Heat-Killed Lactilactobacillus sakei WB2305 and Lactiplantibacillus plantarum WB2324 Inhibited LPS-Induced Inflammation in Human Airway Epithelial Cells

Asthma is characterized by inflammation of the airways, including the inflammatory and airway structural cells. Probiotics, which have diverse effects, even within the same species, are being studied to prevent and mitigate the severity of asthma. Lactilactobacillus sakei WB2305 and Lactiplantibacillus plantarum WB2324 were isolated from kimchi. These strains have acceptable probiotic properties and are safe. In addition, the anti-inflammatory potential of the heat-killed isolates against lipopolysaccharide (LPS)-induced inflammation in the human pulmonary epithelial cell line (A549) was investigated. The heat-killed Lact. sakei WB2305 and Lact. plantarum WB2324 reduced the chemokine and cytokines mRNA expression levels, as shown by the results of using real-time polymerase chain reaction. Western blotting results showed that the nuclear factor-kappa B (NF-κB) activation and mitogen-activated protein kinases (MAPK) signaling pathways were suppressed by treatment with the heat-killed strains. The production amounts of eotaxin, tumor necrosis factor-ɑ (TNF-α), and interleukin-6 (IL-6) were lower than those in LPS-only treated cells. Additionally, 2',7'-dichlorofluorescein diacetate (DCFH-DA) staining confirmed decreased reactive oxygen species (ROS) production in A549 cells. Therefore, the results of present study demonstrate the anti-inflammatory and anti-asthmatic activities of heat-killed Lact. sakei WB2305 and Lact. plantarum WB2324 in human airway epithelial cells.

CRISPR/Cas9 targeting of passenger single nucleotide variants in haploinsufficient or essential genes expands cancer therapy prospects

CRISPR/Cas9 technology has effectively targeted cancer-specific oncogenic hotspot mutations or insertion-deletions. However, their limited prevalence in tumors restricts their application. We propose a novel approach targeting passenger single nucleotide variants (SNVs) in haploinsufficient or essential genes to broaden therapeutic options. By disrupting haploinsufficient or essential genes through the cleavage of DNA in the SNV region using CRISPR/Cas9, we achieved the selective elimination of cancer cells without affecting normal cells. We found that, on average, 44.8% of solid cancer patients are eligible for our approach, a substantial increase compared to the 14.4% of patients with CRISPR/Cas9-applicable oncogenic hotspot mutations. Through in vitro and in vivo experiments, we validated our strategy by targeting a passenger mutation in the essential ribosomal gene RRP9 and haploinsufficient gene SMG6. This demonstrates the potential of our strategy to selectively eliminate cancer cells and expand therapeutic opportunities.

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.

Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population

BACKGROUND

This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA.

METHODS

Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death.

RESULTS

The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively. The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; P < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all P < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA.

CONCLUSION

TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA.

LEVEL OF EVIDENCE

III.

Hepatoprotective Effect of Lactiplantibacillus plantarum DSR330 in Mice with High Fat Diet-Induced Nonalcoholic Fatty Liver Disease

Lactiplantibacillus plantarum DSR330 (DSR330) has been examined for its antimicrobials production and probiotics. In this study, the hepatoprotective effects of DSR330 were examined against non-alcoholic fatty liver disease (NAFLD) in a high-fat diet (HFD)-fed C57BL/6 mouse model. To induce the development of fatty liver, a HFD was administered for five weeks, and then silymarin (positive control) or DSR330 (108 or 109 CFU/day) was administered along with the HFD for seven weeks. DSR330 significantly decreased body weight and altered serum and hepatic lipid profiles, including a reduction in triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels compared to those in the HFD group. DSR330 significantly alleviated HFD-related hepatic injury by inducing morphological changes and reducing the levels of biomarkers, including AST, ALT, and ALP. Additionally, DSR330 alleviated the expression of SREBP-1c, ACC1, FAS, ACO, PPARα, and CPT-1 in liver cells. Insulin and leptin levels were decreased by DSR330 compared to those observed in the HFD group. However, adiponectin levels were increased, similar to those observed in the ND group. These results demonstrate that L. plantarum DSR330 inhibited HFD-induced hepatic steatosis in mice with NAFLD by modulating various signaling pathways. Hence, the use of probiotics can lead to hepatoprotective effects.

Heat-Treated Paraprobiotic Latilactobacillus sakei KU15041 and Latilactobacillus curvatus KU15003 Show an Antioxidant and Immunostimulatory Effect

The lactic acid bacteria, including Latilactobacillus sakei and Latilactobacillus curvatus, have been widely studied for their preventive and therapeutic effects. In this study, the underlying mechanism of action for the antioxidant and immunostimulatory effects of two strains of heat-treated paraprobiotics was examined. Heat-treated L. sakei KU15041 and L. curvatus KU15003 showed higher radical scavenging activity in both the 2-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and 2,2-diphenyl-1-picryl-hydrazyl (DPPH) assays than the commercial probiotic strain LGG. In addition, treatment with these two strains exhibited immunostimulatory effects in RAW 264.7 macrophages, with L. curvatus KU15003 showing a slightly higher effect. Additionally, they promoted phagocytosis and NO production in RAW 264.7 cells without any cytotoxicity. Moreover, the expression of tumor necrosis factor-α, interleukin (IL)-1β, and IL-6 was upregulated. These strains resulted in an increased expression of inducible nitric oxide synthase and cyclooxygenase-2. Moreover, the nuclear factor-κB and mitogen-activated protein kinase signaling pathways were stimulated by these strains. These findings suggest the potential of using L. sakei KU15041 and L. curvatus KU15003 in food or by themselves as probiotics with antioxidant and immune-enhancing properties.

Probiotic Lactiplantibacillus plantarum KU210152 and its fermented soy milk attenuates oxidative stress in neuroblastoma cells

We evaluated the probiotic properties and neuroprotective effects of Lactiplantibacillus plantarum KU210152 and its application in soy milk. L. plantarum KU210152 exhibited high tolerance to artificial gastrointestinal conditions, high adhesion to intestinal cells (HT-29), and safe enzyme production. Conditioned medium acquired from HT-29 cells treated with heat-killed lactic acid bacteria (LAB-CM) was used to evaluate the neuroprotective effects. The CM exhibited neuroprotective effects via cell viability assay, morphological observations, and suppression of ROS production. Heat-killed L. plantarum KU210152 increased brain-derived neurotrophic factor (BDNF) and tyrosine hydroxylase (TH) expression in HT-29 cells. In SH-SY5Y cells, pretreatment with L. plantarum KU210152 CM decreased Bax/Bcl-2 ratio and upregulated BDNF and TH expression. The CM inhibited caspase-9 and caspase-3 activities. The neuroprotective effects of L. plantarum KU210152 were also confirmed in fermented soy milk. Therefore, both L. plantarum KU210152 and the fermented soy milk can be used as functional ingredients with neuroprotective effects against oxidative stress.

