course of lactase deficiency and lactose intolerance in patients [21,22]. ...
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Today, women’s health is a separate issue for doctors of many specialties, including obstetricians and gynecologists, family doctors, etc. There is a wide range of treatment options for managing diseases of the reproductive system in women. But despite this, many of these strategies do not work for our patients. Therefore, we need the latest personalized approaches to therapy. One of the newest trends in women’s health is the correction or restoration of the vaginal microbiome. In our previous publications, we have covered the issue of the normal composition of the vaginal microbiome and its changes in various pathological conditions. Modification of the vaginal microbiome can be a useful strategy in the treatment of sexually transmitted infections, bacterial vaginosis, candidiasis, benign, precancerous and even malignant diseases of the female reproductive system, miscarriage, preterm birth and other pregnancy complications.The concept of using exogenous microorganisms as a treatment has been known for centuries. Possible mechanisms by which exogenous strains of lactobacilli can affect vaginal microbiome include vaginal recolonization, increased production or release of lactic acid and other antimicrobial compounds, and modulation of the local mucosal immune response. From a microbiome perspective, “prebiotics” are nutraceutical compounds that induce bacterial growth or the activity of probiotics or beneficial endogenous microorganisms. One of the limitations of prebiotics is their dependence on the presence of lactobacilli, which are absent or almost absent in dysbiosis. Symbiotics are combinations of prebiotics and probiotics based on the concept that the first nutraceutical can improve the bacterial growth and function of the other. This review highlights the latest views on correction and/or restoration of the vaginal microbiome using not only probiotics, prebiotics, and symbiotic, but also phage-altering agents, phage therapy, vaginal microbiome transplantation, etc. Such methods of correction and/or restoration are currently relevant in the reproductive medicine, gynecology and obstetrics all over the world. Despite the fact that these are the newest methods of correction and/or restoration, they are developing every day and require more detailed coverage of this issue.
... Probiotics are also useful in the treatment of different types of diarrhea caused by the use of antibiotics or inflammatory bowel disease (IBD), and even in the prevention of colon cancer [21,22]. At the level of the gastrointestinal tract, they also play a role in metabolism, improving the digestibility of lactose [23], reducing cholesterol [24], and reducing urinary excretion of oxalate, which is important in cases of nephrolithiasis [25]. Probiotics have been reported to reduce risk factors for infection, for example, in cases of Helicobacter pylori, urinary tract and respiratory tract infections [26,27]. ...
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In the context of functional foods and beverages, probiotic fruit juices offer a unique opportunity to combine probiotics’ health benefits with fruit juices’ nutritious properties. Since most probiotic food products are dairy products, fruit juices could be a viable alternative to dairy foods. Moreover, the variety of tastes with which these juices can be produced can expand the market for these products to consumers of all ages. Important challenges for the probiotic juice manufacturing industry are stability and sensory properties, which can be altered by probiotics or their metabolites. Any functional food must be healthy but still acceptable to consumers’ tastes. To evaluate the safety of these products, and improve the efficacy of probiotics in fruit juices, innovative technologies have been proposed, such as microencapsulation and the contemporary use of antioxidants.
... Functional food supplements, including probiotics [2] , prebiotics [3] , natural antioxidants [4] , bioactive peptides [5] , etc., are rapidly developing and innovating on a global scale. As the most widely studied functional food ingredient [6] , probiotics have shown great application prospects in regulating intestinal immunity [7] , alleviating lactose intolerance [8] , enhancing immune function [9,10] , anticancer [11] , anti-diabetes [12] , antibacterial and antioxidant [13] , anti-aging [14] , and antibiofilm formation [15] . ...
... This definition is supported by experimental and clinical data that showcase the capacity of specific probiotic strains to preserve and restore intestinal and extraintestinal homeostasis [2,3]. Specifically, positive outcomes have been demonstrated for the management of intestinal and systemic diseases, including lactose intolerance [4], Crohn's disease and ulcerative colitis [5], antibiotic-associated diarrhea [6], osteoporosis and other bone-related diseases [7], as well as neurodegenerative [8], autoimmune [9], mood and behavioral disorders [10,11]. Additionally, probiotics have also been investigated as preventive or adjunctive therapeutic agents for cancer [12,13]. ...
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Probiotics are live microorganisms that, when consumed in adequate amounts, exert health benefits on the host by regulating intestinal and extraintestinal homeostasis. Common probiotic microorganisms include lactic acid bacteria (LAB), yeasts, and Bacillus species. Here, we present Probio-ichnos, the first manually curated, literature-based database that collects and comprehensively presents information on the microbial strains exhibiting in vitro probiotic characteristics (i.e., resistance to acid and bile, attachment to host epithelia, as well as antimicrobial, immunomodulatory, antiproliferative, and antioxidant activity), derived from human, animal or plant microbiota, fermented dairy or non-dairy food products, and environmental sources. Employing a rigorous methodology, we conducted a systematic search of the PubMed database utilizing the keyword ‘probiotic’ within the abstracts or titles, resulting in a total of 27,715 studies. Upon further manual filtering, 2207 studies presenting in vitro experiments and elucidating strain-specific probiotic attributes were collected and used for data extraction. The Probio-ichnos database consists of 12,993 entries on the in vitro probiotic characteristics of 11,202 distinct strains belonging to 470 species and 143 genera. Data are presented using a binary categorization approach for the presence of probiotic attributes according to the authors’ conclusions. Additionally, information about the availability of the whole-genome sequence (WGS) of strains is included in the database. Overall, the Probio-ichnos database aims to streamline the navigation of the available literature to facilitate targeted validation and comparative investigation of the probiotic properties of the microbial strains.
... Furthermore, our test meals mainly consisted of yogurts, which can be seen as a source of probiotics. This might have had beneficial effects on the microbiome and ensured a better digestion of lactose [50,54]. Therefore, it would be interesting to investigate whether the higher prevalence of gastrointestinal complaints observed in the 3LGI condition persists when the monosaccharides are replaced by more commonly consumed foods low in GL. ...
... Probiotics work in the treatment of various diseases, such as gastrointestinal diseases (various diarrhea, lactose intolerance, etc.) (Guandalini, 2011;Dailey et al., 2019;Oak and Jha, 2019) and metabolic diseases (obesity and diabetes, etc.) (Bordalo Tonucci et al., 2017;Abenavoli et al., 2019). VSL#3 is a probiotic formula that is designed to improve the function of the intestinal barrier, with a substantial amount of evidence from empirical medical research supporting its use in various digestive system diseases (Cheng et al., 2020), such as irritable bowel syndrome (IBS) (Guandalini et al., 2010) and inflammatory bowel disease (IBD) (Gionchetti et al., 2000;Gionchetti et al., 2003). ...
Article
Compound probiotics have been widely used and commonly co-administered with other drugs for treating various chronic illnesses, yet their effects on drug pharmacokinetics remain underexplored. This study elucidated the impact of VSL#3 on the metabolism of probe drugs for cytochrome P450 enzymes (CYP450s), specifically omeprazole, tolbutamide, midazolam, metoprolol, phenacetin and chlorzoxazone. Male Wistar rats were administered with drinking water containing VSL#3 or not for 14 days and then intragastrically administered a CYP450s probe cocktail; This was done to investigate the host CYP450s metabolic phenotype. Stool, liver/jejunum and serum samples were collected for 16S rRNA sequencing, RNA sequencing, and bile acid profiling. The results indicated significant differences in both alpha and beta diversity of intestinal microbial composition between the probiotic and vehicle groups in rats. In the probiotic group, the bioavailability of omeprazole increased by 269.9%, whereas those of tolbutamide and chlorpropamide decreased by 28.1% and 27.4%, respectively. The liver and jejunum exhibited 1,417 and 4,004 differentially expressed genes, respectively, between the two groups. In the probiotic group, most of CYP450s genes were upregulated in the liver but downregulated in the jejunum. The expression of genes encoding metabolic enzymes and drug transporters also changed. The serum conjugated bile acids in the probiotic group were significantly reduced. Shorter duodenal villi and longer ileal villi were found in the probiotic group. In summary, VSL#3 administration altered the gut microbiota, host drug-processing gene expression, and the intestinal structure in rats, which could be reasons for pharmacokinetic changes. Significance Statement This study focused on the effects of the probiotic VSL#3 on the pharmacokinetic profile of CYP450s probe drugs and the expression of host drug metabolism genes. Compared with previous studies, the current study provides a comprehensive explanation for the host drug metabolism profile modified by probiotics, here combined with the bile acid profile and histopathological analysis.
