Safe and efficacious probiotics: what are they?

Research progress in isolation and identification of rumen probiotics

With the increasing research on the exploitation of rumen microbial resources, rumen probiotics have attracted much attention for their positive contributions in promoting nutrient digestion, inhibiting pathogenic bacteria, and improving production performance. In the past two decades, macrogenomics has provided a rich source of new-generation probiotic candidates, but most of these "dark substances" have not been successfully cultured due to the restrictive growth conditions. However, fueled by high-throughput culture and sorting technologies, it is expected that the potential probiotics in the rumen can be exploited on a large scale, and their potential applications in medicine and agriculture can be explored. In this paper, we review and summarize the classical techniques for isolation and identification of rumen probiotics, introduce the development of droplet-based high-throughput cell culture and single-cell sequencing for microbial culture and identification, and finally introduce promising cultureomics techniques. The aim is to provide technical references for the development of related technologies and microbiological research to promote the further development of the field of rumen microbiology research.

Metabolic fluorine labeling and hotspot imaging of dynamic gut microbiota in mice

Real-time localization and microbial activity information of indigenous gut microbiota over an extended period of time remains a challenge with existing visualizing methods. Here, we report a metabolic fluorine labeling (MEFLA)-based strategy for monitoring the dynamic gut microbiota via ¹⁹F magnetic resonance imaging (¹⁹F MRI). In situ labeling of different microbiota subgroups is achieved by using a panel of peptidoglycan-targeting MEFLA probes containing ¹⁹F atoms of different chemical shifts, and subsequent real-time in vivo imaging is accomplished by multiplexed hotspot ¹⁹F MRI with high sensitivity and unlimited penetration. Using this method, we realize extended visualization (>24 hours) of native gut microbes located at different intestinal sections and semiquantitative analysis of their metabolic dynamics modulated by various conditions, such as the host death and different β-lactam antibiotics. Our strategy holds great potential for noninvasive and real-time assessing of the metabolic activities and locations of the highly dynamic gut microbiota.

Adjuvant probiotic Bifidobacterium animalis subsp. lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study

BACKGROUND

Probiotics had been used to decreased bilirubin level in neonatal jaundice (NJ) without being further studied mechanism and stratification. The intestinal pathogen Escherichia coli produced β-glucuronidase would increase enterohepatic circulation and elevate serum bilirubin levels (SBLs) which might worsen the disease process of NJ.

STUDY OBJECTIVE

We hypothesized that some probiotics could decrease bilirubin level through inhibiting the growth of E. coli. It's assumed that adjuvant probiotic intervention might accelerate the phototherapy for NJ and alleviate the severity of the NJ. Besides, it's further study the efficacy of the probiotic intervention in NJ among the full-term and preterm newborns.

MATERIALS AND METHODS

Firstly, the Bifidobacterium animalis subsp. lactis CP-9 was screened for its anti-E. coli activity. Then, it was orally administered to newborns with NJ in combination with conventional phototherapy (wavelength 425-457 nm) to determine its efficacy. 83 neonatal patients whose serum bilirubinemia was at a concentration of ≥ 15 mg/dL were participated the double-blind randomized trial and conducted in the neonatal ward of China Medical University Children's Hospital (CMUCH, Taichung, Taiwan). The test was conducted in 2 groups: experimental group: phototherapy + B. animalis subsp. lactis CP-9 (n = 43; 5 × 109 CFU/capsule) and control group: phototherapy + placebo (n = 40). The SBL and total phototherapy duration were measured.

RESULTS

The experimental group showed improved serum bilirubin decline rate (-0.16 ± 0.02 mg/dL/h; P = .009, 95% CI -0.12 to -0.2), particularly in the first 24 hour of in-hospital care, and reduced total phototherapy duration (44.82 ± 3.23 h; P = .011, 95% CI: 51.3-38.2) compared with the control group. Especially, probiotics had a significant therapeutic effect (serum bilirubin decline rate: -0.18 ± 0.02 mg/dL/h, 95% CI -0.12 to -0.23, P = .014; phototherapy duration: 43.17 ± 22.72 h, 95% CI 51.9-34.3, P = .019) in the low-risk subgroup (full-term newborns).

