Health benefits and health claims of probiotics: bridging science and marketing
14 Nov 2011-British Journal of Nutrition (Cambridge University Press)-Vol. 106, Iss: 9, pp 1291-1296
TL;DR: An open dialogue between basic and clinical scientists, regulatory authorities, food and nutrition industry, and consumers could bridge the gap between science and marketing of probiotics.
Abstract: Health claims for probiotics are evaluated by the Panel on Dietetic Products, Nutrition and Allergies of the European Food Safety Authority. Despite a substantial amount of basic and clinical research on the beneficial effects of probiotics, all of the evaluated claim applications thus far have received a negative opinion. With the restrictions on the use of clinical endpoints, validated biomarkers for gut health and immune health in relation to reduction in disease risk are needed. Clear-cut criteria for design as well as evaluation of future studies are needed. An open dialogue between basic and clinical scientists, regulatory authorities, food and nutrition industry, and consumers could bridge the gap between science and marketing of probiotics.
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TL;DR: It did appear that the use of fecal microbial transplantation to treat recurrent Clostridium difficile infection is well justified, and there was moderately good evidence for preventing antibiotic-associated diarrhea with Lactobacillus, Bifidobacterium, Streptococcus, or Saccharomyces.
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TL;DR: In this study, symbiotic plus Vitamin E supplementation was the most effective treatment in lowering liver enzymes, leptin, FBS, insulin, TG, TC, and LDL-C among NAFLD patients.
Abstract: Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. Oral administration of symbiotic and Vitamin E has been proposed as an effective treatment in NAFLD patients. This study was carried out to assess the effects of symbiotic and/or Vitamin E supplementation on liver enzymes, leptin, lipid profile, and some parameters of insulin resistance (IR) in NAFLD patients. Materials and Methods: We randomly assigned sixty NAFLD adult patients to receive (1) symbiotic twice daily + Vitamin E?like placebo capsule; (2) 400 IU/d Vitamin E + symbiotic?like placebo; (3) symbiotic twice daily + 400 IU/d Vitamin E; and (4) symbiotic?like placebo + Vitamin E?like placebo for 8 weeks. Results: Symbiotic plus Vitamin E supplementation led to a significant decrease in concentrations of liver transaminase (P ? 0.05). Mean difference of apolipoprotein A?1 was more significant in symbiotic group compared to control. However, mean difference of apolipoprotein B100/A?1 was only significant in symbiotic group compared to control. At the end of the study, significant differences in total cholesterol (TC) and low?density lipoprotein cholesterol (LDL?C) were seen between the symbiotic plus Vitamin E and control groups (P < 0.001). Furthermore, intake of symbiotic plus Vitamin E supplements led to a significant decrease in concentrations of triglycerides (TG) after the intervention. Significant differences in leptin, fasting blood sugar (FBS), and insulin levels were seen between the symbiotic plus Vitamin E and control groups at the end of the study (P < 0.001). In contrast, symbiotic and/or Vitamin E supplementation did not affect high?density lipoprotein cholesterol and homeostasis model assessment for IR levels. Conclusion: In our study, symbiotic plus Vitamin E supplementation was the most effective treatment in lowering liver enzymes, leptin, FBS, insulin, TG, TC, and LDL?C among NAFLD patients. Key words: Leptin, lipid profile, nonalcoholic fatty liver disease, symbiotic, Vitamin E
38 citations
Cites background from "Health benefits and health claims o..."
...Probiotics are live microorganisms that, when consumed in adequate quantities, confer a health benefit to the host.[8] In the past two decades, a number of investigators have sought to determine that probiotics along with prebiotics have anti‐inflammatory, immunomodulatory, antifibrotic, and lipid‐lowering properties....
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TL;DR: For surgical patients, perioperative supplementation with pro-/synbiotics is effective in preventing or controlling SSI and other infectious complications and might also be associated with fewer side effects, lower hospital cost and better quality of life.
38 citations
Cites background from "Health benefits and health claims o..."
...Probiotics are living microorganisms believed to convey health benefits to the host when sufficiently consumed [6]....
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TL;DR: This review provides the reader with a brief overview of NEC and current concepts of its pathophysiology, discusses the microbial ecology of the intestine in preterm infants and factors that may lead to a "dysbiosis", summarizes studies of probiotics in pre Term infants, elaborates on the need for regulation in this area.
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Cites background from "Health benefits and health claims o..."