... The usage of potential probiotics having enzymatic activities such as protease, amylase, and β-galactosidase as starter cultures in various food production contributes to the improvement of sensory properties such as texture and flavor of foods (Abubakr and Al-Adiwish 2017;Oak and Jha 2019;Yalçın et al. 2021). In this study, 21 AAB isolates had protease activity, and eight isolates had amylase activity, while none of the isolates has β-galactosidase activity (Table 5). ...
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This research examined acetic acid bacteria (AAB) isolated from Kombucha beverages produced with Anatolian hawthorn (Crataegus orientalis) as next-generation probiotics. Eighty-six AAB were isolated from the samples and investigated in terms of biosafety, viability in vitro gastrointestinal conditions, technological and bioactive properties, and also in vitro adhesion abilities. Seventy-six isolates demonstrating γ-hemolysis exhibited resistance to erythromycin and ampicillin. Besides, these isolates survived at low pH and in the presence of bile salts. However, the majority of AAB isolates showed tolerance to phenol, pepsin, and pancreatin. Also, twenty-one isolates showed protease enzyme activity, while eight isolates had amylase enzyme activity. Despite most of the isolates showed viability at 1.5% salt, only 19 isolates survived at 10% salt. Most AAB isolates exhibited inhibition zones ranging from 8 to 26 mm against test bacteria, their antioxidant activities were above 80%. Additionally, some isolates exhibited auto-aggregation ability ranging from 0.66 to 23.62% and co-aggregation ability ranging from 1.18 to 71.32%, while hydrophobicity ranged from 1.32 to 69.87% toward xylene. Finally, the indigenous 76 AAB isolates that had remarkable probiotic properties were characterized based on 16S rRNA gene sequencing, and the isolates belonged to Komagateibacter sp. (64.47%), Komagateibacter saccharivorans (15.79%), K. rhaeticus (11.84%), and Gluconobacter sp. (7.90%). As a result, the isolates identified as Gluconobacter sp. A21, Komagataeibacter sp. A139, Gluconobacter sp. A141, and Komagataeibacter sp. A146, which showed high viability under gastrointestinal conditions, safe and acceptable in terms of technological, bioactive, and adhesion properties and could be evaluated as next-generation probiotics.
... Several studies have suggested that probiotics have therapeutic potential for the treatment of digestive disorders, such as IBS, inflammatory bowel disease, lactose intolerance, and antibiotic-associated diarrhea. [1,14,[17][18][19] B. coagulans administration has been shown to alleviate IBS symptoms, including abdominal pain and bloating, altered bowel habits, dysbiosis, and stabilization of the gut microbiota. [16] Based on existing research findings and the known benefits of using B. coagulans this study was designed to evaluate the effectiveness of a specific strain, B. coagulans BCP92, in controlling IBS symptoms. ...
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Background Irritable bowel syndrome (IBS) is a major global healthcare burden that requires effective and well-tolerated intervention. This study aimed to investigate the effectiveness and safety of Bacillus coagulans BCP92, a probiotic, in managing IBS symptoms. Methods This randomized controlled trial included 100 participants who strictly adhered to the protocol. Various parameters such as IBS severity, digestive symptom frequency, gastrointestinal symptom frequency, stool consistency, interleukin-6 levels, stress relief, and anxiety levels were evaluated over 12 weeks. Results B. coagulans BCP92 significantly improved IBS severity ( P < .001), and gastrointestinal symptom frequency ( P < .001) compared with that in the control group. The stool consistency significantly improved ( P < .001). Mental stress relief was remarkable ( P = .001), differentiating the test and control groups. No significant change in interleukin-6 levels was observed; however, the safety assessment revealed an excellent profile with no reported severe adverse events. Conclusion B. coagulans BCP92 is one of the most promising therapeutic options for the management of IBS because it has shown significant efficacy in alleviating symptoms among patients suffering from this condition, resulting in improved stool consistency changes in addition to improving overall mental well-being for its users, thereby foreseeing the elimination of any potential side effects experienced during the implementation of this approach strategy within our health care system, thereby improving patient outcomes and leading to individualization of treatment plans among all individuals diagnosed with this disease entity who may have symptoms, including abdominal pain or discomfort associated with changes in bowel habits.
... Probiotics are commonly added to dairy products including yoghurt, cheese, milk, and kefir, and they can also be consumed as dietary supplements (Diguta et al., 2020;Farid et al., 2021). However, non-dairy probiotic products such as fermented juice, vegetables and beverages have recently gained increasing popularity due to their low risk of eliciting lactose intolerance symptoms and overall health properties (Oak and Jha, 2019). Unpasteurized kombucha is widely recognised as a probiotic beverage because consumers believe that it contains inherent live cultures which can confer beneficial health properties (Laureys et al., 2020;Vargas et al., 2021). ...
... Probiotics can exert their beneficial effects mainly by helping to maintain gut homeostasis and preventing pathogens (D'Aimmo et al., 2007). Immunomodulatory, antioxidant, and anti-carcinogenic activity (Brasiel et al., 2020), reduction of lactose intolerance (Oak & Jha, 2019), reduction of hypertension (Khalesi et al., 2014), reduction of cholesterol levels, and reduce the risk of cardiovascular disease (Sivamaruthi et al., 2021), improving nutrient bioavailability, and increasing the nutritional value of foods (Hariri et al., 2018) are among the benefits of probiotics for health. Therefore, probiotics can be used to prevent and treat various diseases. ...
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There are challenges such as standardization for commercialization and guaranteeing sensory characteristics in camel milk processing. This review gathers a general view of the probiotic camel milk, its contents, its health aspects, and its industrial production. One of the potential candidates of a healthy food product is “probiotic camel milk” which contains several nutritional elements including Lactic acid bacteria and Bifidobacteria and postbiotics such as endopolysaccharides, exopolysaccharides, numerous beneficial enzymes, short‐chain fatty acids, teichoic acids, peptides, peptidoglycan‐derived neuropeptides, cell surface proteins, different vitamins, plasmalogens, and different kinds of organic acids. It should also be considered that camel milk generally has some advantages over cow milk like its health‐beneficial antidiabetic, hypoallergenic, and anticancer properties. As a result, it is gaining much attention from both consumers and manufacturers, and the global probiotic market trend is growing. Although there are obstacles in standardizing processing techniques and maintaining sensory excellence, the health benefits, economic prospects, and adaptability of camel milk and its probiotic variations create a promising avenue for continued research and advancement. Therefore, developing standardized processing techniques and sensory evaluation methods for probiotic camel milk can unlock its full potential as a nutritious beverage, offering a promising solution for consumers seeking healthy and functional food products.
... ese strains have shown the potential to in uence mental health by a ecting the microbiota of the host organism and targeting conditions such as anxiety, depression, and stress. Research suggests that they may impact the gut-brain axis and contribute to mental well-being [21][22][23][24][25]. Predominantly comprising probiotics such as certain strains of Lactobacillus and Bi dobacterium, these bene cial microorganisms have garnered attention for their potential to modulate the gut-brain axis and in uence neural function [21]. ...
... Lacticaseibacillus rhamnosus GG (LGG) is one of the most widely studied probiotic strains that have beneficial effects for human health like prevention of diarrhea and inhibition of pathogenic bacteria (Gorbach et al. 2017;Celebioglu 2021). Lactobacillus acidophilus , an important commercial strain of LAB, is a probiotic bacteria beneficial to human health such as preventing or controlling intestinal infections, improving lactose digestion in lactose intolerance, balancing serum cholesterol levels, and may have also anti-carcinogenic activity (Oak & Jha 2019). ...
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... LI is treated currently with the supplements and symptom management medications, and probiotics gained high interest in the prospective compensation for lactase insufficiency. Probiotics improve lactose digestion in LI by boosting the overall hydrolytic capacity in the small intestine and encouraging colonic fermentation [162]. ...
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... This microbiota is known as probiotics. They could be bacteria or yeast (Bermudez-Brito et al. 2012;Fredua-Agyeman et al. 2017;Oak and Jha 2019). Prebiotics are specialized feed ingredients that boost the activities and growth of beneficial bacteria in the gastrointestinal tract (GIT) and eliminate the pathogenic ones (Gibson et al. 2017). ...
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... It can help to reduce the crystallization of lactose, improve the texture, and enhance the flavor of dairy products. Lactase is also used in the production of infant formula to make it easier to digest for babies who are lactose intolerant or have difficulty digesting lactose (Oak & Jha, 2019). Lactase is used in the baking industry to improve the texture and flavor of baked goods, such as bread, cakes, and cookies, synthesis of lactose. ...
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... Recently in-depth research found that probiotics such as Lactobacillus spp., B. longum, and B. animalis had beneficial impacts, justifying the usage of probiotic yoghurt comprising L. acidophilus and Bifidobacterium spp. (50). Another study found that probiotic yoghurt supplemented with L. acidophilus and Bifidobacterium spp. ...