CONCLUSIONS

In conclusion, B. animalis subsp. lactis CP-9 synergistically improves treatment outcomes of NJ during in-hospital phototherapy including reduced total phototherapy duration and improved serum bilirubin decline rate, particularly in full-term newborns.

The emerging microbiome-based approaches to IBD therapy: From SCFAs to urolithin A

Inflammatory bowel disease (IBD) is a group of chronic gastrointestinal inflammatory conditions which can be life-threatening, affecting both children and adults. Crohn's disease and ulcerative colitis are the two main forms of IBD. The pathogenesis of IBD is complex and involves genetic background, environmental factors, alteration in gut microbiota, aberrant immune responses (innate and adaptive), and their interactions, all of which provide clues to the identification of innovative diagnostic or prognostic biomarkers and the development of novel treatments. Gut microbiota provide significant benefits to its host, most notably via maintaining immunological homeostasis. Furthermore, changes in gut microbial populations may promote immunological dysregulation, resulting in autoimmune diseases, including IBD. Investigating the interaction between gut microbiota and immune system of the host may lead to a better understanding of the pathophysiology of IBD as well as the development of innovative immune- or microbe-based therapeutics. In this review we summarized the most recent findings on innovative therapeutics for IBD, including microbiome-based therapies such as fecal microbiota transplantation, probiotics, live biotherapeutic products, short-chain fatty acids, bile acids, and urolithin A.

Effect of Simulated Gastrointestinal Tract Conditions on Survivability of Probiotic Bacteria Present in Commercial Preparations

Probiotics are recommended, among others, in the diet of children who are under antibiotic therapy, or that suffer from food allergies or travel diarrhea, etc. In the case of toddlers taking probiotic preparations, it is highly recommended to first remove the special capsule, which normally protects probiotic strains against hard conditions in the gastrointestinal tract. Otherwise, the toddler may choke. This removal can impair probiotic survival and reduce its efficacy in a toddler's organism. The aim of this study was to evaluate the survivability of five strains of lactic acid bacteria from the commercial probiotics available on the Polish market under simulated conditions of the gastrointestinal tract. Five probiotics (each including one of these strains: Bifidobacterium BB-12, Lactobacillus (Lb.) rhamnosus GG, Lb. casei, Lb. acidophilus, Lb. plantarum) were protective capsule deprived, added in a food matrix (chicken-vegetable soup) and subjected under simulated conditions of the gastric and gastrointestinal passage. Strain survivability and possibility to growth were evaluated. Obtained results showed that, among all analyzed commercial probiotic strains, the Lb. plantarum was the most resistant to the applied conditions of the culture medium. They showed a noticeable growth under both in vitro gastric conditions at pH 4.0 and 5.0, as well as in vitro intestinal conditions at all tested concentrations of bile salts.

Gut Microbiota and Epilepsy: A Systematic Review on Their Relationship and Possible Therapeutics

Dysbiosis of gut microbiota may lead to a range of diseases including neurological disorders. Thus, it is hypothesized that regulation of the intestinal microbiota may prevent or treat epilepsy. The purpose of this systematic review is to evaluate the evidence investigating the relationship between gut microbiota and epilepsy and possible interventions. A systematic review of the literature was done on four databases (PubMed, Scopus, EMBASE, and Web of Science). Study selection was restricted to original research articles while following the PRISMA guidelines. Six studies were selected. These studies cohesively support the interaction between gut microbiota and epileptic seizures. Gut microbiota analysis identified increases in Firmicutes, Proteobacteria, Verrucomicrobia, and Fusobacteria with decreases in Bacteroidetes and Actinobacteria in epileptic patients. Ketogenic diet, probiotics, and fecal microbiota transplantation (FMT) improved the dysbiosis of the gut microbiota and seizure activity. However, the studies either had a small sample size, lack of subject variability, or short study or follow-up period, which may question their reliability. Nevertheless, these limited studies conclusively suggest that gut microbiota diversity and dysbiosis may be involved in the pathology of epilepsy. Future studies providing more reliable and in depth insight into the gut microbial community will spark promising alternative therapies to current epilepsy treatment.

