Exogenous enzymes and probiotics alter digestion kinetics, volatile fatty acid content and microbial interactions in the gut of Nile tilapia.

Sustainable aquafeed production requires fishmeal replacement, leading to an increasing use of plant-derived ingredients. As a consequence, higher levels of antinutritional substances, such as non-starch polysaccharides and phytate, are present in aquafeeds, with negative effects on fish performance, nutrient digestibility and overall gut health. To alleviate these negative effects, providing exogenous digestive enzymes and/or probiotics can be an effective solution. In this study, we tested the effect of dietary supplementation of enzymes (phytase and xylanase) and probiotics (three strains of Bacillus amyloliquefaciens) on nutrient digestion kinetics and volatile fatty acid content along the gut, and the distal gut microbiome diversity in Nile tilapia. Chyme volatile fatty content was increased with probiotic supplementation in the proximal gut, while lactate content, measured for the first time in vivo in fish, decreased with enzymes along the gut. Enzyme supplementation enhanced crude protein, Ca and P digestibility in proximal and middle gut. Enzymes and probiotics supplementation enhanced microbial interactions as shown by network analysis, while increased the abundance of lactic acid bacteria and Bacillus species. Such results suggest that supplementation with exogenous enzymes and probiotics increases nutrient availability, while at the same time benefits gut health and contributes to a more stable microbiome environment.

Enhanced viability of layer-by-layer encapsulated Lactobacillus pentosus using chitosan and sodium phytate.

Lactobacillus pentosus (LP) are widely used as probiotics in food products, dietary supplements, and nutraceuticals due to their health-promoting effects. To confer a functional effect, the probiotics need to survive during shelf-life and transit through the high acidic conditions of the stomach and bile salts in the small intestine. Herein, LP was firstly encapsulated in a layer-by-layer approach using chitosan (CS) and sodium phytate (SP). After digestion in simulated gastrointestinal fluid (SGF) for 120 min and 4% bile salts for 3 h, plain-LP exhibited a 7.40 and 6.09 colony forming units/ml (cfu/ml) reduction. Interestingly, two layer coated LP ((CS/SP)2-LP) exhibited less death, which reduced 4.34 and 2.33 log cfu/ml, respectively. Specially, (CS/SP)2-LP also showed a higher survival rate compared to plain-LP in heat treatment experiments, especially 65 °C. In conclusion, layer-by-layer encapsulation of LP has great potential for the protection and delivery of probiotics in food and nutraceutical products.

Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel.

In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.

Human Breast Milk miRNA, Maternal Probiotic Supplementation and Atopic Dermatitis in Offspring.

BACKGROUND: Perinatal probiotic ingestion has been shown to prevent atopic dermatitis (AD) in infancy in a number of randomised trials. The Probiotics in the Prevention of Allergy among Children in Trondheim (ProPACT) trial involved a probiotic supplementation regime given solely to mothers in the perinatal period and demonstrated a ~40% relative risk reduction in the cumulative incidence of AD at 2 years of age. However, the mechanisms behind this effect are incompletely understood. Micro-RNAs (miRNA) are abundant in mammalian milk and may influence the developing gastrointestinal and immune systems of newborn infants. The objectives of this study were to describe the miRNA profile of human breast milk, and to investigate breast milk miRNAs as possible mediators of the observed preventative effect of probiotics. METHODS: Small RNA sequencing was conducted on samples collected 3 months postpartum from 54 women participating in the ProPACT trial. Differential expression of miRNA was assessed for the probiotic vs placebo and AD vs non-AD groups. The results were further analysed using functional prediction techniques. RESULTS: Human breast milk samples contain a relatively stable core group of highly expressed miRNAs, including miR-148a-3p, miR-22-3p, miR-30d-5p, let-7b-5p and miR-200a-3p. Functional analysis of these miRNAs revealed enrichment in a broad range of biological processes and molecular functions. Although several miRNAs were found to be differentially expressed on comparison of the probiotic vs placebo and AD vs non-AD groups, none had an acceptable false discovery rate and their biological significance in the development of AD is not immediately apparent from their predicted functional consequences. CONCLUSION: Whilst breast milk miRNAs have the potential to be active in a diverse range of tissues and biological process, individual miRNAs in breast milk 3 months postpartum are unlikely to play a major role in the prevention of atopic dermatitis in infancy by probiotics ingestion in the perinatal period. TRIAL REGISTRATION: ClinicalTrials.gov NCT00159523.