Probiotic Lactobacillus plantarum Ln4 Showing Antimicrobial and Antibiofilm Effect against Streptococcus mutans KCTC 5124 Causing Dental Caries

Dental caries has known as an infectious disease that is considered a serious global public health problem. Recently, report indicate that probiotics play a vital role in maintaining oral health. Therefore, this study aimed to evaluate the prevention effects of Lactobacillus plantarum Ln4 against dental infection by the pathogenic bacterium Streptococcus mutans KCTC 5124 through biofilm formation inhibition. To evaluate such prevention effects against S. mutans KCTC 5124, antimicrobial activity, auto-aggregation, co-aggregation, cell surface hydrophobicity, total exopolysaccharide (EPS) production rate, and biofilm formation were analyzed. Results showed that L. plantarum Ln4 showed higher antimicrobial activity than L. rhamnosus GG (LGG). In the group treated with L. plantarum Ln4, the co-aggregation (58.85%), cell surface hydrophobicity (16.75%), and EPS production rate (73.29%) values were lower than those of LGG and the negative control. Additionally, crystal violet staining and confocal laser scanning microscopy (CLSM) revealed that L. plantarum Ln4 effectively inhibited biofilm formation in S. mutans KCTC 5124. Therefore, L. plantarum Ln4 could be used in the industry as a probiotics to prevent and improve oral health.

Heat-Killed Enterococcus faecium KU22001 Having Effective Anti-Cancer Effects on HeLa Cell Lines at a Lower Temperature

The anti-cancer effects of heat-killed Enterococcus faecium KU22001 (KU22001), KU22002, and KU22005 isolated from human infant feces were investigated. The anti-proliferative activity of these strains against various cancer cell lines was evaluated using the MTT assay. To determine the production of exopolysaccharides (EPS) with potential anti-cancer effect, ethanol precipitation and phenol-sulfuric acid method was used with the cell free supernatant of strains grown at 25°C or 37°C. The EPS yield of E. faecium strains was higher at 25°C than at 37°C. Among these E. faecium strains, KU22001 grown at 25°C was associated with the highest bax/bcl-2 ratio, effective apoptosis rate, cell cycle arrest in the G0/G1 phase, and condensation of the nucleus in the cervical cancer HeLa cell line. In conclusion, these results suggest that KU22001 can be beneficial owing to the anti-cancer effects and production of functional materials, such as EPS.

Fermentation of Inula britannica using Lactobacillus plantarum SY12 increases of epigallocatechin gallate and attenuates toxicity

This study aimed to increase epigallocatechin gallate (EGCG) levels and attenuate the toxicity in Inulabritannica by fermentation using Lactobacillus plantarum SY12. The optimal medium was composed of 10 g of I. britannica, 4 g of xylose, 5 g of soytone, and 5 g of beef extract. The predicted value of EGCG was 237.327 μg/mL. To investigate damage in HepG2 cell lines by I. britannica extracts (IE) or fermented I. britannica extracts (FIE), cell viability, mitochondria membrane potential, the expression of apoptosis and autophagy genes, and chemical composition were measured. FIE increased cell viability, regulation of the gene expression (decreased p53, p62, p-ERK 1/2, and p-p38; increased CDK2 and CDK4) compared with IE. These results were explained by an increase in 1,3-dicaffeoylquinic acid and a decrease in 1-O-caffeoylquinic acid, 1-O-acetylbritannilactone, and ergolide in FIE. In conclusion, these results indicated that fermentation can mitigate the toxicity in I. britannica.

Age and sex differences in coronal lower extremity alignment in a healthy Asian population

BACKGROUND

The purpose of this study was to analyze the coronal alignment of lower extremities according to age and sex in a healthy population and demonstrate the differences.

METHODS

Standing full-lower limb anteroposterior (AP) radiographs of healthy volunteers (670 males and 782 females) aged 18-69 years were retrospectively analyzed. The hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), joint line convergence angle and femoral bowing angle (FBA) were measured. The radiographic parameters were compared according to groups of age and sex. The proportion of volunteers with varus or valgus alignment more than 3° were also analyzed.

RESULTS

With increasing age, HKA and LDFA varus increased. With increasing age, femoral medial bowing decreased. In addition, the HKA showed more varus alignment in males than in females (178.01° vs. 178.82°, P < 0.001). The MPTA was about 1° smaller in males than in females (P < 0.001). The proportion of patients with varus alignment of more than 3° increased with increasing age, with 16.9% in the 10-19 years old and 38.0% in the 60-69 years old groups.

CONCLUSION

This study demonstrated that males showed more varus tibial alignments than females. Varus limb alignment, LDFA, and FBA also increases with age. In contrast, tibial alignment was constant across all age groups. Therefore, differences in lower extremity alignment according to age and sex should be considered in estimating individual prearthritic alignments.

Anti-inflammatory activities of Levilactobacillus brevis KU15147 in RAW 264.7 cells stimulated with lipopolysaccharide on attenuating NF-κB, AP-1, and MAPK signaling pathways

Probiotics confer many beneficial effects on several illnesses, ranging from microbial diarrhea to inflammatory diseases. This study was conducted on whether Levilactobacillus brevis KU15147 obtained from kimchi has anti-inflammatory effects in RAW 264.7 cells stimulated with lipopolysaccharide (LPS) and antioxidant potential. L. brevis KU15147 reduced nitric oxide and prostaglandin E2 levels with decreasing the activation of inducible nitric oxide synthase and cyclooxygenase-2 without cell cytotoxicity. In addition, L. brevis KU15147 attenuated proinflammatory cytokine production including tumor necrosis factor-α, interleukin (IL)-1β, and IL-6 in RAW 264.7 cells stimulated with LPS. Additionally, L. brevis KU15147 reduced the activity of nuclear factor-κB, activator protein-1, and mitogen-activated protein kinase signaling pathways. Furthermore, L. brevis KU15147 downregulated the production of reactive oxygen species. Therefore, L. brevis KU15147 was concluded that had an inhibition effect on LPS-induced inflammatory responses and can be used in functional foods to suppress inflammatory diseases.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10068-023-01318-w.

Assessment of a novel deep learning-based software developed for automatic feature extraction and grading of radiographic knee osteoarthritis

BACKGROUND

The Kellgren-Lawrence (KL) grading system is the most widely used method to classify the severity of osteoarthritis (OA) of the knee. However, due to ambiguity of terminology, the KL system showed inferior inter- and intra-observer reliability. For a more reliable evaluation, we recently developed novel deep learning (DL) software known as MediAI-OA to extract each radiographic feature of knee OA and to grade OA severity based on the KL system.

METHODS

This research used data from the Osteoarthritis Initiative for training and validation of MediAI-OA. 44,193 radiographs and 810 radiographs were set as the training data and used as validation data, respectively. This AI model was developed to automatically quantify the degree of joint space narrowing (JSN) of medial and lateral tibiofemoral joint, to automatically detect osteophytes in four regions (medial distal femur, lateral distal femur, medial proximal tibia and lateral proximal tibia) of the knee joint, to classify the KL grade, and present the results of these three OA features together. The model was tested by using 400 test datasets, and the results were compared to the ground truth. The accuracy of the JSN quantification and osteophyte detection was evaluated. The KL grade classification performance was evaluated by precision, recall, F1 score, accuracy, and Cohen's kappa coefficient. In addition, we defined KL grade 2 or higher as clinically significant OA, and accuracy of OA diagnosis were obtained.

RESULTS

The mean squared error of JSN rate quantification was 0.067 and average osteophyte detection accuracy of the MediAI-OA was 0.84. The accuracy of KL grading was 0.83, and the kappa coefficient between the AI model and ground truth was 0.768, which demonstrated substantial consistency. The OA diagnosis accuracy of this software was 0.92.

