An expert panel was convened in October 2013 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) to discuss the field of probiotics. It is now 13 years since the definition of probiotics and 12 years after guidelines were published for regulators, scientists and industry by the Food and Agriculture Organization of the United Nations and the WHO (FAO/WHO). The FAO/WHO definition of a probiotic--"live microorganisms which when administered in adequate amounts confer a health benefit on the host"--was reinforced as relevant and sufficiently accommodating for current and anticipated applications. However, inconsistencies between the FAO/WHO Expert Consultation Report and the FAO/WHO Guidelines were clarified to take into account advances in science and applications. A more precise use of the term 'probiotic' will be useful to guide clinicians and consumers in differentiating the diverse products on the market. This document represents the conclusions of the ISAPP consensus meeting on the appropriate use and scope of the term probiotic.

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Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)71142-9.pdf

Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders.

http://envismadrasuniv.org/Physiology/pdf/Gut%20flora%20in%20health%20and%20disease.pdf

Gut flora in health and disease

Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma

Gut microbiota is an assortment of microorganisms inhabiting the length and width of the mammalian gastrointestinal tract. The composition of this microbial community is host specific, evolving throughout an individual's lifetime and susceptible to both exogenous and endogenous modifications. Recent renewed interest in the structure and function of this "organ" has illuminated its central position in health and disease. The microbiota is intimately involved in numerous aspects of normal host physiology, from nutritional status to behavior and stress response. Additionally, they can be a central or a contributing cause of many diseases, affecting both near and far organ systems. The overall balance in the composition of the gut microbial community, as well as the presence or absence of key species capable of effecting specific responses, is important in ensuring homeostasis or lack thereof at the intestinal mucosa and beyond. The mechanisms through which microbiota exerts its beneficial or detrimental influences remain largely undefined, but include elaboration of signaling molecules and recognition of bacterial epitopes by both intestinal epithelial and mucosal immune cells. The advances in modeling and analysis of gut microbiota will further our knowledge of their role in health and disease, allowing customization of existing and future therapeutic and prophylactic modalities.

Gut Microbiota in Health and Disease

PART I: PROBIOTICS Chapter 1: Probiotic microorganisms 11 Definition 12 Screening, identification and characterization of Lactobacillus and Bifidobacillus strains 13 Detection and enumeration of gastrointestinal microorganisms 14 Enteric microbial community profiling in gastrointestinal tract by Terminal-Restriction Fragment Length Polymorphism (T-RFLP) 15 Effective dosage for probiotic effects 16 Incorporating probiotics into foods 17 Safety of probiotic microorganisms 18 Legal status and regulatory issues Chapter 2: Selection and maintenance of probiotic microorganisms 21 Isolation of probiotic microorganisms 22 Selection of probiotic mircroorganisms 23 Maintenance of Probiotic Microorganisms Chapter 3: Genetic modification of probiotic microorganisms 31 Mutants obtained from probiotic microorganisms by random mutagenesis 32 Plasmids 33 Vectors for Lactobacilli and Bifidobacteria 34 Genetic recombination Chapter 4: Role of probiotics in health and diseases 41 Cell line models in research 42 Laboratory animal models in research 43 Effects on human health and diseases 44 Effects on farm animals Chapter 5: Mechanisms of probiotics 51 Adhesion to intestinal mucus & epithelium by probiotics 52 Combined probiotics and pathogen adhesion and aggregation 53 Production of antimicrobial substances 54 Immune effects of probiotic bacteria 55 Alteration of microecology in human intestine Chapter 6: Commercially available human probiotic microorganisms 61 Lactobacillus acidophilus, LA-5? 62 Lactobacillus acidophilus NCDO1748 63 Lactobacillus acidophilus NFCM 64 Lactobacillus casei Shirota 65 Lactobacillus gasseri OLL2716 (LG21) 66 Lactobacillus paracasei ssp paracasei, F19(R) 67 Lactobacillus paracasei ssp paracasei, L CASEI 431(R) 68 Lactobacillus rhamnosus GG, LGG(R) 69 Lactobacillus rhamnosus, GR-1(R) and Lactobacillus reuteri , RC- 14(R) 610 Lactobacillus rhamnosus HN001 and 611 LGG(R)MAX, a multispecies probiotic combination 612 Bifidobacterium animalis ssp lactis, BB-12(R) 613 Bifidobacterium breve strain Yakult 614 Bifidobacterium longum BB536 615 Bifidobacterium longum strains BL46 and BL2C - Probiotics for adults and ageing consumers PART II: PREBIOTICS Chapter 7: Prebiotics 71 The prebiotic concept 72 A brief history of prebiotics 73 Advantages and disadvantages of the prebiotic strategy 74 Types of prebiotics 75 Production of prebiotics 76 Prebiotic mechanisms 77 Modulating the intestinal microbiota in infants 78 Modulating the intestinal microbiota in adults 79 Modifying the intestinal microbiota in the elderly 710 Health effects and applications of prebiotics 711 Functional foods for animals 712 Safety of prebiotics 713 Regulation of prebiotics 714 Conclusion

