PROBIOTICS AND ANTIMICROBIALS
SynbioticsDefinition
• A probiotic organism in combination with its prebiotic food
• Providing both the organism and substrate at the time of ingestion may offer improved chance of survival in GI tract
Dysbiosis
• Dysbiosis is an intestinal imbalance where pathogenic microorganisms outnumber beneficial bacterial species.
• Digestive diseases are often caused in part by or result in dysbiosis.
PrebioticsDefinition
• Nondigestible food ingredients– Fructo-oligosaccharides (chicory, inulin)– Lactulose
• Positively affect the endogenous flora• Stimulate the growth of one or a limited
number of bacterial species– FOSBifidobacteria– LactuloseLactobacilli
ProbioticsDefinition
• Nutritional supplement• Contains 1 or more
cultures of living organisms – Typically bacteria or
yeast• Modify the endogenous
microflora• Have a positive effect on
the host
"live microorganisms which when administered in adequate amounts confer a health benefit on the host."
ProbioticsCandidates
• Lactobacillus– acidophilus, reuteri, casei, planatarum,
rhamnosus “GG”
• Bifidobacteria– bifidum, breve, infantis, longum
• Streptococcus– thermophilus
• Saccharomyces• Several combinations on the market
Probiotics Potential Mechanisms of Action
• Inhibition of adhesion• Immunomodulation• Production of antimicrobial substances• Modification of toxins or toxin receptors• Competition for nutrients• Reduction in bacterial translocation• Anti-inflammatory signaling within the
epithelium
PREBIOTICS
Supplements not digested by human enzymes that stimulate growth of beneficial bacteria
• Fructo-oligosaccharides• Inulin• Galacto-,galactosyllactose-,xylo-,isomalto-and
soya oligosaccharides• Pyrodextrins (glucose oligosaccharides)• Lactulose• Breast milk oligosaccharides
Oligosaccharides
• Usual pleasant slight sweet taste
• Add texture to foods
• Naturally occurs in artichoke, onion,garlic, chicory, leek, and to a lesser degree in cereals
• Raffinose and stachynose are major CHO of beans and peas
• Commercially produced (FOS)
Benefits of Oligosaccharides
• Promote the growth of bifido-and lactobacilli
• Lower colon pH
• Discourage growth of Clostridia
• Prevent constipation and diarrhea
• Have low glycemic index
• Water-soluble and of low viscosity
• Do not bind minerals
Inulin
• Naturally occurs in fruits and vegetables
• Longer chain length than FOS
• Provides a fat mimicking texture when added to food
• Now available in a supplement
Bifidobacteria
• At least 4g/day of FOS are needed to increase counts
• Effect increases with increased doses
• Ferment oligosaccharides to SCFA
• Produce B vitamins and some amino acids
• Restore flora after antibiotics
• Inhibit the growth of pathogenic bacteria
PROBIOTICS
Lactobacillus acidophilusFloch,Gastro Clin NA 2005;34:517 : Huebner Gastro Clin NA 2006 :35;355
Elie Metchnikoff
• 1845-1916 , Nobel Prize Winner• Phagocytosis and Ageing• “Intoxication from the gut flora”• Putrefactive bacteria produced toxic substances
absorbed from the gut affecting the nervous and vascular systems causing ageing
• His radical solution for autointoxication was removal of the flora by colectomy
• Another approach was to replace putrefactive bacteria with carbohydrate fermenting bacteria
PROBIOTICS
• Live microbial food supplements which beneficially affect the host animal by improving its intestinal microbial balance.
• Usually strains of bacteria (lactobacilli or bifidobacteria) or yeasts (Saccharomyces)
• Administered in yogurts or capsules
• Survive passage thru the gut
PROPERTIES of PROBIOTICS
• Human origin• Resist upper GI tract secretions• Adhere to human intestinal cells• Colonize the human intestinal tract• Production of antimicrobial substances• Antagonize carcinogenic/ pathogenic flora • Safe in clinical use at > 1010
• Stimulate immune process• Fermentation
Dose of Probiotic
• Varies greatly with product
• Live and active cultureYogurts must contain >108 [100 million]
• L.rhamnosus GG has 10 billion
• VSL#3 has 300 to 450 billion per packet
• Common OTC have millions
IMMUNOREGULATION (A/B)
• Increase IgA production• Increase anti-rotaviral IgA• Production of gamma intereferon, TNF-
alph,IL-1 by mononuclear cells incubated with Lactobacillus.