Microorganismos probióticos y salud / Probiotic microorganisms and health

Objetivo: Mostrar los beneficios de los microorganismos probióticos sobre la salud y su aceptación por parte del consumidor, así como hacer una recopilación de todos los productos probióticos disponibles en el mercado farmacéutico. Material y métodos: Se realizó un estudio del mercado farmacéutico en relación a las formas farmacéuticas con microorganismos probióticos existentes y su evolución en los últimos años. La clasificación de todos los productos probióticos se llevó a cabo en función de la forma farmacéutica en la que se presentan;cada producto irá acompañado de la dosis de microorganismos probióticos que contiene, expresada como Unidades Formadoras de Colonias (UFC). Resultados: Es cada vez mayor el número de cepas probióticas aisladas y los beneficios mostrados sobre la salud del hombre. Encontramos gran diversidad de productos probióticos disponibles en oficinas de farmacia como consecuencia de una demanda cada vez mayor por parte del consumidor; no obstante, cabe resaltar el hecho de que muchos de ellos carecen en envase de información necesaria, por ejemplo, la dosis contenida. Conclusiones: El interés por parte de la industria farmacéutica en lazar nuevas formas farmacéuticas contenidas en microorganismos probióticos será cada vez mayor e irá ligado a la necesidad de una reglamentación específica para estos productos. Muchos de ellos no contienen la dosis mínima requerida para obtener un efecto beneficioso en la salud lo que supone una publicidad engañosa para el consumidor, por tanto, deberían ser retirados del mercado, publicitando únicamente aquellos que contengan una dosis terapéutica y cuyos efectos estén avalados por diferentes ensayos clínicos (AU)

Aims: Show the benefits of the probiotic microorganisms on health and its acceptance by the consumer. As well as collect those probiotic products available in pharmaceutical market. Materials and methods: A study of the pharmaceutical marketin relation to the existing dosage forms with probiotic microorganisms and their evolution in recent years was made. Classifying probiotic products was conducted according to the dosage form in which they are presented; each product must be accompanied by the dose of probiotic-containing, expressed as Colony Forming Units(CFU). Results: It is increasing the number of probiotic strains isolated and the benefits that its shown on human health. We found a diversity of probiotic products available in pharmacies as a result of an increasing demand by consumers; it is important to note that many of them lack necessary information on packaging, for example, the dose contained. Conclusions: The interest of the pharmaceutical industry in develop new dosage forms contained in probiotic microorganisms will be growing and will be linked to the need for a specific regulation for these products. Many of them do not contain the required dose to obtain a beneficial effect on health which is misleading advertising to consumers, therefore, they should be removed from the market, advertising only those products which contain a therapeutic dose and whose effects are endorsed by various clinical trials (AU)

Effect of the use of probiotics in the treatment of children with atopic dermatitis: a literature review / Efecto del uso de los probióticos en el tratamiento de niños con dermatitis atópica; revisión bibliográfica

Introduction: Atopic dermatitis (AD) is a disease that mainly affects the pediatric population involving chronic and repetitive inflammatory skin manifestations. Its evolution is known as atopic march, which is characterized by the occurrence of respiratory and food allergies. Aim: To carry out a classical review of the state-of-the-art scientific literature regarding the effect of probiotics on the treatment of children with AD. Methods: Searches were conducted in Medline and Lilacs through the portals PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) and SciELO (http://www.scielo.br). There was a selection of the available publications in the period from 2001 to 2011, using the keywords atopic dermatitis and probiotics (in English and in Portuguese). Results: After applying the inclusion and exclusion criterias, we selected 12 case-control studies which were conducted in four European countries and Australia. The methodological quality of the studies was assessed according to the STROBE recommendations. Assessment of agreement among researches in classifying the quality of the articles showed excellent agreement (k = 1.00, 95%) with a total of 9 papers at B level. The majority of the studies (75%) indicated a beneficial biological effect of probiotics on AD, including protection against infections, enhancement of the immune response, inflammation reduction and changes in gut the flora. The remaining studies showed no beneficial effects according to the outcomes of interest. Conclusion: The majority of the studies in the scientific literature in this review showed improvements in some inflammatory parameters and in intestinal microbiota and not exactly, changes in clinical parameters. However, the biological effects observed in most of them suggest the possibility of benefits of the use of probiotics as an adjunvant in the treatment of AD (AU)

