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Efficacy of Saccharomyces boulardii for treatment of horses with acute enterocolitis
Abstract
To evaluate the viability of Saccharomyces boulardii after PO administration in clinically normal horses and its efficacy as a treatment for horses with acute enterocolitis.
Prospective study.
5 clinically normal horses and 14 horses with acute enterocolitis.
Feces were collected from 5 clinically normal horses and submitted for microbial culture for 2 days prior to administration of a lyophilized form of S. boulardii (25 or 50 g, PO, q 12 h) for 10 days. Feces were collected for microbial culture 5 and 10 days after treament initiation and 10 days after treatment was discontinued. Fourteen horses with acute enterocolitis were randomly allocated to receive a placebo or S. boulardii (25 g), PO, every 12 hours for 14 days.
S. boulardii was not detected in feces of clinically normal horses. After administration, yeast survived within the gastroinestinal tract but did not permanently colonize it. In horses with acute enterocolitis, the severity and duration of gastrointestinal tract disease during hospitalization were significantly decreased in horses receiving S. boulardii, compared with horses receiving the placebo.
Administration of S. boulardii may help decrease the severity and duration of clinical signs in horses with acute enterocolitis.
... In addition, they carry important amounts of mannan oligosaccharide, a constituent of their cell wall that might be used by bacteria as substrate, possibly favoring the growth of beneficial species of bacteria in the gut. Supplementation with Saccharomyces has been evaluated in horses [70,137], and the strains could be cultured from feces, supporting that the yeasts were viable in horses with colitis [138][139][140]. However, in one study S. boulardii was no longer detectable in the feces ten days after cessation of supplementation [140], suggesting that Saccharomyces is likely to survive the acidic pH of the stomach in horses but may not colonize the gastrointestinal tract permanently. ...
... Supplementation with Saccharomyces has been evaluated in horses [70,137], and the strains could be cultured from feces, supporting that the yeasts were viable in horses with colitis [138][139][140]. However, in one study S. boulardii was no longer detectable in the feces ten days after cessation of supplementation [140], suggesting that Saccharomyces is likely to survive the acidic pH of the stomach in horses but may not colonize the gastrointestinal tract permanently. Some yeast can grow at a pH of three, and some can tolerate and survive in environments with a pH as low as 1.5 [136]. ...
... In horses with enterocolitis, Desrochers et al. found a significant decrease in the duration of diarrhea in horses receiving S. boulardii [140]. However, in a randomized and controlled prospective study using a similar supplement with a larger sample size, supplementation had no significant effect on the clinical outcome (diarrhea, leucopenia, appetite, survival) [139]. ...
Simple Summary
Research on equine gut microbiota has grown and gained significant interest in the last decade. Abnormal alterations in the composition of the gut microbiota are called dysbiosis and have been linked to various gastrointestinal tract diseases and remote organs in human medicine, such as the brain and the lung. Strategies to restore the gut microbiota to prevent and treat such diseases are currently being investigated. This review focuses on the current knowledge regarding gut microbiota dysbiosis and microbiota manipulation techniques in horses.
Abstract
Understanding the importance of intestinal microbiota in horses and the factors influencing its composition have been the focus of many studies over the past few years. Factors such as age, diet, antibiotic administration, and geographic location can affect the gut microbiota. The intra- and inter-individual variability of fecal microbiota in horses complicates its interpretation and has hindered the establishment of a clear definition for dysbiosis. Although a definitive causal relationship between gut dysbiosis in horses and diseases has not been clearly identified, recent research suggests that dysbiosis may play a role in the pathogenesis of various conditions, such as colitis and asthma. Prebiotics, probiotics, and fecal microbiota transplantation to modulate the horse’s gastrointestinal tract may eventually be considered a valuable tool for preventing or treating diseases, such as antibiotic-induced colitis. This article aims to summarize the current knowledge on the importance of intestinal microbiota in horses and factors influencing its composition, and also to review the published literature on methods for detecting dysbiosis while discussing the efficacy of gut microbiota manipulation in horses.
... 1,3,8 Several reports describe the benefits of supplementing feed with probiotics and prebiotics in horses, swine, dogs, and humans. [23][24][25][26][27][28][29][30][31] Thus far, studies describing the beneficial effects of probiotics and prebiotics have not assessed sand clearance from the gastrointestinal tract of horses. Probiotics are living organisms that when ingested exert a beneficial effect beyond nutritional value. ...
... In a recent study of the efficacy of supplementing feed with Saccharomyces boulardii for treatment of acute enterocolitis, probiotic administration decreased the severity and duration of the disease. 26 The study of Desrochers et al 26 supports the use of probiotics as an adjunct to conventional treatments to help modulate inflammation in the large intestine and normalize intestinal motility. ...
... In a recent study of the efficacy of supplementing feed with Saccharomyces boulardii for treatment of acute enterocolitis, probiotic administration decreased the severity and duration of the disease. 26 The study of Desrochers et al 26 supports the use of probiotics as an adjunct to conventional treatments to help modulate inflammation in the large intestine and normalize intestinal motility. ...
... 5 Recent studies have investigated its use in treating GI disease in the zootechnical field and in horses. [6][7][8][9] Although probiotics are used to treat chronic enteropathies (CE) in dogs, the authors could not locate any information in the literature regarding the use of S boulardii in dogs. 1 The current study evaluated the effects of S boulardii in healthy dogs and dogs with CE. The hypothesis was that S boulardii could be administered without any adverse effects and could facilitate the control of CE as an addition to standard therapy. ...
... The study design was extrapolated from a previous study. 6 Preparation and quality control of S boulardii For the study, two galenic formulations were prepared in gelatin-coated capsules. The capsules for the placebo group contained 334 mg maltodextrin. ...
... The median CCECAI score at inclusion (T0) was 8 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) in the S boulardii group and 6.5 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) in the placebo group, with no significant differences between the two groups. ...
Saccharomyces boulardii
is used to treat acute and chronic enteropathies in humans, but to date, no studies have evaluated the use of this yeast in dogs. The current study, a prospective non-randomised, double-blinded, placebo-controlled study, evaluated the effects ofS boulardiiin healthy dogs and dogs with chronic enteropathies (CE). Four healthy dogs and 20 dogs with CE were included. In healthy dogs,S boulardiiwas administered for 10 days. Possible short-term adverse effects were recorded, and quantitative stool cultures for yeasts were performed. In dogs with CE,S boulardiior a placebo was administered in addition to standard treatment protocols. Canine Chronic Enteropathy Clinical Activity Index, abdominal ultrasonography, gastroenteroscopy and histology were performed at the time of diagnosis and after 60 days of treatment. In healthy dogs,S boulardiireached a steady state in five days and was completely eliminated on day 4 after administration. No short-term side effects were seen. Clinical activity index, stool frequency, stool consistency and body condition score improved significantly in dogs with CE receivingS boulardiiversus the placebo. In conclusion,S boulardiican be safely used in dogs with CE and seems to achieve better control of clinical signs than standard therapy alone.
... Moreover, the exact dose required to efficiently colonize the adult equine intestinal tract is still undetermined for the majority of probiotics (Weese, 2003). Most of the studies (Parraga et al., 1997;Kim et al., 2001;Ward et al., 2004;Desrochers et al., 2005) used dosing recommendations given by the product's manufacturer. Assuming that the dosing can be embraced from those used in human medicine, dosing recommendations for horses have been adjusted by weight, although this is not manageable with all commercial probiotic preparations (Weese, 2001). ...
... A study on Saccharomyces boulardii administration in horses with acute enterocolitis showed significant decrease in the duration of watery diarrhea and the duration of gastrointestinal illness (Desrochers et al., 2005). In this study 7 horses received the treatment and another 7 received placebo and no difference was found between these two groups in hospitalization duration, recurrence of diarrhea during hospitalization or disease outcome. ...
... It proved the survival of S. boulardii in horses with gastrointestinal illness, "demonstrating that it can survive in the gastrointestinal tract of horses with intestinal pathology". However, in contrast to findings by Desrochers et al. (2005), it did not prove that the treatment with S. boulardii had any impact on the duration of watery diarrhea. ...
Probiotics are common adjunctive therapy used in human and veterinary medicine, mostly intended for gastrointestinal diseases treatment or prevention. Lactic acid bacteria: Lactobacilli, bifid bacteria and enterococci and Saccharomyces boulardii, a subtype of the nonpathogenic yeast have been most frequently used as probiotic active ingredients. To become a recognized effective probiotic, a certain microorganism must fulfill many expectations, primarily the ability to survive gastrointestinal tract passage, adhere to epithelial cells and colonize intestines to present antimicrobial effect and inhibition of enteric pathogens. Prior to evaluation of clinical efficiency, it is advised to perform in vitro studies in order to identify potentially beneficial properties of probiotic organisms. An effective probiotic product could be of a great value in equine medicine, since both, adult horses and foals, frequently exhibit gastrointestinal problems. However, very little objective research has been carried out on the topic. The effectiveness of probiotic products in horses has been proven in very few studies and some presented serious adverse effects. Therefore, the benefits of probiotics use in equine medicine still remain undetermined.
... Nonetheless, the indiscriminate use of antibiotics is contributing to a global rise in antibiotic resistance [18]. The employment of probiotics, specifically those containing Saccharomyces boulardii, is common in the treatment of colitis in horses, as it can reduce both the intensity and the length of diarrheal episodes [19]. ...
... Probiotics are commonly used to treat colitis in horses. Saccharomyces boulardii decreased the severity and duration of diarrhea [19]. Probiotics should not be recommended for use in neonatal foals less than 24 hours of age due to the potential for reduced absorption of colostrum immunoglobulins. ...
... To date, research exploring their use in equine veterinary practices has mainly used human species and strains from the genera Lactobacillus and Bifidobacterium and the yeast Saccharomyces [7]. Probiotic supplementation has predominantly been used to improve digestion in horses by altering the GI microbiota [8], to reduce the incidence of scouring in foals [9], to treat acute enterocolitis in hospitalised horses [10] to manage other equine GI disorders [11], and also for improving athletic performance [12,13], however, a specific role for probiotics in influencing equine fertility has not been explored. ...
... Future research in this domain could consider different equine populations, such as various breeds, wild versus domesticated and athletes of different disciplines. Other probiotic organisms which have shown to improve equine digestion, such as the yeasts Saccharomyces cerevisiae [55] and S. boulardii [10] could be evaluated for specific impact on the semen microbiome, a concept which has not yet been studied, either by single yeast supplementation or as part of a multi-strain formulation with probiotic bacteria. Equine-specific probiotic species have been investigated for therapeutic application [56,57] and may in the future be administered to stallions for more impact upon the equine fecal and semen microbiomes. ...
Highlights • Pre-, pro and synbiotic supplementation had no effect on sperm quality. • 16SrRNA gene sequencing of stallions faeca land seminal microbiomes. • There was a trend for prebiotics to affect faecal microbial diversity measures. Abstract Probiotic and prebiotic effects on equine semen and gastrointestinal microbiome composition and sperm quality are unknown. This study aimed to evaluate the effects of pre-, pro-or synbiotic supplementation on fecal and semen microbiome composition and sperm quality parameters of stallions. This Latin square crossover trial involved four miniature pony stallions receiving control diet only, or addition of a pro-, pre-or synbiotic formulation. Full-length 16S rRNA gene amplicon sequencing was used to measure diversity of semen and fecal microbiomes. Total sperm count, total motility, progressive motility, DNA integrity, lipid peroxidation and mitochondrial oxidative stress, biomarkers of sperm quality, were measured after each intervention. A general linear model was employed to analyse and compare microbiome diversity measures and sperm quality data across four time points. Shannon's diversity index (alpha-diversity), and evenness of semen and gastrointestinal microbiomes were significantly different (p<0.001). A trend was observed for prebiotic effects on the diversity indices of the GI microbiome (p= 0.07). No effects of treatments were observed on either semen microbiome or sperm quality. Pre-, pro-and synbiotic supplements showed no negative effect on sperm quality parameters observed. This proof of concept provides preliminary data to inform future studies exploring the relationship between microbiomes and fertility. Graphical Abstract Download : Download high-res image (244KB) Download : Download full-size image
... of hospitalization for horses with acute enterocolitis [20] , respectively. However, in Australia, commercial probiotic yeast supplements for horses are not widely available. ...
