E. Myllyluoma

Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota

Background  Irritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial.

Guidance for Substantiating the Evidence for Beneficial Effects of Probiotics: Prevention and Management of Infections by Probiotics

The rationale for the use of probiotics in the management of infectious diseases is supported by their potential to influence and stabilize the composition of gut microbiota, enhance colonization resistance, and modulate immune function parameters. A literature review was conducted to determine the efficacy of using probiotics in selected infections: 1) infectious diarrhea in infants and children, 2) travelers diarrhea, 3) necrotizing enterocolitis in infants, 4) Helicobacter pylori infection, 5) respiratory tract infections in adults and children, 6) ear, nose, and throat infections, and 7) infectious complications in surgical and critically ill patients. The different types of infections that have been subject to clinical studies with different probiotics obviously prevent any generic conclusions. Furthermore, the lack of consistency among studies focusing on 1 specific infection, in study design, applied probiotic strains, outcome parameters, and study population, along with the still limited number of studies, preclude clear and definite conclusions on the efficacy of probiotics and illustrate the need for better-aligned study designs and methodology. Exceptions were the management of infectious diarrhea in infants and travelers diarrhea, antibiotic-associated diarrhea, and necrotizing enterocolitis. Sufficient consistent data exist for these applications to conclude that certain probiotics, under certain conditions, and in certain target populations, are beneficial in reducing the risk of infection. In addition, some evidence exists, although conclusions are premature, for the management of Helicobacter pylori infection and possible reduction of treatment side effects. Certain probiotics may also reduce the risk of various symptoms of respiratory tract infections in adults and children, including ear, nose, and throat infections, although data are currently far too limited to distill any clinical recommendations in this area. Positive but also negative results have been obtained in prevention of infectious complications in surgical and critically ill patients. For future studies it is recommended that researchers provide adequate power, identify pathogens, and report both clinical outcomes and immune biomarkers relating to putative underlying mechanisms.

Probiotic supplementation improves tolerance to Helicobacter pylori eradication therapy--a placebo-controlled, double-blind randomized pilot study.

Background : H. pylori is the major cause of chronic gastritis, and a risk factor for peptic ulcer and gastric cancer.

Effects of Multispecies Probiotic Combination on Helicobacter pylori Infection In Vitro

ABSTRACT Probiotic bacteria alleviate many gastrointestinal symptoms, but the current trend of combining bacteria for additional benefit may make their effects more complex. We characterize four probiotics and their combination in terms of pathogen adhesion, barrier function, cell death, and inflammatory response in Helicobacter pylori-infected epithelial cells. H. pylori-infected Caco-2 cells were pretreated with Lactobacillus rhamnosus GG, Lactobacillus rhamnosus Lc705, Propionibacterium freudenreichii subsp. shermanii Js, Bifidobacterium breve Bb99, or all four organisms in combination. We evaluated the adhesion of H. pylori by in situ immunofluorescence; epithelial barrier function by measurement of transepithelial resistance; apoptosis by measurement of caspase 3 activation; cell membrane leakage by measurement of lactate dehydrogenase release; and inflammation by measurement of interleukin-8 (IL-8), IL-10, prostaglandin E2 (PGE2), and leukotriene B4 (LTB4) release. All probiotics inhibited H. pylori adhesion. L. rhamnosus GG, L. rhamnosus Lc705, P. freudenreichii subsp. shermanii Js, and the combination inhibited H. pylori-induced cell membrane leakage. L. rhamnosus GG, L. rhamnosus Lc705, and the combination initially improved epithelial barrier function but increased the H. pylori-induced barrier deterioration after incubation for 24 to 42 h. L. rhamnosus GG, L. rhamnosus Lc705, and P. freudenreichii subsp. shermanii Js inhibited H. pylori-induced IL-8 release, whereas L. rhamnosus GG, L. rhamnosus Lc705, and B. breve Bb99 suppressed PGE2 release. None of these anti-inflammatory effects persisted when the probiotics were used in combination. The combination thus increased the levels of IL-8, PGE2, and LTB4 released from H. pylori-infected epithelial cells. The proinflammatory actions of the individual components dominated the anti-inflammatory effects when the probiotic bacteria were used in combination. Our results stress that the therapeutic response can be optimized if probiotic strains are characterized before they are used in combination.

Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota: CLINICAL TRIAL: PROBIOTICS IN IBS

Background  Irritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial.

Clinical trial: multispecies probiotic supplementation alleviates the symptoms of IBS and stabilises intestinal microbiota

Background  Irritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial.

Functional dairy products for gastrointestinal infections and dysfunction.

Publisher Summary Fermented milk products have traditionally been used to reduce the risk of abdominal problems and diarrhea during antibiotic treatments. Similarly, they have been used to alleviate the symptoms and reduce the duration of diarrhea. During the past two decades, studies on particular strains, namely probiotics, have transformed information based on folklore into science-based research; infections not only in the intestine, but also in the stomach, have been a focus of the research. There is a growing body of evidence which shows that probiotics can be used as an adjunct therapy to antibiotics used for the eradication of Helicobacter pylori, the main causative agent of gastric ulcers. Intestinal disturbances are not always due to infections, but a disturbed microbiota, together with other thus far undefined mechanisms, is supposed to be connected to many irregular intestinal symptoms, and probiotics and prebiotics are suggested for use for the treatment of irritable bowel syndrome and relief of constipation. Bacteria genera other than Lactobacillus and Bifidobacterium can also be used as probiotics. This chapter presents the studies conducted on strains mainly from the genera, suitable for use in fermented dairy products.

Probiotic-Mediated Decrease of Elevated Serine Protease Activity in Fecal Supernatants of Diarrheic IBS is Positively Correlated With an Improvement of the Symptomatology: A New Biomarker in IBS Probiotic Treatment Efficacy

Background Probiotics are live microorganisms that promote gut health and regulate intestinal homeostasis. How probiotics work is incompletely understood, but may involve induction of cell survival pathways (Akt) and stress/MAP kinase-dependent induction of heat shock proteins. The possibility that probiotics might induce autophagy, however, has not been previously explored. Autophagy is believed to have an important role in promoting cell survival under conditions of stress and in clearance of potentially disease-causing intracellular microorganisms. Polymorphisms in autophagy genes have recently been linked to increased risk of human IBD. Methods Intestinal epithelial cells (human colonic Caco2BBE or rat jejunal IEC18) were treated with conditioned media from Bifidobacterium breve (BB-CM) or other intestinal bacteria (Lactobacillus plantarum, Lactobacillus rhamnosus GG). Initially time dependence was determined using 1% CM and subsequently concentration dependence was determined at 30 or 120 min and 24 hours for rapid transduction events (MAP kinase, LC3 conjugation, or Akt activation) versus long lived cellular survival proteins (heat shock protein induction), all assessed by Western blot analysis. Results BB-CM induced autophagy in a timeand concentration-dependent manner. Western blot analysis demonstrated LC3II activation by conjugation to phosphatidylethanolamine by 120 min after BB-CM. BB-CM also activated p38 MAP kinase and ERK1/2, but within 30 min of addition. Both Lactobacillus plantarum and LGG-CM also stimulated LC3, thereby demonstrating stimulation of autophagy. For BB-CM, inhibition of either p38 MAP kinase with SB203580 ort ERK1/2 activation with PD98059 blocked LC3 activation. A wider panel of gram positive and gram negative bacteria were tested only on LC3 activation and while most gram positive bacteria stimulated LC3 activation, most gram negative did not. Conclusions These studies provide evidence that bioactive agents secreted by probiotic and commensal bacteria can induce autophagy in gut epithelial cells. The induction of autophagy may underlie some of the beneficial clinical effects attributed to a healthy enteric microbiota and probiotic agents.