Introducción: La dermatitis atópica (DA) es una enfermedad que afecta principalmente a la población pediátrica, la participación de crónica y repetitiva inflamatoria de la piel la evolución manifestaciones. Esto se conoce como marcha atópica, que se caracteriza por la aparición de alergias respiratorias y la alimentación. Objetivo: Realizar una revisión sistemática de la literatura del estado de la técnica científica sobre el efecto de los probióticos en el tratamiento de niños con DA. Métodos: Se realizaron búsquedas en Medline y Lilacs a través del PubMed portales (http://www.ncbi.nlm.nih.gov/PubMed/) y SciELO (http://www.scielo.br). Había una selección de las publicaciones disponibles en el período comprendido entre 2001 y 2011, con la dermatitis atópica palabras clave y los probióticos (en inglés y en portugués). Resultados: Después de aplicar los criterios de inclusión y exclusión, se seleccionaron 12 estudios caso-control que se realizaron en cuatro países europeos y Australia. La calidad metodológica de los estudios se evaluó de acuerdo a las recomendaciones STROBE. Evaluación de un acuerdo entre los investigadores en la clasificación de la calidad de los artículos mostraron una excelente concordancia (k = 1,00, IC del 95%) con un total de 9 trabajos en el nivel B. La mayoría de los estudios (75%) indica un efecto beneficioso de los probióticos en DA, incluida la protección contra las infecciones, la mejora de la respuesta inmune, la reducción de la inflamación y cambios en la flora intestinal, la mejora de la condición clínica de la EA. Los estudios restantes no mostraron efectos beneficiosos de acuerdo a los resultados de interés. Conclusión: La mayoría de los estudios en la literatura científica, en el período estudiado, mostró evidencia de beneficios en el uso de probióticos para controlar las manifestaciones clínicas de la DA, sin embargo el costo/ beneficio del tratamiento siempre debe ser evaluada (AU)

Microencapsulation of probiotics for gastrointestinal delivery.

The administration of probiotic bacteria as nutraceuticals is an area that has rapidly expanded in recent years, with a global market worth $32.6 billion predicted by 2014. Many of the health promoting claims attributed to these bacteria are dependent on the cells being both viable and sufficiently numerous in the intestinal tract. The oral administration of most bacteria results in a large loss of viability associated with passage through the stomach, which is attributed to the high acid and bile salt concentrations present. This loss of viability effectively lowers the efficacy of the administered supplement. The formulation of these probiotics into microcapsules is an emerging method to reduce cell death during GI passage, as well as an opportunity to control release of these cells across the intestinal tract. The majority of this technology is based on the immobilization of bacteria into a polymer matrix, which retains its structure in the stomach before degrading and dissolving in the intestine, unlike the diffusion based unloading of most controlled release devices for small molecules. This review shall provide an overview of progress in this field as well as draw attention to areas where studies have fallen short. This will be followed by a discussion of emerging trends in the field, highlighting key areas in which further research is necessary.

Actualizacion en el tratamiento de la colitis ulcerosa / Update on the treatment of ulcerative colitis

En la DDW 2010, acerca del tratamiento de la colitis ulcerosa se han presentado varios ensayos clínicos sobre nuevas terapias, con resultados negativos en su mayoría. Así, rituximab (anti CD 20) y MDX-1100 (inhibidor de quimiocinas) no mostraron eficacia, aunque es probable que en el futuro se prueben dosis más elevadas de ambos agentes. Tampoco se mostró útil un probiótico con capacidad de sintetizar y liberar interleucina 10 en la luz intestinal. Por el contrario, se comunicó otro ensayo con HMPL-004, extracto de una planta utilizada en medicina oriental, con resultados positivos en colitis levesmoderadas. Además de estos ensayos sobre nuevas terapias, también se presentaron datos acerca de las terapias actuales. En relación con los salicilatos, los resultados comunicados vuelven a enfatizar la importancia del cumplimiento en su eficacia y, en este sentido, del empleo en monodosis. En cuanto a su papel protector contra el cáncer de colon, los datos expuestos son contradictorios. Acerca de los agentes biológicos, estudios observacionales comunicados apoyan la eficacia de infliximab y datos controlados preliminares sugieren la utilidad de adalimumab. Sobre la aféresis leucocitaria, además de estudios observacionales españoles, se presentó un póster de un ensayo controlado y ciego, en el que se mostró eficaz para mantener la remisión de la colitis ulcerosa corticorrefractaria. Finalmente, sobre beclometasona se presentaron datos también españoles, retrospectivos y observacionales, que apoyan su utilidad (AU)

Several clinical trials on new therapies in ulcerative colitis were presented in Digestive Disease Week 2010, mostly with negative results. Thus, rituximab (anti CD 20) and MDX-1100 (a chemokine inhibitor) failed to show efficacy, although higher doses of both agents will probably be tested in the future. A probiotic able to synthesize and release interleukin-10 into the gut lumen also failed to prove useful. In contrast, HMPL-004, an extract from a herb used in Oriental medicine, was reported to have positive results in mild-to-moderate colitis. In addition to these data on new therapies, some other results segurion current therapies were also presented. The results communicated on salicylates once again emphasized the importance of compliance to achieve efficacy and the advantages of single-dose regimens in achieving this goal. The data reported on the protective role of salicylates against colon cancer were contradictory. Observational studies of biological agents supported the efficacy of infliximab and controlled preliminary data suggested the utility of adalimumab. Both Spanish observational studies and a poster presenting a blind, controlled trial showed the efficacy of leukocyte apheresis in maintaining remission in steroid-refractory ulcerative colitis. Finally, retrospective and observational Spanish data on beclomethasone supported the usefulness of this drug (AU)