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... It has also been proven that probiotics have a positive effect on reducing serum cholesterol levels by hydrolysis of bile salts which normally emulsify lip absorption of lipids in small intestines (Kumar et al., 2012). Positive impacts of probiotics on allergic reactions to food and lactose intolerance were also confirmed (Oak, Jha, 2019;Jin et al., 2021). Research by some authors has proven the immunomodulatory and even anticancer abilities of probiotic strains (Elham et al., 2022). ...
... There is growing evidence that lactose intolerance symptoms can be treated with probiotic bacteria found in fermented and unfermented milk products [82]. The mechanism of RJ in reducing lactose intolerance relies on the activity of probiotics delivered via fermented milk products, which have been found to play an important role in health benefits, as reported by Hassan et al. (2022). ...
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Background Each individual has a distinct gut microbiota composition that serves a variety of important roles in the metabolism of the host's nutrients, immunomodulation, and maintains immunity and inflammatory response and influences the gut–brain axis (GBA). In addition to modulating the immune system, the hypothalamic–pituitary–adrenal (HPA) axis, and tryptophan metabolism, microorganisms can synthesize several neurotransmitters and generate metabolites, such as short-chain fatty acids (SCFAs), that have neuroactive features. The gut microbiome is highly susceptible to lifestyle modifications, diet and xenobiotics, which leads to dysbiosis. Dysbiosis in the geriatric population can cause numerous disease conditions like Alzheimer's and Parkinson's disease, cardiovascular disease, gastrointestinal disease, and cancer. Dysbiosis of the gut microbiota has been associated with behavioural and neurological disorders such as depression, Alzheimer's, Parkinson's, and autism spectrum disorder. Furthermore, SCFA administration and microbiota alteration have been suggested as therapy objectives for these illnesses. DNA-based culture-independent methods, including next-generation sequencing, which provide quantitative information on the human gut microbiota are used to define the entire gut health and its relation to various disorders. The current review aims to summarize the available literature on the role of gut microbiota in ageing and dysbiosis in disease conditions.
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The human gut microbiota, the vast community of microbes inhabiting the gastrointestinal tract, plays a pivotal role in maintaining health. Bacteria are the most abundant organism, and the composition of bacterial communities is strongly influenced by diet. Gut bacteria can degrade complex dietary carbohydrates to produce bioactive compounds such as short-chain fatty acids. Such products influence health, by acting on systemic metabolism, or by virtue of anti-inflammatory or anti-carcinogenic properties. The composition of gut bacteria can be altered through overgrowth of enteropathogens (e.g., Campylobacter, Salmonella spp.), leading to dysbiosis of the gut ecosystem, with some species thriving under the altered conditions whereas others decline. Various “biotics” strategies, including prebiotics, probiotics, synbiotics, and postbiotics, contribute to re-establishing balance within the gut microbial ecosystem conferring health benefits. Prebiotics enhance growth of beneficial members of the resident microbial community and can thus prevent pathogen growth by competitive exclusion. Specific probiotics can actively inhibit the growth of pathogens, either through the production of bacteriocins or simply by reducing the gastrointestinal pH making conditions less favorable for pathogen growth. This review discusses the importance of a balanced gut ecosystem, and strategies to maintain it that contribute to human health.
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Probiotics are live bacteria that show the potential to promote human health, particularly by enhancing nutrient absorption, digestion, and overall gut microbiota health when taken in adequate proportions. Probiotic consumption has been shown to effectively manage inflammatory-irritable bowel syndrome, including symptoms such as diarrhoea and Crohn's disease. Additionally, probiotics increase the functioning of the gut barrier, which restricts the presence of harmful microorganisms and thus ultimately enhances the immune system. Obesity is a worldwide healthcare concern that is closely associated with several chronic illnesses such as diabetes and cardiovascular disease. Probiotic ingestion regulates insulin sensitivity, hence decreasing the likelihood of developing diabetes. As a result of advances in scientific knowledge, more novel strains can be found or genetically modified, and these strains can then be functionalized according to an individual's particular gut microbiota, opening up new pathways for therapeutic interventions. Because of increased health consciousness among individuals in modern society, foods that contain probiotics have experienced a surge in popularity in recent years. The regulatory agencies should establish regular recommendations for the evaluation of probiotic strains. These guidelines should include the methods of genotyping and screening, in addition to other labelling guidelines. This will assure the consumers' safety, quality and effectiveness of the foodstuffs. In addition, studies involving other fields of expertise, such as microbiologists, immunologists, biotechnologists, food scientists, and nutritionists, are required to achieve an all-encompassing comprehension of the complex associations that exist between probiotics and human health.
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Postbiotics are defined as a preparation of inanimate microorganisms and/or their components that confers a health benefit to the host. They range from cell wall fragments to metabolites, bacterial lysates, extracellular vesicles, and short-chain fatty acids (SCFAs). Postbiotics may influence carcinogenesis via a variety of mechanisms. They can promote homeostatic immune responses, reduce inflammation, induce selective cytotoxicity against tumor cells, as well as the enabling the control of tumor cell proliferation and enhancing intestinal epithelial barrier function. Therefore, probiotics can serve as an adjunct strategy in anticancer treatment together with chemotherapy and immunotherapy. Up to now, the only relevant postbiotics used as interventions in oncological patients remain vitamin K molecules, with few phase-II and III trials available. In fact, postbiotics’ levels are strictly dependent on the gut microbiota’s composition, which may vary between individuals and can be altered under different physiological and pathological conditions. Therefore, the lack of consistent clinical evidence supporting postbiotics’ efficacy is due to their poor bioavailability, short half-life, and fluctuating levels. Synbiotics, a mixture of prebiotics and probiotics, are expected to have a more homogeneous bioavailability with respect to postbiotics and may have greater potential for future development. In this review, we focus on the role of postbiotics as an adjuvant therapy in cancer treatment.
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In recent years, the use of fermented fruit juices to offer protection against mental illness has been increasing enormously. The present study, aimed at formulating a synbiotic fruit beverage for mental well-being using fructo-oligosaccharide (FOS), Gamma-aminobutyric acid (GABA) and Lactobacillus rhamnosus . Guava extract (abbreviated as fruit extract, FE; 10%) supplemented with FOS (1%) fermented for 48 h using L. rhamnosus , was then fortified with 0.05% GABA (FE + FOS + GABA). This GABA-fortified fermented guava beverage exhibited significant in-vitro antioxidant activity as measured by using 2,2-diphenyl-1-picrylhydrazyl (IC 50 value of 0.451 ± 0.05 mg/ml) and ferrous reducing antioxidant capacity (A700 nm value of 0.68 ± 0.06) assays. Fermentation also enhanced total phenolics and flavonoids by 27.63% and 27.41%, respectively. Furthermore, GABA-fortified fermented guava beverage showed a significant neuroprotective effect by negatively modulating oxidative stress and upregulating activity of antioxidant enzymes (superoxide dismutase and catalase) in rotenone treated neuronal cell lines. Taken together, our research findings clearly indicate the propensity of GABA-fortified fermented guava beverage to protect against rotenone mediated neuronal cell damage. Even though the underlying molecular mechanisms need further research, in conclusion, our study demonstrates that the GABA-fortified fermented guava beverage effectively confers neuroprotective effects in vitro, suggesting its potential as a functional beverage for promoting brain health. Graphical Abstract
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Background Probiotics are living microorganisms that may confer health benefits to their host if administered in sufficient quantities. However, data on the use of probiotics in transplant recipients are scarce. Method This multi‐center survey of pediatric nephrologists aimed to examine variations in practice regarding the use of probiotics in pediatric kidney transplant recipients. The survey was conducted via a 10‐item questionnaire (developed in Survey Monkey) administered to pediatric nephrologists participating in the Pediatric Nephrology Research Consortium meeting in April 2023. Results Sixty‐four pediatric nephrologists completed the survey. Twenty‐seven (42.2%) respondents reported having prescribed probiotics to pediatric kidney transplant recipients. The primary reason for probiotic use was the treatment of antibiotic‐associated diarrhea ( n = 20), with other reasons including recurrent Clostridium difficile infection ( n = 15), general gut health promotion ( n = 12), recurrent urinary tract infections ( n = 8), and parental request ( n = 1). Of those who prescribed probiotics, 48.1% held them during periods of neutropenia and 14.8% during central venous line use. Of the 64 respondents, 20 reported the lack of safety data as a concern for using probiotics in kidney transplant recipients. Conclusion Pediatric nephrologists are increasingly prescribing probiotics to pediatric kidney transplant recipients; nevertheless, substantial practice variations exist. The paucity of safety data is a significant deterrent to probiotic use in this population.