...Of interest, this definition implies a health claim and thus has triggered concern by safety authorities such as the European Food Safety Authority and the US Food and Drug Administration.44 This concern becomes even more acute when considering claims for prevention of diseases such as NEC in a highly vulnerable population such as preterm infants....
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...” Of interest, this definition implies a health claim and thus has triggered concern by safety authorities such as the European Food Safety Authority and the US Food and Drug Administration.(44) This concern becomes even more acute when...
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...Meticulously designed studies that are adequately powered and controlled to test the safety and efficacy of individual probiotics are either underway or being planned with close collaboration of the regulatory agencies such as the US Food and Drug Administration....
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References
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TL;DR: The Illumina-based metagenomic sequencing, assembly and characterization of 3.3 million non-redundant microbial genes, derived from 576.7 gigabases of sequence, from faecal samples of 124 European individuals are described, indicating that the entire cohort harbours between 1,000 and 1,150 prevalent bacterial species and each individual at least 160 such species.
Abstract: To understand the impact of gut microbes on human health and well-being it is crucial to assess their genetic potential. Here we describe the Illumina-based metagenomic sequencing, assembly and characterization of 3.3 million non-redundant microbial genes, derived from 576.7 gigabases of sequence, from faecal samples of 124 European individuals. The gene set, ~150 times larger than the human gene complement, contains an overwhelming majority of the prevalent (more frequent) microbial genes of the cohort and probably includes a large proportion of the prevalent human intestinal microbial genes. The genes are largely shared among individuals of the cohort. Over 99% of the genes are bacterial, indicating that the entire cohort harbours between 1,000 and 1,150 prevalent bacterial species and each individual at least 160 such species, which are also largely shared. We define and describe the minimal gut metagenome and the minimal gut bacterial genome in terms of functions present in all individuals and most bacteria, respectively
9,268 citations
"Health benefits and health claims o..." refers background in this paper
...For the fifty-seven most common bacterial species identified by metagenome sequence analysis in the human gut, the inter-individual variability of abundance is between 12- and 2187-fold((16))....
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...However, a clearly distinct composition of gut microbiota, both compared with healthy individuals and between the two diseases, is found in inflammatory bowel disease (ulcerative colitis and Crohn’s disease)((16))....
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TL;DR: It is reported here that the prominent human symbiont Bacteroides fragilis protects animals from experimental colitis induced by Helicobacter hepaticus and that molecules of the bacterial microbiota can mediate the critical balance between health and disease.
Abstract: Humans are colonized by multitudes of commensal organisms representing members of five of the six kingdoms of life; however, our gastrointestinal tract provides residence to both beneficial and potentially pathogenic microorganisms. Imbalances in the composition of the bacterial microbiota, known as dysbiosis, are postulated to be a major factor in human disorders such as inflammatory bowel disease. We report here that the prominent human symbiont Bacteroides fragilis protects animals from experimental colitis induced by Helicobacter hepaticus, a commensal bacterium with pathogenic potential. This beneficial activity requires a single microbial molecule (polysaccharide A, PSA). In animals harbouring B. fragilis not expressing PSA, H. hepaticus colonization leads to disease and pro-inflammatory cytokine production in colonic tissues. Purified PSA administered to animals is required to suppress pro-inflammatory interleukin-17 production by intestinal immune cells and also inhibits in vitro reactions in cell cultures. Furthermore, PSA protects from inflammatory disease through a functional requirement for interleukin-10-producing CD4+ T cells. These results show that molecules of the bacterial microbiota can mediate the critical balance between health and disease. Harnessing the immunomodulatory capacity of symbiosis factors such as PSA might potentially provide therapeutics for human inflammatory disorders on the basis of entirely novel biological principles.
2,097 citations
"Health benefits and health claims o..." refers background in this paper
...In a series of landmark publications((7,19,20)), Dennis Kasper’s group has demonstrated that the capsular polysaccharide polysaccharide A of Bacteroides fragilis is indispensable for normal development of mucosal T lymphocytes and control of exper-...
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...Unfortunately, with a few exceptions((7,8)), the genes that determine or underlie the health benefit delivered by specific probiotic strains have not been identified to date....
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TL;DR: Evidence is provided for the fact that the ageing process deeply affects the structure of the human gut microbiota, as well as its homeostasis with the host's immune system, because of its crucial role in the host physiology and health status.
