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Ȇ ҡӵϽفݽΰܚՓޟϬРட፣ Е ઊҢຄҦзፐҢಣᙒဏȶӶ ᎍ໕ᇅঐᡞȂڏԥߵлୋஷઊ ޠཌྷҢ ޑ(live microorganisms which, when administered in adequate amounts, confer a health benefit on the host) ȷϟᒞηȂҼ֊ઊ ҢຄϛцयȂٯᄈԥઊޠಡຄȄઊ ҢຄٯϛΚঐޠӫມȂԟӶΚঐӼзखϟ Ȃ1907ԒҦᒜᅮစᔽᏱዪூл߽ཌྷҢ ޑᏱঢ়ᇅռᏱঢ়Élie Metchnikoff ॷӒӶߴђ ւ۩ٴҖϜȂ౫Ӷ۩ڐҖܛޠڦሖг ٱϜԥȶٱሗຄȷȂٯޤٱሗຄѠп ښϾၿϲԥড়ಡຄȂйᇅ၏۩Җႈԇԥ ߞჱ౫ຬԥᜱȂՅҦԫٱሗຄڏԥᇩઊ ୋஷІߵޠߞ۾ڽѓਞȄٲᄃαȂઊҢ ຄӶႇџංξԒޠСளҢୋஷॶϜԟϑԇ ӶȂ֊ٻӶѡוᇅᛴਣхٱޠႏІ ڐᜱሖηϑೞΩ௱ᙩңॶңΠȄ ԫಡຄژޣ1965ԒϘೞ DM Lilly RH StillweΡ՞ᏱпȶઊҢຄȷ(probiotics) ޠӫᆏȂՅઊҢຄޠ౫хᇮІڐஆҐဏҦ Parker 1974ԒܛोяޠٿȂٯጃяઊ ҢຄҐΚᆎڏԥҢԥઊޑޠཌྷҢޑȂ ڐѠп።ߵٯဘၿϜϛӤᆎཌྷҢޑޠ ᄙ҂ᒌȂՅҦԫٿኈлөᆎҢ౪ȄҦ Élie MetchnikoffٱሗຄᄈᡞޠઊȂ Յೞউ൶ᆏȶٱሗຄϟЯȷ 1 Ȅ ߗΫԒп ٿȂઊҢຄӶҔጃӫᆏя౫ ȂڐӶຳҀൠϑഃᅛ౿ٯҦԫሊ ߞࢻΠȄԟӶ1930ԒȂСҐхҥ(Shirota) ϑᖆ ෦ႏٱఝຄхҥ(Lactobacillus casei strain ᆣӫᚂ مᖚथဗऋ ҕ ઉҡӵϽ فಛຨ ݽΰ ܚᅋՓ ޟϬРᢎ ʂ१ઉҡհҢᐠ ޟڙShirota) ȂᓎٯࡤӶ1935ԒпᎵӼ(Yakult) ޠӫᆏЖΤҀൠȂԄϭᎵӼӶӓ౩33ঐঢ়І Љԥ30ޠᎵӼ୶ӶҀൠαȄ ဗၾတ(Gut Microflora) 2 ஆҐαȂҔளᡞϲ ޠཌྷҢ ޑထᇅл ҐޠಣᙒȃಡबІڐхᗃޑȂӶߞϾ โϜםԚΚঐᑀҴޠᕘძȂٯҴΚঐҢ ޑق( biosystem) п܅ԫϤһඳޑ፵ȃ ໕ІஆӱޠҭޠȄᡞཌྷҢᄙقಜлԇӶ πȃڴၿȃदဘၿȃݫၿІҫጴ5 τҢᄙقಜȂՅदဘၿقಜέڐϜᡞཌྷҢ ᄙᕘძ(ecosystem)Ϝഷ२ޠಣԚȂՅဘၿຄ ထҐҼםԚΚঐഷτഷፓᚖޠཌྷҢᄙقಜȄ दဘၿཌྷҢᄙᕘძϸոॶၿȃदȃϊဘȃ τဘϜᏣȂदဘၿϲԇԥङቈ (trillions) ཌྷҢޑȂ֊ङ10 14 ঐಡຄІѡಡຄ (archaea) Ȃڐᖃ२໕ङӶ1-2 ϵПϟ( ҂ 1.3 ϵП) Ȃᖃ໕Ҽႇᡞಡबޠ10 ॼȂѠ րϸङ10 4 ޑᆎȄ ҦဘၿជၷᄛпІ ڏԥմ ޠϾ ᗚႬ՞ȂٻூτဘԚཌྷҢޑޠ ӵழȂτဘηӱՅᆑᙡτҭޠಡຄᆎ ȂڐಡຄѠႁ50 400-500 ᆎȂڐϜ99.9% ܓზຄ(obligate anaerobes) Ȃկ τഌϸဘၿຄထґೞஊᎵяٿȂԥ೩Ӽ ຄထґೞጃᇰяٿȂڐτഌӌҦᔤఝຄ (Bacteroidetes) Ꮺຄߟ(Firmicutes) ڎτຄ ܛಣԚޠȄԫѵȂϛӤഌ՞ޠဘၿڐಡຄ ໕ІಣӬҼϛΚኻȄຄҦदԇӶȂٯӶဘȃଠဘІτဘϜቩђȄဘၿຄထҐ ޠಣӬҼᓎԒឮޠߞȂпІॶ๗ᄻޠϛ 2016ԑ60ڢ6 Ѯѕѿᚂৱϴѐ 31
Transcript
Page 1: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

