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Influence of probiotic supplementation on climacteric symptoms in menopausal women-A mini review

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Abstract

Menopause (MP) is a natural physiological event of woman's life and is defined as the absence of menstrual periods for at least twelve months and loss of function of ovarian. The common symptoms of MP are irregular vaginal bleeding, hot flushes especially in head and chest, night sweats, insomnia, vaginal and urinary symptoms, cognitive dysfunction, increased cancer risk, osteopenia, high blood pressure, diabetes, and cardiovascular diseases. Microbiome has been associated with several health benefits. Probiotic supplementation helps to enhance the quality of microbiome thereby confers the health benefits to the host system. The microbiome, hormone (estrogen) changes, and probiotic intervention are related to the health status of the female reproductive system. The vaginal microbiome (VM) play a critical role in female reproductive health and MP, which can be greatly influenced by probiotics, and other medicine especially antibiotics and hormone therapy. The role of VM in supporting vaginal health is not clear and debatable. Understanding the role of vaginal Lactobacillus could expose the pathogenesis of vaginal dysbiosis, which helps to improve diagnostic and therapeutic strategies for several dysbiosis associated health issues and menopause-related symptoms. Recent studies suggested that the intervention of probiotic preparation with or without nutraceutical formulation (mostly with isoflavones) improve the health status of menopausal women. The mechanism of probiotics mediated health improvement in menopausal women is not yet described clearly. Several controversies are there on the link between probiotic, gut microbiota, vaginal microbiota, and estrogen deficit. The present review summarizes the influence of probiotic supplementation on climacteric symptoms in menopausal women. The literature search was made in Scopus, Google Scholar, PubMed using the keywords "probiotics" and "menopause". The documents were carefully checked for the relevance to the current manuscript, and the selection was made without any restriction in the year of publication.
INFLUENCE OF PROBIOTIC SUPPLEMENTATION ON CLIMACTERIC SYMPTOMS IN
MENOPAUSAL WOMEN-A MINI REVIEW
Review Article
BHAGAVATHI SUNDARAM SIVAMARUTHI, PERIYANAINA KESIKA, CHAIYAVAT CHAIYASUT
Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200,
Thailand
Email: chaiyavat@gmail.com
*
Received: 21 Feb 2018, Revised and Accepted: 04 Sep 2018
ABSTRACT
Menopause (MP) is a natural physiological event of woman’s life and is defined as the absence of menstrual periods for at least twelve months and
loss of function of ovarian. The common symptoms of MP are irregular vaginal bleeding, hot flushes especially in head and chest, night sweats,
insomnia, vaginal and urinary symptoms, cognitive dysfunction, increased cancer risk, osteopenia, high blood pressure, diabetes, and cardiovascular
diseases. Microbiome has been associated with several health benefits. Probiotic supplementation helps to enhance the quality of microbiome
thereby confers the health benefits to the host system. The microbiome, hormone (estrogen) changes, and probiotic intervention are related to the
health status of the female reproductive system. The vaginal microbiome (VM) play a critical role in female reproductive health and MP, which can
be greatly influenced by probiotics, and other medicine especially antibiotics and hormone therapy. The role of VM in supporting vaginal health is
not clear and debatable. Understanding the role of vaginal Lactobacillus could expose the pathogenesis of vaginal dysbiosis, which helps to improve
diagnostic and therapeutic strategies for several dysbiosis associated health issues and menopause-related symptoms. Recent studies suggested
that the intervention of probiotic preparation with or without nutraceutical formulation (mostly with isoflavones) improve the health status of
menopausal women. The mechanism of probiotics mediated health improvement in menopausal women is not yet described clearly. Several
controversies are there on the link between probiotic, gut microbiota, vaginal microbiota, and estrogen deficit. The present review summarizes the
influence of probiotic supplementation on climacteric symptoms in menopausal women. The literature search was made in Scopus, Google Scholar,
PubMed using the keywords “probiotics” and “menopause”. The documents were carefully checked for the relevance to the current manuscript, and
the selection was made without any restriction in the year of publication.