... Garber et al. applied this same yeast species to a high-starch and a high-fiber diet, by supplementing a group of ponies on a grass hay and alfalfa diet with a 4% Saccharomyces cerevisiae product, resulting in increased fiber fermentation and nutrient uptake by the ponies [44] . Desrochers et al. administered Saccharomyces boulardii (10 x 10 9 yeast cells orally every 12 hours for 10 days) to 14 horses with acute enterocolitis, significantly decreasing the severity and duration of intestinal disease during hospitalization, compared to horses receiving the placebo [20] . In contrast, neither single nor multispecies probiotic supplementation has been shown to be efficacious in treating equine salmonellosis. ...
Background: Probiotic bacteria are used widely as nutritional supplements and treatment interventions in the management of livestock and companion animals. The aim of this review is to summarise the current evidence reporting on the safety, tolerability and efficacy of probiotic bacteria use in horses.
Methods: An online search of five databases for studies reporting on the use of probiotic bacteria use in horses which were either healthy or had a gastrointestinal or extra-intestinal disease was conducted.
Results: A total of 18 articles were eligible for full review. No clear benefits were identified to support supplementation of equids with probiotic bacteria to improve starch and fibre digestion, nor for the treatment of colic or prevention of salmonellosis. Conflicting results were seen with the management of scouring in neonatal foals. Exacerbation of diarrhoea and additional adverse events were reported in response to the administration of high doses of novel probiotic bacterial species. Probiotic bacteria given to exercising horses, improved aerobic fitness and stamina. The majority of probiotic bacterial species used in equine studies are bacterial species commonly used for human consumption and indigenous to the human gastrointestinal microbiota.
Conclusions: There is a paucity of evidence to support the use of probiotic bacteria in the health maintenance and disease management of horses. While there are unclear and conflicting results associated with probiotic bacteria use for gastrointestinal conditions in both horses and foals, the administration of multi-strain bacterial formulations to increase stamina in exercising horses shows promise.
... of hospitalization for horses with acute enterocolitis [20] , respectively. However, in Australia, commercial probiotic yeast supplements for horses are not widely available. ...
... Garber et al. applied this same yeast species to a high-starch and a high-fiber diet, by supplementing a group of ponies on a grass hay and alfalfa diet with a 4% Saccharomyces cerevisiae product, resulting in increased fiber fermentation and nutrient uptake by the ponies [44] . Desrochers et al. administered Saccharomyces boulardii (10 x 10 9 yeast cells orally every 12 hours for 10 days) to 14 horses with acute enterocolitis, significantly decreasing the severity and duration of intestinal disease during hospitalization, compared to horses receiving the placebo [20] . In contrast, neither single nor multispecies probiotic supplementation has been shown to be efficacious in treating equine salmonellosis. ...
Background
Commercial probiotics are used widely as nutritional supplements and treatment interventions in the management of livestock and companion animals. A summary of the current evidence to support their use in equine health and disease is currently lacking. Therefore the aim of this review is to summarise the current evidence reporting on the safety, tolerability and efficacy of probiotic supplementation in horses of all ages.
Methods
An online search was conducted in Medline, Pubmed, CINAHL, Embase and Web of Science
databases for studies reporting on the use of probiotics in both male and female horses of any breed and age, which were either healthy or had a gastrointestinal or extra-intestinal disease.
Results
A total of 22 articles were eligible for full review. Multi-strain probiotic formulations produced more favourable shifts in the composition of the intestinal microbiota compared to single species alone, reducing scouring in neonatal foals, assisting with salmonella shedding, improving athletic performance and enhancing digestion in supplemented horses. The probiotic yeast Saccharomyces was reported to improve digestion and reduce periods of hospitalisation associated with acute enterocolitis. There was no clear benefit reported to date to support probiotic use in the treatment of colic and salmonellosis. Adult horses generally tolerated probiotics, whereas foals responded poorly to higher doses of multi- strain probiotics, developing diarrhoea or experiencing aggravation of this symptom, especially when non-native strains were administered for prolonged periods. Additional supplementation with prebiotics supported probiotic colonisation and was associated with an increase in colonic lactobacilli counts and a greater Firmicutes: Bacteroidetes ratio. While equine species and strains of intestinal microbiota have been identified as potential probiotics, their use has not been well established, and the majority of probiotics used in equine studies being of human origin.
Conclusions
There is a paucity of evidence to support the use of probiotics in the health maintenance and disease management of horses. Studies have largely focussed on the prevention and treatment of gastrointestinal disease using human probiotic species and strains. While some promising results are reported, including: multi-species formulations for reducing scouring in neonatal foals; assisting with salmonella shedding; improving athletic performance; and enhancing digestion, an opportunity exists for further research to characterise the microbiome of various equine tissue sites to assist in the development of safe and effective probiotic formulations. We were unable to identify studies exploring the extra-intestinal effects of probiotic use in breeding horses, suggesting further avenues for research.
... Positive results on intestinal barrier function in various laboratory and production animals led to research investigating the efficacy of probiotics and prebiotics in healthy horses and in horses with gastrointestinal disease. In a randomized blinded placebo-controlled clinical trial the efficacy of S. boulardii in treating the diarrhea associated with acute colitis in horses was assessed [112] . Acute colitis can be caused by several pathogens, making identification of a specific cause difficult. ...
... The lack of efficacy was attributed to difficulty in standardization of treatment, and a possible lack of colonization by S. boulardii because the fecal samples of some horses were negative for S. boulardii. In the study by Desrocher et al. [112] , administration of 10 X 10 [9] CFU with the feed twice daily showed viable fecal S. boulardii at 5 days, but not at 20 days. Therefore S. boulardii may have beneficial effects but does not appear to colonize the ceca and colons of horses [114,115] . ...
Many of the nutrients beneficial for intestinal health are present in normal foods, but their normal daily intake may be too low to exert optimum effects on intestinal barrier function and immune status. Evidence from laboratory and farm production animals strongly supports dietary supplementation with additional nutrients and nutraceuticals, however research in horses remains scarce and inconclusive. Careful consideration of the outcome desired for horses in care, together with the types of nutraceuticals available, is needed to develop effective strategies for maintenance of healthy intestinal barrier function and for treatment of various leaky gut syndromes in horses. This review presents these issues in the context of what is known about the effects of nutraceutical-type nutrients on the mammalian (including equine) g.i. tract and intestinal microbiome with the aim of providing suggestions for the equine situation.
... Literature describing the application of pre-and probiotics in horses is ancient and very limited, showing a clear inconsistency in findings with a main focus on gastrointestinal disease application [199][200][201][202][203][204][205][206] (Table 6). Manufacturers and industrials of prebiotics and probiotics suggest that the incorporation of these supplements in horse diets may help them in maintaining, even restoring, the whole equine intestinal microbiome. ...
... Significant decrease of diarrhea incidence; body weight gain in probiotic treated foals [202] S. boulardii Significant reduction of the severity and duration of diarrhea in a hospital setting probiotic treated horses of clinical signs in horses with enterocolitis [203] Lb. pentosus WE7 Negative effect of probiotic supplementation reflected in high increase of the occurrence of diarrhea and urgent need for veterinary intervention in the probiotic group [204] S. cerevisiae; Lb. acidophilus; E. faecium ...
In livestock production, lactic acid bacteria (LAB) represent the most widespread microorganisms used as probiotics. For such critical use, these bacteria must be correctly identified and characterized to ensure their safety and efficiency. Recently, probiotics have become highly recognized as supplements for humans and in particular for animals because of their beneficial outcome on health improvement and well-being maintenance. Various factors, encompassing dietary and management constraints, have been demonstrated to tremendously influence the structure, composition, and activities of gut microbial communities in farm animals. Previous investigations reported the potential of probiotics in animal diets and nutrition. But a high rate of inconsistency in the efficiency of probiotics has been reported. This may be due, in a major part, to the dynamics of the gastrointestinal microbial communities. Under stressing surroundings, the direct-fed microbials may play a key role as the salient limiting factor of the severity of the dysbiosis caused by disruption of the normal intestinal balance. Probiotics are live microorganisms, which confer health benefits on the host by positively modifying the intestinal microflora. Thus, the aim of this review is to summarize and to highlight the positive influence of probiotics and potential probiotic microbe supplementation in animal feed with mention of several limitations.
... For example in a study by Weese et al, only 2/13 (15%) of veterinary and human probiotics contained the specified organism at the concentration propagated on the leaflet 7 . Probiotics have been evaluated as a means to treat or prevent a variety of gastrointestinal diseases in horses 4,6,[8][9][10] . While some studies have shown some beneficial effects of probiotics, other studies could not corroborate these results. ...
... For example two studies have evaluated the efficacy of the yeast S. boulardii for treatment of acute enterocolitis. In one study, horses receiving S. boulardii had a shorter duration of diarrhea and watery diarrhea 10 . In the second study a beneficial effect could not be shown 11 . ...
... In adult horses, research has been undertaken to identify the enteral microbiota, which is a good step towards understanding dysbiosis and what a probiotic strain might be able to achieve (Kauter et al. 2019). Nevertheless, despite Saccharomyces boulardii showing positive effects on gut health in particular digestibility and to treat enterocolitis (Desrochers et al. 2005), it is difficult to know which strains are effective and which are not. Variability in formulations, dose, viable count, FACETS Downloaded from www.facetsjournal.com ...
The recognition that microbes are the life support system of the biosphere and play a major role in the health of all life forms provides us with a unique opportunity to channel resources into utilizing them for our benefit. This policy document was prepared by assessing the scientific rationale and evidence for the application of beneficial microbes to One Health. Ten recommendations are made including the establishment of a new national program that creates strategies, provides funding, and partners with industries and end-users to make Canada a self-directed global leader in this transformative field. Issues covered include biotics, fecal microbiota transplant, fundamental and applied research, regulatory, the education system, and applications to pollinators, aquaculture, coral, biofertilizers, livestock, companion animals, horses, and sustainability of agriculture and environmental management. It is hoped that this document will provide politicians, bureaucrats, academics, and representatives of the end users of beneficial microbial products the incentive to appoint an expert panel to develop the means to implement a program of this type. At a time when climate change, biodiversity, long-term health, integration of cultures, and access to home resourced nutritious food are high on government agendas, the proposed program offers a novel means to positively influence residents across the country.
... Fusobacteria was also more abundant in colitis horses than in healthy horses. Alterations in the dominant gut bacterial species are associated with colitis; however, mechanisms linking the gut microbial diversity to colitis need to be elucidated (Costa et al. 2012;Desrochers et al. 2005;Uzal and Diab 2015). The aforementioned studies have shown that colitis is not caused by a single pathogen but is rather a gut-associated disease and is caused by major disturbances in the gut microbiota. ...
Microbiota in the gastrointestinal tract play a crucial role in nutrient digestion, health and so forth in equines. As the research attention on gut microbes has increased, several studies have investigated the composition of the gastrointestinal microbial flora in equines. This article reviews the effects of breed, age, intestinal site, nutritional management and diseases on the gastrointestinal microbiota of horses and donkeys, thus offering references for improving the gastrointestinal microecological environment in these animals and preventing and controlling disease occurrence in them.
... Horses are susceptible to GIT disorders such as enterocolitis that may be due to antimicrobial use, stressful conditions, or pathogen infection (e.g., Clostridioides difficile; Salmonella). In one study, a Saccharomyces boulardii reduced the severity and duration of illness in horses with acute enterocolitis (Desrochers et al., 2005). In another study, a probiotic mixture of 3 Lactobacillus strains and 1 Enterococcus strain reduced the incidence of Salmonella shedding in horses admitted for routine medical and surgical treatments (Ward et al., 2004). ...