CONCLUSIONS

The novel DL software known as MediAI-OA demonstrated satisfactory performance comparable to that of experienced orthopedic surgeons and radiologists for analyzing features of knee OA, KL grading and OA diagnosis. Therefore, reliable KL grading can be performed and the burden of the radiologist can be reduced by using MediAI-OA.

The Feasibility of Fast, Four-Dimensional Computed Tomography-Based O-Ring Linac Plans for Stereotactic Body Radiotherapy in Patients with Poor Performance Status

PURPOSE/OBJECTIVE(S)

As patients with poor performance status cannot endure long treatment times, it can lead to unplanned and prolonged radiation treatment or discontinuation of treatment. Moreover, prolonged radiation treatment appears to negatively affect survival for patients. We aimed to verify the feasibility of fast 4DCT-based O-ring linear accelerator (LINAC) treatment in lung 4D stereotactic body radiotherapy (SBRT).

MATERIALS/METHODS

This study included data of 38 patients who received lung 4D-SBRT. Gating20-70% plans were based on 4DCT data obtained at phase values ranging from 20-70% using a C-arm LINAC. Non-GatingFB plans were retrospectively established based on 4DCT data obtained at phase values of 0-90% using an O-ring LINAC. The prescribed dose of 4,800 cGy was delivered to PTV in four fractions. The conformity index (CI), homogeneity index (HI), and gradient measurement (GM) of the PTV were analyzed to compare dosimetric data between Gating20-70% and Non-GatingFB plans. Organs at risks (OARs) were analyzed in accordance with the RTOG 0915 protocol. Treatment delivery time and total monitor units (MU) were analyzed to compare the efficiency of treatment delivery. Statistical comparisons were performed using the Wilcoxon signed-rank test (p<0.05).

RESULTS

For the PTV, there was no significant difference in the CI or HI between Gating20-70% and Non-GatingFB plans (CI: 1.337±0.137, 1.335±0.174, HI: 0.939±0.015, 0.939±0.016, all at p>0.05). However, there was a significant difference in GM between Gating20-70% and Non-GatingFB plan (1.528±0.206 cm, 1.381±0.222 cm, p<0.001). For OARs, all plans met the criteria for dose constraint. There was a significant difference between Gating20-70% and Non-GatingFB plans except in the spinal cord. In particular, D1000cc and D1500cc values for the ipsilateral lung for Gating20-70% plans were 31.6% and 59.9% lower than those for Non-GatingFB plans (D1000cc: 50.780±132.061 cGy, 34.755±102.480 cGy, p<0.001, D1500cc: 6.641±14.598 cGy, 2.666±7.926 cGy, p<0.001). Treatment delivery time was 92% longer for Gating20-70% plans than for Non-GatingFB plans (5.0±0.4 min, 9.6±3.3 min, p = 0.043). The total MU value for Gating20-70% plans was 9.6% higher than that for Non-GatingFB plans (3665.8±230.7, 4016±236.9, p = 0.039).

CONCLUSION

When compared to OARs both plans were acceptable per RTOG-0915 protocol, but significant differences were between Non-GatingFB and Gating20-70% plans. However, treatment delivery time of Non-GatingFB plans decreased by 47.9% than Gating20-70% plans. We verified the feasibility of fast 4DCT-based O-ring LINAC treatment for patients who cannot endure long treatment times due to poor performance status in lung 4D-SBRT. In further study, we will analyze dosimetric differences and treatment delivery efficiency considering tumor motion according to tumor location.

Neuroprotective Effects of Heat-Killed Levilactobacillus brevis KU15152 on H2O2-Induced Oxidative Stress

This study proposed to demonstrate the neuroprotective effects of heat-killed Levilactobacillus brevis KU15152. Heat-killed L. brevis KU15152 showed antioxidant activity similar to that of Lacticaseibacillus rhamnosus GG, in terms of radical scavenging activity. To evaluate the neuroprotective effects, conditioned medium (CM) obtained by incubating heat-killed bacteria in intestinal cells (HT-29) was used through gut-brain axis. CM from L. brevis KU15152 protected neuroblastoma cells (SH-SY5Y) against H2O2-induced oxidative stress. Pretreatment with CM significantly alleviated the morphological changes induced by H2O2. Heat-killed L. brevis KU15152 showed an increased brain-derived neurotrophic factor (BDNF) expression in HT-29 cells. L. brevis KU15152-CM remarkably downregulated the Bax/Bcl-2 ratio, while upregulating the expression of BDNF and tyrosine hydroxylase (TH) in SH-SY5Y cells. Furthermore, L. brevis KU15152-CM reduced caspase-3 activity following H2O2 treatment. In conclusion, L. brevis KU15152 can be potentially used as food materials to avoid neurodegenerative diseases.

Heat-Killed Latilactobacillus sakei CNSC001WB and Lactobacillus pentosus WB693 Have an Anti-inflammatory Effect on LPS-Stimulated RAW 264.7 Cells

Excessive inflammatory results, such as those seen in rheumatoid arthritis and cardiovascular diseases, are known to cause various complications. Therefore, we aimed to investigate whether heat-killed Latilactobacillus sakei CNS001WB and Lactobacillus pentosus WB693 can prevent inflammatory reactions. When LPS-stimulated RAW 264.7 cells were handled with either heat-killed Lact. sakei CNSC001WB or Lact. pentosus WB693, the production of nitric oxide reduced. Furthermore, the expression of cyclooxygenase (COX)-2 and proinflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6, was suppressed. The expression of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4), which play important roles in inflammatory diseases, especially arthritis, was also reduced. Moreover, these strains inhibited nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) pathways, which activate various cytokines and inflammatory mediators. Additionally, heat-killed Lact. sakei CNSC001WB and Lact. pentosus WB693 inhibited the reactive oxygen species (ROS) production. Based on these results, we concluded that heat-killed Lact. sakei CNSC001WB and Lact. pentosus WB693 sufficiently inhibited the inflammatory response and may have anti-inflammatory potential.

Probiotic Weissella cibaria displays antibacterial and anti-biofilm effect against cavity-causing Streptococcus mutans

Streptococcus mutans is a significant contributor to dental caries and causes functional and aesthetic discomfort. Weissella cibaria strains were isolated from kimchi, and their functional properties were determined. In this study, the antibacterial and antibiofilm effects of four W. cibaria strains (D29, D30, D31, and B22) were evaluated against three S. mutans strains using culture fluid and cell-free supernatants. The results showed that W. cibaria reduced the exopolysaccharides production and auto-aggregation, increased co-aggregation, and downregulated virulence factors, leading to the inhibition of bacterial growth and biofilm formation. These findings were confirmed using scanning electron microscopy and confocal laser scanning microscopy. These results indicate that oral health can be potentially improved by W. cibaria.

The limited use of a tourniquet during total knee arthroplasty under a contemporary enhanced recovery protocol has no meaningful benefit: a prospective randomized controlled trial

PURPOSE

This prospective randomized controlled trial aimed to determine whether the limited use of tourniquets during total knee arthroplasty (TKA) would be more beneficial under the contemporary enhanced recovery after surgery (ERAS) protocol than the conventional use of tourniquets.