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The purpose of this review is to thoroughly explore and document the potential uses of fruits and vegetables as baby food. It aims to achieve several key objectives, including the identification of phytochemical compounds present in fruits and vegetables, the assessment of their biological properties, and the examination of their practical applications in the baby food. Ultimately, this review seeks to provide a comprehensive understanding of how fruits and vegetables can be used as baby food and enhance food quality in terms of nutritional value. Nutritional challenges in babies due to dietary factors have become an escalating issue in recent times. The incorporation of solid foods into a baby’s diet is of utmost importance for their overall growth and well-being. Inappropriate dietary practices leads to nutrient deficiencies, food allergies, and obesity. Cereal foods gained prominence as a popular choice for complementary baby feeding due to their convenience, nutrient content, and ease of digestion. Fruits and vegetables are rich in vitamins, minerals, dietary fiber, and antioxidants, thus boost their immune system, regulates bowel, prevent constipation and makes babies healthier. Fruits, vegetables and cereal products are essential for wellbeing of developing babies compared to dairy and cereal based food products. Furthermore, inclusion of fruit, vegetable, and cereal-based (rice) ingredients in baby food acts as prebiotics for enhancing probiotic growth. Additionally, exposing babies to variety of flavors and textures promote babies to eat these nutritious food products.
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Probiotics, prebiotics, and synbiotics have all been studied with growing interest in recent decades for their health-enhancing attributes. Probiotics have been advocated as a cost-effective and secure alternative as well as an adjunct for the management of several chronic disorders and to improve overall health. They have demonstrated the ability to modulate and rehabilitate the already existing gut microflora and enhance the immunity of the host, thereby protecting against several illnesses. Bifidobacterium, Lactobacilli, Saccharomyces boulardii, and Bacillus coagulans are some of the most frequently used probiotic strains. Prebiotics, on the other hand, are the most widely used fibers that specifically support the growth of probiotics and enhance human health through nutrient enrichment, modification of gut microbiota, and immune system. Prebiotics include FOS, GOS, and Inulin. When prebiotics are combined with probiotics, they are referred to as “synbiotics,” and they have the ability to boost the viability of the probiotics. This chapter highlights the function of probiotics and prebiotics, both separately and in combination (synbiotics), in immune system modulation, infection treatment, inflammatory bowel disease management, and cancer therapy.
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Probiotics are live microbes, that when administered in adequate amounts, confer a health benefit on the host. Various health benefits have been documented for different strains/combinations of probiotics; mostly related to digestive and immune health. Because the gut is also linked to many other organ systems, health benefits outside the gut have been reported. Further, new strains from species not previously used in food and dietary supplements are being investigated as so-called next generation probiotics (NGPs). These NGPs are often intended to become drugs rather than dietary supplements or functional foods. The future may also bring new delivery formats that are not consumed but otherwise applied to the body. To develop these NGPs and better understand the mechanism of action of current probiotics, the so-called omics techniques are helpful. For a layperson, it is difficult to identify a good quality probiotic. However, careful reading of the product label can help to identify the strains and counts at the end of a product’s shelf life. Information © The Authors 2023
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Background: Probiotics constitute the viable and beneficial microbes, which offer a dietary means to sustain the balance of gastro-intestinal (GI) microflora. Owing to their multiple health benefits, these have recently gained wide attention among researchers for exploring their potential in safeguarding the health of humans and animals. Probiotics could also modulate host-immune responses, thereby help in counteracting the immunological dysfunctions. Probiotics can inhibit the systemic invasion of pathogens entering through the GI mucosa/ oral cavity and have been found to possess effective prophylactic and therapeutic utilities against various infectious pathogens as well as non-infectious diseases and disorders. Objective: The present review expedites the role of probiotics in curing the ailments related to allergic and inflammatory disease conditions. Method: A thorough reviewing of the literature and patents available on probiotics and their role in countering inflammation and allergy was conducted using authentic published resources available on Medline, PubMed, PubMed Central, Science Direct and other scientific databases. The information retrieved has been compiled and analysed pertaining to the theme of the study. Results: Various micro-organisms have been evaluated for their probiotic efficacy, among these, the lactic acid bacteria viz. Lactobacillus sp. and Bifidobacterium sp. have extensively been studied and widely exploited. In the current post-globalized era of self and complementary medicines, the concept of probiotics and their therapeutic as well as prophylactic usage is gaining wide acceptance. As more and more bacterial strains are being proven for their pronounced influence on down regulation of immune regulation, atopic, inflammatory conditions, the use of probiotics is getting increased especially in the developed countries where such indications are high in prevalence. Apart from usage in immune related disorders, probiotics have been found to be effective in treating pouchitis, infantile diarrhoea due to infections, bacterial vaginosis, urinary tract infections, dental carries, diabetes, cancers as well augmenting the gut mucosal tolerance to various antibiotics and lactose intolerance. Conclusion: The resent review gives an insight towards potent utility of this branch of beneficial microbial therapy in allergy and inflammations, which is still in the emerging phase and more scientific evidences need to be explored regarding exploration of the mechanisms of action, further experimental trials and validation of controlled clinical studies in humans along with designing novel strategies for monitoring the possible microbial changes in their composition and metabolism associated with their interaction upon host immune system.
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Background: Plant derived products are not only served as dietary components but also used to treat and prevent the inflammatory associated diseases like cancer. Among the natural products pentacyclic terpenoids including ursolic acid and oleanolic acid are considered as the promising anti-inflammatory therapeutic agents. Objectives: The current review extensively discusses the anti-inflammatory therapeutic potential of these pentacyclic moieties along with their proposed mechanisms of action. Furthermore, the relevant patents have also been listed to present the health benefits of these promising therapeutic agents to pin down the inflammatory diseases. Expert opinion: Pentacyclic terpenoids are known to negatively down-regulate a variety of extracellular and intracellular molecular targets associated with disease progression. The major anti-inflammatory effects of these molecules have been found to be mediated via inactivation of NFкβ, STAT3/6, Akt/mTOR pathways. A number of patents on UA & OA based moieties have been reported between 2010 and 2016. Still there have been only a few compounds which meet the need of sufficient hydro solubility and bioavailability along with higher anti-inflammatory activities. Thus, it has been essential to develop novel derivatives of terpenpoids which may not only overcome the solubility issues but also may improve their therapeutic effects. In addition, scientific community may utilize nanotechnology based drug delivery systems so as to increase the bio-availability, selectivity and dosages related problems.
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Probiotics are live microorganisms that provide health benefits to the host when ingested in adequate amounts. The strains most frequently used as probiotics include lactic acid bacteria and bifidobacteria. Probiotics have demonstrated significant potential as therapeutic options for a variety of diseases, but the mechanisms responsible for these effects have not been fully elucidated yet. Several important mechanisms underlying the antagonistic effects of probiotics on various microorganisms include the following: modification of the gut microbiota, competitive adherence to the mucosa and epithelium, strengthening of the gut epithelial barrier and modulation of the immune system to convey an advantage to the host. Accumulating evidence demonstrates that probiotics communicate with the host by pattern recognition receptors, such as toll-like receptors and nucleotide-binding oligomerization domain-containing protein-like receptors, which modulate key signaling pathways, such as nuclear factor-ĸB and mitogen-activated protein kinase, to enhance or suppress activation and influence downstream pathways. This recognition is crucial for eliciting measured antimicrobial responses with minimal inflammatory tissue damage. A clear understanding of these mechanisms will allow for appropriate probiotic strain selection for specific applications and may uncover novel probiotic functions. The goal of this systematic review was to explore probiotic modes of action focusing on how gut microbes influence the host.
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A symbiotic relationship between the liver and intestinal tract enables the healthy status of both organs. Microflora resident in intestinal lumen plays a significant role in hepatocytes function. Alterations to the type and amount of microorganisms that live in the intestinal tract can result in serious and harmful liver dysfunctions such as cirrhosis, nonalcoholic fatty liver disease, alcoholic liver disease, and hepatic encephalopathy. An increased number of pathogens, especially enterobacteriaceae, enterococci, and streptococci species causes the elevation of intestinal permeability and bacterial translocation. The presence of high levels of lipopolysaccharide (LPS) and bacterial substances in the blood result in a portal hypertension and ensuing hepatocytes damage. Several methods including the usage of antibiotics, prebiotics, and probiotics can be used to prevent the overgrowth of pathogens. Compared to prebiotic and antibiotic therapy, probiotics strains are a safer and less expensive therapy. Probiotics are "live microorganisms (according to the FAO/WHO) which when administered in adequate amounts confer a health benefit on the host". EVIDENCE ACQUISITIONS: Data from numerous preclinical and clinical trials allows for control of the flora bacteria quantity, decreases in compounds derived from bacteria, and lowers proinflammatory production such as TNF-α, IL-6 and IFN-γ via down-regulation of the nuclear factor kappa B (NF-κ B). On the other hand, probiotic can reduce the urease activity of bacterial microflora. Furthermore, probiotic decreases fecal pH value and reduces ammonia adsorption. In addition, the serum level of liver enzymes and other substances synthesized by the liver are modulated subsequent to probiotic consumption. According to our knowledge, Probiotic therapy as a safe, inexpensive and a noninvasive strategy can reduce pathophysiological symptoms and improve different types of liver diseases without side effects.