Probiotics, prebiotics, and other biotic substances are not only effective ways to promote a healthy gastrointestinal tract, an effective immune system, and the overall health of humans, but also in agricultural and companion animals. Because key differences exist in regard to gastrointestinal tract anatomy and physiology, dietary management and feeding strategy, and disease susceptibility, however, biotic types and amounts often differ according to host species and life stage. Despite these differences, the literature demonstrates the value of biotics in agricultural and companion animal species. While high variability in responsiveness and efficacy has been reported, biotic substances may be effectively used to improve digestion, reduce morbidity, and increase growth rate and/or efficiency in agricultural animals and promote gastrointestinal health and immune response in companion animals. As the oversight of antibiotic use intensifies, population density of animals and humans increases, and production strategies of agricultural animals are more heavily scrutinized, the importance of biotics and other health promotors will continue to increase in the future. To date, the effects of animal biotic use has focused primarily on the farm, home, or veterinary clinic. In the future, their impact must be viewed on a larger scale. As global “One Health” approaches seek to reduce antimicrobial use and resistance and there are increasing demands for sustainable and safe food production, biotics will continue to be an important part of the solution. As knowledge of gastrointestinal microbiomes grows and the biotic field develops, more targeted and effective strategies for health promotion in these species is expected. At the 2023 International Scientific Association for Probiotics and Prebiotics meeting, experts were invited to participate in a discussion group focused on ‘The Use of Probiotics and Prebiotics in Agricultural and Companion Animals’. This review reports the outcomes of that discussion, including the documented use of probiotics, prebiotics, and other biotic substances to promote health or treat disease in agricultural and companion animals, provide implications of animal biotic use on human health, and provide perspective on how scientific advances may impact the development and improvement of biotics in the future.
... In the work presented here, the preparation used was not cultured to confirm its composition, relying on information obtained from the package insert and the manufacturer's direct statement. Studies in the literature indicate that when probiotic strains are used, both foals and adult horses fail to achieve sustained colonization of the digestive tract (after 5 and 10 days of use, respectively) (1,40). However, the strains were detected in the feces during probiotic application and several days later, which was not observed in the present study. ...
Background
Oral probiotic dietary supplements are widely used in veterinary medicine, including in horses. It is hypothesized that the presence of probiotic strains can both modulate the intestinal microbiota and affect mucosal immunity parameters. Such a study has not yet been conducted in horses.
Methods
This study involved 12 healthy horses, which were randomly divided into a control group and a group that received a commercial oral probiotic formula containing Lactobacillus rhamnosus, Pedioccus acidilactici or Enterococcus faecium for 84 days. Fecal samples were collected from all horses on day 0 (D0), 28 days after starting the probiotic (D28), 56 days (D56), 84 days (D84) and 28 days after stopping the probiotic (DX) treatment. The samples were subjected to microbiome analysis via next-generation sequencing of hypervariable regions V3-V4 and V7-V9 of the 16S rRNA gene for analysis of short-chain fatty acids via HPLC analysis and fecal secretory immunoglobulin A (SIgA) quantification via ELISA.
Results
Microbiome analysis revealed no significant differences in either alpha or beta diversity parameters between the groups. No probiotic strains were detected in the samples. Significant changes were detected in three taxa: the family Bacteroidales RF16 group, the genus Erysipelotrichaceae UCG-004, and the genus Fibrobacter during the study in both groups. In all the cases, there was a gradual decrease in relative abundance over time. The concentrations of SCFAs, specifically acetic and propionic acids, significantly increased over time in both groups according to the generalized linear mixed effects (GLME) model. There were no significant differences in fecal SIgA secretion.
Conclusion
The present study revealed no effect of the use of a commercial probiotic dietary supplement on either mucosal immunity or the composition of the intestinal microbiota.
... Arslan et al. (2012) investigate the role of probiotic in reducing the mortality rate and increase the survive of puppies infected with parvovirus after symptomatic treatment. Desrochers et al. (2005) have reported that Saccharomyces boulardii might help to decrease the severity and duration of clinical signs in horses with acute enterocolitis. Furthermore, in dogs, probiotic Enterococcus faecium has been reported to reduce fecal numbers of Cl. perfringens and stimulate immune functions (Westermarck et al., 2005). ...
... Other concerns with commercial probiotics include the potential for administering bacteria containing transferrable antimicrobial resistance genes [45,48], the association with the development of diarrhea (rather than prevention of) in foals [49][50][51], and questions regarding the bacteria that should be administered to horses with colitis [52]. Although no studies report adverse effects of probiotics in adult horses with diarrhea, the evidence of the positive effects associated with their use in adult horses is limited to questionable [53], likely due partly to persistent issues with quality control [45][46][47]. While probiotics can potentially improve intestinal health, more research is needed to maximize their potential for use in horses with diarrhea. ...
Background
This study aimed to describe and compare therapeutic approaches for horses with acute diarrhea in different geographic regions worldwide.
Methods
Clinical information was retrospectively collected from diarrheic horses presented to participating institutions between 2016 and 2020, including fluid therapy on admission, antimicrobial drugs, probiotics, anti-endotoxic medications, anti-inflammatory drugs, gastroprotectants, digital cryotherapy, and toxin-binding agents. Seasonal and geographic differences were investigated.
Results
1438 horses from 26 participating hospitals from 5 continents were included. On admission, 65% (926/1419) of horses were administered a fluid bolus. Antimicrobial drugs were administered to 55% (792/1419) within the first 24 hours of admission, with penicillin and gentamicin being the most used combination (25%, 198/792). Horses with leukopenia (OR: 2.264, 95%CI: 1.754 to 2.921; P<0.001) or meeting systemic inflammatory response syndrome criteria (OR: 2.542, 95%CI: 1.919 to 3.368; P<0.001) had higher odds of being administered antimicrobial drugs. Other treatments administered included probiotics (15%, 215/1438), polymyxin B (13%; 187/1438), pentoxifylline (8%; 118/1438), gastroprotectants (44%; 626/1419), digital cryotherapy (34%; 489/1435), plasma transfusion (13%; 182/1410) and toxin-binding agents (36%; 515/1438).
Limitations
Due to the retrospective nature of the study, the rationale for treatment decisions was unavailable, and associations with survival could not be evaluated.
Conclusions
Treatments varied between hospitals from different geographic regions. Prospective clinical trials are required to evaluate the effects of various treatments on survival.
... The evidence base for the effect of feeding probiotics to horses is sparse and warrants further investigation, particularly as this appears to be readily accepted by some horse-owners. To date studies have focused upon the effect of feeding probiotics to reduce diarrhoea, reduce faecel shedding of Salmonella organisms or in combination with psyllium as a treatment for sand colic (Weese (2002), Weese et al. (2004) and Weese & Rousseau (2005), Jouany et al. (2008), Desrochers et al. (2005)). ...
https://livrepository.liverpool.ac.uk/id/eprint/3180785
... For this reason, lactobacilli are often included in probiotic formulations (e.g., L. acidophilus). Although, research is limited and existing results are varied on the efficacy of probiotics in horses, some studies have provided evidence that exogenous lactobacilli and other probiotics could have beneficial effects [4,5]. ...
Cereal grains are often included in equine diets. When starch intake exceeds foregut digestion starch will reach the hindgut, impacting microbial ecology. Probiotics (e.g., lactobacilli) are reported to mitigate GI dysbioses in other species. This study was conducted to determine the effect of exogenous lactobacilli on pH and the growth of amylolytic and lactate-utilizing bacteria. Feces were collected from 3 mature geldings fed grass hay with access to pasture. Fecal microbes were harvested by differential centrifugation, washed, and re-suspended in anaerobic media containing ground corn, wheat, or oats at 1.6% (w/v) starch and one of five treatments: Control (substrate only), L. acidophilus, L. buchneri, L. reuteri, or an equal mixture of all three (10⁷ cells/mL, final concentration). After 24 h of incubation (37°C, 160 rpm), samples were collected for pH and enumerations of total amylolytics, Group D Gram-positive cocci (GPC; Enterococci, Streptococci), lactobacilli, and lactate-utilizing bacteria. Enumeration data were log transformed prior to ANOVA (SAS, v. 9.3). Lactobacilli inhibited pH decline in corn and wheat fermentations (P < 0.0001). Specifically, addition of either L. reuteri or L. acidophilus was most effective at mitigating pH decline with both corn and wheat fermentation, in which the greatest acidification occurred (P < 0.05). Exogenous lactobacilli decreased amylolytics, while increasing lactate-utilizers in corn and wheat fermentations (P < 0.0001). In oat fermentations, L. acidophilus and L. reuteri inhibited pH decline and increased lactate-utilizers while decreasing amylolytics (P < 0.0001). For all substrates, L. reuteri additions (regardless of viability) had the lowest number of GPC and the highest number of lactobacilli and lactate-utilizers (P < 0.05). There were no additive effects when lactobacilli were mixed. Exogenous lactobacilli decreased the initial (first 8 h) rate of starch catalysis when wheat was the substrate, but did not decrease total (24 h) starch utilization in any case. These results indicate that exogenous lactobacilli can impact the microbial community and pH of cereal grain fermentations by equine fecal microflora ex vivo. Additionally, dead (autoclaved) exogenous lactobacilli had similar effects as live lactobacilli on fermentation. This latter result indicates that the mechanism by which lactobacilli impact other amylolytic bacteria is not simple resource competition.
... Horses receiving Sacc. boulardii had a shorter period of watery diarrhea, but this finding should be interpreted with caution since only seven animals were used per group, and there was no difference between treatment groups 58 . Furthermore, obtained results may be confounded by treatment protocols. ...
There are many reports of the positive effects of probiotics on gastrointestinal tract (GIT) microorganisms and the immunological systems of their hosts. Probiotics have prophylactic and metaphylactic properties. The two main mechanisms of action of probiotics seem to be the release of compounds with beneficial effects and direct interaction with the cells of the host. The aim of this review was to evaluate the benefits of probiotic use in farm animals and to identify how they influence farm animal performance. The published data suggest that dietary supplementation of probiotics can improve the growth performance, nutrient digestibility, and immune response of farm animals, including cows, sheep, goats, pigs, aquacultures, and poultry. In ruminants, studies have shown that probiotics can significantly enhance the immune response, milk yield, food digestibility, and weight gain, particularly in ruminants exposed to stressful conditions. This is also the case in aquaculture as probiotics have been shown to enhance growth and reproduction traits, provide protection against pathogens, have positive effects on immunity, optimize digestion, and increase water quality. In horses, there is still controversy about the advantages of probiotic supplementation. In addition, some studies showed valuable effects of using probiotics on treatments of GIT diseases, and some studies showed adverse effects of supplementation of probiotics in horses. In poultry, balancing the intestinal microflora is not achievable but controlling the population of microflora is possible and studies showed that supplementation of probiotics could influence some aspects such as improving performance and health parameters. So, probiotics are used by almost all farmers who are trying to reduce antibiotic resistance. In conclusion, dietary supplementation of probiotics to farm animals has many notable influences on their performance, immune system, and diet digestion.
... Lactobacillus reuteri reduces the adhesion of C. difficile to epithelial cells and significantly reduces the number of clostridial cells in the faeces of horses (Dicks et al., 2015). Similarly, Saccharomyces boulardii has also shown potential in the prevention of equine CDI following success in humans (Desrochers et al., 2005;Boyle et al., 2013;Carstensen et al., 2018). This microorganism releases proteases that digest C. difficile toxin A, reduce its ability to bind to host intestinal cells and interfere with host cell signalling to reduce damaging inflammatory responses (Castagliuolo et al., 1996;Chen et al., 2006). ...
Clostridioides (Clostridium) difficile presents a significant health risk to humans and animals. The complexity of the bacterial-host interaction affecting pathogenesis and disease development creates an ongoing challenge for epidemiological studies, control strategies and prevention planning. The recent emergence of human disease caused by strains of C. difficile found in animals adds to mounting evidence that C. difficile infection (CDI) may be a zoonosis. In equine populations, C. difficile is a known cause of diarrhoea and gastrointestinal inflammation, with considerable mortality and morbidity. This has a significant impact on both the well-being of the animal and, in the case of performance and production animals, it may have an adverse economic impact on relevant industries. While C. difficile is regularly isolated from horses, many questions remain regarding the impact of asymptomatic carriage as well as optimization of diagnosis, testing and treatment. This review provides an overview of our understanding of equine CDI while also identifying knowledge gaps and the need for a holistic One Health approach to a complicated issue. This article is protected by copyright. All rights reserved.