Probiotic Use and Psoriatic Arthritis Disease Activity

OBJECTIVE

Probiotics have been hypothesized to mediate inflammation through gut microbiome modulation. Spondyloarthropathies have subclinical gut inflammation associated with inflammatory disease that may benefit from probiotic use. We aimed to evaluate associations between probiotic use and patient-reported outcomes in patients with psoriatic arthritis (PsA).

METHODS

Using FORWARD, The National Databank for Rheumatic Diseases, we examined probiotic use among patients with PsA and rheumatoid arthritis (RA), a comparator in which gut inflammation is less clearly related to pathogenesis. Patient-reported outcome measures such as pain and physical function were compared for probiotic users and nonusers among patients with PsA and RA. Patients were propensity score-matched for taking a probiotic by demographics and nonmedication supplements.

RESULTS

More patients have reported probiotic use over the past decade, with less than 1% reporting use in 2008 and approximately 7% in 2018. Probiotic users are more likely to be white women with higher education, income, and supplement use. Following propensity score matching, probiotic users with PsA had significantly lower Short Form 36 Physical Component Summary (SF-36 PCS) scores and higher pain scores than nonusers with PsA (33.11 ± 11.50 vs. 40.82 ± 11.03; P = 0.04 and 4.78 ± 3.09 vs. 3.00 ± 2.58; P = 0.03). There were no significant differences in Patient Activity Scale II, Health Assessment Questionnaire II, SF-36 PCS, and Short Form 36 Mental Component Summary scores or pain among users with PsA before and after probiotic initiation.

CONCLUSION

We found increasing probiotic use in patients with PsA and important differences between users and nonusers. After accounting for these differences, we found no statistical difference in health outcomes after probiotic use.

Lactic acid bacteria, Enterococcus faecalis Y17 and Pediococcus pentosaceus G11, improved growth performance, and immunity of mud crab (Scylla paramamosain)

Mud crabs (Scylla paramamosain), a commercially important cultured species in the southeastern region of China, is usually infected by Vibriosis or parasites, causing great economic losses in cultured farms. Previous studies have demonstrated that probiotics benefited in enhancing the immune response against invading pathogens in aquatic animals. In this study, the effects of dietary administration of lactic acid bacteria (LAB) (Enterococcus faecalis Y17 and Pediococcus pentosaceus G11) on growth performance and immune responses of mud crab were assessed. Both strains (Y17 and G11) showed an inhibitory activity against bacterial pathogens (Aeromonas hydrophila, Vibrio parahaemolyticus, Vibrio alginolyticus, Staphylococcus aureus, and β Streptococcus), and a wide pH tolerance range of 2-10. In vivo, mud crabs were fed a control diet and experimental diets supplemented with 10⁹ cfu g^-1 diet either Y17 or G11 for 6 weeks before subjecting to a challenge test with V. parahaemolyticus for 12 h. The probiotic-supplemented diets had significant effects on weight gain and specific growth rate during the feeding trial. Increased serum enzyme activities of phenoloxidase, lysozyme, and SOD were observed in the hemolymph of mud crab in Y17 and G11-supplemented groups compared to that in the controls (P < 0.01). The significantly up-regulated expression of gene CAT, LYS, proPO, and SOD could be seen in hepatopancreas in G11-supplemented groups. After the pathogenicity test, the survival rate of Y17 + and G11 + V. parahaemolyticus groups was 66.67% and 80.00%, respectively, compared with 53.33% for the control groups. Taken together, dietary supplementation of Y17 and G11 strains were beneficial in mud crab, which could increase growth performance, modulate immune system and protect the host against V. parahaemolyticus infection.

Exploring the relationship between exposure to technological and gastrointestinal stress and probiotic functional properties of lactobacilli and bifidobacteria

Strains of Lactobacillus and Bifidobacterium are considered probiotic because of their associated potential health benefits. Probiotics are commonly administered orally via incorporation into food products. Microorganisms for use as probiotics encounter stress conditions, which include acid, bile, osmotic, oxidative, heat and cold stresses. These can occur during processing and storage and during passage through the gastrointestinal tract, and can affect viability. Probiotic bacteria have to remain viable to confer any health benefits. Therefore, the ability to withstand technological and gastrointestinal stresses is crucial probiotic selection criteria. While the stress tolerance mechanisms of lactobacilli and bifidobacteria are largely understood, the impact of exposure to stressful conditions on the functional properties of surviving probiotic microorganisms is not clear. This review explores the potentially positive and negative relationships between exposure to stress conditions and probiotic functional properties, such as resistance to gastric acid and bile, adhesion and colonization potential, and tolerance to antibiotics. Protective strategies can be employed to combat negative effects of stress on functional properties. However, further research is needed to ascertain synergistic relationships between exposure to stress and probiotic properties.