Keywords: Probiotics, Estrogen, Menopause, Vaginal microbiome, Climacteric symptoms
© 2018 The Authors. Published by I nnovare Academic Sciences Pvt Ltd. This is an open ac cess article u nder the CC BY license (http://creativecommons.org/licenses/by/4. 0/)
DOI: http://dx.doi.org/10.22 159/ijap.2018v10i6.29156
INTRODUCTION
Menopause (MP) is a natural physiological event of woman’s life and
is defined as the absence of menstrual periods for at least twelve
months and loss of function of ovarian. MP is not a rapid biological
event but is a relatively slow biological process. The age of MP varies
(46-52 y) among the people, which greatly depends on the
socioeconomic status, personal health care, and food habits. There is
no unswerving test to predict the onset of MP. Moreover, MP can’t be
predictable with the time of initial mensural period. The symptoms
and the experience of the perimenopausal transition period differ
for each woman [1, 2].
The common symptoms of MP are irregular vaginal bleeding, hot
flushes especially in head and chest (about 85% of woman
experiencing the hot flushes), night sweats, insomnia, vaginal
symptoms (dryness, irritation, dyspareunia, and infections), urinary
symptoms (frequent urination, urinary incontinence), cognitive
dysfunction, physical changes, restlessness, muscle and joint pain,
and MP also associated with increased cancer risk, osteopenia, high
blood pressure, diabetes, and cardiovascular diseases. The
symptoms are not common to all woman. Some people do not feel
any or some of the symptoms during their MP [3-5].
The hormone changes or deficiency is the main cause of MP. Thus,
hormone replacement therapy (HRT) is the primary treatment
method to nullify or reduce the MP symptoms and to prevent the
development of heart diseases and osteoporosis. The mode of
administration, dose, and combination of the hormone are the key
factors that affect the efficiency of the treatment and help to reduce
the adverse side effects. Oral administration therapy was less
effective compared to transdermal estrogen therapy [5].
Though HRT has beneficial effects, some of the controversial side
effects were reported. The contentious HRT increased the risk of
cancer development, thromboembolism, and cardiovascular
consequences. There was no general treatment procedure, and HRT
should be customized for each woman [6-8]. Moreover, many
women seek alternative treatments other than HRT, when there are
several health risks and uncertainty on reported benefits of HRT [6].
The serotonin-norepinephrine reuptake inhibitor and selective
serotonin reuptake inhibitor were used to treat the hot flushes. These
inhibitors help to improve vasomotor symptoms and sleep quality [9].
The phytoestrogens (PE) are phenolic compounds present in plants with
mammalian estrogenic activity. PE binds to estrogen receptors and
endorses either agonist or antagonist functions [10].
Probiotics are living microbes when administered in an adequate
amount, confers beneficial effects in the host health. Commonly,
lactic acid bacteria (LAB) are considered as probiotics, and
beneficial impact of the probiotics is highly associated with an
individual’s health status, age, and lifestyle [11]. Probiotic strains
were reported for several health aids and applications [11-23].
Changes in the gut microbiome influence the several physiological
and biological process. The microbiome changes during estrogen
deficiency, characteristics of MP, critically affects the MP symptoms
and facilitates the development of illness like inflammatory diseases.
The supplementation of probiotics significantly influences the gut
microbiome of an individual [24].
Since the alternative therapies for MP with phytoestrogen and herbal
products have been detailed previously by Borrelli and Ernst [25]. The
current review narrates the probiotic based alternative treatment for MP
and its impact on climacteric symptoms of menopausal women. The
literature search was made in Scopus, Google Scholar, PubMed using the
keywords “probiotics” and “menopause”. The documents were carefully
checked for the relevance to the current review, and the selection was
made without any restriction in the year of publication.
Microbiome of women
The microbiome is unique for every individual to some extent. The
gut microbiome plays an essential role in almost all biological events
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Chaiyas ut et al.
Int J App Pharm, Vol 10, Issue 6, 2018, 43-46
44
and cognitive functions. Subsequently, microbiome might possibly
have a role in making healthy offspring moreover in persuading the
general health status of an individual. The microbiome of a woman
differs from man. The vaginal microbiome (VM) is influenced by
several factors like menses, vaginal discharge, and sperm. VM
greatly influences the health status of offspring. Lactobacillus spp.