METHODS

One hundred patients with knee osteoarthritis who underwent primary TKA were randomly assigned to the limited tourniquet (LT, n = 51) and conventional tourniquet (CT, n = 49) groups. Operation time, serial hemoglobin drops, calculated blood loss, transfusion rate, D-dimer levels, and the presence of deep vein thrombosis (DVT) were assessed. In addition, visual analog scale (VAS) scores for pain around the knee and thigh were measured while resting during the day, at night, and during ambulation. Opioid consumption, range of motion, knee circumference, and postoperative complications were also analyzed. Isokinetic muscle strength, knee injury and osteoarthritis outcome scores, and Euro-QoL-5D scores were also assessed before and 3 months after TKA. For statistical analysis, Chi-square and Fisher's exact tests were performed to compare the differences in categorical variables. Continuous variables were compared using an independent t test or Mann‒Whitney U test.

RESULTS

The average tourniquet time was 46.7 min in the CT group and 5.4 min in the LT group. Knee pain on the first night after surgery was significantly higher in the CT group (3.2 vs. 4.6, p = 0.033). However, daytime pain in the thigh at 2 weeks and in the knee at 3 months after TKA were higher in the LT group than in the CT group (p = 0.048 and p = 0.036, respectively). The D-dimer level 3 months after TKA was also higher in the LT group than in the CT group (p = 0.028), but there was no difference in DVT incidence between the two groups (n.s.). Additionally, there were no significant differences in the other variables between the groups.

CONCLUSIONS

Although the limited use of tourniquets did not increase the operation time, blood loss, or transfusion rate, this study found that the limited use of tourniquets would not provide additional meaningful benefit in reducing pain and early functional restoration after TKA when applying the ERAS protocol.

LEVEL OF EVIDENCE

I.

Effect of set-type yoghurt supplemented with the novel probiotic Lantiplantibacillus plantarum 200655 on physicochemical properties and the modulation of oxidative stress-induced damage

The present study developed a functional yoghurt supplemented with Lantiplantibacillus plantarum 200655 and evaluated its physicochemical properties and antioxidant activities. Yoghurt samples were prepared using commercial starter cultures and probiotics and grouped as follows: control sample without probiotics (C), GG (supplemented with Lacticaseibacillus rhamnosus GG), R (supplemented with L. plantarum KCTC 3108), and S (supplemented with L. plantarum 200655). The GG, R, and S samples had shorter fermentation time compared with the C sample. Lactic acid bacteria count, pH, and titratable acidity were similar in all samples during refrigerated storage. However, the GG, R, and S samples showed increased viscosity and water holding capacity (WHC), and decreased syneresis. The S sample had no adverse effect on organoleptic properties. Furthermore, the S sample had the highest antioxidant activity and significantly inhibited LPS-induced oxidative stress in intestinal cells. These findings suggest the potential use of L. plantarum 200655 in dairy products with therapeutic benefits.

Immune-Enhancing Effect of Heat-Treated Levilactobacillus brevis KU15159 in RAW 264.7 Cells

Probiotics are alive microbes that present beneficial to the human's health. They influence immune responses through stimulating antibody production, activating T cells, and altering cytokine expression. The probiotic characteristics of Levilactobacillus brevis KU15159 were evaluated on the tolerance and adherence to gastrointestinal conditions. L. brevis KU15159 was safe in a view of producing various useful enzymes and antibiotic sensitivity. Heat-treated L. brevis KU15159 increased production of nitric oxide (NO) and phagocytic activity in RAW 264.7 cells. In addition, heat-treated L. brevis KU15159 upregulated the expression of inducible nitric oxide synthase (iNOS) and proinflammatory cytokines including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6, at protein as well as mRNA levels. In addition, the mitogen-activated protein kinase (MAPK) pathway, which regulates the immune system, was activated by heat-treated L. brevis KU15159. Therefore, L. brevis KU15159 exhibited an immune-enhancing effect by the MAPK pathway in macrophage.

Soy yogurt using Lactobacillus plantarum 200655 and fructooligosaccharides: neuroprotective effects against oxidative stress

This study aimed to evaluate the effect of Lactobacillus plantarum 200655 and fructooligosaccharides (FOS) on soymilk fermentation and the neuroprotective effects of fermented soymilk (FS). The addition of FOS did not affect the physicochemical properties during fermentation. It helped that L. plantarum 200655 survive for 21 days of storage at 4 °C. FOS increased the β-glucosidase activity of L. plantarum 200655, total phenolic content, and antioxidant activities, such as radical scavenging and reducing power of FS. In addition, FS with FOS exerted neuroprotective effects in SH-SY5Y cells against H2O2-induced oxidative stress. FS with 3% and 5% FOS (FS3 and FS5) significantly increased cell viability and gene expression of neuronal markers, such as brain-derived neurotrophic factor and tyrosine hydroxylase. Moreover, FS3 and FS5 significantly reduced lactate dehydrogenase release and the gene expression of Bax/Bcl-2 ratio, caspase-9, and caspase-3. These results indicated that FS3 and FS5, with enhanced antioxidant properties, could protect SH-SY5Y cells against H2O2-induced damage. Therefore, soymilk fermented with L. plantarum 200655 and FOS can be used as a prophylactic functional food with neuroprotective effects against oxidative stress.

Presence of Night Pain, Neuropathic Pain, or Depressive Disorder Does Not Adversely Affect Outcomes After Total Knee Arthroplasty: A Prospective Cohort Study

BACKGROUND

A considerable proportion of patients warranting total knee arthroplasty (TKA) have night pain, neuropathic pain, and/or depressive disorder, which may not be resolved by TKA. This prospective, longitudinal cohort study aimed to document the prevalence of night pain, neuropathic pain, and depressive disorder in patients with advanced knee osteoarthritis undergoing TKA and to determine whether the specific coexisting pain and/or disorder at the time of TKA adversely affected postoperative outcomes.

METHODS

In this study, 148 patients undergoing TKA were longitudinally evaluated. The presence of night pain, neuropathic pain (determined using Douleur Neuropathique 4 [DN4]) and depressive disorder (determined using the Patient Health Questionnaire-9 [PHQ-9]) was determined before and 6 weeks, 3 months and 1 year after TKA. In addition, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQol-5 Dimension (EQ-5D) scores were assessed before and 1 year after TKA. Potential associations of night pain, neuropathic pain, and/or depressive disorder with pre- and postoperative WOMAC and EQ-5D scores were examined in subgroup analyses.

RESULTS

Preoperatively, 72% (n = 106) of patients reported night pain, and the prevalences of neuropathic pain and depressive disorder were 15% and 17%, respectively. Preoperatively, compared with patients without night pain, those with night pain had significantly poorer preoperative WOMAC scores, but no significant difference was seen between groups 1 year after TKA. Preoperatively, the WOMAC, EQ-5D, and EQ-5D health scores of patients with neuropathic pain were not significantly different from those of patients without neuropathic pain, and there was no difference in clinical outcome scores 1 year after TKA between these groups. Preoperatively, the patients with depressive disorder showed significantly poorer preoperative WOMAC, EQ-5D, and EQ-5D health scores than those without depressive disorder, but no significant differences in scores were observed 1 year after TKA between these groups.