Comparison of maintenance effect of probiotics and aminosalicylates on ulcerative colitis: A meta-analysis of randomized controlled trials

Objective

To evaluate the maintenance effect of probiotics versus that of aminosalicylates on ulcerative colitis.

Methods

MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and the Chinese Biomedical Database were searched in English or Chinese. Data extracted were selected with strict criteria.

Results

In six randomized controlled trials (RCTs), a total of 721 participants were enrolled and the maintenance effect of probiotics (n = 364) versus that of aminosalicylates (n = 357) on ulcerative colitis was investigated. No significant difference was observed between probiotics and aminosalicylate groups (relative risk (RR) = 1.08; 95% confidence interval (CI): 0.91–1.28; P = 0.40). Three RCTs compared the incidence of adverse events with probiotics versus those with aminosalicylates. No significant difference was observed in the incidence of adverse events between the two groups (RR = 1.20; 95% CI: 0.92–1.56; P = 0.17).

Conclusions

Probiotics and aminosalicylates both showed a maintenance effect on ulcerative colitis. However, more well-designed RCTs are required.

Enhancement of the immune response and protection against Vibrio parahaemolyticus by indigenous probiotic Bacillus strains in mud crab (Scylla paramamosain)

In a previous study, bacterial communities of the intestine in three populations of crabs (wild crabs, pond-raised healthy crabs and diseased crabs) were probed by culture-independent methods. In this study, we examined the intestinal communities of the crabs by bacterial cultivation with a variety of media. A total of 135 bacterial strains were isolated from three populations of mud crabs. The strains were screened for antagonistic activity against Vibrio parahaemolyticus using an agar spot assay. Antagonistic strains were then identified by 16S rRNA gene sequence analysis. Three strains (Bacillus subtilis DCU, Bacillus pumilus BP, Bacillus cereus HL7) with the strongest antagonistic activity were further evaluated for their probiotic characteristics. The results showed that two (BP and DCU) of them were able to survive low pH and high bile concentrations, showed good adherence characteristics and a broad spectrum of antibiotic resistance. The probiotic effects were then tested by feeding juvenile mud crabs (Scylla paramamosain) with foods supplemented with 10(5) CFU/g of BP or DCU for 30 days before being subjected to an immersion challenge with V. parahaemolyticus for 48 h. The treated crabs showed significantly higher expression levels of immune related genes (CAT, proPO and SOD) and activities of respiratory burst than that in controlled groups. Crabs treated with BP and DCU supplemented diets exhibited survival rates of 76.67% and 78.33%, respectively, whereas survival rate was 54.88% in crabs not treated with the probiotics. The data showed that indigenous mud-associated microbiota, such as DCU and BP, have potential application in controlling pathogenic Vibriosis in mud crab aquaculture.

The influence of probiotic treatment on sulfasalazine metabolism in rat

Probiotics are live microorganisms claimed to exert beneficial effects on the host. This study investigated their effect on the metabolism and pharmacokinetics of sulfasalazine (SSZ), a drug whose efficacy depends on metabolism by azoreductase (AR) in the gut microbiota to sulfapyridine (SP) and 5-acetylsalicylic acid (5-ASA). The probiotic strains Lactobacillus acidophilus L10, Bifidobacterium lactis B94 and Streptococcus salivarius K12 possessed AR activity and a corresponding ability to metabolize SSZ. Treatment of male Wistar rats (n = 5) with oral 2 g doses of a mixture of the three probiotics (total dose 1.8 × 10⁹ cfu) every 12 h for 3 days resulted in a significant increase (p < 0.05) in AR activity in ex vivo colon contents with a corresponding increase in SSZ metabolism. Similar probiotic treatment of male Wistar rats (n = 8) followed by an oral 100 mg/kg dose of SSZ produced high plasma levels of SP, but pharmacokinetic parameters of SSZ and SP were not significantly different from control rats given SSZ. These results indicate that probiotic strains possess AR activity and can metabolize SSZ. Treatment with probiotics increases AR activity in the gut microbiota but has no effect on plasma levels of SSZ and SP following a subsequent oral dose of SSZ.