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A 72-year-old man with severe lactose intolerance was admitted for non-ST-segment elevation myocardial infarction. The coronary angiogram revealed occlusion of the distal third of the first diagonal artery and several non-significant lesions. The pre-discharge echocardiogram revealed moderate left ventricular systolic dysfunction. Discharged on dual antiplatelet therapy, rosuvastatin, perindopril and carvedilol, he was repeatedly readmitted in the following days for abdominal pain/bloating, diarrhea and nausea despite avoiding food products containing lactose. To date, there has been no comprehensive study on the relationship between lactose intolerance and coronary disease, nor has its impact on therapeutics been appropriately addressed. Intolerance to lactose-containing prescription medicines is an extremely rare phenomenon and few strategies are available to overcome this condition, as it has received little attention from the scientific community. Commercial forms of the lactase enzyme and probiotics can limit symptom severity, but different routes of administration, different brands of the same medicine or completely different medicines may be necessary. Some measures were proposed to our patient and, soon afterwards, he was completely asymptomatic in both gastrointestinal and cardiovascular terms.
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Bacteria of the genus Lactobacillus are widely used as oral probiotics due to their putative health benefits. In this study, we compared the colonization ability of two Lactobacillus strains that were identified as autochthonous to the human gastrointestinal tract (Lactobacillus reuteri ATCC PTA 6475 (MM4-1a) and Lactobacillus mucosae FSL-04) with that of an allochthonous strain (Lactobacillus acidophilus DDS-1). Colonization ability was tested in a single-blinded, cross-over study, with twelve human subjects. The test strains were quantified in fecal samples by two independent methods, selective plating and molecular typing and quantitative real time PCR. The study revealed that the two autochthonous strains (L. reuteri ATCC PTA 6475 and L. mucosae FSL-04) reached higher population levels in fecal samples and were recovered more frequently from subjects compared to the allochthonous strain (L. acidophilus DDS-1). All three strains became undetectable 8 days after the end of consumption with one exception, showing that persistence of all three strains remains short term in most individuals. In conclusion, this study showed that autochtho-nous Lactobacillus strains can be established more efficiently, albeit temporarily, in the human gastrointestinal tract, suggesting that evolutionary and ecological characteristics could be valuable criteria for the selection of probiotic strains.
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Most people are born with the ability to digest lactose, the major carbohydrate in milk and the main source of nutrition until weaning. Approximately 75% of the world's population loses this ability at some point, while others can digest lactose into adulthood. This review discusses the lactase-persistence alleles that have arisen in different populations around the world, diagnosis of lactose intolerance, and its symptomatology and management. © 2012 Mattar et al, publisher and licensee Dove Medical Press Ltd.
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Bifidobacterium animalis subsp. lactis BLC1 is a probiotic bacterium that is widely exploited by food industries as the active ingredient of various functional foods. Here we report the complete genome sequence of B. animalis subsp. lactis BLC1, which is expected to provide insights into the biology of this health-promoting microorganism and improve our understanding of its phylogenetic relatedness with other members of the B. animalis subsp. lactis taxon.
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We systematically reviewed evidence to determine lactose intolerance (LI) prevalence, bone health after dairy-exclusion diets, tolerable dose of lactose in subjects with diagnosed LI, and management. We searched multiple electronic databases for original studies published in English from 1967-November 2009. We extracted patient and study characteristics using author's definitions of LI and lactose malabsorption. We compared outcomes in relation to diagnostic tests, including lactose challenge, intestinal biopsies of lactase enzyme levels, genetic tests, and symptoms. Fractures, bone mineral content (BMC) and bone mineral density (BMD) were compared in categories of lactose intake. Reported symptoms, lactose dose and formulation, timing of lactose ingestion, and co-ingested food were analyzed in association with tolerability of lactose. Symptoms were compared after administration of probiotics, enzyme replacements, lactose-reduced milk and increasing lactose load. Prevalence was reported in 54 primarily nonpopulation based studies (15 from the United States). Studies did not directly assess LI and subjects were highly selected. LI magnitude was very low in children and remained low into adulthood among individuals of Northern European descent. For African American, Hispanic, Asian, and American Indian populations LI rates may be 50 percent higher in late childhood and adulthood. Small doses of lactose were well tolerated in most populations. Low level evidence from 55 observational studies of 223,336 subjects indicated that low milk consumers may have increased fracture risk. Strength and significance varied depended on exposure definitions. Low level evidence from randomized controlled trials (RCTs) of children (seven RCTs) and adult women (two RCTs) with low lactose intake indicated that dairy interventions may improve BMC in select populations. Most individuals with LI can tolerate up to 12 grams of lactose, though symptoms became more prominent at doses above 12 grams and appreciable after 24 grams of lactose; 50 grams induced symptoms in the vast majority. A daily divided dose of 24 grams was generally tolerated. We found insufficient evidence that use of lactose reduced solution/milk, with lactose content of 0-2 grams, compared to a lactose dose of greater than 12 grams, reduced symptoms of lactose intolerance. Evidence was insufficient for probiotics (eight RCTs), colonic adaptation (two RCTs) or varying lactose doses (three RCTs) or other agents (one RCT). Inclusion criteria, interventions, and outcomes were variable. Yogurt and probiotic types studied were variable and results either showed no difference in symptom scores or small differences in symptoms that may be of low clinical relevance. There are race and age differences in LI prevalence. Evidence is insufficient to accurately assess U.S. population prevalence of LI. Children with low lactose intake may have beneficial bone outcomes from dairy interventions. There was evidence that most individuals with presumed LI or LM can tolerate 12-15 grams of lactose (approximately 1 cup of milk). There was insufficient evidence regarding effectiveness for all evaluated agents. Additional research is needed to determine LI treatment effectiveness.
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The objective of this study was to determine the efficacy of live and killed probiotics to decrease the presence of hydrogen using the breath hydrogen test (BHT). This pretest-posttest control group design single blinded randomized study was performed in 5 government elementary schools in Tuminting subdistrict, Manado, Indonesia from March to May 2008. The study for inclusion as subjects consisted of healthy 10-12 year old children with heights and weights within normal limits using the Centers for Disease Control (CDC) criteria whose BHT was 220 parts per million (ppm), indicating lactose malabsorption. One hundred thirty children were screened, 86 met criteria, 43 children were randomized into two groups. Thirty-nine children who were given live probiotic and 40 children who were given killed probiotic completed the study. There was a significant difference when comparing the BHT results before and 120 minutes after giving probiotic for the children taking both the live and the killed probiotic (p < 0.001). When the children taking the live and killed probiotics were compared, there was no difference in the BHT at 120 minutes of probiotic (p = 0.453) by t-test. The administration of live or killed probiotic for 2 weeks can decrease the results of a BHT in children with lactose malabsorption. No adverse reactions attributable to treatment were noted.
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Lactase enzyme supplements and probiotics with high beta-galactosidase activity may be valid treatment options for the lactose intolerance. Aim of this study was to assess whether supplementation with tilactase or Lactobacillus reuteri when compared to placebo affects hydrogen breath excretion and gastrointestinal symptoms in lactose intolerant patients during lactose breath test (H,-LBT). Sixty lactose intolerant patients participated in the study and were randomized to three 20 patients-treatment groups: tilactase group (tilactase 15 minutes before control H2-LBT); placebo group (placebo 15 minutes before control H2-LBT); Lactobacillus reuteri group (LR) (LR b.i.d. during 10 days before control H2-LBT). The outcomes were LBT normalization rate, and influences of treatments on both mean maximum hydrogen concentration and clinical score. LBT normalization rate was significantly higher in tilactase and LR groups with respect to placebo. Tilactase was significantly more effective than LR in achieving LBT normalization (p <0.01). Both significant reduction of mean peak H2 excretion and improvement of the mean clinical score were observed in tilactase and LR groups after treatment with respect to placebo (p <0.0001). Tilactase was significantly more effective than LR in reducing both mean peak hydrogen excretion and mean clinical score. In lactose intolerants, tilactase strongly improves both LBT results and gastrointestinal symptoms after lactose ingestion with respect to placebo. Lactobacillus reuteri also is effective but lesser than tilactase. This probiotic may represent an interesting treatment option for lactose intolerance since its use is simple and its effect may last in the time after stopping administration.