Handbook of Probiotics and Prebiotics

In order to assess the potential of lactobacilli to cause serious infections, we studied the prevalence of bacteremia due to Lactobacillus species during a 4-year period (1989-1992) in southern Finland, which has a population of about 2.5 million. Among 3,317 blood culture isolates, lactobacilli were identified in eight patients, five of whom had a severe disease predisposing to bacteremic complications. The eight strains isolated were identified to the species level and typed by carbohydrate fermentation tests and by direct sequencing of enzymatically amplified 16S rRNA. The results did not provide evidence that any particular species or subspecies of Lactobacillus was the cause of the infections; no infections caused by isolates similar to the recently introduced dairy probiotic strain, Lactobacillus GG (ATCC 53103), were observed. The data show an infrequent association of lactobacilli with bacteremic infections in spite of the ubiquitous presence of these organisms in the gastrointestinal tract and their widespread consumption in fermented milks; thus, there is strong evidence that their pathogenic potential is very low.

Lactobacilli and Bacteremia in Southern Finland, 1989–1992

The concentration of fecal mucin and the adhesion of specific probiotics and their combinations in the intestinal mucus of infants during and after rotavirus diarrhea and in healthy children were determined. Mucus was prepared from fecal samples from 20 infants during and after rotavirus diarrhea and from 10 healthy age-matched children. Mucin concentration was determined, and the adhesion of five probiotics— Lactobacillus rhamnosus GG, Lactobacillus casei Shirota, Lactobacillus paracasei F19, Lactobacillus acidophilus LA5, and Bifidobacterium lactis Bb12—and their combinations was tested in vitro. The mean concentrations of fecal mucin during and after rotavirus diarrhea, 15.2 and 14.1 mg/g, were comparable to that in healthy children, 14.9 mg/g. The adherence of probiotics ranged from 1 to 34% in healthy subjects as indicated for the following strains: L. rhamnosus GG, 34%; B. lactis Bb12, 31%; L. acidophilus LA5, 4%; L. paracasei F19, 3%; and L. casei Shirota, 1% (P 5 0.0001). The distinctive pattern of probiotic adherence was not influenced by rotavirus diarrhea. The adhesion of Bb12 in the presence of GG increased from 31 to 39% in healthy infants (P 5 0.018) and in episodes of diarrhea increased from 26 to 44% (P 5 0.001). Rotavirus diarrhea does not decrease the production of fecal mucin or with respect to the adhesion of probiotic bacteria tested in vitro. Combination of specific probiotic strains may enhance adherence in a synergistic manner. Optimal clinical application of these interactions may offer novel therapeutic guidelines for the treatment and prevention of gastrointestinal infections.

http://envismadrasuniv.org/Probiotics/pdf/Adherence%20of%20Probiotic%20Bacteria.pdf

Adherence of Probiotic Bacteria to Human Intestinal Mucus in Healthy Infants and during Rotavirus Infection

Assessment of adhesion properties of novel probiotic strains to human intestinal mucus

Background: Constipation is a common problem in elderly subjects, probiotics have been suggested to improve intestinal motility and reduce fecal enzyme activity. Methods: Elderly subjects (n = 28) were enrolled in an open parallel study. The subjects were divided into 3 groups: 1 control group receiving juice; 1 group receiving juice supplemented with Lactobacillus reuteri, and 1 group receiving juice supplemented with Lactobacillus rhamnosus and Propionibacterium freudenreichii. During the first 3 weeks all subjects consumed unsupplemented juice. In the subsequent 4 weeks, the subjects received their designated juice. During the last 3 weeks, all subjects again received unsupplemented juice. From the subjects, defecation frequency, laxative use, fecal pH, mucin content and azoreductase activity were assessed during the last week of each period. Results: The subjects receiving the L. rhamnosus/P. freudenreichii-supplemented juice exhibited a 24% increase in defecation frequency. However, no reduction in laxative use was observed. The fecal azoreductase activity was also significantly reduced in this group. No changes in fecal pH or mucin excretion were observed. Conclusion: Some relief from constipation may be observed with the combination of L. rhamnosus/P. freudenreichii. This probiotic combination also reduced fecal enzyme activity. The tested probiotics did not affect the mucosal barrier.

Seppo Salminen

Papers

Handbook of Probiotics and Prebiotics

Lactobacilli and Bacteremia in Southern Finland, 1989–1992

Adherence of Probiotic Bacteria to Human Intestinal Mucus in Healthy Infants and during Rotavirus Infection

Assessment of adhesion properties of novel probiotic strains to human intestinal mucus

Effect of probiotics on constipation, fecal azoreductase activity and fecal mucin content in the elderly.