CONCLUSION

This study revealed a considerable prevalence of night pain, neuropathic pain, and depressive disorder in patients undergoing TKA and that patients with these specific conditions reported poorer functional and quality of life scores preoperatively. However, such adverse effects disappeared after TKA. Our study findings suggest that TKA can provide satisfactory outcomes for patients with these specific conditions.

Effect of distance between the feet on knee joint line orientation after total knee arthroplasty in standing full-limb radiographs

PURPOSE

Although knee joint line orientation (KJLO) after total knee arthroplasty (TKA) has been emphasized as an important factor that can affect postoperative knee kinematics, the effect of foot position on KJLO has not been fully understood. This study aimed to (1) identify the anatomical and positional factors that determine KJLO after TKA, and (2) determine the effect of foot position on KJLO after TKA. The hypothesis of this study was that the post-TKA KJLO would change depending on the distance between the feet, as well as the coronal implant positions.

METHODS

A total of 92 radiographs from 46 patients who underwent TKA were retrospectively reviewed. Two postoperative standing full-limb anteroposterior radiographs taken with the feet in different positions (with both feet in contact with each other or shoulder width apart) from each patient were evaluated. The correlation between KJLO after TKA and possible anatomical and positional factors, including leg length, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), ankle joint line orientation (AJLO), mechanical tibiofemoral angle (mTFA), and distance between the feet, were analyzed, and the KJLO equation was computed using multiple linear regression. KJLO was also compared among different combinations of valgus or varus alignment of the femoral and tibial components.

RESULTS

LDFA, MPTA, AJLO, and distance between the feet were identified as determinants of KJLO after TKA, and the distance between the feet was strongly correlated with KJLO. Based on the KJLO equation (KJLO [°] = 107.548 - 0.441 × LDFA [°] - 0.832 × MPTA [°] + 0.093 × AJLO [°] + 0.037 × ITD [mm]), KJLO changes by 3.7° per 100 mm of distance between the feet. The KJLO of patients with valgus femoral and varus tibial components was more parallel to the ground than those with other combinations.

CONCLUSION

KJLO after TKA was strongly affected by the distance between the feet when taking full-limb radiography, and the KJLO changed by 3.7° per 100 mm of distance between the feet. To assess the KJLO after TKA reproducibly, standardization of the distance between the feet is necessary.

LEVEL OF EVIDENCE

IV.

Reduction of postoperative nausea and vomiting risk in the second stage during bilateral total knee arthroplasty with a 1-week interval

PURPOSE

Total knee arthroplasty (TKA) is often performed sequentially on both sides during a single hospital stay. Patients who experience postoperative nausea and vomiting (PONV) after the first operation are concerned about PONV recurrence after the second operation. However, there are few studies regarding the incidence of PONV in staged bilateral TKA with a ≥ 1-week interval. This study aimed to identify the differences in (1) PONV incidence, (2) use of rescue antiemetics, and (3) the amount of opioid consumption between the first and second operations for staged bilateral TKA with a 1-week interval. Based on our anecdotal experience, the hypothesis of this study was that during staged bilateral TKA at a 1-week interval, the PONV incidence and rescue antiemetic requirement after the second operation will be lower than those after the first operation, regardless of opioid consumption.

METHODS

Fifty-eight consecutive patients who underwent staged bilateral TKA with a 1-week interval were retrospectively reviewed. All second-stage operations were performed with the same anaesthesia protocol and perioperative patient management protocol as the first-stage operation. PONV incidence was the primary outcome. The requirement for rescue antiemetic drugs and the amount of opioid consumption were secondary outcome variables. The outcome variables were recorded during three postoperative days (Days 0-2) for each stage and were compared between the first and second operations.

RESULTS

The incidence rates of nausea and vomiting on Day 0 (p = 0.001 and p = 0.004, respectively) and nausea on Day 1 (p = 0.008) were significantly lower after the second operation. Rescue antiemetic use on Day 0 was significantly lower after the second operation (p = 0.001). The total opioid consumption 72 h after surgery was significantly higher after the second operation (61.76 vs. 34.28 mg, p < 0.001).

CONCLUSION

During staged bilateral TKA with a 1-week interval, PONV incidence was lower after the second operation, even with increased opioid consumption.

LEVEL OF EVIDENCE

III.

Optimization of an Industrial Medium and Culture Conditions for Probiotic Weissella cibaria JW15 Biomass Using the Plackett-Burman Design and Response Surface Methodology

The objective of this study was to optimize industrial-grade media for improving the biomass production of Weissella cibaria JW15 (JW15) using a statistical approach. Eleven variables comprising three carbon sources (glucose, fructose, and sucrose), three nitrogen sources (protease peptone, yeast extract, and soy peptone), and five mineral sources (K₂HPO₄, potassium citrate, L-cysteine phosphate, MgSO₄, and MnSO₄) were screened by using the Plackett-Burman design. Consequently, glucose, sucrose, and soy peptone were used as significant variables in response surface methodology (RSM). The composition of the optimal medium (OM) was 22.35 g/l glucose, 15.57 g/l sucrose, and 10.05 g/l soy peptone, 2.0 g/l K₂HPO₄, 5.0 g/l sodium acetate, 0.1 g/l MgSO₄·7H₂O, 0.05 g/l MnSO₄·H₂O, and 1.0 g/l Tween 80. The OM significantly improved the biomass production of JW15 over an established commercial medium (MRS). After fermenting OM, the dry cell weight of JW15 was 4.89 g/l, which was comparable to the predicted value (4.77 g/l), and 1.67 times higher than that of the MRS medium (3.02 g/l). Correspondingly, JW15 showed a rapid and increased production of lactic and acetic acid in the OM. To perform a scale-up validation, batch fermentation was executed in a 5-l bioreactor at 37°C with or without a pH control at 6.0 ± 0.1. The biomass production of JW15 significantly improved (1.98 times higher) under the pH control, and the cost of OM was reduced by two-thirds compared to that in the MRS medium. In conclusion, OM may be utilized for mass producing JW15 for industrial use.

Protective Effects of a Novel Lactobacillus brevis Strain with Probiotic Characteristics against Staphylococcus aureus Lipoteichoic Acid-Induced Intestinal Inflammatory Response

Probiotics can effectively modulate host immune responses and prevent gastrointestinal diseases. The objective of this study was to investigate the probiotic characteristics of Lactobacillus brevis KU15152 isolated from kimchi and its protective potential against intestinal inflammation induced by Staphylococcus aureus lipoteichoic acid (aLTA). L. brevis KU15152 exhibited a high survival rate in artificial gastric and bile environments. Additionally, the adhesion capability of the strain to HT-29 cells was higher than that of L. rhamnosus GG. L. brevis KU15152 did not produce harmful enzymes, such as β-glucuronidase, indicating that it could be used as a potential probiotic. The anti-inflammatory potential of L. brevis KU15152 was determined in HT-29 cells. Treatment with L. brevis KU15152 suppressed the production of interleukin-8 without inducing significant cytotoxicity. The downregulatory effects of L. brevis KU15152 were involved in the suppression of nuclear factor-kappa B activation mediated by the extracellular signal-regulated kinase and Akt signaling pathways. Collectively, these data suggest that L. brevis KU15152 can be used in developing therapeutic and prophylactic products to manage and treat aLTA-induced intestinal damage.