(especially Lactobacillus crispatus, L. gasseri, L. iners, and L. jensenii)
are the dominant bacterial species present in VM of healthy women,
and any alteration in the composition of VM leads to several adverse
conditions like preterm birth, infertility, inflammatory and high risk
of sexually transmitted diseases. Finally, it affects the quality of life
[26-28]. Atopobium, Prevotella, Peptoniphilus, Dialister, Megasphaera,
Gardnerella are some of the leading non-Lactobacillus microbial
community residing in the urogenital tract of women [26].
The role of VM in sustaining vaginal health is not clear and
controversial. Understanding the role of vaginal Lactobacillus could
uncover the pathogenesis of vaginal dysbiosis, which helps to refine
diagnostic and therapeutic strategies for several dysbiosis
associated health issues and to diminish or manage the menopause-
related symptoms [29].
The VM composition differs in post-menopausal women when
compared with premenopausal women, particularity the Lactobacillus
content. The VM is extremely affected by the HRT [30-32]. Menopause
decreases a load of Lactobacillus in VM, and also affects the diversity of
microbes. Age, menstruation, hormone levels, intercourse, other lifestyle
habits like smoking, hygiene have an impact on the bacterial community
of a woman [33, 34]. The description of the VM in different stages in a
woman’s life is multifaceted [35].
The dramatic change in VM could be noted at the time of puberty
when hormone (estrogen) and glycogen levels increase [36]. The
increased level of estrogen and glycogen facilitates or promote the
growth of Lactobacillus, and it is known that the high level of
glycogen is maintained during the fertile period of a woman and
further decline in its level during menopause. Lactobacillus protects
the vaginal area from pathogenic colonization by creating the acidic
microenvironment, but an overgrowth of microaerophilic bacteria
cause distress, itching, and foul-smelling discharge [37, 38]. Several
studies suggested that diversity of Lactobacillus spp. and its richness
has been decreased during or after menopause [36].
Probiotics and menopause
The postmenopausal women with the significantly high Nugent
score (between 4 to 6) were screened and selected for the study.
The Nugent scoring is an unbiased, semi-quantitative evaluation
(microbial content) of vaginal secretion. The subjects were
randomly divided into two groups and supplemented with either
probiotic (lyophilized L. reuteri RC-14 and L. rhamnosus GR-1 along
with sodium alginate; 2.5 × 109
About 2044 women (40-65 y) were supplemented with a mixture of
soybean extract (contains genistein and daidzein; 30 mg each), L.
sporogenes (500 million spores), 5 µg of vitamin D and 141 mg of
calcium for six months and the changes in climacteric symptoms
were assessed by questionnaire. The changes were noted by
gynecologists and self-assessment. The results suggested that the
soybean extract with probiotic supplementation significantly
improved the climacteric symptoms and sexuality [40].
CFU each) or placebo (lactose) for
fourteen days. After the intervention, vaginal swabs were collected
and further subjected to Nugent scoring. The results showed that
about 60% of women who received probiotic supplement had a
reduction in their Nugent score from the baseline when compared to
that of the placebo group. About three grade reduction was observed
among the probiotic group, which indicates the significant
improvement in the host health. The results suggested that the oral
supplementation of probiotics help to restore the normal flora of the
vagina [39].
A double-blind, randomized, placebo-controlled study was conducted
with postmenopausal women with vaginal atrophy symptoms to know
the impact of supplementation of Gynoflor® vaginal tablets (a blend of L.
acidophilus KS400 and estriol 0.03 mg). The supplement was provided
for 12 d for initial treatment and 2 tablets per week for 12 w to maintain
the effects. Vaginal maturation index (VMI) was changed positively in the
treatment group (35.2%) when compared to placebo (9.9%). The study
proved that Gynoflor® is effective in reducing vaginal atrophy
symptoms and improved the VMI [41].
The ovariectomized mouse was supplemented with L. reuteri ATCC
PTA 6475 via oral gavage (1×109 CFU/ml trice per day) and through
drinking water (1.5×108 CFU/ml) for four weeks. The probiotic
supplementation significantly reduced the bone resorption and
osteoclastogenesis. The increase in CD4+
Postmenopausal breast cancer patients receiving chemotherapy (with
vaginal atrophy and altered microbiota) were treated with probiotics (a
mixture of 1 × 10
T-lymphocytes has been
reduced and thereby L. reuteri directly repressed osteoclastogenesis,
and probiotic intervention altered the gut microbiome of the
experimental mouse, especially Clostridiales was increased in the
treated mouse. The results suggested that supplementation of L.
reuteri suppress the post-menopausal bone loss [42].
