Metabolic syndrome and synbiotic targeting of the gut microbiome

The Gut Microbiome and Symptom Burden After Kidney Transplantation: An Overview and Research Opportunities

Many kidney transplant recipients continue to experience high symptom burden despite restoration of kidney function. High symptom burden is a significant driver of quality of life. In the post-transplant setting, high symptom burden has been linked to negative outcomes including medication non-adherence, allograft rejection, graft loss, and even mortality. Symbiotic bacteria (microbiota) in the human gastrointestinal tract critically interact with the immune, endocrine, and neurological systems to maintain homeostasis of the host. The gut microbiome has been proposed as an underlying mechanism mediating symptoms in several chronic medical conditions including irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, and psychoneurological disorders via the gut-brain-microbiota axis, a bidirectional signaling pathway between the enteric and central nervous system. Post-transplant exposure to antibiotics, antivirals, and immunosuppressant medications results in significant alterations in gut microbiota community composition and function, which in turn alter these commensal microorganisms' protective effects. This overview will discuss the current state of the science on the effects of the gut microbiome on symptom burden in kidney transplantation and future directions to guide this field of study.

A Narrative Review on the Advance of Probiotics to Metabiotics

Recently, the term metabiotics has emerged as a new concept of probiotics. This concept entails combining existing probiotic components with metabolic by-products improve specific physiological functionalities. Representative ingredients of these metabiotics include short-chain fatty acids (SCFAs), bacteriocins, polysaccharides, and peptides. The new concept is highly regarded as it complements the side effects of existing probiotics and is safe and easy to administer. Known health functions of metabiotics are mainly immune regulation, anti-inflammatory, anticancer, and brain-neurological health. Research has been actively conducted on the health benefits related to the composition of intestinal microorganisms. Among them, the focus has been on brain neurological health, which requires extensive research. This study showed that neurological disorders, such as depression, anxiety, autism spectrum disorder, Alzheimer's disease, and Parkinson's disease, can be treated and prevented according to the gut-brain axis theory by changing the intestinal microflora. In addition, various studies are being conducted on the immunomodulatory and anticancer effects of substances related to metabiotics of the microbiome. In particular, its efficacy is expected to be confirmed through human studies on various cancers. Therefore, developing various health functional effects of the next-generation probiotics such as metabiotics to prevent or treatment of various diseases is anticipated.

Synbiotics as potent functional food: recent updates on therapeutic potential and mechanistic insight

Synbiotics are the specific mixtures of prebiotics with probiotics intended to give health benefits to the host by stabilizing and supporting the gut microbiota.The prebiotic substance used in the synbiotics selectively favors the growth and metabolite production of probiotics. Gut microbiome dysbiosis may lead to generation and progression of various chronic diseases. Synbiotics act synergistically to modulate the gut ecosystem for improvement of metabolic health of the host. Probiotics have been found promising against various diseases being safer, effective, as an alternative or combinatorial therapy. Specific combinations of probiotics with suitable prebiotic substrate as synbiotics, may be the more effective therapeutic agents that can provide all benefits of probiotics as well as prebiotics. Though, effective combinations, dosage, mechanism of action, safety, cost effectiveness and other clinical investigations are required to be established along with other relevant aspects. Synbiotics have the potential to be functional food of importance in future. Present review summarizes the mechanistic overview of synbiotics related to gut microbiota, therapeutic potential and promising health benefits for human illnesses according to the available literature. In present scenario, synbiotics are more promising future alternatives as therapeutics to maintain healthy microbiota inside the host gut which directly affects the onset or development ofrelated disorders or diseases.