Antibacterial and Antibiofilm Effect of Cell-Free Supernatant of Lactobacillus brevis KCCM 202399 Isolated from Korean Fermented Food against Streptococcus mutans KCTC 5458

This study aims to determine the antibiofilm effect of cell-free supernatant (CFS) of Lactobacillus brevis strains against Streptococcus mutans strains. To study the antibiofilm mechanism against S. mutans strains, antibacterial effects, cell surface properties (auto-aggregation and cell surface hydrophobicity), exopolysaccharide (EPS) production, and morphological changes were examined. The antibiofilm effect of L. brevis KCCM 202399 CFS as morphological changes were evaluated by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM), compared with the control treatment. Among the L. brevis strains, L. brevis KCCM 202399 showed the highest antibiofilm effect on S. mutans KCTC 5458. The antibacterial effect of L. brevis KCCM 202399 against S. mutans KCTC 5458 was investigated using the deferred method (16.00 mm). The minimum inhibitory concentration of L. brevis KCCM 202399 against S. mutans KCTC 5458 was 25.00%. Compared with the control treatment, L. brevis KCCM 202399 CFS inhibited the bacterial adhesion of S. mutans KCTC 5458 by decreasing auto-aggregation, cell surface hydrophobicity, and EPS production (45.91%, 40.51%, and 67.44%, respectively). L. brevis KCCM 202399 CFS inhibited and eradicated the S. mutans KCTC 5458 biofilm. Therefore, these results suggest that L. brevis KCCM 202399 CFS may be used to develop oral health in the probiotic industry.

Effects of the Probiotic Lactiplantibacillus plantarum KU15120 Derived from Korean Homemade Diced-Radish Kimchi Against Oxidation and Adipogenesis

Intestinal microflora can influence abnormal adipocyte growth. Therefore, this study was aimed to investigate the probiotic properties and antioxidant and antiobesity effects of isolated strains from homemade kimchi. Among the isolated strains, Lactiplantibacillus plantarum KU15120 showed high tolerance to artificial gastric juice and bile salt conditions, high adhesion to HT-29 cells, nonproduction of β-glucuronidase, nonhemolysis, and acceptable resistance to antibiotics. It showed high antioxidant activity, including DPPH and ABTS radical scavenging and antioxidant activity, as determined by the β-carotene bleaching assay. Oil red O staining and intracellular triglyceride levels revealed reduced lipid accumulation, which confirmed the anti-adipogenic activity of L. plantarum KU15120. In addition, the expression levels of fatty acid synthase, CCAAT/enhance-binding protein α, and peroxisome proliferator-activated receptor γ, were significantly lower in the probiotic-treated group than in the control group. These results suggest that L. plantarum KU15120 has probiotic properties, antioxidant, and antiobesity effects and could be used as a therapeutic probiotics.

Relationship between radiographic measurements and knee adduction moment using 3D gait analysis

BACKGROUND

Radiographic factors estimate the state of the static knee joint, and it is questionable how well these parameters reflect the dynamic knee condition. The external knee adduction moment (KAM) during gait is known to be a kinetic variable contributing to osteoarthritis progression. This study aims to investigate the effects of static radiographic parameters on the dynamic KAM during gait.

METHODS

Overall, 123 patients (mean age, 65.7 years; standard deviation, 8.1 years; 34 men and 89 women) were included. Seven radiographic parameters including the mechanical tibiofemoral angle (mTFA), Kellgren-Lawrence grade, and ankle joint line orientation (AJLO) were measured on radiographs, and the maximum KAM and KAM-time integral in the stance phase were obtained using three-dimensional gait analysis. The correlation and multiple regression analyses were performed for identifying significant radiographic measurements associated with the KAM.

RESULTS

Most of the radiographic measurements correlated with the maximum KAM and KAM-time integral. As a result of multiple regression analysis, the mTFA (p < 0.001) and AJLO (p = 0.003) were identified as significant factors associated with the KAM-time integral (R² = 0.450); the mTFA (p < 0.001) and AJLO (p = 0.003) were identified as a significant factor associated with the maximum KAM (R² = 0.352) in multiple regression analysis. The discriminant validity of KAM was highest at varus 5.7 degree of the mTFA and 7.5 degree of the AJLO.

SIGNIFICANCE

The mTFA and AJLO were significantly associated with the KAM. However, to be used as a surgical indication for corrective osteotomy, a longitudinal study is needed to validate whether the mTFA and AJLO values directly cause osteoarthritis progression as we have suggested.

LEVEL OF EVIDENCE

III.

Chrysanthemum indicum suppresses adipogenesis by inhibiting mitotic clonal expansion in 3T3-L1 preadipocytes

Herbs have been of interest to treat diseases, including obesity, owing to their various bioactive constituents that exhibit therapeutic and prophylactic properties. The present study examined the anti-adipogenic effects and mechanisms of Chrysanthemum indicum aqueous extract (CAE) in 3T3-L1 preadipocytes. CAE comprises 1,3-dicaffeoylquinic acid, chlorogenic acid, kaempferol-3-O-glucoside, caffeic acid, and apigenin, which were corresponded with previous reports. CAE inhibited the accumulation of lipid droplets and significantly alleviated the expression of lipogenesis- and adipogenesis-associated biomarkers. Treatment with CAE inhibited the mitotic clonal expansion (MCE), corroborated by cell cycle arrest at the G₀ /G₁ phase, and mitigated the expression of cell cycle progression-associated proteins and in addition to phosphorylation of MCE-promoting transcription factors. Moreover, CAE downregulated the activation of Akt and extracellular signal-regulated kinase 1/2 signaling pathways. In summary, CAE facilitates adipogenic inhibition during the early phase of differentiation, especially MCE, and its phenolic compounds can contribute to its anti-obesogenic properties. PRACTICAL APPLICATIONS: Chrysanthemum indicum has been mainly used as traditional herbal tea and drinks. Chrysanthemum indicum aqueous extract (CAE) inhibits adipogenesis by suppressing mitotic clonal expansion during the early phase of differentiation in 3T3-L1 preadipocytes. 1,3-Dicaffeoylquinic acid, chlorogenic acid, kaempferol-3-O-glucoside, caffeic acid, and apigenin were detected in CAE. Based on these findings, CAE can be used as nutraceutical agents for prevention and treatment of obesity.

Anti-adipogenic Effects of the Probiotic Lactiplantibacillus plantarum KU15117 on 3T3-L1 Adipocytes

In this study, we investigated the probiotic properties and anti-obesity effects of bacterial strains isolated from homemade kimchi. Lactiplantibacillus plantarum KU15117 was isolated using lactobacilli selective medium. L. plantarum KU15117 did not produce β-glucuronidase and showed high tolerance to artificial gastric juice and bile salt, acceptable resistance to antibiotics, and high adhesion ability to HT-29 cells. The anti-adipogenic activity of L. plantarum KU15117 at 10⁹ CFU/well was confirmed by the reduction of oil red O staining and intracellular triglyceride level. Additionally, the expression levels of fatty acid synthase, CCAAT/enhance-binding protein-α, and peroxisome proliferator-activated receptor-γ, which are associated with the early stage of adipocyte differentiation, were significantly lower in the probiotic-treated group than in the control group. These results suggest that L. plantarum KU15117 has probiotic properties and anti-obesity effects and could be used as a prophylactic probiotics.