Symptomatic postmenopausal women were treated with probiotic
(B. breve B3 ATCC 15700; 1 trillion CFU) and nutraceutical formula
(80 mg of soy isoflavones, 50 mg of Angelica sinensis extract, 200 mg
of Morus alba leaf extract, and 56.25 mg of magnesium) for 4 w or
probiotic and placebo or vice versa. The menopause rating scale
(MRS) score was reduced, and a significant reduction in
triglycerides, LDL, and increase in HDL was observed in the
probiotic-treated group. The intervention of probiotic and
nutraceutical formula improved the MRS score and risk of
cardiovascular diseases [43]. Peri-menopausal women subjects were
supplemented with isoflavones and probiotics (34 mg/d isoflavones;
probiotic combinations and dosage were not revealed in the study)
for 12 w. The hot flush frequency (HFF), hot flush intensity, self-
reported HFF, and hot flush severity, plasma lipids and blood
pressure were measured. The results suggested that moderate
intervention of red clover isoflavone and probiotics significantly
reduced the self-reported vasomotor symptoms [44].
9 CFU of L. crispatus LbV 88, 1 × 109CFU of L. rhamnosus
LbV 96, 0.2 × 109 CFU of L. ensenii LbV 116 and 0.3 × 109
CFU of L. gasseri
LbV 150N) twice daily for two weeks. After treatment, changes in the
vaginal microbiota and Nugent score were reexamined and compared
with baseline. The results suggested that probiotic intervention
significantly reduced the Nugent score in the probiotic-treated group
when compared to that of the placebo. The vaginal microbiota also
altered positively in probiotic-treated women. The study proved that
probiotic supplementation helps to regain the normal vaginal flora in
women receiving chemotherapy for cancer [45].
Table 1: The influence of probiotic supplementation on the consequences of menopause
S.
No.
Subjects
Intervention
Dose
Duration
Findings
1
Postmenopausal women
(72 subjects)
L. rhamnosus GR-1 and L.
reuteri
RC-14
2.5 × 109
14 d
CFU
each
Nugent score was reduced, and
health status improved
significantly.
2
Women (2044 subjects)
Soy extract (genistein and
daidzein; 30 mg each),
L
.
sporogenes,
calcium (141
mg) and vitamin D (5 µg).
500 million
spores
6 mo
Improved the climacteric
symptoms and sexuality
3
Postmenopausal women
with vaginal atrophy
L. acidophilus KS400 and
estriol 0.03 mg (Gynoflor®)
-
Single tablet for
12 d followed by
Gynoflor ® improved VMI after
the 12-day initial therapy, and
Chaiyas ut et al.
Int J App Pharm, Vol 10, Issue 6, 2018, 43-46
45
symptoms
2 tablets per
week for 12 w
two tablets weekly was
appropriate to prevent the
relapse.
4
Balb/c mice
ovariectomized MP
model
L. reuteri ATCC PTA 6475
1×10
CFU/ml via oral
gavage.
9
1.5 × 10
CFU/ml in
drinking water.
8
Trice per day for
4 w
Significantly protected mice from
bone resorption and loss.
Suppressed the CD4+T-
lymphocytes increase.
5
Postmenopausal women
(43 subjects)
B. breve B3 ATCC 15700,
nutraceutic preparation
1 trillion CFU
4 w
Menopause rating scale score
was reduced. Reduced the risk of
cardiovascular diseases
6
Peri-menopausal
women (62 subjects)