... However, a 2013 study of S. cerevisiae supplementation in a dozen geldings found no effect on either fermentation profiles or fiber digestion [63]. Similarly, one study of Saccharomyces boulardii supplementation in 14 horses with acute enterocolitis showed a significant reduction in severity and duration of intestinal disease during hospitalization despite a lack of colonization [64]. However, in a study of 21 horses with antimicrobial induced diarrhea, S. boulardii supplementation had no statistical impact on the improvement of clinical parameters, length of hospital stay, incidence of secondary complications or survival [65]. ...
Diarrhea in foals is a problem of significant clinical and economic consequence, and there are good reasons to believe microbiota manipulation can play an important role in its management. However, given the dynamic development of the foal microbiota and its importance in health and disease, any prophylactic or therapeutic efforts to alter its composition should be evidence based. The few clinical trials of probiotic preparations conducted in foals to date show underwhelming evidence of efficacy and a demonstrated potential to aggravate rather than mitigate diarrhea. Furthermore, recent studies have affirmed that variable but universally inadequate quality control of probiotics enables inadvertent administration of toxin-producing or otherwise pathogenic bacterial strains, as well as strains bearing transferrable antimicrobial resistance genes. Consequently, it seems advisable to approach probiotic therapy in particular with caution for the time being. While prebiotics show initial promise, an even greater scarcity of clinical trials makes it impossible to weigh the pros and cons of their use. Advancing technology will surely continue to enable more detailed and accurate mapping of the equine adult and juvenile microbiota and potentially elucidate the complexities of causation in dysbiosis and disease. In the meantime, fecal microbiota transplantation may be an attractive therapeutic shortcut, allowing practitioners to reconstruct a healthy microbiota even without fully understanding its constitution.
... Yuyama (2004) S. boulardii Significant reduction in the severity and duration of diarrhea in a hospital setting in probiotic-treated horses of clinical signs in horses with enterocolitis Desrochers et al. (2005) L. pentosus WE7 A negative effect of probiotic supplementation is reflected in a high increase in the occurrence of diarrhea and an urgent need for veterinary intervention in the probiotic group Weese and Rousseau (2005) S. cerevisiae; L. acidophilus; E. faecium ...
In livestock production, probiotics have become highly recognized as supplements for animals because of their beneficial outcome on health improvement and well-being maintenance. Several studies are contributing to the better understanding of the impact of probiotics and prebiotics on the modulation of the intestinal microbiota and their subsequent effects on the host’s health. Several factors, encompassing dietary and management constraints, have been demonstrated to tremendously influence the structure, composition, and activities of gut microbial communities in farm animals. Under stressing surroundings, the direct-fed microbes and feed ingredients may play a key role as the salient limiting factor of the severity of the dysbiosis caused by disruption of the normal intestinal homeostasis. Probiotics are live microorganisms; prebiotics as nondigestible feed components may confer health benefits on the host by positively modifying the intestinal microflora. This work discusses definitions of probiotics and prebiotics. Criteria that have to be met by those kinds of formulas are also presented. A glance at the commercial market of probiotics and prebiotics for animal feeding has also been discussed additionally to the main selective criteria and requirements for probiotic strains and the feed ingredients associated. The chapter offers a list of the most commonly used probiotics and prebiotics, and some pertinent examples of formulas and preparations used in animal nutrition. Examples of the available study results on the effect of probiotics and prebiotics on animal performance parameters and welfare are also summarized.
... There are minimal studies and equivocal evidence for the clinical use of probiotics in equine gastrointestinal diseases (reviewed by Schoster et al. [20]). The clinical benefit has not been assessed in cases of large colon torsions; there are a small number of studies assessing their benefit in acute enterocolitis [21,22], foal diarrhoea [23,24] and for salmonella shedding [25][26][27]. There were limitations to the analysis of these data since not all respondents answered this question, and it was therefore, unclear whether this item omission was because the respondents were not routinely using supplements. ...
Background
Evidence is lacking concerning re‐introduction of feed and water following colic surgery.
Objectives
To describe current approaches of European and American specialists to re‐introduction of feed and water in adult horses following surgical treatment of common intestinal lesions, assuming an uncomplicated recovery.
Study design
Cross‐sectional survey.
Methods
Electronic invitations, with a link to the online survey, were sent to 1,430 large animal specialists, including Diplomates of the ECVS, ACVS, ECEIM and ACVIM colleges.
Results
The response rate was 12.6% including partial respondent data. Responses for each multiple‐choice question were between 123 and 178. Results are expressed as the percentage of the total number of responses and as a range where specific lesions are grouped together. Respondents reported that horses with large intestinal displacements were offered free choice water (63%‐65%) within 3 hours (55%‐63%), whereas horses with a small intestinal strangulating lesion were offered < 2 L water (64%‐74%) 12‐24 hours (28%‐34%) post‐operatively. Horses with a large colon displacement were offered feed within 3 hours of surgery (16%) with the majority offered feed 6‐12 hours (35%‐36%) post‐operatively. Horses with small intestinal strangulating lesions and small colon lesions were offered feed 24‐48 hours (34%‐42%) after surgery. Following small intestinal, small colon or caecal lesions, horses were re‐introduced feed in handfuls (79%‐93%) and initially with grass (41%‐54%). Horses with large colon displacements were mostly fed handfuls (49%‐50%) of forage initially, but a number of respondents would offer larger quantities such as a small bucket (35%‐37%) and predominantly of hay (50%‐51%).
Main limitations
Low response rate. This study did not take into account common post‐operative complications that may alter the clinical approach.
Conclusions
This post‐operative colic nutrition survey is the first to describe current clinical practice. Further research is required to investigate nutritional strategies in post‐operative colic cases.
... The most likely reasons for the failure of probiotics to improve disease outcomes in horses to date is that the taxa included in formulations are chosen empirically based on data from other species with the most common bacterial probiotics being Lactobacillus, Bifidobacterium and Enterococci [65] which are present in very low abundance in the large colon of the horse [67][68][69]. Furthermore, the survival of bacteria during passage through low pH stomach fluid and the digestive process may limit the dose reaching the target site with short faecal survival times seen in both bacterial and yeast probiotics studies [70,71]. Prebiotics are products that are intended to alter microbiota by acting as selective substrates for host microbiota. ...
Simple Summary
There is increasing evidence for the importance of gut bacteria in animal health and disease. This is particularly relevant for gastrointestinal infections, such as parasitic worms, which share a niche with gut bacteria. Parasitic worms are highly prevalent in domestic horses and are a significant cause of disease in this population. This commentary explores the complex relationships between the most common parasitic worm in horses (cyathostomins) and gut bacteria, based on recent studies in horses and other species. We propose novel theories and avenues for research that harness these relationships and have the potential to improve control of parasitic worms, and overall equine health, in the future.
Abstract
The importance of the gut microbiome for host health has been the subject of intense research over the last decade. In particular, there is overwhelming evidence for the influence of resident microbiota on gut mucosal and systemic immunity; with significant implications for the outcome of gastrointestinal (GI) infections, such as parasitic helminths. The horse is a species that relies heavily on its gut microbiota for GI and overall health, and disturbances in this complex ecosystem are often associated with life-threatening disease. In turn, nearly all horses harbour parasitic helminths from a young age, the most prevalent of which are the small strongyles, or cyathostomins. Research describing the relationship between gut microbiota and cyathostomin infection is in its infancy, however, to date there is evidence of meaningful interactions between these two groups of organisms which not only influence the outcome of cyathostomin infection but have long term consequences for equine host health. Here, we describe these interactions alongside supportive evidence from other species and suggest novel theories and avenues for research which have the potential to revolutionize our approach to cyathostomin prevention and control in the future.
... Limited changes were only found concerning relative abundance of bacterial families, with an enrichment of Lactobacillus in the probiotic group at week six [144]. Yet, evidence of probiotic efficiency in horses is weak despite several putative clinical applications including acute enterocolitis [145], diarrhea in foals [146] as well as fecal sand clearance [147]. ...
Understanding the complex interactions of microbial communities including bacteria, archaea, parasites, viruses and fungi of the gastrointestinal tract (GIT) associated with states of either health or disease is still an expanding research field in both, human and veterinary medicine. GIT disorders and their consequences are among the most important diseases of domesticated Equidae, but current gaps of knowledge hinder adequate progress with respect to disease prevention and microbiome-based interventions. Current literature on enteral microbiomes mirrors a vast data and knowledge imbalance, with only few studies tackling archaea, viruses and eukaryotes compared with those addressing the bacterial components.
Until recently, culture-dependent methods were used for the identification and description of compositional changes of enteral microorganisms, limiting the outcome to cultivatable bacteria only. Today, next generation sequencing technologies provide access to the entirety of genes (microbiome) associated with the microorganisms of the equine GIT including the mass of uncultured microbiota, or “microbial dark matter”.
This review illustrates methods commonly used for enteral microbiome analysis in horses and summarizes key findings reached for bacteria, viruses and fungi so far. Moreover, reasonable possibilities to combine different explorative techniques are described. As a future perspective, knowledge expansion concerning beneficial compositions of microorganisms within the equine GIT creates novel possibilities for early disorder diagnostics as well as innovative therapeutic approaches. In addition, analysis of shotgun metagenomic data enables tracking of certain microorganisms beyond species barriers: transmission events of bacteria including pathogens and opportunists harboring antibiotic resistance factors between different horses but also between humans and horses will reach new levels of depth concerning strain-level distinctions.
... In one study of 14 horses with diarrhea, administration of S boulardii decreased the duration of diarrhea from 7 to 5 days, compared with control horses. 59 In contrast, there was no significant difference in return to normal manure, return to normal heart rate, appetite improvement, or any other clinical variables measured between Saccharomyces-treated and control horses in a randomized prospective study. 60 The administration of Lactobacillillus spp and Bifidobacterium animalis lactis had no impact on clostridial shedding and minimal impact on the composition of the fecal microbiota in foals when administered for 3 weeks. ...
Acute, infectious, diarrhea in adult horses is a major cause of morbidity and is associated with numerous complications. Common causes include salmonellosis, clostridiosis, Coronavirus, and infection with Neorickettsia risticii (Potomac horse fever). Treatment is empirical and supportive until results of specific diagnostic tests are available. Supportive care is aimed at restoring hydration, correcting electrolyte imbalances, and limiting the systemic inflammatory response. The mainstays of therapy are intravenous fluid therapy, electrolyte supplementation where necessary, nonsteroidal anti-inflammatory agents, and nutritional support. Specific therapies include colloid oncotic support, antibiotics, hyperimmune plasma, polymyxin B, pentoxifylline, probiotics, binding agents, gastroprotectants, laminitis prevention, and coagulation prophylaxis.
... To the best of our knowledge, no research activities have been performed in the field of equine probiotic strategy, revealing the impact of Lactobacilli, particularly Lactobacillus farciminis on the GP in horses. However, the beneficial impact of exogenous Lactobacilli and other probiotics in horses toward digestibility and fermentation endproducts as well as acute enterocolitis treatment has been reported [9,10]. ...
The effect of equine fecal inocula on the in vitro gas, methane (CH4), and carbon dioxide (CO2) production was elucidated in the present study. Fecal inocula were obtained from four Azteca horses (aged 5–8 years, 480 ± 20.1 kg). In vitro fermentation (up to 48 hours) was performed with substrate consisting of 50% (w/w) oat straw and 50% (w/w) of a commercial concentrate in the presence of a commercial Lactobacillus farciminis product (0–6 mg/g DM of substrate). Incorporation of L. farciminis resulted in increased levels of asymptotic gas (GP), CH4, and CO2 production (P <.05). The lag time and the rate of GP were shown to be independent from L. farciminis addition (linear, P >.05; quadric, P >.05). Furthermore, a slight reduction in fermentation pH (linear, P =.029) and higher metabolizable energy values (P =.001) were obtained with L. farciminis supplementation in a dose-dependent manner. No significant impact of L. farciminis on dry matter degradability values was estimated (P >.05). In vitro gas, CH4, and CO2 production were increased (linear, P ≤.001) in the presence of L. farciminis from 6 hours of incubation onward. In conclusion, addition of L. farciminis at a dose-dependent manner (2–6 mg/g DM of diet) was observed to be persuasive in terms of attaining amicable hindgut fermentation by improving fecal gas kinetics viz. gas, CH4, and CO2 production without any side effect.
... Therefore, treatment could potentially inhibit the beneficial components of the fecal bacterial microbiota. Probiotics are also commonly used, although to date several studies have not shown any clear benefit for treatment or prevention of diarrhea in foals [12,14,37,38]. One potential reason could be that the organisms found in most commercial probiotics (e.g. ...