Qualitative and semiquantitative analysis of Lactobacillus species in the vaginas of healthy fertile and postmenopausal Chinese women

The present study aimed to investigate the prevalence and quantity of Lactobacillus species in the vaginas of healthy Chinese women. Vaginal samples from 92 fertile and 22 postmenopausal healthy Chinese women were analysed using a 16S rRNA gene clone library and species-specific PCR followed by sequencing and real-time PCR. A total of 13 different Lactobacillus species were detected. Species-specific PCR showed that 3% of the fertile women were colonized by one species of Lactobacillus and 97% were colonized by two or more species. Among the postmenopausal women, 91% were colonized by one species of Lactobacillus and 9% were colonized by two species. In the fertile women, L. iners (82.61%), L. crispatus (70.65%) and L. gasseri (67.39%) were more prevalent than L. jensenii (40.22%), L. acidophilus (39.13%), L. brevis (23.91%), L. plantarum (5.43%), L. johnsonii (3.26%), L. fermentum (2.17%), L. salivarius (2.17%), L. rhamnosus (1.09%), L. reuteri (1.09%) and L. paracasei (1.09%); L. delbrueckii was not detected. In the postmenopausal women, L. fermentum, L. rhamnosus, L. reuteri and L. delbrueckii were not detected, and the other 10 species were detected in just a few samples. The prevalence of these species according to the clone library differed from the prevalence indicated by the species-specific PCR. According to the semiquantitative analysis, the total Lactobacillus DNA concentrations were higher in fertile women than in postmenopausal women. Sixty-one per cent of the fertile women were predominantly colonized by L. iners, 35% by L. crispatus, and 2% by L. gasseri. Associations between pairs of Lactobacillus species in fertile women were significant (P<0.05) between the following pairs: L. iners and L. gasseri, L. iners and L. jensenii, L. iners and L. acidophilus, L. gasseri and L. acidophilus, and L. gasseri and L. jensenii. In conclusion, this study provided detailed information on Lactobacillus species colonizing the vaginas of healthy Chinese fertile and postmenopausal women. The study also showed that the diversity of Lactobacillus species in fertile women was higher than in postmenopausal women. According to our study, different techniques, such as species-specific PCR and comparison against a 16S rRNA gene clone library, resulted in different findings regarding species prevalence. These findings highlight the importance of standardization of techniques used for evaluation of bacterial communities. According to our findings regarding species associations, L. iners and L. gasseri may have influences on colonization and proliferation of other vaginal Lactobacillus species.

State of the art in benefit-risk analysis: food microbiology

Over the past years benefit-risk analysis (BRA) in relation to foods and food ingredients has gained much attention; in Europe and worldwide. BRA relating to food microbiology is however a relatively new field of research. Microbiological risk assessment is well defined but assessment of microbial benefits and the weighing of benefits and risk has not been systematically addressed. In this paper the state of the art in benefit-risk analysis in food microbiology is presented, with a brief overview of microbiological food safety practices. The quality and safety of foods is commonly best preserved by delaying the growth of spoilage bacteria and contamination by bacterial pathogens. However, microorganisms in food can be both harmful and beneficial. Many microorganisms are integral to various food production processes e.g. the production of beer, wine and various dairy products. Moreover, the use of some microorganisms in the production of fermented foods are often claimed to have beneficial effects on food nutrition and consumer health. Furthermore, food safety interventions leading to reduced public exposure to foodborne pathogens can be regarded as benefits. The BRA approach integrates an independent assessment of both risks and benefits and weighs the two using a common currency. Recently, a number of initiatives have been launched in the field of food and nutrition to address the formulation of the benefit-risk assessment approach. BRA has recently been advocated by EFSA for the public health management of food and food ingredients; as beneficial and adverse chemicals can often be found within the same foods and even the same ingredients. These recent developments in the scoping of BRA could be very relevant for food microbiological issues. BRA could become a valuable methodology to support evaluations and decision making regarding microbiological food safety and public health, supplementing other presently available policy making and administrative tools for microbiological food safety management.