Effects of the combination of Lactobacillus helveticus and isomalto-oligosaccharide on survival, gut microbiota, and immune function in Apis cerana worker bees

The adult worker bees were fed sucrose syrup or sucrose syrup supplemented with Lactobacillus helveticus KM7, prebiotic isomalto-oligosaccharide (IMO), or L. helveticus KM7 combined with IMO. Survival rate, gut microbiota, and gene expression of gut antimicrobial peptides in worker honey bees were determined. Administration of L. helveticus KM7 and IMO significantly increased the survival rate in worker bees relative to bees fed sucrose only. Then, higher concentration of both lactic acid bacteria and Bifidobacterium in the gut and lower counts of gut fungi, Enterococcus, and Bacteroides-Porphyromonas-Prevotella were observed in bees fed the combination of KM7 and IMO compared with control bees. The combination of L. helveticus KM7 with IMO showed a greater or comparable modulating effect on those bacteria relative to either KM7 or IMO alone. Furthermore, the combination treatment of L. helveticus KM7 and IMO enhanced mRNA expression of antimicrobial peptide genes, including Abaecin, Defensin, and the gene encoding prophenoloxidase (PPO) in the gut compared with both control bees and those either L. helveticus KM7 or IMO alone. These results suggest that the combination of L. helveticus KM7 and IMO synergistically modifies the gut microbiota and immunity and consequently improves the survival rate of Apis cerana adult workers.

Effect of a Multispecies Synbiotic Supplementation on Body Composition, Antioxidant Status, and Gut Microbiomes in Overweight and Obese Subjects: A Randomized, Double-Blind, Placebo-Controlled Study

Studies investigating the effect of multispecies synbiotic supplementation in obesity management are limited. The current study was performed to evaluate the effects of multispecies probiotics mixed with fructooligosaccharides on body composition, antioxidant status, and gut microbiome composition in overweight and obese individuals. We employed a randomized, double-blind, placebo-controlled trial design, in which 63 individuals aged 18-45 years were assigned to receive either a synbiotic supplement or placebo for 12 weeks. The synbiotic group consumed a daily dose of 37 × 10⁹ colony-forming units (CFU) of a unique blend of seven different probiotics, along with 2 g of fructooligosaccharides, while the placebo group consumed 2 g of maltodextrin daily. Assessments were performed at baseline, week 6, and the end of the study. The results of the study indicated that synbiotic supplementation resulted in a significant reduction in waist circumference and body fat percentage compared to the baseline measurements, as observed at 12 weeks. At the end of the study, there were no significant differences observed in body weight, BMI, waist circumference, or percentage of body fat between the synbiotic group and the placebo group. An analysis of plasma antioxidant capacity revealed that synbiotic supplementation caused a significant increase in Trolox equivalent antioxidant capacity (TEAC) and a concomitant decrease in malondialdehyde (MDA) in the test group when compared to the placebo. For the gut microbiota analysis, synbiotic supplementation significantly decreased Firmicutes abundance and the Firmicutes/Bacteroidetes (F/B) ratio at week 12 as compared to the placebo group. Nevertheless, the synbiotic group did not exhibit any substantial alterations in other biochemical blood parameters compared to the placebo group. These findings suggest that multispecies synbiotic supplementation could be a beneficial strategy to improve body composition, antioxidant status, and gut microbiome composition in overweight and obese subjects.

Development of soy protein isolate/sodium carboxymethyl cellulose synbiotic microgels by double crosslinking with transglutaminase and aluminum chloride for delivery system of Lactobacillus acidophilus

This study was carried out to develop soy protein isolate (SPI)/sodium carboxymethyl cellulose (NaCMC) synbiotic microgels by applying a double-crosslinking technique using transglutaminase and different concentrations of AlCl₃ (0, 6, 7, 8 %) and also by adding Lactobacillus acidophilus (L. acidophilus) and pectic oligosaccharide. Synbiotic microgels crosslinked using 8 % AlCl₃ (SPI/NaCMC-Al³⁺₈ microgels) showed the highest encapsulation efficiency (92 %). The double-crosslinked microgels exhibited a smooth surface as proved by SEM. FT-IR, XRD, and DSC analyses showed the possible interaction within matrices and demonstrated the higher thermal stability of synbiotic microgels prepared using a higher concentration of AlCl₃. All in all, after exposure to simulated digestion fluid, heat treatment (72 °C, 15 s), and refrigerated storage, more cells in double-crosslinked microgels survived compared to single-crosslinked microgels. In particular, probiotic viability was highest in SPI/NaCMC-Al³⁺₈ microgels. These results indicate that the SPI/NaCMC-Al³⁺₈ microgels developed in this study can effectively protect L. acidophilus against the external environment.