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In this study we examined whether small doses of lactose induced symptoms in 39 lactose maldigesters and 15 lactose digesters in a randomized, crossover, double-blind design. The test doses were 200 mL fat-free, lactose-free milk to which 0, 0.5, 1.5, and 7 g lactose was added. Every third day of a lactose-free diet, after an overnight fast, the subjects drank one of the test milks in random order and registered the occurrence and severity of gastrointestinal symptoms in the next 12 h. During the study, the maldigesters reported significantly more abdominal bloating (P = 0.0003) and abdominal pain (P = 0.006) than the digesters. There was no difference in the mean severity of the reported symptoms between the test milks and the lactose-free milk in the group of lactose maldigesters, of whom one-third did not experience any symptoms from any of the test doses. The same proportion (64%) of the maldigesters experienced symptoms after both the lactose-free milk and the milk with 7 g lactose. However, the symptoms occurred inconsistently with the different test doses in 59% of the maldigesters. Thus, it can be concluded that the gastrointestinal symptoms in most lactose maldigesters are not induced by lactose when small amounts (0.5-7.0 g) of lactose are included in the diet.
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Lactose maldigestion is a common genetic trait in up to 70% of the world's population. In these subjects, the ingestion of lactose may lead to prebiotic effects which can be confirmed by measurement of breath hydrogen. After a period of continuous lactose ingestion, colonic bacterial adaptation is measurable as improved parameters of lactose digestion. There may be inherent benefits in this process of adaptation which may protect against some diseases. We attempt to link therapeutically beneficial probiotics (VSL3, Seaford Pharmaceuticals Inc, Ontario) with improvement in parameters of lactose maldigestion. Two groups of five subjects with maldigestion were fed one or four packets of VSL3 (one packet containing 450x10 9 live bacteria) before testing and then 17 days later. A 50 g lactose challenge was carried out before and after feeding. While there was a trend toward increasing rather than reducing of summed breath hydrogen, no statistically significant changes were observed between results from before testing and those from testing 17 days later. The authors conclude that direct consumption of the probiotic VSL3 may not improve parameters of lactose maldigestion without metabolic activation. In its present format, therefore, the test for colonic adaptation cannot be used to demonstrate direct bacterial embedding with VSL3.
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The adhesion properties of Bifidobacterium longum and Bifidobacterium catenulatum strains with an acquired resistance to acid and their ability to competitively exclude Salmonella enterica serovar Typhimurium, Escherichia coli, Listeria monocytogenes, Enterobacter sakazakii, and Clostridium difficile from adhering to human intestinal mucus were evaluated and compared with the results when the same experiments were run with the original acid-sensitive strains. In half of the four studied cases, the acid-resistant derivative showed a greater ability to adhere to human intestinal mucus than the original strain. The ability of bifidobacteria to inhibit pathogen adhesion to mucus was not generally improved by the acquisition of acid resistance. In contrast, three of the four acid-resistant strains showed a greater ability to displace preadhered pathogens than the original strains, especially preadhered Salmonella Typhimurium and C. difficile. Overall, the induction of acid resistance in bifidobacteria could be a strategy when selecting strains with enhanced stability and improved surface properties that favor their potential functionality as probiotics against specific pathogens.
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Dietary fibre consumption is associated with improved glucose homeostasis. In contrast, dietary polyphenols have been suggested to exert both beneficial and detrimental effects on glucose and insulin metabolism. Recently, we reported that a polyphenol-rich insoluble dietary fibre preparation from carob pulp (carob fibre) resulted in lower postprandial acylated ghrelin levels after a liquid meal challenge test compared with a control meal without supplementation. The effects may, however, differ when a different food matrix is used. Thus, we investigated the effects of carob fibre on glucose, insulin and ghrelin responses in healthy humans in combination with a glucose load. In a randomized single-blind cross-over study involving twenty healthy subjects (aged 22-62 years), plasma glucose, total and acylated ghrelin, and serum insulin were repeatedly assessed before and after the ingestion of 200 ml water with 50 g glucose and 0, 5, 10 or 20 g carob fibre over a period of 180 min. The intake of 5 and 10 g carob fibre increased the plasma glucose by 47 % and 64 % (P < 0.001), and serum insulin by 19.9 and 24.8 % (P < 0.001), compared with the control. Plasma acylated ghrelin concentrations did not change significantly after the consumption of carob-enriched glucose solution. Total ghrelin decreased only after 10 g carob fibre (P < 0.001) compared with control. In conclusion, we showed that polyphenol-rich carob fibre, administered within a water-glucose solution, increases postprandial glucose and insulin responses, suggesting a deterioration in glycaemic control.
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To determine whether eating Lactobacillus rhamnosus GG (LGG) in the form of commercially available yoghurt improves clearance of vancomycin-resistant enterococci (VRE). Double-blind, randomised, placebo-controlled trial. Renal ward of Austin Health, a tertiary hospital, Feb-Oct 2005. 27 VRE-positive patients, 14 receiving active treatment and 13 controls. Subjects were randomly assigned to either a treatment group (receiving 100 g daily of yoghurt containing LGG for 4 weeks) or a control group (receiving standard pasteurised yoghurt). Faecal samples were obtained three times at about weekly intervals. Treated patients were tested for VRE again at 8 weeks. Patients in the control group who had failed to clear VRE after 4 weeks were then given LGG-containing yoghurt for 4 weeks, as an open continuation. Number of faecal specimens clear of VRE. Of the 27 patients enrolled, 23 completed the study. Two patients were lost to follow-up, one died and one withdrew. All 11 patients in the treatment group who completed the study cleared VRE. Three subjects reverted to VRE positivity after using antibiotics to which LGG is sensitive, while all others remained negative for at least 4 weeks after trial completion. Twelve control subjects completed the study, of whom one cleared VRE and 11 remained VRE-positive. Eight of these 11 patients were subsequently crossed over to receive LGG yoghurt, and all cleared VRE within 4 weeks. To our knowledge, this is the first description of a probiotic therapy to successfully treat gastrointestinal carriage of VRE in renal patients. Further investigation of the use of LGG in VRE-positive patients is warranted.
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A randomized double blind clinical trial was conducted to assess the efficacy of a special infant formula containing Lactobacillus rhamnosus LMG P-22799 (probiotic: 5 x 10(8) CFU/100mL), inulin (prebiotic: 0.15 g/100mL), dietary fiber (soy polysaccharides: 0.2 g/100mL) and increased amounts of zinc+iron (+0.4 and +0.6 mg/100mL, respectively) as active ingredients for the early dietary management of 58 Indonesian well-nourished male infants aged 3-12 months suffering from acute diarrhea with moderate dehydration. After adequate oral rehydration, the patients were randomly assigned to receive either a low lactose infant formula supplemented with added precooked rice (1.5 g/100mL) with the above active ingredients (study group) or a low lactose infant formula with added precooked rice without the above active ingredient supplement (control group). No antibiotic, anti-secretory drug or antiemetic was given at all. Both study and control groups showed similar outcomes for weight gain and stool weight. The duration of diarrhea was significantly shorter in the study group than in the control group (1.63 versus 2.45 days; p<0.05; for the study and control group respectively). No treatment failure or other side effects were observed during the course of the study. The present study supports the evidence for the efficacy of a special anti-diarrhea infant formula containing probiotic, prebiotic, fiber and iron+zinc after oral rehydration by shortening the duration of infantile diarrhea in developing countries. However, from the results of our study we cannot discern the individual contribution of the active ingredients and also not whether they may act independent from each other or in a synergistic way.
Chapter
Probiotics are nonpathogenic microorganisms that confer a health benefit on the host when administered in adequate amounts. Ample evidence is documented to support the potential application of probiotics for the prevention and treatment of infections. Health benefits of probiotics include prevention of diarrhea, including antibiotic-associated diarrhea and traveler's diarrhea, atopic eczema, dental carries, colorectal cancers, and treatment of inflammatory bowel disease. The cumulative body of scientific evidence that demonstrates the beneficial effects of probiotics on health and disease prevention has made probiotics increasingly important as a part of human nutrition and led to a surge in the demand for probiotics in clinical applications and as functional foods.