(live microorganisms which, when administered in adequate amounts, confer a health benefit on the host)

1907Élie Metchnikoff

1965 DM Lilly RH Stillwe (probiotics)

Parker 1974

Élie Metchnikoff1

1930 (Shirota) (Lactobacillus casei strain

Shirota) 1935 (Yakult)33

30

(Gut Microflora)2

( biosystem)

5

(ecosystem)

(trillions) 1014

(archaea) 1-2 (1.3 ) 10

104

50 400-500 99.9%(obligate anaerobes)

(Bacteroidetes) (Firmicutes)

2016 60 6 31

Page 2: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

(anaerobic bioreactor)

B10%

3

(conjugation reaction)

()

4

5

(inflammatory cytokine)(proinflammatory cascades)

pH

(Paneth cells)

(defensins)

2016 60 6 32

Page 3: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

(peptides) -opioid

(cannabinoid receptors)

6

(Lactobacillus rhamnosus GG, LGG)(Lactobacillus casei)

(clostridium)

(bifidobacteria)pH

(bacteriocins) La-14(Lactobacillus acidophilus

La-14) (Listeria monocytogenes)

(mycobacterium)1

50%(small intestinal bacteria

overgrow, SIBO)(hypochlorhydria) IgA

( b a c t e r i a l translocation)

(Escherichia coli) (Klebsiella spp) (Enterococci) (Streptococci species)

40%80%

DNADNA

(endotoxemia)

2016 60 6 33

Page 4: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

(nitric oxide)

/

5

7

8

(symbiosis)

9

5

10

(bactericidal antimicrobial peptides, AMPs) IgA(secretory IgA, SIgA) AMPs SIgA

2016 60 6 34

Page 5: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

11,12

40-50

(ulcerative colitis) (Crohn's disease)

5,6

() (

)( )

(antibiotic-associated

diarrhea)(inflammatory bowel disease)

(irritable bowel syndrome)(relapsing Clostridium

Difficile colitis)(nonalcoholic fatty liver disease)

(intracolonic instillation of probiotics)

( 1,2)

(acid tolerant lactobacilli)

13

(dysbiosis)

- (gut-liver axis)

2016 60 6 35

Page 6: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

- 15

14

(risk-infants)

(vaginal candidiasis)(Helicobacter pylori)

(inflammatory bowel disease)

16

20-30

(genomic analyses)

https://youtu.be/X3jDOs6hAcg ( Intracolonic instillation of probiotics )

( 1) ( 2)

2016 60 6 36

Page 7: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

(prebiotics)

(Bifidobacteria)(Enterobacteriaceae)

BK

( >60 )