Dietary supplementation with synbiotics improves growth performance, antioxidant status, immune function, and intestinal barrier function in broilers subjected to cyclic heat stress

This study investigated the effects of synbiotics supplementation on growth performance, antioxidant status, immune function, and intestinal barrier function in broilers subjected to cyclic heat stress. One hundred and forty-four 22-day-old male broilers were randomly assigned to one of three treatment groups of six replicates each for a 21-day study, with eight birds per replicate. Broilers in the control group were reared at a thermoneutral temperature and received a basal diet. Broilers in the other two heat-stressed groups were fed a basal diet supplemented without (heat-stressed group) and with 1.5 g/kg synbiotic (synbiotic group). One and a half gram of the synbiotic consisted with 3 × 10⁹ colony forming units (CFU) Clostridium butyricum, 1.5 × 10⁹ CFU Bacillus licheniformis, 4.5 × 10¹⁰ CFU Bacillus subtilis, 600 mg yeast cell wall, and 150 mg xylooligosaccharide. Compared with the control group, heat stress increased rectal temperatures at 28, 35, and 42 days of age, respectively (P < 0.05). Birds subjected to heat stress had reduced weight gain, feed intake, and feed efficiency during 22 to 42 days (P < 0.05). In contrast, supplementation with the synbiotic decreased rectal temperature at 42 days of age and elevated weight gain of heat stress-challenged broilers (P < 0.05). Heat-stressed broilers exhibited a lower superoxide dismutase (SOD) activity in jejunal mucosa and a higher malondialdehyde accumulation in serum, liver and jejunal mucosa (P < 0.05), and the regressive SOD activity was normalized to control level when supplementing synbiotic (P < 0.05). Heat stress increased interleukin-1β (IL-1β) and interferon-γ (IFN-γ) levels in serum and IL-1β content in jejunal mucosa of broilers (P < 0.05). Synbiotic reduced IL-1β level in serum of broilers subjected to heat stress (P < 0.05). Compared with the control group, elevated serum diamine oxidase activity and reduced jejunal villus height were observed in broilers of the heat-stressed group (P < 0.05), and the values of these two parameters in the synbiotic group were intermediate (P > 0.05). Heat stress upregulated mRNA abundance of IL-1β and IFN-γ and downregulated gene expression levels of occluding and zonula occluden-1 (ZO-1) in jejunal mucosa of broilers (P < 0.05). The alterations in the mRNA expression levels of jejunal IL-1β and ZO-1 were reversed by the synbiotic (P > 0.05). In conclusion, dietary synbiotics could improve growth performance, antioxidant capacity, immune function, and intestinal barrier function in heat-stressed broilers.

Synbiotics and Gut Microbiota: New Perspectives in the Treatment of Type 2 Diabetes Mellitus

The number of people with type 2 diabetes mellitus (T2DM) has increased sharply over the past decades. Apart from genetic predisposition, which may cause some of the diagnosed cases, an unhealthy diet and lifestyle are incentive triggers of this global epidemic. Consumption of probiotics and prebiotics to gain health benefits has become increasingly accepted by the public in recent years, and their critical roles in alleviating T2DM symptoms are confirmed by accumulating studies. Microbiome research reveals gut colonization by probiotics and their impacts on the host, while oral intake of prebiotics may stimulate existing metabolisms in the colon. The use of synbiotics (a combination of prebiotics and probiotics) can thus show a synergistic effect on T2DM through modulating the gastrointestinal microenvironment. This review summarizes the research progress in the treatment of T2DM from the perspective of synbiotics and gut microbiota and provides a class of synbiotics which are composed of lactulose, arabinose, and Lactobacillus plantarum, and can effectively adjust the blood glucose, blood lipid, and body weight of T2DM patients to ideal levels.