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1. 1. Washed suspensions of Bifidobacterium bifidum ferment glucose to approx. 1.5 moles of acetate and 1 mole of lactate. Xylose yields 1 mole of acetate and 1 mole of lactate. 2. 2. Aldolase (EC 4.1.2.7) and glucsoe-6-phosphate dehydrogenase (EC 1.1.1.49) are absent from cell-free extracts of B. bifidum . 3. 3. An enzyme catalysing the conversion of fructose 6-phosphate into acetylphosphate and erythrose 4-phosphate is shown to be present in cell-free extracts: d -fructose-g-phosphate d -erythrose-4-phosphate-lyase (phosphate-acetylating). The trivial name fructose-6-phosphate phosphoketolase may be given. 4. 4. By the action of transaldolase (EC 2.2.1.2.) and transketolase (EC 2.2.1.1) pentose phosphates are formed from fructose 6-phosphate and erythrose 4-phosphate. 5. 5. Pentose phosphates are split by xylulose-5-phosphate phosphoketolase (EC 4.1.2.9) into acetylphosphate and glyceraldehyde 3-phosphate. 6. 6. Lactate dehydrogenase (EC 1.1.1.27) is shown to have an absolute requirement for fructose 1,6-diphosphate. This explains the presence of low amounts of phosphofructokinase (EC 2.7.1.11) in cell-free extracts. 7. 7. The theoretical fermentation balances of glucose and xylose agree with those found experimentally. 8. 8. The results strengthen the previous suggestions that the classification of B. bifidum in the genus Lactobacillus is not justified.
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Aim: To estimate the incidence of secondary lactase deficiency (SLD) in patients with postinfectious irritable bowel syndrome (PIBS) and the value of the small bowel microflora in its development and to elaborate treatment options for SLD. Subjects and methods: One hundred and thirty-eight patients with PIBS, including 112 (81.2%) women and 26 (18.8%) men, were examined. The patients' mean age was 33.9 +/- 9.1 years. The duration of the disease was 2.6 +/- 1.4 years. Lactase deficiency (LD) was diagnosed using the color scale to test biopsy specimens from the duodenal retrobulbar region. The bacterial overgrowth syndrome (BOS) was identified by a 2-hour lactulose (20 ml) hydrogen breath test. Sixty patients with moderate SLD were randomized to 2 groups: 1) 41 patients received basic therapy (mesim forte as one tablet t.i.d., no-spa, 40 mg, t.i.d.) and combined probiotic bifiform (Ferrosan) containing Bifidobacterium longum 107, Enterococcus faecium 107 as one capsule t.i.d. for 14 days. Group 2 patients (n = 19) had basic therapy in combination with placebo. Results: SLD was detected in 59.4% of the patients with PIBS, including 43.5 and 15.9% with moderate and severe forms, respectively. In all cases, SLD was accompanied by BOS in the small bowel lumen, as confirmed by the results of a hydrogen breath test [101 +/- 37 ppm (a normal value of < 20 ppm)]. After a 14-day course of therapy with the combined probiotic bifiform, restoration of eubiosis in the small bowel lumen was achieved in 70.8% of the patients, as shown by the lesser degree of BOS (86.9 +/- 40.9 and 17.4 +/- 6.6 ppm before and after treatment, respectively; p < 0.01) and by normalization of the lactase test (p < 0.01). In the comparative placebo group, 68.4% showed no clear positive changes, SLD and BOS remained. Conclusion: The changes in the small bowel intraluminal microflora, which developed after prior intestinal infection, played a great role in the development of SLD. Bifiform belongs to the currently available probiotics and may be recommended to correct SLD in patients with PIBS resulting from the impaired microbiota of the small bowel and to prevent BOS.
Article
Aim: To identify micronutrient deficiencies in patients with functional bowel diseases (FBD) and to reveal their correction with functional foods and probiotics. Subjects and methods: The health status was evaluated in 90 patients aged 18 to 67 years with FBD. All the patients were randomized into 3 groups according to the treatment regimen. Group 1 took Amaltea goat's milk 200 ml/day during basic therapy; Group 2 received multispecies and multistrain RioFlora Balance probiotics in addition to the above components; Group 3 (a control group) had traditional basic dietary therapy. All the groups continued their treatment for 14 days. Results: The performed examinations have demonstrated that diet-based treatment fortified with goat's milk and multispecies probiotics makes it possible to more promptly achieve remission and to level off clinical manifestations than in the control group. The patients using multispecies probiotics versus the control group showed a reduction in fat-soluble vitamin deficiencies and a considerable improvement in quality of life. Conclusion: FBD lacks a specific clinical picture and may be masked as lactase deficiency, which commonly leads to noticeable limitations in patients' diet and favors the development of vitamin deficiency. Of particular concern is the development of vitamin D deficiency in young patients, which may result in the early development of osteoporosis in the future. To specify the composition of enzymes in the patients gives grounds to refuse restricted diets, and the dietary addition of functional foods (goat's milk fortified with vitamins and minerals), particularly in combination with multistrain probiotics, produces a pronounced clinical effect and eliminates fat-soluble vitamin deficiencies.
Article
Objective To determine whether the beneficial effects of yogurt are dependent on the viability of lactic bacteria and exclusive to fresh yogurt, by comparison with the effects of yogurt that is pasteurized after fermentation. Material and method Using a double-blind design in a healthy adult population over 75 days, we compared the effects of fresh and pasteurized yogurt on microbiological (presence of viable bacteria in yogurt and DNA detection in feces) and immunological (nephelometry, hematometry, and flow cytometry) parameters. A questionnaire was used to assess gastrointestinal comfort. Differences in lactose absorption after ingestion of fresh or pasteurized yogurt were determined by breath hydrogen analysis. Results There were no significant differences in the results obtained for microbiological or immunological parameters, gastrointestinal comfort, or lactose test between the two types of yoghourt ingested. Lactobacillus delbrueckii ssp. bulgaricus (L. bulgaricus) was isolated in 0.7% of the fecal samples analyzed. Streptococcus thermophilus was not found in any sample. DNA from lactic bacteria was detected in only 12.5% of the samples analyzed. Conclusion Transit through the gastrointestinal tract affects survival of L. bulgaricus and S. thermophilus. No differences were found in the immunological parameters, gastrointestinal comfort, or lactose overload after intake of fresh or pasteurized yogurt.
Article
Aim of the study In a double-blind, randomized, controlled, multicentric study, the study compared the efficacy of a specific adapted formula (lactose-free, high-mineral, low-osmolarity formula, containing rice and pectin fortified with Saccharomyces boulardii) in the management of infants with acute diarrhea with a standard formula used to feed healthy infants from birth. Methodology Seventy infants with an average age of 163 days ± 11.7 suffering from acute diarrhea with an average of 6.6 ± 0.4 stools per day received, after randomization, either a standard (control) formula (n = 36) or an adapted lactose-free formula fortified with S. boulardii (26 mg/100 ml; n = 34). The duration of the diarrhea was defined as the time needed until the occurrence of the first normal stool after the last liquid stool. Results At inclusion, the age, weight, and number of stools per day were the same in the two groups. There were 15 infants with rotavirus in the treated group and 13 in the control group. The duration of the diarrhea from time of inclusion was significantly reduced in the treated group (35.4 ± 3.7 h) versus the control group (67.1 ± 5 h; p < 0.001), In both groups, with or without rotavirus, the duration of diarrhea did not depend on the presence or absence of rotavirus but only on the treatment. The average daily weight gain was significantly higher in the treated group compared with the control group (74.2 ± 26.4 g versus 23.7 ± 6.7 g; p < 0.05). The oral rehydration solution consumption was, however, higher in the control group than in the treated group; the consumption of formula was higher in the treated group, but these differences were not significant. The number of stools as of Day 4 remained significantly higher in the control group than in the treated group. After 6.5 days, almost no S. boulardii was found in the stools. Conclusion In moderately dehydrated infants (<10 %), the use of a specially designed formula, containing S. boulardii (Novalac AD+/Diarinova+), significantly shortens the duration of diarrhea and allows quicker weight regain than a standard formula.
Article
Lactose intolerance results in gastrointestinal discomfort and the malabsorption of certain nutrients, such as calcium. The replacement of milk with low-lactose and probiotic-enriched dairy products is an effective strategy of mitigating the symptoms of lactose intolerance. Lactobacillus rhamnosus HN001 (HN001) is a safe, immunity-stimulating probiotic. We have developed a process to increase the hydrolysis of lactose and HN001 growth in yogurt versus β-galactosidase (βG) concentration and enzymatic hydrolysis time (EHT) before bacterial fermentation. The objective of this study was to optimize the conditions by which yogurt is processed as a function of βG and EHT using a multifactorial design, with lactose content, HN001 growth, process time, and sensory quality as dependent variables. Further, the shelf life of the optimized yogurt was evaluated. In the optimization study, polynomials explained the dependent variables. Based on Pearson correlation coefficients, HN001 growth correlated positively with the hydrolysis of lactose. However, low lactose content and high HN001 count increased the fermentation time and lowered the sensory quality. The optimized conditions-using polynomials to obtain yogurt with >1 × 10(7) cfu of HN001/mL, <10 g of lactose/L, and a minimum overall sensory quality of 7 on the Karlsruhe scale-yielded a theoretical value of 910 neutral lactose units/kg for βG and 2.3h for EHT, which were validated in an industrial-scale assay. Based on a shelf-life study at 3 temperatures, the hydrolysis of lactose and the growth of HN001 continue during storage. Arrhenius equations were developed for the variables in the shelf-life study. Our results demonstrate that it is feasible to develop a low-lactose yogurt to which HN001 has been added for lactose-intolerant persons who wish to strengthen their immune system.