Probiotic Therapy for the Treatment of Spondyloarthritis: A Randomized Controlled Trial

Objective.

To investigate the effect of an orally administered probiotic on disease activity, fatigue, quality of life, and intestinal symptoms in patients with active spondyloarthritis.

Methods.

Patients with active spondyloarthritis [defined as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 3, Bath Ankylosing Spondylitis Functional Index (BASFI) ≥ 3, Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) ≥ 2, or peripheral joint count ≥ 2] were randomized to oral probiotic or placebo for 12 weeks. Patients and assessors were blinded to treatment allocation. The primary outcome measure was 10% improvement in the BASFI. Additional outcome measures were improvements in the ASsessments in Ankylosing Spondylitis (ASAS)-endorsed core domains: pain, spinal mobility, patient global, peripheral joint and entheseal scores, stiffness, C-reactive protein, and fatigue. The ASAS20 criteria, a composite measure of response, were also applied. Quality of life and bowel symptoms were quantified using the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and Dudley Inflammatory Bowel Symptom Questionnaire (DISQ).

Results.

Sixty-three patients were randomized to oral probiotic (n = 32) or placebo (n = 31). All patients completed the trial. No significant difference was noted between groups in any of the core domains. The mean BASFI fell from 3.5 ± 2.0 to 2.9 ± 1.9 in the probiotic group and from 3.6 ± 1.9 to 3.1 ± 2.2 in the placebo group (p = 0.839). The mean BASDAI fell from 4.2 ± 2.2 to 3.2 ± 2.1 in the probiotic group and 4.5 ± 2.0 to 3.9 ± 2.2 in the placebo group (p = 0.182). No significant adverse events were recorded in the probiotic-treated group.

Conclusion.

In this randomized controlled trial, the probiotic combination administered did not demonstrate significant benefit over placebo, despite a theoretical rationale for this therapy.

The effects of an orally administered probiotic on sulfasalazine metabolism in individuals with rheumatoid arthritis: a preliminary study

AIM

To carry out a pilot study to investigate the effect of short-term oral probiotic administration on the metabolism of sulfasalazine (SSZ) in patients with rheumatoid arthritis (RA) stabilized on SSZ.

METHODS

Twelve subjects with RA taking stable doses of SSZ for a minimum of 3 months prior to the study, received a probiotic preparation contained three strains of bacteria (1.8 x 10(9) CFU/day) twice daily for 1 week. Single point blood and 12-h urine samples were taken before and after probiotic treatment and 3 weeks following discontinuation of probiotics, for determination of SSZ and its metabolites. The presence of the probiotic bacteria in the feces of patients was investigated by denaturing gradient gel electrophoresis (DGGE).

RESULTS

Adverse events recorded were three instances of gastrointestinal disturbance and one flare of RA. Plasma and urinary levels of SSZ and its metabolites showed no statistically significant changes after probiotic administration and the incidence of gastrointestinal disturbance did not appear to be ascribed to higher sulfapyridine plasma levels. Probiotic-specific DGGE bands were detected in the feces of some patients after the treatment period.

CONCLUSIONS

Short-term treatment of RA patients with a multi-strain probiotic did not significantly influence SSZ metabolism as has been demonstrated in animal models.

Nutritional Interventions and Therapies in Autism

Part 1 in this series (“Nutritional Intake and Therapies in Autism”) addressed the nutrient intake of children with autism and the myriad factors likely to affect dietary intake and nutritional status. These included medical/nutritional factors (gastrointestinal symptoms/ issues, food allergies, metabolic abnormalities and/or preexisting nutrient deficiencies, and nutrition-related medication side effects) and behavioral/contextual factor subcategories (problem eating behaviors, sensory processing difficulties, and family factors). Part 2 of this 2-part series covers nutrition interventions used in autism, with emphasis on safety and efficacy as delineated by an evidence-based approach. Nutrition intervention topics will be introduced as to the scientific rationale or purported mechanism of the intervention, safety, efficacy, untoward effects, and interactions with nutrients, medications, or other dietary supplements. Broad topics of discussion include nutrition assessment of the child with autism, dietary supplements/herbs used in autism (multivitamins, probiotics, omega-3 fatty acids, vitamin B6—maganesium, melatonin, methylator pathway nutrients), and special diets, including a gluten-free, casein-free diet and the specific carbohydrate diet. Finally, behavioral/contextual interventions are discussed, and suggestions for future research to support clinical practice are proposed.