Prophylactic effects of probiotics on respiratory viruses including COVID-19: a review

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is mainly transmitted through respiratory droplets. The symptoms include dry cough, fever, and fatigue; however, high propagation, mutation, and fatality rates have been reported for SARS-CoV-2. This review investigates the structure of SARS-CoV-2, antiviral mechanisms, preventive strategies, and remedies against it. Effective vaccines have been developed by Pfizer (95% effective), AstraZeneca (90% effective), Moderna (94.5% effective) vaccine, among others. However, herd immunity is also required. Probiotics play a major role in the gut health, and some are known to have therapeutic potential against viral infections. Their modes of antiviral activities include direct interaction with targeted viruses, production of antiviral metabolites, and immunomodulatory effects on the host. Hence, probiotics can be a useful prophylactic against COVID-19, and more studies are required on the effects of probiotics against other viral infections that may occur in future.

Optimization of Medium Composition for Biomass Production of Lactobacillus plantarum 200655 Using Response Surface Methodology

This study aimed to optimize medium composition and culture conditions for enhancing the biomass of Lactobacillus plantarum 200655 using statistical methods. The one-factor-at-a-time (OFAT) method was used to screen the six carbon sources (glucose, sucrose, maltose, fructose, lactose, and galactose) and six nitrogen sources (peptone, tryptone, soytone, yeast extract, beef extract, and malt extract). Based on the OFAT results, six factors were selected for the Plackett- Burman design (PBD) to evaluate whether the variables had significant effects on the biomass. Maltose, yeast extract, and soytone were assessed as critical factors and therefore applied to response surface methodology (RSM). The optimal medium composition by RSM was composed of 31.29 g/l maltose, 30.27 g/l yeast extract, 39.43 g/l soytone, 5 g/l sodium acetate, 2 g/l K₂HPO₄, 1 g/l Tween 80, 0.1 g/l MgSO₄·7H₂O, and 0.05 g/l MnSO₄·H₂O, and the maximum biomass was predicted to be 3.951 g/l. Under the optimized medium, the biomass of L. plantarum 200655 was 3.845 g/l, which was similar to the predicted value and 1.58-fold higher than that of the unoptimized medium (2.429 g/l). Furthermore, the biomass increased to 4.505 g/l under optimized cultivation conditions. For lab-scale bioreactor validation, batch fermentation was conducted with a 5-L bioreactor containing 3.5 L of optimized medium. As a result, the highest yield of biomass (5.866 g/l) was obtained after 18 h of incubation at 30°C, pH 6.5, and 200 rpm. In conclusion, mass production by L. plantarum 200655 could be enhanced to obtain higher yields than that in MRS medium.

Physicochemical Analysis of Yogurt Produced by Leuconostoc mesenteroides H40 and Its Effects on Oxidative Stress in Neuronal Cells

Leuconostoc mesenteroides H40 (H40) was isolated from kimchi, and its probiotic properties and neuroprotective effect was evaluated in oxidatively stressed SH-SY5Y cells. H40 was stable in artificial gastric conditions and can be attached in HT-29 cells. In addition, H40 did not produce β-glucuronidase and showed resistant to several antibiotics. The conditioned medium (CM) was made using HT-29 cells refined with heat-killed probiotics (Probiotics-CM) and heated yogurts (Y-CM) to investigate the neuroprotective effect. Treatment with H40-CM not only increased cell viability but also significantly improved brain derived neurotropic factor (BDNF) expression and reduced the Bax/Bcl-2 ratio in oxidatively stress-induced SH-SY5Y cells. Besides, probiotic Y-CM significantly increased BDNF mRNA expression and decreased Bax/Bcl-2 ratio. The physicochemical properties of probiotic yogurt with H40 was not significantly different from the control yogurt. The viable cell counts of lactic acid bacteria in control and probiotic yogurt with H40 was 8.66 Log CFU/mL and 8.96 Log CFU/mL, respectively. Therefore, these results indicate that H40 can be used as prophylactic functional dairy food having neuroprotective effects.

Antimicrobial and anti-biofilm effects of probiotic Lactobacillus plantarum KU200656 isolated from kimchi

The probiotic properties and anti-pathogenic effects of Lactobacillus plantarum KU200656 (KU200656) isolated from Korean fermented kimchi against Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium were investigated. KU200656 showed high tolerance to artificial gastric acid (99.48%) and bile salts (102.40%) and this strain was safe according to antibiotic sensitivity test; it could not produce harmful enzymes, including β-glucuronidase. KU200656 exhibited high adhesion (4.45%) to intestinal cells, HT-29 cells, with high cell surface hydrophobicity (87.31% for xylene and 81.11% for toluene). Moreover, KU200656 co-aggregated with pathogenic bacteria and exhibited antibacterial activity and anti-adhesion properties against pathogens. The cell-free supernatant (CFS) of KU200656 inhibited biofilm formation by pathogenic bacteria. In addition, half of the minimum inhibitory concentration of the KU200656 CFS downregulated the expression of biofilm-related genes, as determined by quantitative real-time PCR. Therefore, KU200656 was demonstrated to possess anti-pathogenic effects and have potential for use as probiotics in the food industry.

Potential neuroprotective effects of heat-killed Lactococcus lactis KC24 using SH-SY5Y cells against oxidative stress induced by hydrogen peroxide

The present study was an investigation of the neuroprotective effects of probiotic bacteria in SH-SY5Y neuroblastoma cells experiencing oxidative stress. The bacterial strains were: commercial Lactobacillus rhamnosus GG; two isolated bacterial strains (Lactobacillus delbrueckii KU200170 and Lactobacillus plantarum KU200661); and probiotic Lactococcus lactis KC24. To evaluate the neuroprotective effects of the bacteria, a conditioned medium (CM) was prepared using HT-29 cells cultured with the heat-killed probiotic strains. Of the bacterial strains tested, the oxidatively stressed SH-SY5Y cells were most viable when cultured with L. lactis KC24-CM. L. lactis KC24-CM promoted the expression of brain-derived neurotropic factor (BDNF) in the HT-29 cells. It also significantly increased BDNF expression and reduced the apoptosis-related Bax/Bcl-2 ratio in the oxidatively stressed SH-SY5Y cells. Therefore, L. lactis KC24 is a potential psychobiotic for use in the functional food industry.

Fermented dairy products as delivery vehicles of novel probiotic strains isolated from traditional fermented Asian foods

The screening of novel probiotic strains from various food sources including fruits, vegetables, herbs, and traditional fermented foods, have been of growing concern recently. Most of these potential probiotic lactic acid bacteria isolates were distinguished from the commercial probiotics based on multiple therapeutic effects and functionalities. Recent in vitro and in vivo investigates have also verified the usage of probiotics to lower the risk of diseases. Application of these novel strains in fermented dairy products is also an emerging trend to improve the physical and quality characteristics, functional properties, and safety of dairy products. Moreover, since dairy products are one of the highest consumed products in the globe, the dispatch channels for fermented dairy products are already established. Therefore, incorporating novel probiotic strains into fermented dairy products might be the most feasible approach for their delivery. In this context, our aim is to discuss the feasibility of dairy products as delivery vehicles for novel probiotic strains. Thus, we summarize the scientific evidence that points to a dynamic future for the production of fermented dairy-based probiotics.