Background
Diarrhea in foals affects up to 60% of foals during the first six months of life. The effect of diarrhea on the fecal bacterial microbiota in foals has not been investigated. Little is known on the fecal bacterial microbial richness and diversity of foals at a young age. The objective was to compare the fecal bacterial microbiota of healthy foals to foals with diarrhea at two and four weeks of life.
Methods
Fecal samples were collected from foals (n = 20) at 1–14 (T1) and 15–28 (T2) days of age and analyzed using high throughput sequencing. Differences in relative abundance of bacterial taxa, alpha diversity and beta diversity indices were assessed between age-matched foals with diarrhea (n = 9) and healthy foals (n = 11), and between time points.
Results
Differences in microbial community composition based on time point and health status were observed on all taxonomic levels. Of 117 enriched species in healthy foals at T2, 50 (48%) were Lachnospiraceae or Ruminococcaceae. The Chao richness index was increased in healthy foals at T2 compared to T1 (p = 0.02). Foals with diarrhea had a significantly lower richness index than non-diarrheic foals at T2 (p = 0.04). Diarrhea had an inconsistent effect, while time point had a consistent effect on microbial community structure.
Conclusions
Preventative and therapeutic measures for diarrhea should focus on maintaining bacterial microbiota richness. Lachnospiraceae and Ruminococcaceae were underrepresented in foals with diarrhea. These should be evaluated further as potential therapeutic options.
Electronic supplementary material
The online version of this article (doi:10.1186/s12917-017-1064-x) contains supplementary material, which is available to authorized users.
... There is limited research evaluating probiotic use in horses with gastrointestinal disease [166]. Horses with acute enterocolitis administered S. boulardii had a shorter duration of diarrhea than those fed a placebo [179]. However, there was no significant difference in duration of hospitalization or outcome in the two groups. ...
All species, including horses, suffer from alterations that increase intestinal permeability. These alterations, also known as “leaky gut”, may lead to severe disease as the normal intestinal barrier becomes compromised and can no longer protect against harmful luminal contents including microbial toxins and pathogens. Leaky gut results from a variety of conditions including physical stressors, decreased blood flow to the intestine, inflammatory disease and pathogenic infections, among others. Several testing methods exist to diagnose these alterations in both a clinical and research setting. To date, most research has focused on regulation of the host immune response due to the wide variety of factors that can potentially influence the intestinal barrier. This article serves to review the normal intestinal barrier, measurement of barrier permeability, pathogenesis and main causes of altered permeability, and highlight potential alternative therapies of leaky gut in horses while relating what has been studied in other species. Conditions resulting in barrier dysfunction and leaky gut can be a major cause of decreased performance but also death in horses, a better understanding of the intestinal barrier in disease and ways to optimize the function of this barrier is vital to the long-term health and maintenance of these animals.
Antibiotics have long been used to preserve animal health, improve growth, and increase efficiency in animal industries, but the overuse of antibiotics as growth promoters led to the development of resistant bacteria. As a result of this predicament, researchers investigated safer alternative biotechnological breakthroughs, which led notably to the use of probiotics (bacteria and yeast) and prebiotics as feed additives in livestock. Since then, the focus of research teams has shifted to more varied fields of application of probiotics and prebiotics, in animal nutrition. Nowadays, these additives are commonly included in feeds for various species of production animals (swine, poultry, ruminants, and aquaculture). Recently, paraprobiotics and postbiotics are also being studied. The reason for the inclusion of these “biotics” in animal feeds is wide: promotes animal health and productivity by enhancing gut health, nutrient utilization, as well as boosting immune system functionality and reducing foodborne pathogen carriage. In more recent years, an increased concern of the consumer on the sustainability of animal production has been recorded. This chapter aims at reviewing research findings on the potential application of “biotics” into an integrated approach of sustainable farming practices, which is not only limited in terms of environmental concerns but also about of combining profitability with an increase in animal welfare.
Prebiotics are non-digestible food ingredients that promote the growth of beneficial microorganisms in the intestines and are marketed for use in supporting equine digestion, metabolism, growth and immunity. Synbiotics are supplements that contain combinations of prebiotics and probiotic bacteria and/or yeasts. Both are commercially available and promoted for use in enhancing equine athletic performance and reducing morbidity associated with intestinal disease. The aim of this review was to summarise the literature reporting on the use of prebiotics and synbiotics, in equine nutritional practice. An online search of the biomedical and pharmacology databases Embase and PubMed was conducted that identified fifteen papers evaluating the effects of prebiotic or synbiotic supplementation in horses. The current literature indicates that prebiotics provide diverse benefits in equine health and disease prevention. These benefits include improvements in athletic performance; increased production of volatile fatty acids associated with hindgut fibre fermentation; improvements in insulin resistance and carbohydrate metabolism associated with reduction in the development of gastric mucositis, hindgut acidosis and laminitis. Prebiotic fibre is thought to have an enteroprotective effect by improving the composition and diversity of the intestinal microbiota, that in turn impacts immune function via metabolomic effects. Synbiotic supplements containing psyllium seed husks have been shown to improve intestinal sand clearance and relieve sand colic. Prebiotic yeast extract supplementation is associated with reducing intestinal pathobionts, and accelerating healing in acute enterocolitis. Overall, the current evidence to support the use of prebiotics and synbiotics in equine health and disease is not extensive but promising.
Lactic acid bacteria (LAB) are a diverse group of bacteria that comprise low GC content Gram-positive cocci or rods that produces lactic acid as the major end product of the fermentation process. Bifidobacterium genera may also be considered as a part of the LAB group for possessing some similar phenotypical characteristics despite the higher GC content. The key feature of LAB metabolism is efficient carbohydrate fermentation. This contributes to the production of several microbial metabolites that result in the improvement of flavor and texture of fermented foods, in addition to its positive impact on the human health when LAB is administered as a probiotic.
The book deals with advances made in the functionalities of LAB, such as their effect on vitamin D receptor expression, impact on neurodegenerative pathologies, production of B-vitamins for food bio-enrichment, production of bacteriocins to improve gut microbiota dysbiosis, production of metabolites from polyphenols and their effects on human health, effect on reducing the immunoreaction of food allergens, as biological system using time-temperature to improve food safety, and the use of probiotics in animal feed. The book also reviews the use of LAB and probiotic technologies to develop new functional foods and functional pharmaceuticals.
Gastrointestinal microbiota play a crucial role in nutrient digestion, maintaining animal health and welfare. Various factors may affect microbial balance often leading to disturbances that may result in debilitating conditions such as colic and laminitis. The invention of next-generation sequencing technologies and bioinformatics has provided valuable information on the effects of factors influencing equine gut microbiota. Among those factors are nutrition and management (e.g., diet, supplements, exercise), medical substances (e.g., antimicrobials, anthelmintics, anesthetics), animal-related factors (breed and age), various pathological conditions (colitis, diarrhea, colic, laminitis, equine gastric ulcer syndrome), as well as stress-related factors (transportation and weaning). The aim of this review is to assimilate current knowledge on equine microbiome studies, focusing on the effect of factors influencing equine gastrointestinal microbiota. Decrease in microbial diversity and richness leading to decrease in stability; decrease in Lachnospiraceae and Ruminococcaceae family members, which contribute to gut homeostasis; increase in Lactobacillus and Streptococcus; decrease in lactic acid utilizing bacteria; decrease in butyrate-producing bacteria that have anti-inflammatory properties may all be considered as a negative change in equine gut microbiota. Shifts in Firmicutes and Bacteroidetes have often been observed in the literature in response to certain treatments or when describing healthy and unhealthy animals; however, these shifts are inconsistent. It is time to move forward and use the knowledge now acquired to start manipulating the microbiota of horses.
Management of adult horses with acute colitis is challenging, as intensive therapy is often required, the causative agents are frequently elusive, complications such as laminitis are common and the prognosis can be poor. The most commonly identified causes include infectious causes such as salmonellosis and clostridiosis, parasitic causes (larval cyathostominosis) and non-infectious causes such as antimicrobial administration and right dorsal colitis. Testing for infectious agents, in particular Salmonella spp., should always be performed, due to the risk of disease transmission to other animals and to people. While specific therapies exist for some conditions, supportive therapy, particularly fluid therapy and anti-inflammatory therapy, are key. The prognosis is variable, with morbidities such as laminitis often affecting the likelihood of a positive long-term outcome.
Colitis Χ is an acute or peracute colitis of unknown origin, which is characterized by a sudden, watery diarrhea that is usually accompanied by symptoms of hypovolemic shock and leads to death in less than 24 hours. Although colitis X has been studied extensively, the causative factor has not been clarified yet and prognosis is average to poor, as mortality could reach 90-100%. Still, mortality rate could fall to 75%, if treatment is imminent and aggressive. Occasionally the disease has been attributed to viruses, parasites, bacteria, use of antibiotics and sulfonamides and heavy metal poisoning. Stress is considered as an aggravatingfactor for colitis X. The clinical signs are similar to those described for other forms of acute- peracute colitis. Diarrhea and abdominal pain constitute the main discoveries, but at the same time tachykardia, tachypnea, weak pulse, congested or cyanotic mucous membranes and increased capillary refill time are noted. In most cases, colitis X leads to death between 4 to 14 hours. As far as the laboratory findings are concerned, the most important finding is the leucopenia, initially characterized by neutropenia, which might evolve in neutrophilia. Moreover, haemoconcentration is noted with an increase in the packed cell volume, whilst thetotal proteins are initially increased, but changes into a lower than normal value. The most significant laboratory finding in colitis X is the increase of total Cortisol concentration in blood plasma.Histopathologically, the mucosa of the large colon is hemorrhagic, necrotic and covered with fibrohemorrhagic exudate, while the submucosa, the muscular tunic and the local lymphonodes are edematous. The treatment of colitis X should be dire and aggressive, including administration of fluids, electrolytes and blood plasma, anti-inflammatory and analgesic drugs and antibiotics. Preventing dehydration is of paramount importance. The applicationof nutritional measures is important. More specifically, parenteral or normal feeding could be used to address the exacerbated metabolism of the sick horse. Finally, the use of probiotics is considered beneficial in the restoration of the normal intestinal flora. The most common probiotics contain Lactobacillus spp. and Bifidobacterium spp.
Probiotics and prebiotics are being used for many years as alternatives to antibiotic growth promoters in pigs and poultry. A lot of research has been performed more on probiotics and much less in prebiotics with the purpose to define their effects on both animals and human and to clear their mechanisms of interactions with the body. This chapter will be focused on the practical applications of probiotics and prebiotics in pigs, with reference to some possible mechanisms.
Numerous yeast products and yeast-containing feed ingredients are commercially produced, marketed, and used extensively in animal feeds around the world. Considerable research has been conducted to evaluate the potential animal growth performance and health benefits of adding yeast, yeast-derivatives, and yeast-containing ingredients into animal feeds. Active dry yeasts are commonly used solely or in combination with beneficial bacteria in probiotic products. Nutritional yeasts are used as supplements in animal feeds due to their relatively high protein and amino acid, energy, and micronutrient content compared with common feed grains and oilseed meals. Other important yeast-based products contain nutraceutical compounds present in yeast cells and cell walls (i.e. β-glucans, mannanoligosaccharides, nucleotides) that have generally been shown to improve animal growth performance and health. Specialty yeast products, such as selenium yeast (highly concentrated and bioavailable source of selenium) and Phaffia rhodozyma yeast (contains pigment that improves flesh color in salmon and trout) have specific applications in some animal feeds. Ethanol co-products such as corn distillers dried grains with solubles (DDGS) and new grains distillers dried yeast ingredients, containing more than 40% crude protein, also contain significant amounts of yeast cell and nutraceutical components. Therefore, because these yeast-based products have several nutritional and health benefits, they are becoming alternative supplements in animal feed due to restrictions on antimicrobial growth promoter use in many countries. However, it is difficult for nutritionists to differentiate the characteristics, composition, and optimal feeding applications among the diverse number of yeast-containing products available. Furthermore, most of these products contain combinations of probiotics and nutraceutical compounds with different modes of action, making it difficult to determine which compounds contribute to specific responses observed. Quantification of these nutraceutical compounds is difficult, and except for methods to determine viable yeast in dried active yeast products, there are no standard methods for determining dead yeast concentration or fast, inexpensive, and accurate methods to estimate the proportion of yeast components in various yeast-containing additives and feed ingredients. Due to the increasing popularity of using yeast-based products in animal feeds, development of analytical approaches to estimate yeast and its components in these products is greatly needed. In this review, various categories of commercially available yeast and yeast-containing additives and feed ingredients will be described along with our current knowledge about their role in improving animal growth performance, health, and proposed mechanisms of action, and challenges of quantifying yeast content and their biologically active components.