The use of customised probiotics in the cultivation of western king prawns (Penaeus latisulcatus Kishinouye, 1896)

This study presents a comprehensive review of probiotics usage in aquaculture with a specific emphasis on our research series on the effectiveness of the customised probiotics, Pseudomonas synxantha and Pseudomonas aeruginosa on the cultivation of western king prawns, Penaeus latisulcatus. These customised probiotics resulted from tests using five inhibition test methods between the bacteria isolated from two commercial probiotic products and Vibrio spp. isolated from western king prawns and other aquatic animals. The results proved the suitability and safety of these probiotics in the cultivation of western king prawns as they conclusively met all the essential requirements for appropriate probiotics. These probiotics have shown similar beneficial effects as the common prebiotics, Bio-Mos and beta-1,3-d-glucan on the growth, survival and immune responses of the prawns. The supplementation of probiotics with the formulated feed was more efficacious and more practical than direct application into the rearing media. The prawns exposed to the combined probiotics were healthier than those exposed to the individual probiotics. P. aeruginosa was more effective for improving prawn health than P. synxantha. The probiotic-fed prawns were not influenced by Vibrio harveyi at 10(3) CFU ml(-1) for 36 h of challenge. In conclusion, these customised probiotics can be used as appropriate probiotics and as a suitable replacement of antibiotics, for disease control in western king prawn aquaculture.

Prospects for the development of probiotics and prebiotics for oral applications

There has been a paradigm shift towards an ecological and microbial community-based approach to understanding oral diseases. This has significant implications for approaches to therapy and has raised the possibility of developing novel strategies through manipulation of the resident oral microbiota and modulation of host immune responses. The increased popularity of using probiotic bacteria and/or prebiotic supplements to improve gastrointestinal health has prompted interest in the utility of this approach for oral applications. Evidence now suggests that probiotics may function not only by direct inhibition of, or enhanced competition with, pathogenic micro-organisms, but also by more subtle mechanisms including modulation of the mucosal immune system. Similarly, prebiotics could promote the growth of beneficial micro-organisms that comprise part of the resident microbiota. The evidence for the use of pro or prebiotics for the prevention of caries or periodontal diseases is reviewed, and issues that could arise from their use, as well as questions that still need to be answered, are raised. A complete understanding of the broad ecological changes induced in the mouth by probiotics or prebiotics will be essential to assess their long-term consequences for oral health and disease.

Probiotics and Prebiotics: Why Are They “Bugging” Us in the Pharmacy?

OBJECTIVES Specific organisms can be added to foods to target an effect (probiotics) or non-digestible carbohydrates can be used to foster the development of a favorable flora in the intestinal tract (prebiotics). The significance of pro- and prebiotics have been studied extensively, providing many current and theoretical treatment options. The objective of this paper is to provide a brief overview of commercial products available for the practicing clinician.

METHODS The literature was evaluated for the most commonly used and studied pre- and probiotics available. In addition, information regarding each of the products was obtained from the manufacturer.

RESULTS We found that all products are not formulated the same and the content of live organisms can differ. Currently available products are relatively safe but caution should be used for any patients that may have allergies to inactive ingredients in the product or are immunocompromised.

CONCLUSIONS Many probiotics and prebiotics are commercially available to aid in promoting healthy bowel flora to resist disease. This reference can be a helpful tool for the pharmacist when answering questions or making recommendations to a patient.

Effects of a multi-strain probiotic (PrimaLac) on performance and antibody responses to Newcastle disease virus and infectious bursal disease virus vaccination in broiler chickens

The effects of the probiotic PrimaLac (Lactobacillus acidophilus, Lactobacillus casei, Enterococcus faecium and Bifidobacterium bifidium) was investigated on performance and immune responses to vaccination against Newcastle disease and infectious bursal disease in broiler chickens. Use of PrimaLac significantly (P<0.05) enhanced broiler performance by improving body weight and decreasing the feed conversion ratio. Although administration of the probiotic appeared to improve the antibody responses to Newcastle disease virus and infectious bursal disease vaccination, the antibody titres of the probiotic-treated group were not significantly different from those not receiving probiotics.