Inula britannica Inhibits Adipogenesis of 3T3-L1 Preadipocytes via Modulation of Mitotic Clonal Expansion Involving ERK 1/2 and Akt Signaling Pathways

The flower of Inula britannica contains various phenolic compounds with prophylactic properties. This study aimed to determine the anti-adipogenic effect of an I. britannica flower aqueous extract (IAE) and its underlying mechanisms in the 3T3-L1 preadipocytes and to identify the phenolic compounds in the extract. Treatment with IAE inhibited the adipogenesis by showing a dose-dependent suppressed intracellular lipid accumulation and mitigated expression levels of lipogenesis- and adipogenesis-associated biomarkers including transcription factors. IAE exerted an anti-adipogenic effect through the modulation of the early phases of adipogenesis including mitotic clonal expansion (MCE). Treatment with IAE inhibited MCE by arresting the cell cycle at the G0/G1 phase and suppressing the activation of MCE-related transcription factors. Furthermore, IAE inhibited adipogenesis by regulating the extracellular signal-regulated kinase 1/2 and Akt signaling pathways. Protocatechuic acid, chlorogenic acid, kaempferol-3-O-glucoside, and 6-methoxyluteolin, which are reported to exhibit anti-adipogenic properties, were detected in IAE. Therefore, modulation of early phases of adipogenesis, especially MCE, is a key mechanism underlying the anti-adipogenic activity of IAE. In summary, the anti-obesity effects of IAE can be attributed to its phenolic compounds, and hence, IAE can be used for the development of anti-obesity products.

Immune-stimulating Effect of Lactobacillus plantarum Ln1 Isolated from the Traditional Korean Fermented Food, Kimchi

This study aimed to determine the immune-stimulating effects of heat-killed Lactobacillus plantarum Ln1 (HK-Ln1) through the production of nitric oxide (NO) and pro-inflammatory cytokine achieved by inducing NF-κB and mitogen-activated protein kinase (MAPK)-signaling pathways in macrophages. HK-Ln1 showed higher NO and cytokine production compared t°Control (nonstimulated lipopolysaccharide); in addition, the expression of inducible nitric oxide synthase (iNOS) was induced through HK-Ln1treatment. The phosphorylation of IκB-α and p65 increased following treatment by HK-Ln1, which implicates IκB-α degradation and the translocation of p65 to nucleus. In addition, the phosphorylation of MAPKs, ERK 1/2, JNK, and p38 was induced following HK-Ln1 treatment.

Antioxidant and Anti-Inflammatory Effect of Probiotic Lactobacillus plantarum KU15149 Derived from Korean Homemade Diced-Radish Kimchi

Lactobacillus plantarum KU15149 was demonstrated to have probiotic behavior and functions, including antioxidant and anti-inflammatory activity. L. plantarum KU15149 obtained from homemade diced-radish kimchi has a high survival rate under artificial gastric acid (pH 2.5, 0.3% pepsin) and bile salt (0.3% oxgall) conditions. However, L. plantarum KU15149 did not produce β-glucuronidase, which is known to be a carcinogenic enzyme with resistance to several antibiotics, such as gentamycin, kanamycin, streptomycin, tetracycline, and ciprofloxacin. L. plantarum KU15149 strongly adhered to HT-29 cells and had high antioxidant activity in terms of 2,2-diphenyl- 1-picrylhydrazyl (DPPH) free radical-scavenging and β-carotene bleaching assays. L. plantarum KU15149 also exhibited a pronounced inhibition of nitric oxide (NO) production, along with expression of nitric oxide synthase (iNOS) and cyclooxygenase -2 (COX-2) as well as proinflammatory cytokines, such as TNF-α, IL-1β, and IL-6, when RAW 264.7 cells were stimulated with LPS. Therefore, L. plantarum KU15149 exhibited pharmaceutical functionality as a potential probiotic.

Probiotic Properties of Lactobacillus brevis KU200019 and Synergistic Activity with Fructooligosaccharides in Antagonistic Activity against Foodborne Pathogens

This study aims to evaluate the probiotic properties of Lactobacillus brevis (L. brevis) KU200019 and the synergistic activity with prebiotics on antimicrobial activity, and the potential application as an adjunct culture in fermented dairy products. The commercial strain, L. brevis ATCC 14869 was used as reference strain. L. brevis KU200019 was showed higher viability in simulated gastric (99.38±0.21%) and bile (115.10±0.13%) conditions compared to reference strain. L. brevis KU200019 exhibited antimicrobial activity against various foodborne pathogens. The supplementation of fructooligosaccharides (FOS) enhanced viability of lactic acid bacteria (>8 Log CFU/mL) and antioxidant activity [2,2-diphenyl-2-picrylhydrazyl radical assay (DPPH) assay, 31.23±1.14%; 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assay, 38.82±1.46%] in fermented skim milk during refrigerated storage. L. brevis KU200019 was distinguished from the reference strain by its higher probiotic potential, antimicrobial activity, and higher antioxidant activity in fermented milk. Therefore, L. brevis KU200019 with FOS was demonstrated promising properties for further application in fermented dairy products with enhanced safety and quality.

Immunomodulatory Effects by Bifidobacterium longum KACC 91563 in Mouse Splenocytes and Macrophages

The present study evaluates the immunomodulatory effect of Bifidobacterium longum KACC 91563 in murine primary splenocytes and macrophages. B. longum KACC 91563 regulated Tand B-cell proliferation and inhibited the Th1 (IL-2, IFN-γ)/Th2 (IL-4, IL-10) cytokine imbalance and immune cytokine production. Moreover, immunoglobulin E (IgE) levels were significantly lower after treatment with B. longum KACC 91563. These findings suggest that B. longum KACC 91563 could modulate the systemic immune system toward both IgE production and regulation of the Th1/Th2 balance.

Investigating the antimicrobial and antibiofilm effects of cinnamaldehyde against Campylobacter spp. using cell surface characteristics

Campylobacter species are known as biofilm-forming bacteria in food systems. The aim of this study was to evaluate the antimicrobial and antibiofilm effects of cinnamaldehyde against Campylobacter jejuni and Campylobacter coli isolated from chicken meat. The biofilm-forming C. jejuni and C. coli strains from chicken meat were investigated using minimum inhibitory concentration (MIC) and Campylobacter spp. characteristics. The MIC value was 31.25 µg/mL for the Campylobacter strains tested. Cinnamaldehyde had an inhibition and degradation effect on Campylobacter biofilms at concentrations > 15.63 µg/mL. Campylobacter strains treated with 15.63 µg/mL CA exhibited significantly decreased autoaggregation, motility, exopolysaccharide production, and soluble protein. In addition, Campylobacter biofilms formed on stainless steel were degraded following cinnamaldehyde treatment, as determined by scanning electron microscopy. Taken together, these results suggest that cinnamaldehyde constitutes a potential natural preservative against Campylobacter and a nontoxic biofilm remover that could be applied to control food poisoning in the poultry manufacturing-related food industry. PRACTICAL APPLICATION: Cinnamaldehyde was able to effectively remove the biofilm of Campylobacter in the small crack of stainless steel. Cinnamaldehyde has a potential to replace the synthetic antimicrobial and/or antibiofilm agent as well as has a positive influence on consumer concern for the food safety issues of the poultry industries.