Definitive identification of the underlying etiology is challenging in many cases of equine enteritis and colitis. Although molecular techniques have improved our ability to detect potential pathogens, in approximately 50% of cases a definitive diagnosis still cannot be achieved. This difficulty arises in part because potential pathogens may be identified in the intestinal contents of healthy horses. As a result, merely identifying that such an organism is present may be insufficient evidence for a definitive diagnosis. Applying the appropriate diagnostic tools in a timely manner can optimize the clinician's ability to identify and treat these conditions. In some cases, however, the application of specific therapies will be based upon a presumptive diagnosis derived from the history, examination findings, and clinicopathologic data. Additional treatment is most often symptomatic and supportive in nature, and a thorough understanding of the underlying treatment concepts can help to ensure appropriate and timely intervention.
Horses with inflammatory diseases such as an acute abdominal crisis, enterocolitis, septic endometritis and pleuritis risk developing laminitis. This chapter presents medical therapeutic options for septic/endotoxic horses with presumptive acute developmental laminitis. The pathophysiology of sepsis-related laminitis (SRL) is unclear, but it may share characteristics of each of the three experimental models of laminitis including oral administration of excessive carbohydrate in the form of corn starch or oligofructose. The chapter first clarifies the patient population, after which factors associated with sepsis, endotoxemia, and systemic inflammatory response implicated in the pathogenesis of laminitis is discussed. The epidemiology of 'at-risk' septic horses is described. No direct evidence exists to support the use of intestinal protectants in septic horses for laminitis prevention; however, horses receiving DTO smectite had an improved mucous membrane color, suggesting recovery from sepsis/toxemia. No clinical studies have evaluated the efficacy of lidocaine as a preventive therapy for laminitis in clinical cases of equine sepsis/endotoxemia.
Horses with colitis often do not have adequate voluntary intake of feeds to support recovery. In addition, they may not tolerate forced enteral feeding, due to ileus, abdominal distention, or colic. Parenteral nutrition is the appropriate form of nutritional support in these cases. This review provides guidelines for selection of cases for parenteral nutrition (PN), as well as steps to institute it. Guidelines for dextrose and insulin therapy are also provided. New nutritional considerations, as well as probiotics, for critically ill horses are discussed. Recommendations are provided for specific forms of colonic disorders.
Saccharomyces boulardii is a non-pathogenic yeast which has been used as both a preventive and therapeutic agent for the treatment of a variety of diarrhoeal diseases. The studies with animal models and evidence from human volunteers and patients indicate a profile which is effective in the therapy of diarrhoea and is remarkably safe for oral ingestion. The pharmacokinetic data demonstrate that 5. boulardü reaches a steady-state concentration quickly and maintains a high stable level as long as the yeast is taken daily. Once the agent is discontinued, S. boulardü is quickly eliminated from the colon. Clinical trials studying antibiotic-associated diarrhoea, nasogastric-tube alimentation diarrhoea, Clostridium difficile-disease, acute diarrhoea and chronic diarrhoea in HI V-infected patients are reviewed.
The possible role of Saccharomyces boulardii, a nonpathogenic yeast with beneficial effects on the human intestine, in the maintenance treatment of Crohns disease has been evaluated. Thirty-two patients with Crohns disease in clinical remission (CDAI < 150)="" were="" randomly="" treated="" for="" six="" months="" with="" either="" mesalamine="" 1="" g="" three="" times="" a="" day="" or="" mesalamine="" 1="" g="" two="" times="" a="" day="" plus="" a="" preparation="" of="">Saccharomyces boulardii 1 g daily. Clinical relapses as assessed by CDAI values were observed in 37.5% of patients receiving mesalamine alone and in 6.25% of patients in the group treated with mesalamine plus the probiotic agent. Our results suggest that Saccharomyces boulardii may represent a useful tool in the maintenance treatment of Crohns disease. However, in view of the products cost, further controlled studies are needed to confirm these preliminary data.
The effect of the yeast, Saccharomyces boulardii, on experimental cecal colonization of broilers with Salmonella typhimurium and Campylobacter jejuni was investigated. Duplicate pens of broiler chicks were given ad libitum access to a standard feed supplemented with no yeast (control), or 1 g (1x), or 100 g (100x) dried S. boulardii/kg feed. All chicks except negative controls were challenged on Day 4 with 3.2 x 10(8) cfu S. typhimurium and 6.5 x 10(8) cfu C. jejuni by oral gavage. After 3 wk, the broilers were euthanatized and ceca were aseptically removed and analyzed for Salmonella and Campylobacter. Frequency of Salmonella colonization was significantly (P < 0.05) reduced due to yeast treatment. Of the positive control birds, 70% were colonized with Salmonella; whereas only 20 and 5% of the 1x and 100x yeast-treated birds were colonized. Mean number of Salmonella per gram of ceca and contents were log 1.64, 0.35, and 0.15, respectively, for the control, 1x, and 100x yeast-treated birds. Campylobacter colonization was not significantly affected by yeast treatment. Similar results were obtained from a second trial conducted in larger isolation floor pens.
To determine the safety and efficacy of a new preventive agent for antibiotic-associated diarrhea (AAD) in patients receiving at least one beta-lactam antibiotic.
A double-blinded, placebo-controlled, parallel group study was performed in a high-risk group of hospitalized patients receiving a new prescription for a beta-lactam antibiotic and having no acute diarrhea on enrollment. Lyophilized Saccharomyces boulardii or placebo (1 g/day) was given within 72 h of the start of the antibiotic(s) and continued until 3 days after the antibiotic was discontinued, after which the patients were followed for 7 wk.
Of the 193 eligible patients, significantly fewer, 7/97 (7.2%), patients receiving S. boulardii developed AAD compared with 14/96 (14.6%) on placebo (p = 0.02). The efficacy of S. boulardii for the prevention of AAD was 51%. Using a multivariate model to adjust for two independent risk factors for AAD (age and days of cephalosporin use), the adjusted relative risk was significantly protective for S. boulardii (RR = 0.29, 95% CI = 0.08, 0.98).
The prophylactic use of S. boulardii given with a beta-lactam antibiotic resulted in a significant reduction of AAD with no serious adverse reactions.
OBJECTIVE--To determine the safety and efficacy of a new combination treatment for patients with Clostridium difficile-associated disease (CDD). The treatment combines the yeast Saccharomyces boulardii with an antibiotic (vancomycin hydrochloride or metronidazole). DESIGN--A double-blind, randomized, placebo-controlled, parallel-group intervention study in patients with active CDD. Patients received standard antibiotics and S boulardii or placebo for 4 weeks, and were followed up for an additional 4 weeks after therapy. Effectiveness was determined by comparing the recurrence of CDD in the two groups using multivariate analysis to control for other risk factors for CDD. SETTING--National referral study of ambulatory or hospitalized patients from three main study coordinating centers. PATIENTS--A total of 124 eligible consenting adult patients, including 64 who were enrolled with an initial episode of CDD, and 60 who had a history of at least one prior CDD episode. Patients who were immunosuppressed due to acquired immunodeficiency syndrome or cancer chemotherapy within 3 months were not eligible. INTERVENTION--Treatment with oral S boulardii (1 g/d for 4 weeks) or placebo in combination with a standard antibiotic. MAIN OUTCOME MEASURE--Recurrence of active CDD. RESULTS--A history of CDD episodes dramatically increased the likelihood of further recurrences. Multivariate analysis revealed that patients treated with S boulardii and standard antibiotics had a significantly lower relative risk (RR) of CDD recurrence (RR, 0.43; 95% confidence interval, 0.20 to 0.97) compared with placebo and standard antibiotics. The efficacy of S boulardii was significant (recurrence rate 34.6%, compared with 64.7% on placebo; P = .04) in patients with recurrent CDD, but not in patients with initial CDD (recurrence rate 19.3% compared with 24.2% on placebo; P = .86). There were no serious adverse reactions associated with S boulardii. CONCLUSIONS--The combination of standard antibiotics and S boulardii was shown to be an effective and safe therapy for these patients with recurrent CDD; no benefit of S boulardii was demonstrated for those with an initial episode of CDD.
To evaluate the potential of biotherapeutic agents (microorganisms with therapeutic properties) for the prevention and/or treatment of selected intestinal and vaginal infections.
The MEDLINE database was searched for all relevant articles published between 1966 and September 1995. Search terms used were biotherapeutic agent, probiotic, Lactobacillus, Saccharomyces, Bifidobacterium, Candida, gastrointestinal- system, vaginitis, vaginosis-bacterial, and related terms. The bibliographies of obtained articles were also reviewed.
All placebo-controlled human studies on biotherapeutic agents were reviewed. English-language open trials, case series and reports, and animal studies were reviewed only if they were especially relevant to providing information on the potential efficacy, adverse effects, or mechanisms of action of these agents.
Placebo-controlled studies have shown that biotherapeutic agents have been used successfully to prevent antibiotic-associated diarrhea (Lactobacillus caseiGG, bifidobacterium longum, B longum with L acidophilus, and Saccharomyces boulardii), to prevent acute infantile diarrhea (Bifidobacterium bifidum with Streptococcus thermophilus), to treat recurrent Clostridium difficile disease (S boulardii), and to treat various other diarrheal illnesses (Enterococcus faecium SF68, L caseiGG, and S boulardii). There is also evidence for Lactobacillus acidophilus in the prevention of candidal vaginitis. Few adverse effects have been reported. However, many of the studies tested only small numbers of patients or volunteers.
There is now evidence that administration of selected microorganisms is beneficial in the prevention and treatment of certain intestinal and, possibly, treatment of vaginal infections. In an effort to decrease the reliance on antimicrobials, the time has come to carefully explore the therapeutic applications of biotherapeutic agents.
The prevalence of Campylobacter and Salmonella on retail poultry carcasses remains a significant public health concern. The stresses associated with transporting poultry prior to slaughter have been shown to increase pathogen populations both in the intestinal tract and on the carcass exterior. The yeast, Saccharomyces boulardii, was evaluated for its ability to reduce populations of Salmonella and Campylobacter in broiler chickens subjected to transport stress. Chicks, inoculated with individual strains of Salmonella and Campylobacter were held for 6 wk and then divided into two groups with half of the chickens receiving 10% dried yeast in the feed for 60 h. The birds were then caged and transported to simulate commercial conditions. After euthanatizing the birds, the ceca were aseptically removed and analyzed for Salmonella and Campylobacter. With no yeast treatment, transport stress caused the Salmonella colonization frequency to increase more than fivefold, from 3.3 to 16.7%. Yeast treatment significantly reduced the frequency of Salmonella colonization to lower than prestress levels, as no Salmonella were recovered from the ceca of these birds (P < 0.05). Similar results were obtained from birds challenged with a mixture of Salmonella and Campylobacter strains. Before transport, 53.3% of these chickens were positive for Salmonella. Transport stress increased the colonization rate to 67.5% in control birds, whereas the colonization of yeast-treated chickens decreased to 40% (P < 0.05). Frequency of Campylobacter isolation from the ceca was not affected by treatment, but Campylobacter populations present in the ceca were significantly reduced in the mixed strain trial (P < 0.05).