Role of probiotic therapy in IBD

There is mounting evidence that probiotic therapy may alter disease expression in both animal models of IBD and in patients with IBD. The effects appear to be modest at best and may reflect the choice of probiotic organism, the variability in concentrations of organisms administered, and the variability of the diseases being treated. This review examines the data of all fully published articles currently available for the role of probiotics in the treatment of IBD.

Plasminogen-dependent proteolytic activity in Bifidobacterium lactis

Bifidobacteria represent one of the most important health-promoting bacterial groups of the intestinal microbiota. The binding of plasminogen to species of Bifidobacterium has been recently reported. To further explore the interaction between bifidobacteria and plasminogen, we investigated the role of Bifidobacterium lactis BI07 plasminogen-dependent proteolytic activity in the degradation of host-specific substrates. Our experimental data demonstrate that the recruitment of plasminogen on the bacterial cell surface and its subsequent conversion into plasmin by host-derived plasminogen activators provide B. lactis BI07 with a surface-associated plasmin activity effective in degradation of physiological substrates such as extracellular matrix, fibronectin and fibrinogen. The ability of bifidobacteria to intervene in the host plasminogen/plasmin system may contribute to facilitating colonization of the host gastrointestinal tract.

Fermentation of calcium-fortified soymilk with Lactobacillus: effects on calcium solubility, isoflavone conversion, and production of organic acids

The objective of this study was to enhance calcium solubility and bioavailability from calcium-fortified soymilk by fermentation with 7 strains of Lactobacillus, namely, L. acidophilus ATCC 4962, ATCC33200, ATCC 4356, ATCC 4461, L. casei ASCC 290, L. plantarum ASCC 276, and L. fermentum VRI-003. The parameters that were used are viability, pH, calcium solubility, organic acid, and biologically active isoflavone aglycone content. Calcium-fortified soymilk made from soy protein isolate was inoculated with these probiotic strains, incubated for 24 h at 37 degrees C, then stored for 14 d at 4 degrees C. Soluble calcium was measured using atomic absorption spectrophotometry (AA). Organic acids and bioactive isoflavone aglycones, including diadzein, genistein, and glycetein, were measured using HPLC. Viability of the strains in the fermented calcium-fortified soymilk was > 8.5 log(10) CFU/g after 24 h fermentation and this was maintained for 14-d storage at 4 degrees C. After 24 h, there was a significant increase (P < 0.05) in soluble calcium. L. acidophilus ATCC 4962 and L. casei ASCC 290 demonstrated the highest increase with 89.3% and 87.0% soluble calcium after 24 h, respectively. The increase in calcium solubility observed was related to lowered pH associated with production of lactic and acetic acids. Fermentation significantly increased (P < 0.05) the level of conversion of isoflavones into biologically active aglycones, including diadzein, genistein, and glycetein. Our results show that fermenting calcium-fortified soymilk with the selected probiotics can potentially enhance the calcium bioavailability of calcium-fortified soymilk due to increased calcium solubility and bioactive isoflavone aglycone enrichment.

Probiotic products in Canada with clinical evidence: what can gastroenterologists recommend?

Probiotics, defined as 'live microorganisms, which when administered in adequate amounts, confer a health benefit on the host', are finally becoming an option for gastroenterologists in Canada, after being available for many years in Japan, Europe and the United States of America. Unfortunately, Health Canada and the US Food and Drug Administration have not controlled the use of the term 'probiotic' or put into place United Nations and World Health Organization guidelines. The net result is that a host of products called 'probiotics' are available but are not truly probiotic. The aim of the present review was to discuss the rationale for probiotics in gastroenterology, and specifically examine which products are options for physicians in Canada, and which ones patients might be using. It is hoped that by clarifying what probiotics are, and the strengths and limitations of their use, specialists will be better placed to make recommendations on the role of these products in patient care. In due course, more clinically documented probiotics will emerge, some with therapeutic effects based on a better understanding of disease processes.