A mixture of probiotic LAB
34 mg/d
isoflavones and
probiotics
12 w
Suppressed the self-reported
vasomotor symptoms
7
Postmenopausal breast
cancer patients
L. crispatus LbV 88, L.
rhamnosus
LbV 96,
L. ensenii
LbV 116 and
L. gasseri
LbV
150N
2.5 × 109
2 w
CFU in
total
Reduction in Nugent score,
Improved the vaginal microbiota
CONCLUSION
Generally, probiotic supplementation improved the health status of
gastrointestinal (GI) system, and it has been proved by several
clinical and human studies. Recently, the health benefits of probiotic
were beyond the GI and its associated system such as anti-aging,
anti-inflammation, improved the cognitive decline, anti-
hypertension, anti-hypercholesterolemia, etc. The role of probiotic
to manage the postmenopausal disorders and to control the
climacteric symptoms is the recent subject of interest for several
researchers [46]. The well-planned, placebo-controlled clinical
studies on the health benefits of probiotics in menopausal women
are very limited (table 1). The reports clearly suggested that the
intervention of optimum level of probiotic supplementation along
with some nutraceuticals improved the climacteric symptoms and
vaginal health status by altering the microbiota. Several studies
recommend the isoflavones supplementation to treat symptoms of
menopause. The combination of an enzyme producing probiotics
such as β-glucosidase producing probiotics with soy extract help to
improve the symptoms of menopause via producing bioactive
isoflavone aglycones [47]. A study reported that the fermentation of
soy milk with L. acidophilus does not significantly increase the
absorption of Ca in osteopenic post-menopausal women [48]. Some
controversial reports stated that the supplementation of soy-
isoflavone does not influence the microbiota of menopausal women
[49]. The mechanism of probiotics mediated health improvement in
menopausal women is not yet explained clearly. The connection
between probiotic, gut microbiota, vaginal microbiota, and hormone
(estrogen) deficit are the subject of several controversies. Further
detailed well-planned intensive studies are required to explore the
mysteries between the probiotics and menopause.
ACKNOWLEDGMENT
BSS and PK gratefully acknowledge the CMU Post-Doctoral
Fellowship, and Faculty of Pharmacy, Chiang Mai University for the
support. All the authors wish to thank CMU research grant for the
necessary support.
AUTHORS CONTRIBUTIONS
BSS and PK contributed to conception and design, acquisition,
manuscript preparation, and critical revision of the manuscript. CC
involved in the review and finalization of the manuscript. All the
authors agree with the content of the manuscript.
CONFLICT OF INTERESTS
The authors declare that there is no conflict of interests
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... Preliminary evidence from a mini review suggested that probiotics are beneficial for reducing menopausal symptoms and enhancing vaginal health [5]. However, this review was limited by the low number of key words used, databases searched, and the lack of meta-analysis. ...
... Menopausal symptoms are thought to arise from both deficiencies and fluctuations in oestrogen, therefore therapies which target oestrogen balance may reduce the impact of negative symptoms which present during the menopause transition. While several studies have assessed the effects of probiotics on symptoms known to occur during the menopause transition, to date, no meta-analytic quantification of these effects has been presented [5]. ...
... A key strength of this review is that it enhances work conducted by Sivamaruthi et al. [5] who conducted literature searches using the keywords "probiotics" and "menopause" across Google Scholar, Scopus, and PubMed. The present review used a wide variety of key words and terms relating to probiotics, menopause, and menopausal symptoms, and a wider range of databases. ...
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Examining the impact of probiotics on menopause-specific health outcomes.
... Probiotics are referred to as live non-pathogenic good bacteria or microorganisms that exhibit beneficial effects on the host's health when administered appropriately (Sivamaruthi et al. 2018). Several studies have proved the health benefits of probiotics against various gastrointestinal tract disturbances (Sivamaruthi et al. 2019), such as antibiotic-associated diarrhea, traveler's diarrhea (Demers et al. 2014), functional constipation (Chmielewska and Szajewska 2010), radiation-induced diarrhea (Demers et al. 2014), etc. ...
... Soybean also contains lunasin, a polypeptide that can inhibit the expression of COX-2 enzyme in cryptic epithelial cells of the distal colon in mice that have been induced with carcinogen [4]. Soybean extract combined with probiotics significantly improves women's climacteric symptoms and sexuality [5]. The quality of spermatogenesis in newborn Wistar mice will reduce when their mothers are administered soybean tempeh ethanol extract from preovulation until the weaning season [6]. ...
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... Probiotic preparations with or without pharmaceutical formulations have been shown to enhance the health of menopausal women [37]. Therefore, probiotic bacteria may benefit human health and maintain a healthy microbial gut [38]. ...