• Adherant Lactobacilli and Bifidobacteria significantly increase phagacytosis.
• Lactobacillus GG has been used to treat cow milk allergy and atopic eczema
Probiotic Organisms in USE
• Bifidobactor sp. (bifidum, longum, breve,animalis, infantis,adolescentis)
• Streptoccus thermophilus
• Saccharomyces boulardii,cerevisiae
• Enerococcus faecium
• Lactobaciilli sp. (casei, acidophilus, bulgaricus, gaseri)
• L.rhamnosus, GG• Lactococcus sp.
(lactis,cremaris)
CLAIMS FOR PROBIOTICS
• Increase resistance to infection• Decrease duration of diarrhea disease• Stimulate immunity, modulate cytokine gene
expression, stimulate phagocytosis• Beneficial effect on blood pressure,serum
cholesterol, diabetes mellitus,lactose digestion and allergy
• Regression of tumors and reduction in carcinogens
Antibiotics
Trade name Active ingredientAureomycin chlortetracyclineTerramycin oxytetracyclineBacitracin bacitracinGallimycin gallimycinTylan tylosin
Common antibiotics used to promote growth, feed efficiency
steroids
• General classifications
– Estrogens – estradiol and estrone
– Non-steroidal compounds with estrogenic activity -diethylstilbestrol (DES) and zeranol
– Androgens – testosterone and trenbolone acetate (TBA)
– Progestagens – progesterone and melengestrol acetate (MGA)
– ß-adrenergic, ß agonists, repartitioning agents• lipolysis (fat mobilization), protein synthesis eg clenbuterol,
cimaterol ractopamine
Probiotics
• Lactobacillus sp.– reuteri– casei– ramnosus– acidophilus
• Streptococcus sp.• Bifidobacterium sp.
– infantis– lactis– longum– breve– bifidum
• Sacharomyces boulardii (non-human)
• VSL no.3
Dysbiosis
• Dysbiosis is an intestinal imbalance where pathogenic microorganisms outnumber beneficial bacterial species.
• Digestive diseases are often caused in part by or result in dysbiosis.
Dysbiosis
•Decreased immune function•Poor diet—excessive carbohydrates, sugar and trans fat•Drugs—especially antibiotics, oral contraceptives and cortisone-like medications
•Intestinal infection•Decreased intestinal motility (aka constipation)•Stress—including long-term emotional stress•Maldigestion and malabsorbtion
Major Causes
Dysbiosis
•Abdominal pain or cramps•Colon cancer•Constipation or diarrhea•Distention/bloating•Fatigue•Fatigue after eating•Flatulence
•Bad Breath•Body Odor•Food Allergy•Hypoglycemia•Inability to lose weight•Irregular bowel movements
•Irritable bowel syndrome•Itchy anus•Leaky gut syndrome•Poor complexion•Poor digestion•Rheumatoid arthritis•Spastic colon
Common Symptoms
Probiotics: Proposed uses
• Infectious diarrhea• Antibiotic-associated diarrhea• IBD, IBS, and pouchitis• Necrotizing Enterocolitis• Bacterial vaginosis• Recurrent UTI’s• Atopic diseases• Immune system enhancement• H pylori infections• Dental caries• Radiation induced diarrhea• Cardiovascular risk reduction• Constipation• Rheumatoid arthritis
Probiotics: proposed mechanisms
• Adherence and subsequent stimulation of gut immune system– Up-regulation of mucin gene– Enhance secretory IgA– Maintain normal macrophage function
• Competition for essential nutrients• Production of antimicrobial factors• Provide favorable environment for growth of other
beneficial bacteria• Production of short-chain fatty acids with anti-
inflammatory properties
Why should YOU care?
• Chemical farming and pesticides have lead to sterilization of soil and water (chlorination).
• Antibiotics, hormones, and other drugs are given to chickens and cattle used for food.
• Stress, medications, and typical American diet all promote dysbiosis.
Special Probiotics
• Homeostatic Soil Organisms (HSO’s) are specific probiotic strains of microorganisms found in the soil.
• In nature, HSO’s help plants digest inorganic substances, protect roots from parasites, yeast, and fungi, and provide growth factors and different hormones.
• When ingested orally in a probiotic formulation, may have advantages over non-HSO probiotic formulas, due to ability to implant and survive in the gut.