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Probiotics

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Probiotics may have antibacterial, ... Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 produce significant improvement of atopic eczema in children: ... – PowerPoint PPT presentation

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Title: Probiotics


1
Probiotics Prebiotics- What are they all about?
  • marketing gimmick or tool?

2
Background
  • Probiotics are dietary supplements containing
    potentially beneficial bacteria or yeast, with
    lactic acid bacteria (LAB).
  • LAB have been used in the food industry for many
    years, because they are able to convert sugars
    and other carbohydrates into lactic acid.
  • This provides the characteristic sour taste of
    fermented dairy foods such as yogurt, and acts as
    a preservative, by lowering the pH

3
And
  • Prebiotics are a category of functional food,
    defined as Non-digestible food ingredients that
    beneficially affect the host by selectively
    stimulating the growth and/or activity of one or
    a limited number of bacteria in the colon, and
    thus improve host health eg. oligosacchirides

4
The Theory
  • The body contains a miniature ecology of
    microbes, collectively known as the gut flora
  • The number of bacterial types can be thrown out
    of balance by a wide range of circumstances
    including the use of antibiotics or other drugs,
    excess alcohol, stress, disease, exposure to
    toxic substances, or even the use of
    antibacterial soap

5
The Players
  • BIFIDOBACTERIUM
  • LACTOBACILLUS
  • LACTOCOCCUS
  • SACCHAROMYCES
  • STREPTOCOCCUS THERMOPHILUS
  • ENTEROCOCCUS

6
How do they work?
  • Probiotics may have antibacterial,
    immunomodulatory, anticarcinogenic,
    antidiarrhoeal, antiallergenic and antioxidant
    activities
  • The antibacterial ability may partially be due to
    the ability to colonize the colon and reinforce
    the barrier function of the intestinal mucosa

7
Also
  • Lactobacillus casei has been demonstrated to
    increase levels of circulating IgA in infants
    infected with rotavirus
  • Lactobacillus acidophilus and Bifidobacterium
    bifidum appear to enhance the nonspecific immune
    phagocytic activity of circulating blood
    granulocytes

8
And
  • S. boulardii has been found to secrete a protease
    which digests two protein exotoxins, toxin A and
    toxin B, which appear to mediate diarrhoea and
    colitis caused by Clostridium difficile
  • Lactobacillus rhamnosus GG and Bifidobacterium
    lactis Bb12 produce significant improvement of
    atopic eczema in children the decrease in the
    signs and symptoms occurred in parallel with a
    reduction in the concentration of circulating
    CD4 T lymphocytes and an increase in TGF-beta1,
    indicating suppressive effects on T cell
    functions in this disorder

9
Really?
  • Do they survive in the acidic stomach
    environment, the alkaline conditions in the
    duodenum, as well as their ability to adhere to
    the intestinal mucosa of the colon and to
    colonize the colon. Some probiotics, such as
    Lactobacillus GG and Lactobacillus plantarum
    299v, do. After passage through the stomach and
    the small intestine, they become established
    transiently in the colon.

10
The Fanclub
  • Dr. Elie Metchnikoff, the father of modern
    immunology
  • Dr. Minoru Shirota ,Yakult
  • Dr Jean-Michel Antoine, science director at
    Danone
  • All bar the first may have conflicts of interest
    but it does get better

11
Evidence of effects
  • Vandenplas et al in Eur J Paeds 2007 indicated
    selected strains of probiotics result in a
    statistically significant but clinically moderate
    benefit in shortening the duration of diarrhoea
    caused by acute infectious gastroenteritis
  • Tellado in Cur Opin Crit Care 2007 indicate that
    they may contribute to better prognosis in
    pancreatitis

12
Furthur papers
  • Nomura et al in Hepatogastroenterology 2007
    showed probiotics reduce the rate of infection
    after Whipples procedure
  • Moayeddi in EBM 2007 indicated that used of
    probiotics in H pylori eradication therapy
    improved efficacy and reduced s/e

13
Now for us GPs
  • Hickson et al BMJ 2007 indicated in a randomised
    double blind trial that consumption of a
    probiotic drink containing L casei, L bulgaricus,
    and S thermophilus can reduce the incidence of
    antibiotic associated diarrhoea and C difficile
    associated diarrhoea
  • Cochrane indicate they may be of use in AAD and
    infective diarrhoea in conjunction with ORT

14
So
  • I suggest when giving antibiotics to all age
    groups apart from pregnant and breast feeding
  • Anecdotal evidence so far less DV, lower
    incidence of vaginal thrush, controlled
    diverticulosis
  • Potential s/e theoretically include flatulence/
    constipation/ Lactobacillus bacteraemia and
    endocarditis
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