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Hypercholesterolemia is a key factor in the progression of atherosclerosis and cardiovascular disease (CVD). CVD is a significant public health concern with a high death rate. Some of the main factors linked to CVD include genetics and lifestyle. Dyslipidemia has been one of the factors related to the onset of several CVD-related diseases. Several clinicopathological studies have shown a correlation between high cholesterol levels, particularly low-density lipoprotein cholesterol (LDL-c), and CVD development. Probiotics have received a lot of attention for various beneficial effects, especially their ability to reduce blood cholesterol in humans. Probiotics were shown in several investigations to affect hypercholesterolemia by influencing cholesterol biosynthesis. The current review focuses on the human dietary interventions with probiotics and their effects on CVD risk factors and hypercholesterolemia. The outcomes are debatable and consider various parameters such as probiotic strain, dosing frequency, therapeutic response, dietary changes, and so forth. As a result, probiotics have the propensity to become dietary supplements in moderate/severe hypercholesterolemic patients, which significantly reduces the CVD risk.
... Menopause occurs in most women between the ages of 45 and 55, although timing and symptoms can vary depending on the individual. Menopausal symptoms are increasingly recognized as having significant health implications through decreases in estrogen levels and lower estrogen exposure [1,2]. Major symptoms include vasomotor issues (hot flushes and/or night sweats), sleep disruption, vaginal symptoms (dryness and/or infections), depression and anxiety, cognitive changes (declines in memory and concentration), and sexual dysfunction [3,4]. ...
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This study evaluated the efficacy of Lactobacillus acidophilus YT1 (MENOLACTO) for alleviating menopausal symptoms. This study was a multi-center, randomized, double-blinded, placebo-controlled clinical trial involving female subjects (ages: 40–60 years) with menopausal symptoms and a Kupperman index (KMI) score ≥ 20. Subjects were administered 1 × 108 CFU/day MENOLACTO or placebo, with the primary endpoint being total KMI score, and the effect of secondary endpoints on alleviating menopausal symptoms according to individual categories of the modified KMI, as well as a quality of life questionnaire (MENQOL questionnaire). After 12 weeks, total KMI scores decreased significantly, demonstrating improved menopausal symptoms relative to placebo along with improved modified KMI scores. Additionally, quality of life, according to the MENQOL questionnaire, significantly improved in all four symptoms—physical, psychosocial, vasomotor, and sexual symptoms. Moreover, we observed no significant difference between the two groups or significant changes in blood follicle-stimulating hormone and estradiol levels or endometrial thickness. These results demonstrated that MENOLACTO alleviated menopausal symptoms without notable side effects and improved quality of life, suggesting its efficacy as an alternative supplement to alleviate menopausal symptoms in women ineligible for hormonal therapy.
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Dental diseases are widespread health problems encountered globally. Tooth decay is one of the most widespread oral health issues globally. Key factors contributing to the development of dental caries include inadequate oral hygiene, the presence of specific carbohydrates in the diet, dental biofilm formation, high levels of cariogenic microbes, reduced salivary flow, insufficient fluoride exposure, gingival recession, genetic predispositions, and neglect of personal dental care. Various preventive strategies have been employed to lower the risk of developing dental caries. Probiotics are live microorganisms that, when taken in appropriate quantities, provide health benefits to the host. They are acknowledged as potential supplementary treatments for various diseases. This manuscript reviews recent research on the role of probiotics in preventing dental caries and explores the potential mechanisms behind their effects. Literature reviews show that regular consumption of probiotic products significantly lowers the risk of dental caries by inhibiting cariogenic bacteria and promoting beneficial microbes in the oral cavity. The beneficial effects of probiotics are likely due to their ability to buffer salivary pH, produce bacteriocins and enzymes (such as dextranase, mutanase, and urease), and compete for adhesion and colonization on tooth surfaces. Additional research is needed to evaluate the effectiveness of long-term probiotic supplementation in controlling dental diseases and to assess how probiotic use during childhood affects the risk of developing caries.
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Personal care products, especially cosmetics, are regularly used all over the world. The used cosmetics are discharged continuously into the environment that affects the ecosystem and human well-being. The chemical and synthetic active compounds in the cosmetics cause some severe allergies and unwanted side effects to the customers. Currently, many customers are aware of the product composition, and they are stringent in product selection. So, cosmetic producers are keen to search for an alternative, and natural active principles for the development and improvisation of the cosmetic products to attain many customers. Phytochemicals are known for several pharmacological and cosmeceutical applications. Fermentation process improved the quality of the active phytochemicals and also facilitates the easy absorption of them by human system. Recently, several research groups are working on the cosmeceutical importance of fermented plant extracts (FPE), particularly on anti-ageing, anti-wrinkle, and whitening property of FPE. The current manuscript is presenting a brief on cosmeceutical importance of FPE.