Synbiotics: a New Route of Self-production and Applications to Human and Animal Health

Synbiotics are preparations in which prebiotics are added to probiotics to achieve superior performance and benefits on the host. A new route of their formation is to induce the prebiotic biosynthesis within the probiotic for synbiotic self-production or autologous synbiotics. The aim of this review paper is first to overview the basic concept and (updated) definitions of synergistic synbiotics, and then to focus particularly on the prebiotic properties of probiotic wall components while describing the environmental factors/stresses that stimulate autologous synbiotics, that is, the biosynthesis of prebiotic-forming microcapsule by probiotic bacteria, and finally to present some of their applications to human and animal health.

Progress in application of probiotics, prebiotics, and synbiotics in irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by recurrent abdominal pain accompanied by changes in defecation frequency and/or stool characteristics. The global incidence of IBS is increasing year by year. Intestinal symptoms caused by IBS (such as constipation, diarrhea, abdominal pain, and abdominal distension) and accompanying changes in general nervous system function can significantly reduce patients' quality of life and work efficiency, and lead to high medical costs. Therefore, finding safe, effective, and economical treatments has become a hot research topic in recent years. Studies have shown that the intestinal flora of patients with IBS is different from that of healthy subjects, and regulating the intestinal flora can treat IBS. The purpose of this review is to summarize the application and recent progress of probiotics, prebiotics, and synbiotics in the treatment of IBS by regulating the intestinal flora.

Synbiotic Supplements in the Prevention of Obesity and Obesity-Related Diseases

Obesity and being overweight have reached incredible proportions worldwide and are one of the most common human health problems. The causes of obesity are multifactorial, including a complex interplay among genes, metabolism, diet, physical activity, and the environment. The intestinal microbiota has the ability to affect the host physiology for both benefit and damage, either directly or through microbial metabolites. The aim of this review is to discuss the mechanisms by which the intestinal microbiota could act as a key modifier of obesity and related metabolic abnormalities. The synbiotic components provide an optimal target for modulation of the intestinal microbiota and help reshape the metabolic profile in obese people. The development of novel functional foods containing synbiotic ingredients may present a support in the prevention of obesity as one of the risk factors for chronic diseases. Knowledge of the synbiotic mechanisms of action and the use of new functional foods supplemented with probiotics and prebiotics will facilitate the clinical application and development of individual health care strategies.

Impact of synbiotic supplementation on cardiometabolic and anthropometric indices in patients with metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Probiotic and synbiotic products are being widely used by a large number of patients and clinicians; however, effects on cardiometabolic indices in patients with the metabolic syndrome remain unclear. This meta-analysis aimed to evaluate the effects of a synbiotic intervention on lipid profile, insulin resistance, blood pressure, anthropometric parameters, and inflammatory markers.

METHODS

We searched MEDLINE, Scopus, and Clarivate Analytics Web of Science by October 2021. Studies were selected if they reported the effectiveness of the synbiotic intervention on cardiometabolic and anthropometric indices. The weighted mean difference was calculated as the effect size using a random-effects model. Subgroup analyses were conducted to determine sources of heterogeneity. Dose-dependent effects were assessed using a dose-response meta-analysis of differences in means.

RESULTS

Five trials (1049 participants) were finally included in the meta-analysis. Synbiotic intervention significantly reduced serum insulin levels (WMD, -6.39 μU/mL; 95%CI, (-7.2 to -5.4); p = 0.001, I2 = 88.2%, N = 5), triglycerides (WMD, -20.3 mg/dl; 95%CI, (-32.7 to -7.8); p = 0.001, I2 = 87.7, N = 5), total cholesterol (WMD, -7.8 mg/dl; 95%CI, ( -12.5 to -3.02); p = 0.001; I2 = 66.7%, N = 5), low-density lipoprotein cholesterol (WMD, -9.02 mg/dl; 95%CI, (-10.8 to -7.2); p < 0.001, I2 = 0%, N = 5), waist circumference (WMD, -4.04 cm; 95%CI, ( -4.9 to -3.08), p < 0.001; I2 = 22.7%, N = 3), body weight (WMD, -4.3 kg; 95%CI, (-6.2 to -2.5); p = 0.001; I2 = 0%, N = 2), systolic blood pressure (WMD, -1.8 mmHg; 95% CI, (-2.8 to -0.7); p = 0.001; I2 = 0%, N = 3), and serum interleukin-6 concentrations (WMD, -0.2 pg/mL; 95%CI, (-0.3 to -0.08); p = 0.001, I2 = 39.8%, N = 2), and increased high-density lipoprotein cholesterol levels (WMD, 2.3 mg/dl; 95%CI, (0.2-4.4); p = 0.03; 03; I2 = 93.1%, N = 5). Synbiotic administration did not significantly affect fasting plasma glucose, homeostatic model assessment for insulin resistance, body mass index, diastolic blood pressure, heart rate, and serum C-reactive protein concentrations.