Abstract: Background: Age-related physiological changes in the gastrointestinal tract, as well as modifications in lifestyle, nutritional behaviour, and functionality of the host immune system, inevitably affect the gut microbiota, resulting in a greater susceptibility to infections. Methodology/Principal Findings: By using the Human Intestinal Tract Chip (HITChip) and quantitative PCR of 16S rRNA genes of Bacteria and Archaea, we explored the age-related differences in the gut microbiota composition among young adults, elderly, and centenarians, i.e subjects who reached the extreme limits of the human lifespan, living for over 100 years. We observed that the microbial composition and diversity of the gut ecosystem of young adults and seventy-years old people is highly similar but differs significantly from that of the centenarians. After 100 years of symbiotic association with the human host, the microbiota is characterized by a rearrangement in the Firmicutes population and an enrichment in facultative anaerobes, notably pathobionts. The presence of such a compromised microbiota in the centenarians is associated with an increased inflammatory status, also known as inflammageing, as determined by a range of peripheral blood inflammatory markers. This may be explained by a remodelling of the centenarians’ microbiota, with a marked decrease in Faecalibacterium prauznitzii and relatives, symbiotic species with reported anti-inflammatory properties. As signature bacteria of the long life we identified specifically Eubacterium limosum and relatives that were more than ten-fold increased in the centenarians. Conclusions/Significance: We provide evidence for the fact that the ageing process deeply affects the structure of the human gut microbiota, as well as its homeostasis with the host’s immune system. Because of its crucial role in the host physiology and health status, age-related differences in the gut microbiota composition may be related to the progression of diseases and frailty in the elderly population.
1,180 citations
"Health benefits and health claims o..." refers background in this paper
...Moreover, the intestinal microbiota also changes in time as was illustrated recently in a study, in which age groups up to 100 years were compared((17))....
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TL;DR: The nonclassic actions of vitamin D are cell specific and provide a number of potential new clinical applications for 1,25(OH)(2)D(3) and its analogs, however, the use ofitamin D metabolites and analogs for these applications remains limited by the classic actions of Vitamin D leading to hypercalcemia and hypercalcuria.
Abstract: Context: Vitamin D receptors are found in most tissues, not just those participating in the classic actions of vitamin D such as bone, gut, and kidney. These nonclassic tissues are therefore potential targets for the active metabolite of vitamin D, 1,25(OH)2D. Furthermore, many of these tissues also contain the enzyme CYP27B1 capable of producing 1,25(OH)2D from the circulating form of vitamin D. This review was intended to highlight the actions of 1,25(OH)2D in several of these tissues but starts with a review of vitamin D production, metabolism, and molecular mechanism. Evidence Acquisition: Medline was searched for articles describing actions of 1,25(OH)2D on parathyroid hormone and insulin secretion, immune responses, keratinocytes, and cancer. Evidence Synthesis: Vitamin D production in the skin provides an efficient source of vitamin D. Subsequent metabolism to 1,25(OH)2D within nonrenal tissues differs from that in the kidney. Although vitamin D receptor mediates the actions of 1,25(OH)2D, regulati...
882 citations
TL;DR: This Review highlights the documented signalling interactions of the surface molecules of probiotic bacteria (such as long surface appendages, polysaccharides and lipoteichoic acids) with PRRs with respect to host pattern recognition receptors of the gastrointestinal mucosa.
Abstract: Interactions between host cell receptors and the surface molecules of bacteria are important determinants of the nature of the relationship between the two organisms. In this Review, Lebeer, Vanderleyden and De Keersmaecker examine the signalling interactions of probiotic bacterial cell surface molecules. How can probiotic bacteria transduce their health benefits to the host? Bacterial cell surface macromolecules are key factors in this beneficial microorganism–host crosstalk, as they can interact with host pattern recognition receptors (PRRs) of the gastrointestinal mucosa. In this Review, we highlight the documented signalling interactions of the surface molecules of probiotic bacteria (such as long surface appendages, polysaccharides and lipoteichoic acids) with PRRs. Research on host–probiotic interactions can benefit from well-documented host–microorganism studies that span the spectrum from pathogenicity to mutualism. Distinctions and parallels are therefore drawn with the interactions of similar molecules that are presented by gastrointestinal commensals and pathogens.
852 citations
"Health benefits and health claims o..." refers background in this paper
...For a number of strains, it has been demonstrated now that the probiotic bacteria can bind to receptors on cells of the immune system including dendritic cells((27))....
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