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Atopic dermatitis (AD) is one of the chronic inflammatory skin diseases characterized by conflicts in epidermal barrier and wired immune response. About 10%-20% of the population is affected by AD, especially infants. Topical application of corticosteroids, antihistamines, and antibiotics are used to treat severe AD condition. Recent studies suggest that disturbance in skin and intestinal microbiota is majorly linked to skin diseases. Probiotics are known for the positive alteration of an individual's microbiome and associated with several health benefits. Clinical studies suggest that probiotic and synbiotic supplementation protect infants from a stringent AD to some extent. Reduction in the risk of AD development upon probiotic supplementation was not observed in all studied populations. Further studies are needed to regularize microbiome of skin and intestine in AD patients that may reduce AD severity. Present review summarizes the outcomes from clinical studies on AD using probiotic as an alternative treatment candidate. © 2018 Asian Pacific Journal of Tropical Biomedicine Produced by Wolters Kluwer-Medknow.
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The composition of gut microflora and its metabolic activity are closely correlated with the host immune system, and the changes in the biometric of the microbiome lead to inflammatory diseases like inflammatory bowel disease. The supplementation of probiotics and synbiotic could indeed manipulate the microflora, which can be an alternative therapy for ulcerative colitis, and Crohn’s disease. Several in vitro, in vivo and clinical studies for the initiation and maintenance of remission in patients with inflammatory bowel disease have been completed. Those studies evaluated the efficacy of many probiotic formulations, especially about VSL#3. Even though the clinical studies proved that almost all the probiotic interventions are safe and bring improvement to patients, some studies are deficient in sample size, proper controls, and follow-ups. This paper summarizes the possible mechanism of inflammatory bowel disease development, probiotics, the clinical outcome of probiotic and synbiotic interventions for ulcerative colitis and Crohn’s disease, as well as the adverse effect of probiotic treatments.
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Background: Due to chemotherapy and estrogen deprivation therapy, genitourinary syndrome of menopause is a common condition in breast cancer patients. We aimed to determine the effect of an orally administered Lactobacillus preparation on the vaginal microbiota in breast cancer patients. Methods: Postmenopausal breast cancer patients receiving chemotherapy, with vaginal atrophy and an intermediate vaginal microbiota (Nugent score 4-6), were either randomized to the intervention group receiving probiotic capsules of 4 Lactobacillus species or to the control group receiving placebo twice daily for 2 weeks. Consecutive vaginal swabs were taken at baseline, 1 day after administration of the last capsule (follow-up 1), and after 1 week (follow-up 2) in 22 patients (11 vs. 11). Results: We observed a positive influence on the vaginal microbiota in 7/11 (63%) women in the intervention group, and 4/11 (36%) women in the control group. There was a shift in Nugent score towards normal microbiota levels in the intervention group (-1.3 at follow-up 1, -0.45 at follow-up 2) and a significant deterioration of the Nugent score in the control group (+0.4 at follow-up 1, +2.5 at follow-up 2). Conclusion: The orally administered Lactobacillus preparation has the potential to improve the vaginal microbiota in women undergoing chemotherapy for breast cancer.
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Sex differences in gut microbiota are acknowledged, and evidence suggests that gut microbiota may have a role in higher incidence and/or severity of autoimmune diseases in females. Additionally, it has been suggested that oral, vaginal, and gut microbiota composition can be regulated by estrogen levels. The association of vaginal microbiota with vulvovaginal atrophy at menopause is well described in the literature. However, the relevance of oral and gut microbiota modulation in the immune system during estrogen deficiency and its effect on inflammatory diseases is not well explored. Estrogen deficiency is a condition that occurs in menopausal women, and it can last approximately 30 years of a woman’s life. The purpose of this mini- review is to highlight the importance of alterations in the oral and gut microbiota during estrogen deficiency and their effect on oral and inflammatory diseases that are associated with menopause. Considering that hormone replacement therapy is not always recommended or sufficient to prevent or treat menopause-related disease, we will also discuss the use of probiotics and prebiotics as an option for the prevention or treatment of these diseases.
