Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial

Prebiotics are non-digestible (by the host) food ingredients that have a beneficial effect through their selective metabolism in the intestinal tract. Key to this is the specificity of microbial changes. The present paper reviews the concept in terms of three criteria: (a) resistance to gastric acidity, hydrolysis by mammalian enzymes and gastrointestinal absorption; (b) fermentation by intestinal microflora; (c) selective stimulation of the growth and/or activity of intestinal bacteria associated with health and wellbeing. The conclusion is that prebiotics that currently fulfil these three criteria are fructo-oligosaccharides, galacto-oligosaccharides and lactulose, although promise does exist with several other dietary carbohydrates. Given the range of food vehicles that may be fortified by prebiotics, their ability to confer positive microflora changes and the health aspects that may accrue, it is important that robust technologies to assay functionality are used. This would include a molecular-based approach to determine flora changes. The future use of prebiotics may allow species-level changes in the microbiota, an extrapolation into genera other than the bifidobacteria and lactobacilli, and allow preferential use in disease-prone areas of the body.

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Dietary modulation of the human colonic microbiota: updating the concept of prebiotics

Background:An obvious difference between breast-fed and formula-fed newborn infants is the development of the intestinal flora, considered to be of importance for protection against harmful micro-organisms and for the maturation of the intestinal immune system. In this study, novel molecular

Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods.

Probiotics are usually defined as microbial food supplements with beneficial effects on the consumers. Most probiotics fall into the group of organisms' known as lactic acid-producing bacteria and are normally consumed in the form of yogurt, fermented milks or other fermented foods. Some of the beneficial effect of lactic acid bacteria consumption include: (i) improving intestinal tract health; (ii) enhancing the immune system, synthesizing and enhancing the bioavailability of nutrients; (iii) reducing symptoms of lactose intolerance, decreasing the prevalence of allergy in susceptible individuals; and (iv) reducing risk of certain cancers. The mechanisms by which probiotics exert their effects are largely unknown, but may involve modifying gut pH, antagonizing pathogens through production of antimicrobial compounds, competing for pathogen binding and receptor sites as well as for available nutrients and growth factors, stimulating immunomodulatory cells, and producing lactase. Selection criteria, efficacy, food and supplement sources and safety issues around probiotics are reviewed. Recent scientific investigation has supported the important role of probiotics as a part of a healthy diet for human as well as for animals and may be an avenue to provide a safe, cost effective, and 'natural' approach that adds a barrier against microbial infection. This paper presents a review of probiotics in health maintenance and disease prevention.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2672.2006.02963.x

Probiotics and their fermented food products are beneficial for health.

The human gastrointestinal tract is colonised by a complex ecosystem of microorganisms. Intestinal bacteria are not only commensal, but they also undergo a synbiotic co-evolution along with their host. Beneficial intestinal bacteria have numerous and important functions, e.g., they produce various nutrients for their host, prevent infections caused by intestinal pathogens, and modulate a normal immunological response. Therefore, modification of the intestinal microbiota in order to achieve, restore, and maintain favourable balance in the ecosystem, and the activity of microorganisms present in the gastrointestinal tract is necessary for the improved health condition of the host. The introduction of probiotics, prebiotics, or synbiotics into human diet is favourable for the intestinal microbiota. They may be consumed in the form of raw vegetables and fruit, fermented pickles, or dairy products. Another source may be pharmaceutical formulas and functional food. This paper provides a review of available information and summarises the current knowledge on the effects of probiotics, prebiotics, and synbiotics on human health. The mechanism of beneficial action of those substances is discussed, and verified study results proving their efficacy in human nutrition are presented.

https://www.mdpi.com/2072-6643/9/9/1021/pdf

Effects of Probiotics, Prebiotics, and Synbiotics on Human Health.

Food products fermented by lactic acid bacteria have long been used for their proposed health promoting properties. In recent years, selected probiotic strains have been thoroughly investigated for specific health effects. Properties like relief of lactose intolerance symptoms and shortening of rotavirus diarrhoea are now widely accepted for selected probiotics. Some areas, such as the treatment and prevention of atopy hold great promise. However, many proposed health effects still need additional investigation. In particular the potential benefits for the healthy consumer, the main market for probiotic products, requires more attention. Also, the potential use of probiotics outside the gastrointestinal tract deserves to be explored further. Results from well conducted clinical studies will expand and increase the acceptance of probiotics for the treatment and prevention of selected diseases.

Probiotics: an overview of beneficial effects

Probiotics: effects on immunity

Background: The gastrointestinal microflora is an important constituent of the gut mucosal defense barrier. We have previously shown that a human intestinal floral strain, Lactobacillus GG (ATCC 53103), promotes local antigen-specific immune responses (particularly in the IgA class), prevents permeability defects, and confers controlled antigen absorption. Objective: The aim of this study was to evaluate the clinical and immunologic effects of cow's milk elimination without ( n = 14) and with ( n = 13) the addition of Lactobacillus GG (5 × 10 8 colony-forming units/gm formula) in an extensively hydrolyzed whey formula in infants with atopic eczema and cow's milk allergy. The second part of the study involved 10 breast-fed infants who had atopic eczema and cow's milk allergy. In this group Lactobacillus GG was given to nursing mothers. Methods: The severity of atopic eczema was assessed by clinical scoring. The concentrations of fecal α
 1 -antitrypsin, tumor necrosis factor-α, and eosinophil cationic protein were determined as markers of intestinal inflammation before and after dietary intervention. Results: The clinical score of atopic dermatitis improved significantly during the 1-month study period in infants treated with the extensively hydrolyzed whey formula fortified with Lactobacillus GG. The concentration of α
 1 -antitrypsin decreased significantly in this group ( p = 0.03) but not in the group receiving the whey formula without Lactobacillus GG ( p = 0.68). In parallel, the median (lower quartile to upper quartile) concentration of fecal tumor necrosis factor-α decreased significantly in this group, from 709 pg/gm (91 to 1131 pg/gm) to 34 pg/gm (19 to 103 pg/gm) ( p = 0.003), but not in those receiving the extensively hydrolyzed whey formula only ( p = 0.38). The concentration of fecal eosinophil cationic protein remained unaltered during therapy. Conclusion: These results suggest that probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy, and by alleviating intestinal inflammation, may act as a useful tool in the treatment of food allergy. (J Allergy Clin Immunol 1997;99:179-85.)

https://www.jacionline.org/article/S0091-6749(97)70093-9/pdf

Probiotics: A novel approach in the management of food allergy ☆ ☆☆ ★ ★★

Infections of the gastrointestinal tract are a major health problem for both adults and children worldwide. Changes in the normal human gut microflora result in the development of intestinal disorders. Pathogenic bacteria alter the intestinal microecology and intestinal colonization resistance. A healthy gastrointestinal microflora forms a barrier against invading organisms. Normal intestinal microbes and some probiotic bacteria can enhance the host's defence mechanisms against pathogens. They can also improve intestinal immunity by adhering to intestinal mucosa and stimulating local immune responses. Thus the maintenance of a balanced intestinal microecology improves the ability to preserve intestinal integrity.

Erika Isolauri

Papers

Probiotics: an overview of beneficial effects

Probiotics: effects on immunity

Probiotics: A novel approach in the management of food allergy ☆ ☆☆ ★ ★★

Gut flora in normal and disordered states.

Cow-milk allergy