Disturbances of the intestinal flora are said to be a cause of indigestion and the development of antimicrobiotic-associated diarrhea (AAD). Their role in the pathogenesis of typhlocolitis in the horse is in discussion. In order to recognize disturbances of the intestinal flora the function and composition of the normal flora should be known. The article gives a definition of the intestinal flora and informs about its main functions for the host. These functions include the microbial digestion of cellulose which ends in the production of short chain fatty acids. They serve as a nutritious fuel for the macro-organism and especially its intestinal mucosa. The indigenous microflora prevents infections by building up a colonization resistance of the mucous membranes and by activation of the gut associated immune system. Materials and methods used in gutflora evaluations are presented and briefly discussed. The main part of the article reviews studies which used bacteriological techniques to evaluate the qualitative and quantitative composition of the intestinal flora in adult horses. There is little information about the flora of the small intestine in the horse: like in other species, the number of total bacterial counts, E. coli and streptococci rise continuously from duodenum to ileum. Lactobacilli predominate the flora of the duodenum but their numbers remain nearly constant throughout the small intestine. There are some more studies of the cecal flora of the horse which is predominated by obligate anaerobic bacteria. Streptococci, enterobacteria and lactobacilli are regularly found in cecal contents. Most of the work is done with faeces and we attempted to summarise the results of the fecal flora studies. In conclusion, reference-ranges for the most consistently found bacteria in the faeces of the horse are proposed. One gram of normal fecal flora of the horse should contain at least Ig 5 lactobacilli. Clostridia should not be found in numbers of more than Ig 3. Blood agar plates, incubated aerobically, should allow the growth of Ig 6 to Ig 8 of enterococci, Ig 4,5 to Ig 6 of enterobacteria and of Ig 3 to Ig 5 of aerob bacilli. Bacteria of other groups which are able to grow on blood agar (for example acinetobacter spp., staphylococci, coryneforme bacteria) should not exceed Ig 6 in total.
Eighty‐six horses presented for examination at the Rural Veterinary Centre between January 1986 to December 1991 with acute diarrhoea. The average age of affected horses was 3.2 ± 0.2 years (mean ± SE), with 69% three years or younger. Sixty‐one horses were male (36 stallions, 25 geldings) and 83 horses were Thoroughbreds (47) or Standardbreds (36). Sixty‐six horses were undergoing routine training at the time of onset of diarrhoea. Eight horses were afflicted with a non‐specific illness within one to five days before the onset of diarrhoea, whereas eight horses developed diarrhoea during or within 48 h of discontinuation of antimicrobial therapy. Three horses developed the diarrhoea within 24 h of road transportation.
Clinically, the disorder was characterised by a fever, sudden onset of profuse diarrhoea, clinical evidence of dehydration (estimated to be 5 to 12% of body weight at the time of admission) and shock. Degenerative leucopaenia, hyponatraemia, hypochloraemia, hyperkalaemia, hyperglycaemia and azotaemia were characteristic laboratory findings. Laminitis was a sequel in about 30% of cases. The cause of diarrhoea remained undetermined in most cases. Salmonellas were isolated from faecal or tissue samples in only two cases. Similarly, there was no evidence of seroconversion to Erhlichia risticii in 17 cases.
Sixty‐two of the horses survived the acute phase of the disease in response to supportive care. In horses that did not survive, necropsies were performed and revealed sanguineous or turbid peritoneal fluid. The colonic and caecal walls were oedematous and thickened with serosal congestion and discolouration of these organs evident grossly. Histopathological examination of the caecum and colon revealed diffuse congestion, oedema, inflammatory reactions and submucosal vascular thrombosis with varying degrees of mucosal devitalisation.
Most cases presented in this series represent a distinct syndrome of diarrhoea characterised by acute diarrhoea predominantly affecting young horses in training with concomitant signs of fever and toxaemia.
Saccharomyces boulardii is a nonpathogenic yeast used in the treatment of Clostridium difficile diarrhea and colitis. We have reported that S. boulardii inhibits C. difficile toxin A enteritis in rats by releasing a 54-kDa protease which digests the toxin A molecule and its brush border membrane (BBM) receptor (I. Castagliuolo, J. T. LaMont, S. T. Nikulasson, and C. Pothoulakis, Infect. Immun. 64:5225–5232, 1996). The aim of this study was to further evaluate the role of S. boulardii protease in preventing C. difficile toxin A enteritis in rat ileum and determine whether it protects human colonic mucosa from C. difficile toxins. A polyclonal rabbit antiserum raised against purified S. boulardii serine protease inhibited by 73% the proteolytic activity present in S. boulardii conditioned medium in vitro. The anti-protease immunoglobulin G (IgG) prevented the action of S. boulardii on toxin A-induced intestinal secretion and mucosal permeability to [3H]mannitol in rat ileal loops, while control rabbit IgG had no effect. The anti-protease IgG also prevented the effects of S. boulardii protease on digestion of toxins A and B and on binding of [3H]toxin A and [3H]toxin B to purified human colonic BBM. Purified S. boulardii protease reversed toxin A- and toxin B-induced inhibition of protein synthesis in human colonic (HT-29) cells. Furthermore, toxin A- and B-induced drops in transepithelial resistance in human colonic mucosa mounted in Ussing chambers were reversed by 60 and 68%, respectively, by preexposing the toxins to S. boulardii protease. We conclude that the protective effects of S. boulardii on C. difficile-induced inflammatory diarrhea in humans are due, at least in part, to proteolytic digestion of toxin A and B molecules by a secreted protease.
Samples of faeces and blood were obtained from 66 adult horses with diarrhoea. The results of routine bacteriological, parasitological, haematological and biochemical tests were correlated with the outcome of the cases. Twenty-two (33 per cent) of the horses died or were destroyed as a consequence of the diarrhoea. A diagnosis was reached in only 23 cases (35 per cent), and in nine of them only at post mortem examination. Salmonella typhimurium was isolated from five cases. Statistical analysis revealed significant differences between the horses which survived and those which died in their packed cell volumes, white blood cell counts, neutrophil counts, serum albumin concentrations and alkaline phosphatase activities.
Saccharomyces boulardii (S.b.) is largely used in Western European countries for the treatment of acute infectious enteritis and antibiotic-induced gastrointestinal disorders. To study the mechanisms of the protective effect of S.b. against enteral pathogen infection, we assessed the response of the intestinal secretion of secretory IgA (s-IgA) and of the secretory component of immunoglobulins (SC) to oral administration of high doses (0.5 mg/g body weight, three times per day) of S.b. cells in growing rats. S.b. cells (biological activity: 2.8 x 10(9) viable cells/100 mg) were administered daily by gastric intubation to weanling rats from day 14 until day 22 postpartum. Control groups received either 0.9% saline or ovalbumin following the same schedule. Expressed per milligram of cell protein, SC content was significantly increased in crypt cells isolated from the jejunum (48.5% vs saline controls, P less than 0.05) as it was in the duodenal fluid (62.8% vs saline controls, P less than 0.01) of rats treated with S.b. Oral treatment with S.b. had no effect on the secretion of SC by the liver. In the duodenal fluid of rats treated with S.b. cells, the mean concentration of s-IgA was increased by 56.9% (P less than 0.01) over the concentration of s-IgA measured in saline controls.(ABSTRACT TRUNCATED AT 250 WORDS)
A patient with six documented episodes of recurrent Clostridium difficile colitis over an eight-month period is described. Relapses of colitis occurred despite treatment with vancomycin, metronidazole, bacitracin, and cholestyramine. Each recurrence appeared to begin successively closer to the end of the previous course of treatment. Four episodes were sufficiently severe to require hospitalization for rehydration. Saccharomyces boulardii, a nonpathogenic yeast, was begun prior to discontinuing vancomycin therapy for the last recurrence and was continued for three months. Serial stool cultures and assays for C. difficile showed persistence of the organism but rapid reduction of high titers of cytotoxin. No further recurrences of diarrhea or colitis were encountered while the patient was taking Saccharomyces boulardii and for 18 months of follow-up after the yeast was discontinued.
Saccharomyces boulardii, a nonpathogenic yeast, has been widely used in Europe to prevent antibiotic-associated diarrhea (AAD). We performed a prospective double-blind controlled study to investigate AAD in hospitalized patients and to evaluate the effect of S. boulardii, a living yeast, given in capsule form concurrently with antibiotics. Over 23 mo, 180 patients completed the study. Of the patients receiving placebo, 22% experienced diarrhea compared with 9.5% of patients receiving S. boulardii (p = 0.038). Risk factors found to be associated with AAD were multiple antibiotic combinations (containing clindamycin, cephalosporins, or trimethoprim-sulfamethoxazole) and tube feeding. Clostridium difficile, an anaerobe found in the stools of most patients with pseudomembranous colitis, was variably associated with AAD. We evaluated the role of C. difficile in AAD in the study population and found no significant association between the presence of C. difficile or cytotoxin with AAD. Approximately 33% of the patients without diarrhea harbored at least one C. difficile-positive stool and nearly 50% of these patients had detectable cytotoxin. Similar values were obtained in patients with diarrhea. Of C. difficile-positive patients, 31% (5/16) on placebo developed diarrhea compared with 9.4% (3/32) on S. boulardii; this difference was not statistically significant (p = 0.07). There were no discernable adverse effects of yeast administration. We conclude that S. boulardii reduces the incidence of antibiotic-associated diarrhea in hospitalized patients.
Investigation of oral administration of Saccharomyces boulardii in healthy volunteers demonstrates several cellular and humoral changes in peripheral blood. Among its effects are the increase of erythrocytes, leucocytes, polymorphs, neutrophils, complement components C3, C5, C3d, serum anticomplementary activity and leucocyte chemokinesis, specially when autologous serum and antigen have been added to the culture medium and decrease of complement haemolytic activity (CH50, classic and alternative pathways). We have also demonstrated that in vitro S. boulardii was able to activate complement directly, to fix C3b to its surface and that its phagocytosis by mononuclear cells was complement-dependent. The overall changes in serum proteins suggested changes of acute phase proteins typical of an inflammatory process. Furthermore S. boulardii had no mitogenic response of lymphocyte populations. Our results demonstrated that S. boulardii activates the reticuloendothelial system and complement system and suggest that S. boulardii merits therapeutic trial in a variety of clinical situations.
Eighty-six horses presented for examination at the Rural Veterinary Centre between January 1986 to December 1991 with acute diarrhoea. The average age of affected horses was 3.2 +/- 0.2 years (mean +/- SE), with 69% three years or younger. Sixty-one horses were male (36 stallions, 25 geldings) and 83 horses were Thoroughbreds (47) or Standardbreds (36). Sixty-six horses were undergoing routine training at the time of onset of diarrhoea. Eight horses were afflicted with a non-specific illness within one to five days before the onset of diarrhoea, whereas eight horses developed diarrhoea during or within 48 h of discontinuation of antimicrobial therapy. Three horses developed the diarrhoea within 24 h of road transportation. Clinically, the disorder was characterised by a fever, sudden onset of profuse diarrhoea, clinical evidence of dehydration (estimated to be 5 to 12% of body weight at the time of admission) and shock. Degenerative leucopaenia, hyponatraemia, hypochloraemia, hyperkalaemia, hyperglycaemia and azotaemia were characteristic laboratory findings. Laminitis was a sequel in about 30% of cases. The cause of diarrhoea remained undetermined in most cases. Salmonellas were isolated from faecal or tissue samples in only two cases. Similarly, there was no evidence of seroconversion to Erhlichia risticii in 17 cases. Sixty-two of the horses survived the acute phase of the disease in response to supportive care. In horses that did not survive, necropsies were performed and revealed sanguineous or turbid peritoneal fluid. The colonic and caecal walls were oedematous and thickened with serosal congestion and discolouration of these organs evident grossly.(ABSTRACT TRUNCATED AT 250 WORDS)
Based on experimental evidence in animals showing that the oral administration of Saccharomyces boulardii is effective in reducing morbidity and mortality due to Clostridium difficile-induced pseudomembranous colitis, we conducted an open trial to examine the effects of the living yeast, given as primary therapy, in a selected group of infants and children with persistent intestinal symptoms related to toxinogenic C. difficile overgrowth. Over a period of 10 consecutive months, we studied 19 eligible patients (median age 8 months) who presented with enteral symptoms lasting for > 15 days and who had solely C. difficile in stools with positive cytotoxin B assay. Serotyping of the strains and determination in vitro of production of toxins A and B were performed subsequently. The patients presented with persistent or protracted diarrhea, malabsorption, and failure to grow (n = 8), or with repeated attacks of colics, emesis, and hypermeteorism without diarrhea (n = 4), or with both entities (n = 7). Patients with chronic protracted diarrhea (n = 3) had depressed jejunal disaccharidase activities and ultrastructural changes of enterocytes, including sparce and shortened microvilli. None had evidence of colitis. All the strains of C. difficile tested (n = 17) belonged to pathogenic serotypes (A1, A8, C, F, G, H, and K) and produced in vitro high levels of toxins A (n = 16) and B (n = 17). S. boulardii was given orally in a lyophilized form over 15 days (250 mg two to four times per day according to age).(ABSTRACT TRUNCATED AT 250 WORDS)
In a randomized, single-center, double-blind, placebo-controlled pilot study, 20 patients with established Crohn's disease suffering from diarrhea and moderate complaints as measured by the BEST Index, were treated with the yeast preparation Saccharomyces boulardii (S.b.) in a dosage of 250 mg t.i.d., initially for two weeks in addition to the basic treatment. A reduction in the frequency of bowel movements (5.0 +/- 1.4 vs. 4.1 +/- 2.3 evacuations/day, p < 0.01) and in the BEST Index (193 +/- 32 vs. 168 +/- 59, p < 0.05) as compared to baseline was registered. After this initial phase, the patients were allocated in randomized order to the control group (n = 7) receiving placebo, or to the verum group (n = 10) receiving S.b.(250 mg t.i.d.) for 7 weeks, while the basic treatment was maintained. The group treated with S.b. showed a significant reduction in the frequency of bowel movements in the tenth week, to 3.3 +/- 1.2 evacuations per day, and in the BEST Index, to 107 +/- 85. In the control group taking placebo, however, this effect was not observed. By contrast, the frequency of bowel movements and the BEST Index rose again in the tenth week until reaching initial values (4.6 +/- 1.9 evacuations daily and 180 +/- 61, respectively). No adverse drug events were observed. In order to confirm these positive effects of S.b. in patients with Crohn's disease, further controlled multicenter trials in a larger patient population should be performed.