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Background Natural estrogen decline leads to vasomotor symptoms (VMS). Hormone therapy alleviates symptoms but increases cancer risk. Effective treatments against VMS with minimal cancer risks are needed. We investigate the effects of a highly bioavailable aglycone rich Red Clover isoflavone treatment to alleviate existing menopausal VMS, assessed for the first time by 24hour ambulatory skin conductance (SC) Methods and results We conducted a parallel, double blind, randomised control trial of 62 peri-menopausal women aged 40–65, reporting ≥ 5 hot flushes/day and follicle stimulating hormone ≥35 IU/L. Participants received either twice daily treatment with bioavailable RC extract (RCE), providing 34 mg/d isoflavones and probiotics, or masked placebo formulation for 12 weeks. The primary outcome was change in daily hot flush frequency (HFF) from baseline to 12 weeks using 24hr SC. Secondary outcomes were change in SC determined hot flush intensity (HFI), self-reported HFF (rHFF) and hot flush severity (rHFS), blood pressure and plasma lipids. A significant decrease in 24hr HFF (P < 0.01) and HFI (P<0.05) was found when comparing change from baseline to 12 months of the RCE (-4.3 HF/24hr, CI -6.8 to -2.3; -12956 μS s⁻¹, CI -20175 to -5737) with placebo (0.79 HF/24hr, CI -1.56 to 3.15; 515 μS s⁻¹, CI -5465 to 6496). rHFF was also significantly reduced (P <0.05)in the RCE (-2.97 HFs/d, CI -4.77 to -1.17) group compared to placebo (0.036 HFs/d, CI -2.42 to 2.49). Other parameters were non-significant. RCE was well tolerated. Conclusion Results suggest that moderate doses of RCE were more effective and superior to placebo in reducing physiological and self-reported VMS. Findings support that objective physiological symptom assessment methods should be used together with self-report measures in future studies on menopausal VMS. Trial registration ClinicalTrials.gov NCT02028702
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ABSTRACT Objective: Oral care cosmetics are essential for all populations and are systematically used to treat oral problems. The chemicals free natural cosmetics are the choice of many people. Thus, this study was aimed to formulate and to assess the natural mouthwash (MW) solution from Lactobacillus fermented Thai medicinal plants juice. Methods: The selected (betel, green tea, clove, black galingale, mangosteen, and noni) plant juices were subjected to Lactobacillus plantarum mediated fermentation. The fermented plant juices (FPJ) were formulated into MW solution with different concentrations of peppermint oil. MW formulations were assessed for physical appearance, stability, and anti-microbial activities. Results: About 2% of peppermint oil in FPJ was found as organoleptically optimum. The pH and refractive indexes of the MWs were not affected during storage and stability assessments. All the FPJ-MWs formulations showed antimicrobial activity against Group A Staphylococcus, and other oral pathogens - Escherichia coli, Streptococcus aureus, and Pseudomonas aeruginosa. Moreover, black galingale, mangosteen, and noni based MW formulas also exhibited anti-candida activity. The MW made from fermented black galingale (Kaempferia parviflora) juice was the most potent antimicrobial formulation with excellent physical stability. Conclusion: The study concluded that fermented plant-herbal juices can be used as natural MW recipe with 2% of peppermint oil to improve the flavor and aroma. The formulations were stable, free of microbial contamination, and also exhibited antimicrobial activity. Further extended stability study and clinical trials are necessary to develop a commercial FPJ-based natural MW recipe.
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Communities of microbiota have been associated with numerous health outcomes, and while much emphasis has been placed on the gastrointestinal niche, there is growing interest in the microbiome specific for female reproductive health and the health of their offspring. The vaginal microbiome plays an essential role not only in health and dysbiosis, but also potentially in successful fertilization and healthy pregnancies. In addition, microbial communities have been isolated from formerly forbidden sterile niches such as the placenta, breast, uterus, and Fallopian tubes, strongly suggesting an additional microbial role in women’s health. A combination of maternally linked prenatal, birth, and postnatal factors, together with environmental and medical interventions, influence early and later life through the microbiome. Here, we review the role of microbes in female health focusing on the vaginal tract and discuss how male and female reproductive microbiomes are intertwined with conception and how mother–child microbial transfer is a key determinant in infant health, and thus the next generation.