17,18

(colony-forming unit, , CFUs)

p H0.8-2

( pH 4-7 ) (along with

2016 60 6 37

Page 8: ð Ú ¡ õQ ý A }~ ¨ } ° c ø K O S ìð Ú c ¡ õ Q ý A } ~ ¨ } ø K O S ì ð Ú c P ¢ 7 é P ¢ £ R â Ð 6 ö Õ ^ Å ^ d × % õ Í ; K · Ï M ¢ (live microorganisms

foods)

pH 1.5-3.0pH 1.0

1.5% 19

20-40%

20

([interleukin], IL-10) TGF-

TNF T(helper T cell)

(threshold gain)

1. Sekirov I, Russell SL, Antunes LC, et al: Gut microbiota in health and disease. Physiol Rev 2010; 90: 859–904.

2. Doré J, Corthier G: The human intestinal

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microbiota. Gastroentérol Clin Biol 2010: 34: S7–S15.

3. Lankaputhra WEV, Shah NP: Surv iva l o f L a c t o b a c i l l u s a c i d o p h i l u s a n d Bifidobacterium ssp. in the presence of acid and bile salts. Cult Dairy Prod J 1995; 30: 2–7.

4. Shanahan F, Coll ins SM: Pharmabiot ic m a n i p u l a t i o n o f t h e m i c r o b i o t a i n gastrointestinal disorders, from rationale to reality. Gastroenterol Clin North Am 2010; 39: 721–26.

5. N g S C , H a r t A L , K a m m M A , e t a l : Mechanisms of action of probiotics: recent advances. Inflamm Bowel Dis 2009; 15: 300–10.

6. Rousseaux C, Thuru X, Gelot A, et a l : L a c t o b a c i l l u s a c i d o p h i l u s m o d u l a t e s in tes t inal pain and induces opioid and cannabinoid receptors. Nat Med 2007; 13: 35–7.

7. Kau AL, Ahern PP, Griffin NW, et al: Human nut r i t ion , the gut microbiome and the immune system. Nature 2011; 474: 327–36.

8. Hwang EN, Kang SM, Kim MJ, e t a l : Screening of Immune-Active Lactic Acid Bacteria. Korean J Food Sci Anim Resour 2015; 35(4): 541-50.

9. Macpherson AJ, Harris NL: Interactions between commensal intestinal bacteria and

the immune system. Nat Rev Immunol 2004; 4: 478–85.

10. Madsen KL: Interactions between microbes and the gut epithelium. J Clin Gastroenterol 2011; 45(Suppl): S111–114.

11. Besselink MG, van Santvoort HC, Buskens E, et al: Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-bl ind, placebo-control led t r ia l Lancet 2008; 371: 651–9.

12. Boyle RJ, Robins-Browne RM, Tang ML: Probiotic use in clinical practice: what are the risks? Am J Clin Nutr 2006; 83: 1256–64.

13. Goran H, Nermin S , Kar ina V, e t a l : Probiotics for Standard Triple Helicobacter pylori Eradication A Randomized, Double-blind, Placebo-controlled Trial. Medicine (Baltimore) 2015; 94(17): e685.

14. Clarke G, Cryan JF, Dinan TG, e t a l : Review article: probiotics for the treatment of irritable bowel syndrome - focus on lactic acid bacteria. Aliment Pharmacol Ther 2012; 35(4): 403-13.

15. Moraes-Filho JP, Quigley EM: The intestinal microbiota and the role of probiotics in irritable bowel syndrome: a review. Arq Gastroenterol 2015; 52(4): 331-8.

16. Wi l l i a m s M D , H a C Y, C i o r b a M A : Probiotics as therapy in gastroenterology:

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a s t u d y o f p h y s i c i a n o p i n i o n s a n d recommendations. J Clin Gastroenterol 2010; 44: 631–6.

17. Bajaj JS, Saeian K, Christensen KM, et al: Probiotic yogurt for the treatment of minimal hepatic encephalopathy. Am J Gastroenterol 2008; 103: 1707–15.

18. Hempel S, Newberry S, Ruelaz A, et al: Services USDoHaH. Safety of Probiotics to Reduce Risk and Prevent or Treat Disease. 2011.

19. Snydman DR: The safety of probiotics. Clin Infect Dis 2008; 46(Suppl 2): S104–111.

20. Shanahan F: Probiotics in perspective. Gastroenterology 2010; 139: 1808–12.

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