Basic remarks:
Among travellers to distant countries with a low socioeconomic status and poor hygiene, traveller's diarrhea is a major problem. Once this epidemiological fact had been recognized, intensive efforts were made to reduce the incidence of this illness by prophylactic medication. Among non-antibiotic substances investigated, Saccharomyces boulardii (SB) appeared to show promising results in earlier studies.
Method:
In a placebo-controlled, double-blind study, various dosages (250 mg and 1,000 mg SB) were administered prophylactically to 3,000 Austrian travellers to distant regions.
Results:
A significant reduction in the incidence of diarrhea was observed, with success depending directly on the rigorous use of the preparation. A tendency was noted for SB to have a varying regional effect, which was particularly marked in North Africa and in the Near-east (Turkey!); in addition, the effect also proved to be dose-dependent. The medication can be classified as low on side effects.
The clinical and clinicopathologic characteristics of fatal necrotizing enterocolitis were examined in 16 horses (age 4 months to 12 years). At initial presentation, 8 of 16 horses were pyrexic (median temperature, 38.4 degrees C; range, 33.8 to 40.6 degrees C); all 16 were tachycardic (median heart rate, 93 bpm, range, 66 to 138 bpm); 13 of 16 were tachypneic (median heart rate, 36 bpm, range, 16 to 80 bpm), dehydrated, and had discolored mucous membranes. All horses that were pyrexic were also tachycardic and tachypneic. PCV was high (> 45%) in 14 horses. Six horses were leukopenic (< 5,000 cells/microL); 12 were neutropenic (< 2,300 cells/microL), and 14 had > 100 band neutrophils/microL. Twelve horses were acidemic (pH < 7.37; range, 6.88 to 7.33) and the venous bicarbonate concentration was low (< 23 mEq/L) in 14 horses. Median anion gap in 16 horses was 31.5 mEq/L (> 15 mEq/L in 15 horses). Eleven of 16 horses were hyponatremic (< 137 mEq/L), 1 horse was hypernatremic (> 143 mEq/L), 3 were hypokalemic (< 3.2 mEq/L), 6 were hyperkalemic (> 4.5 mEq/L), and 14 were hypochloremic (< 98 mEq/L). Serum creatinine concentrations were high (> 1.4 mg/dL) in 15 horses. Abdominal fluid was examined in 12 horses 4 had total protein concentrations > 2.5 g/dL and 6 had nucleated cell counts > 5,000/ microL and < 10,000/microL; none had > 10,000/microL. Eight of 12 samples revealed a nondegenerate neutrophilia (> 50%). Abdominal fluid collected from 4 horses immediately before death was normal in 2 horses and indicative of suppurative inflammation in 2. All 8 horses tested had low or nonexistent serum immunofluorescent antibody titers to Ehrlichia risticii. Four of 16 horses had Salmonella spp isolated from feces or tissues. All 16 horses either died (5 of 16; 31%) or were euthanized because of a grave prognosis. Median time to death was 45.5 hours (range, 7 to 113 hours) from the time of admission. Death was preceded by severe abdominal pain in 14 horses. Fatal necrotizing enterocolitis of horses is characterized by a brief course, profound dehydration, electrolyte derangements, acid-base abnormalities, and terminally, severe abdominal pain. Abdominal fluid analysis was frequently not indicative of the severity of disease.
The purpose of this study was to evaluate the effects of probiotic administration on the prevalence of fecal shedding of Salmonella, the prevalence of postoperative diarrhea, the length of antimicrobial therapy, and the length of the hospitalization stay during the postoperative period in horses with colic. Two commercially available probiotics for horses were used in a double-blind prospective study of 200 horses undergoing surgery for colic. Probiotic or placebo was administered PO once a day for 7 days postoperatively, and fecal cultures for Salmonella were obtained daily for 10 days. After selection of 186 patients completing the treatment protocol, the results indicated that the commercial probiotic formulations had no effect on Salmonella shedding, prevalence of diarrhea, length of antimicrobial therapy, or length of hospitalization (P > .05). Twenty percent of the horses yielded 1 or more positive fecal cultures for Salmonella; of these horses, 74% were classified as asymptomatic shedders. Twenty-six percent of all horses had fluid diarrhea postoperatively, with only 12% of these horses having positive fecal cultures for Salmonella. The most common isolate was Salmonella krefeld (24 of 39 isolates). Among the different gastrointestinal disorders, horses with feed and sand impactions appeared to be more prone to shed Salmonella.
To assess the preventive effect of Saccharomyces boulardii on diarrhea in critically ill tube-fed patients and to evaluate risk factors for diarrhea.
Prospective, multicenter, randomized, double-blind placebo-controlled study.
Eleven intensive care units in teaching and general hospitals.
Critically ill patients whose need for enteral nutrition was expected to exceed 6 days.
S. boulardii 500 mg four times a day versus placebo.
Diarrhea was defined by a semiquantitative score based on the volume and consistency of stools. A total of 128 patients were studied, 64 in each group. Treatment with S. boulardii reduced the mean percentage of days with diarrhea per feeding days from 18.9 to 14.2% [odds ratio (OR) = 0.67, 95% confidence interval (CI) = 0.50-0.90, P = 0.0069]. In the control group, nine risk factors were significantly associated with diarrhea: nonsterile administration of nutrients in open containers, previous suspension of oral feeding, malnutrition, hypoalbuminemia, sepsis syndrome, multiple organ failure, presence of an infection site, fever or hypothermia, and use of antibiotics. Five independent factors were associated with diarrhea in a multivariate analysis: fever or hypothermia, malnutrition, hypoalbuminemia, previous suspension of oral feeding, and presence of an infection site. After adjustment for these factors, the preventive effect of S. boulardii on diarrhea was even more significant (OR = 0.61, 95% CI = 0.44-0.84, P < 0.0023).
S. boulardii prevents diarrhea in critically ill tube-fed patients, especially in patients with risk factors for diarrhea.
To characterize horses with acute diarrhea and determine risk factors for failure to survive.
Retrospective study.
122 adult horses admitted for acute diarrhea at the teaching hospital between Jan 1, 1990 and Dec 31, 1996.
Medical records of horses with acute diarrhea were reviewed to abstract information regarding signalment, history, physical examination, clinicopathologic testing, treatment, and outcome.
91 of 122 (74.6%) horses lived and were discharged from the hospital. Horses with history of administration of antimicrobials for a problem preceding diarrhea were approximately 4.5 times less likely to survive. The following variables that had been determined at the time of admission were significantly associated with failure to survive: administration of antimicrobial drugs for another illness, serum creatinine concentration > 2.0 mg/dl, PCV > 45%, tachycardia (heart rate > 60 beats/min), and low serum total protein concentration. Prevalence of laminitis was 11.5%.
Diarrheic horses that are azotemic and have clinicopathologic findings consistent with hemoconcentration and hypoproteinemia have a poor prognosis for survival. Antimicrobial administration may induce diarrhea, and antimicrobial-associated diarrhea may have a worse prognosis than other types of acute diarrhea.
The detection of lectin sites for mannose-sensitive adhesion in the outer membrane of Saccharomyces boulardii and the irreversible binding of both enteropathogenic Escherichia coli (EPEC) and salmonellae (serovar Salmonella Typhimurium and Salmonella Enteritidis) provided the motivation to carry out further investigations to find out whether also other enteric bacteria such as entero-haemorrhagic Escherichia coli (EHEC) and the DT 104 mutant of S. Typhimurium have the capacity for binding to the cell wall of this yeast. Reference strains and fresh isolates from clinical cases of EHEC infections as well as salmonellae of the DT 104 mutant were included in this study using the agglutination test. The results first of all showed that EHEC of the serogroup O 157 and the DT 104 mutant of S. Typhimurium were bound to the surface of Saccharomyces boulardii. Because these bacteria do not respond very well to drugs but most of the gastrointestinal infections are caused by them, the use of S. boulardii for treatment and prophylaxis could be an excellent alternative.
Probiotics are nonpathogenic microorganisms that, when ingested, exert a positive influence on the health or physiology of the host. They can influence intestinal physiology either directly or indirectly through modulation of the endogenous ecosystem or immune system. The results that have been shown with a sufficient level of proof to enable probiotics to be used as treatments for gastrointestinal disturbances are 1) the good tolerance of yogurt compared with milk in subjects with primary or secondary lactose maldigestion, 2) the use of Saccharomyces boulardii and Enterococcus faecium SF 68 to prevent or shorten the duration of antibiotic-associated diarrhea, 3) the use of S. boulardii to prevent further recurrence of Clostridium difficile-associated diarrhea, and 4) the use of fermented milks containing Lactobacillus rhamnosus GG to shorten the duration of diarrhea in infants with rotavirus enteritis (and probably also in gastroenteritis of other causes). Effects that are otherwise suggested for diverse probiotics include alleviation of diarrhea of miscellaneous causes; prophylaxis of gastrointestinal infections, which includes traveler's diarrhea; and immunomodulation. Trials of gastrointestinal diseases that involve the ecosystem are currently being performed, eg, Helicobacter pylori infections, inflammatory bowel disease, and colon cancer.
To evaluate contents of commercial probiotic products marketed for veterinary or human administration.
Microbiologic culture assay.
8 veterinary probiotics and 5 human probiotics.
Quantitative bacteriologic culture was performed on all products, and isolates were identified via biochemical characteristics. Comparison of actual contents versus label claims was performed.
Label descriptions of organisms and concentrations accurately described the actual contents of only 2 of 13 products. Five veterinary products did not specifically list their contents. Most products contained low concentrations of viable organisms. Five products did not contain 1 or more of the stated organisms, and 3 products contained additional species. Some products contained organisms with no reported probiotic effects; some of these organisms could be pathogens.
Most commercial veterinary probiotic preparations are not accurately represented by label claims. Quality control appears to be poor for commercial veterinary probiotics.
The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (10(10)-10(12) colony-forming units per g) (n = 30), or lyophilized S. boulardii, (10(10)-10(12) colony forming units per g) (n = 30) or pasteurized cow milk as placebo (n = 29); on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40% of the patients, 27% had rotavirus. Lactobacillus and S. boulardii significantly reduced the number of depositions (p < 0.001) and diarrheal duration (p < 0.005). Similarly both significantly (p < 0.002) reduced vomiting as compared with placebo. There was no difference between treatments depending on rotavirus status. In conclusion, L. casei and L. acidophillus strains CERELA and S. boulardii are useful in the management of persistent diarrhea in children.