CONCLUSIONS

The present findings suggest that synbiotic intervention effectively improves cardiometabolic risk factors in patients with metabolic syndrome.

Bioactive components of mushrooms: Processing effects and health benefits

Mushrooms have been recognized for their culinary attributes for long and were relished in the most influential civilizations in history. Currently, they are the focus of renewed research because of their therapeutic abilities. Nutritional benefits from mushrooms are in the form of a significant source of essential proteins, dietary non-digestible carbohydrates, unsaturated fats, minerals, as well as various vitamins, which have enhanced its consumption, and also resulted in the development of various processed mushroom products. Mushrooms are also a crucial ingredient in traditional medicine for their healing potential and curative properties. The literature on the nutritional, nutraceutical, and therapeutic potential of mushrooms, and their use as functional foods for the maintenance of health was reviewed, and the available literature indicates the enormous potential of the bioactive compounds present in mushrooms. Future research should be focused on the development of processes to retain the mushroom bioactive components, and valorization of waste generated during processing. Further, the mechanisms of action of mushroom bioactive components should be studied in detail to delineate their diverse roles and functions in the prevention and treatment of several diseases.

Probiotics, Prebiotics, and Synbiotics in the Irritable Bowel Syndrome Treatment: A Review

Irritable bowel syndrome is not a life-threatening disease, yet it significantly affects the quality of life and contributes to economic loss. It is estimated that even up to 45% of the world's population can suffer from the disease. The first attempts to diagnose irritable bowel syndrome were made at the end of the 19th century; however, establishing appropriate diagnostic criteria and treatment methods is still ongoing. To date, little is known about the etiology of irritable bowel syndrome; however, growing attention is drawn to the intestinal microbiota as a factor in the disease development. For this reason, researchers have conducted many studies on therapies that modulate the microbiota, among which probiotics, prebiotics, and synbiotics are widely studied. To date, most studies have examined probiotics; however, there are also several studies demonstrating the efficacy of prebiotics and synbiotics. The aim of this review was to summarize findings on the usefulness of probiotics, prebiotics, and synbiotics in the treatment of irritable bowel syndrome.

Co-Encapsulated Synbiotics and Immobilized Probiotics in Human Health and Gut Microbiota Modulation

Growing interest in the development of innovative functional products as ideal carriers for synbiotics, e.g., nutrient bars, yogurt, chocolate, juice, ice cream, and cheese, to ensure the daily intake of probiotics and prebiotics, which are needed to maintain a healthy gut microbiota and overall well-being, is undeniable and inevitable. This review focuses on the modern approaches that are currently being developed to modulate the gut microbiota, with an emphasis on the health benefits mediated by co-encapsulated synbiotics and immobilized probiotics. The impact of processing, storage, and simulated gastrointestinal conditions on the viability and bioactivity of probiotics together with prebiotics such as omega-3 polyunsaturated fatty acids, phytochemicals, and dietary fibers using various delivery systems are considered. Despite the proven biological properties of synbiotics, research in this area needs to be focused on the proper selection of probiotic strains, their prebiotic counterparts, and delivery systems to avoid suppression of their synergistic or complementary effect on human health. Future directions should lead to the development of functional food products containing stable synbiotics tailored for different age groups or specifically designed to fulfill the needs of adjuvant therapy.