Article
Enterotoxigenic Bacteroides fragilis (ETBF) strains have been suggested to be associated with acute and persistent diarrheal disease, inflammatory bowel disease and colorectal cancer, although further epidemiological studies are needed for clarification. Here, a pilot study was performed to examine the effect of the oral administration of yogurt supplemented with a probiotic strain on the cell numbers of fecal ETBF in a healthy population. Among 420 healthy adults, 38 subjects were found to be ETBF carriers, giving a prevalence of approximately 9%. Among them, 32 subjects were enrolled in an open, randomized, parallel-group study to ingest yogurt supplemented with a probiotic strain, Bifidobacterium longum BB536 (BB536Y group), for 8 weeks, with milk provided to the control group (milk group). The cell numbers of ETBF and the dominant species of the B. fragilis group were measured by a quantitative PCR method. Compared with the baseline values, there was a significant decrease in the cell number of ETBF at week 8 in the BB536Y group but not in the milk group. Linear mixed models analysis for longitudinal data revealed a significant difference in the changes of ETBF cell number between the two groups during the intervention phase. These results imply the potential of probiotic yogurt for eliminating ETBF in the microbiota, but its clinical significance needs to be evaluated in the future. This is the first report of a possible effect of probiotic intake on ETBF in the microbiota.
Article
In a double-blind, randomized, controlled, multicentric study, the study compared the efficacy of a specific adapted formula (lactose-free, high-mineral, low-osmolarity formula, containing rice and pectin fortified with Saccharomyces boulardii) in the management of infants with acute diarrhea with a standard formula used to feed healthy infants from birth. Seventy infants with an average age of 163 days+/-11.7 suffering from acute diarrhea with an average of 6.6+/-0.4 stools per day received, after randomization, either a standard (control) formula (n=36) or an adapted lactose-free formula fortified with S. boulardii (26mg/100ml; n=34). The duration of the diarrhea was defined as the time needed until the occurrence of the first normal stool after the last liquid stool. At inclusion, the age, weight, and number of stools per day were the same in the two groups. There were 15 infants with rotavirus in the treated group and 13 in the control group. The duration of the diarrhea from time of inclusion was significantly reduced in the treated group (35.4+/-3.7h) versus the control group (67.1+/-5h; p<0.001), In both groups, with or without rotavirus, the duration of diarrhea did not depend on the presence or absence of rotavirus but only on the treatment. The average daily weight gain was significantly higher in the treated group compared with the control group (74.2+/-26.4g versus 23.7+/-6.7g; p<0.05). The oral rehydration solution consumption was, however, higher in the control group than in the treated group; the consumption of formula was higher in the treated group, but these differences were not significant. The number of stools as of Day 4 remained significantly higher in the control group than in the treated group. After 6.5 days, almost no S. boulardii was found in the stools. In moderately dehydrated infants (<10 %), the use of a specially designed formula, containing S. boulardii (Novalac AD+/Diarinova+), significantly shortens the duration of diarrhea and allows quicker weight regain than a standard formula.
Article
In human trials, Bifidobacterium longum BB536 alleviates subjective symptoms of Japanese cedar pollinosis, an IgE-mediated type I allergy caused by exposure to Japanese cedar, and significantly suppresses the increase of plasma thymus- and activation-regulated chemokine (TARC) associated with pollen dispersion. In the present study, we investigated the suppressive effects of BB536 on the production of T helper type 2 (Th2)-attracting chemokines, such as TARC and macrophage-derived chemokine (MDC), together with the mechanisms of their production. Murine splenocytes were cultured with heat-killed BB536, and the levels of Th2-attracting chemokines in the supernatants were measured. TARC and MDC were produced in cultures without stimulation, and the production was significantly suppressed by BB536. These chemokines were produced by antigen-presenting cells (APCs) of splenocytes stimulated with an anti-CD40 antibody. Furthermore, TARC production was induced with granulocyte macrophage colony-stimulating factor that was produced by T cells and dendritic cells. BB536 suppressed MDC production induced with the anti-CD40 antibody by APCs from the spleen, mesenteric lymph nodes (MLNs) and Peyer's patches, and it suppressed TARC production by APCs from the spleen and MLNs. These results indicate that BB536 suppresses the production of Th2-attracting chemokines induced by the T cell-APC interaction, suggesting a novel mechanism for alleviating symptoms of allergic disorders by probiotics.
Article
To determine whether the beneficial effects of yogurt are dependent on the viability of lactic bacteria and exclusive to fresh yogurt, by comparison with the effects of yogurt that is pasteurized after fermentation. Using a double-blind design in a healthy adult population over 75 days, we compared the effects of fresh and pasteurized yogurt on microbiological (presence of viable bacteria in yogurt and DNA detection in feces) and immunological (nephelometry, hematometry, and flow cytometry) parameters. A questionnaire was used to assess gastrointestinal comfort. Differences in lactose absorption after ingestion of fresh or pasteurized yogurt were determined by breath hydrogen analysis. There were no significant differences in the results obtained for microbiological or immunological parameters, gastrointestinal comfort, or lactose test between the two types of yogurt ingested. Lactobacillus delbrueckii ssp. bulgaricus (L. bulgaricus) was isolated in 0.7% of the fecal samples analyzed. Streptococcus thermophilus was not found in any sample. DNA from lactic bacteria was detected in only 12.5% of the samples analyzed. Transit through the gastrointestinal tract affects survival of L. bulgaricus and S. thermophilus. No differences were found in the immunological parameters, gastrointestinal comfort, or lactose overload after intake of fresh or pasteurized yogurt.
Article
The effect of nonfermented dairy products containing yogurt or acidophilus cultures on lactose utilization by lactose-maldigesting humans was investigated. Yogurt and acidophilus milk containing 10(7) or 10(8) of Streptococcus thermophilus and Lactobacillus bulgaricus, or Lactobacillus acidophilus, respectively, were prepared using commercially processed 2% low fat milk. Immediately following inoculation, products were refrigerated. Lactose maldigestion was monitored by measuring breath hydrogen excretion at hourly intervals for 8 h following consumption of 400 ml of each test meal containing approximately 20 g of lactose. The yogurt milk containing 10(8) cfu/ml was shown to contain significant concentrations of microbial beta-galactosidase (EC 3.2.1.23; approximately 3 U/ml), which remained stable for at least 14 d at refrigerator temperatures. Breath hydrogen peaks were delayed and significantly lower (approximately 20 ppm at 5 to 7 h) than control values (approximately 70 ppm at 4 h), and intolerance symptoms were eliminated in all subjects. Yogurt milk containing 10(7) cfu/ml demonstrated intermediate breath hydrogen values and was marginally significantly different from control values. Lactobacillus acidophilus strains with varying resistance to bile and total beta-galactosidase-producing potential were also tested. Only one strain, LA-1, which demonstrated low bile resistance and intermediate beta-galactosidase activity, was capable of significantly decreasing breath hydrogen values when 10(8) cfu/ml of milk was consumed.
Article
The survival of four strains of lactic acid bacteria in human gastric juice, in vivo and in vitro, and in buffered saline, pH 1 to 5, has been investigated. The strains studied include two Lactobacillus acidophilus strains, Lactobacillus bulgaricus, and Streptococcus thermophilus. In addition, the adhesion of these strains to freshly collected human and pig small intestinal cells and to pig large intestinal cells has been studied and the effect of milk on both survival and adhesion tested. As a result of these investigations, an in vitro test system for screening potential cultures for use as human dietary adjuncts can be developed. The ability to survive in gastric juice and to adhere varied significantly for the strains tested; L. acidophilus ADH survived and adhered better than the others while S. thermophilus survived and adhered poorly. For all strains, both survival and adhesion was enhanced by milk. As all strains adhered to some extent to both human and pig intestinal cells, the adhesion mechanism is probably a nonspecific attachment as opposed to other reported specific Lactobacillus adhesion to gastric tissue. From the survival and adhesion data it seems feasible to obtain elevated levels of viable Lactobacillus sp. in human intestine by careful selection of the bacterial strains ingested. Furthermore, the in vitro methods used here should be valuable to screen potential strains. The data presented here can then be correlated with human in vivo studies monitoring the beneficial effect of ingestion of these Lactobacillus.