Consensus statements from the Workshop 'Probiotics and Health: Scientific Evidence' / Declaraciones consensuadas del Workshop: “Probióticos y Salud: Evidencia Científica”

This report shows the level of scientific consensus on definition, characteristics and health benefits of probiotics. The content of the report has derived from the scientific meeting: Workshop on Probiotics and Health. Scientific evidence, that congregated several Spanish experts, including gastroenterologists, microbiologists, nutritionists, immunologists and food technologists, among others, who have agreed with the statements shown in this document. Each statement has been sustained with the most relevant scientific aspects that were discussed during the Workshop and the following evaluation of there port by all experts who approved and signed it (AU)

En este documento se muestra una base de consenso entorno a la definición, características y propiedades beneficiosas de los probióticos. El contenido fue generado a partir de la reunión científica Workshop Probióticos y Salud. Evidencia Científica, que agrupó a una variedad de expertos españoles gastroenterólogos, microbiólogos, nutricionistas, inmunólogos y tecnólogos de alimentos, entre otros, que se han adherido en su mayoría a las sentencias que constituyen este documento. Para cada sentencia se establecen las aspectos científicos más relevantes que la respaldan y que son consecuencia del acuerdo al que se ha llegado tras el debate surgido en la reunión y la evaluación posterior del contenido por todos los expertos que han firmado este documento (AU)

Pilot study of probiotic dietary supplementation for promoting healthy kidney function in patients with chronic kidney disease.

INTRODUCTION: Uremic syndrome consists of nitrogenous waste retention, deficiency in kidney-derived hormones, and reduced acid excretion, and, if untreated, may progress to coma and eventual death. Previous experience suggests that oral administration of a probiotic formulation of selected microbial strains may extend renoprotection via intraintestinal extraction of toxic waste solutes in patients with chronic kidney disease (CKD)stages 3 and 4. This report presents preliminary data from a pilot study. METHODS: This was a 6-month prospective, randomized, double-blind, placebo-controlled crossover trial of a probiotic bacterial formulation conducted in four countries, at five institutions, on 46 outpatients with CKD stages 3 an nd 4: USA (n=10), Canada (n=113), Nigeria (n=115), and Argentina (n=8). Outcomes were compared using biochemical parameters:blood urea nitrogen (BUN), serum creatinine, and uric acid. General well-being was assessed as a secondary parameter by a quality of life (QQOL) questionnaire on a subjective scale of 1-10. RESULTS: Oral ingestion of probiotics (90 billion colony forming units [CFUs]/day) was well tolerated and safe during the entire trial period at all sites. BUN levels decreased in 29 patients (63%, P<0.05), creatinine levels decreased in 20 patients (43%, no statistical significance), and uric acid levels decreased in 15 patients (33%, no statistical significance). Almost all subjects expressed a perceived substantial overall improvement in QOL (86%, P<0.05). CONCLUSION: The main outcomes of this preliminary trial include a significant reduction of BUN, enhanced well-being, and absence of serious adverse effects, thus supporting the use of the chosen probiotic formulation for bowel-based toxic solute extraction. QOL and BUN levels showed statistically significant differences in outcome (P<0.05) between placebo and probiotic treatment periods at all four sites (46 patients). A major limitation of this trial is the small sample size nd elated inconsistencies.

A probiotic strain of Bacillus polyfermenticus reduces DMH induced precancerous lesions in F344 male rat.

Bacillus polyfermenticus has been used in an effective treatment for long-term intestinal disorders, as live strains in the form of active endospores have been shown to reach the target intestine successfully. In this study, we have assessed the effects of B. polyfermenticus on the antioxidant system and the process of colon carcinogenesis in male F344 rats. The rats were divided into three groups after a 1-week adaptation period, and were then fed on either a high-fat and low-fiber diet (control and DMH groups), or a high-fat and low-fiber diet supplemented with B. polyfermenticus (3.1x10(8) cfu/d) (DMH+B. polyfermenticus group). One week after beginning the diets, the rats were subjected to 6 weeks of treatment with 1,2-dimethylhydrazine (DMH, 30 mg/kg/week, s.c.). The dietary treatments continued over the entirety of the experimental period. Nine weeks after the initial DMH injection, the rats supplemented with B. polyfermenticus evidenced significantly lower numbers of aberrant crypt foci than were observed in the DMH group. Injections with DMH resulted in significantly higher leukocytic DNA damage and plasma lipid peroxidation levels, as well as a lower plasma total antioxidant potential, and these factors recovered as the result of supplementation with B. polyfermenticus. These data indicate that B. polyfermenticus exerts a protective effect on the antioxidant system and the process of colon carcinogenesis, thereby suppressing the development of preneoplastic lesions.

Novel approaches to the nutritional management of the allergic infant.

The increased prevalence of atopic diseases, i.e. atopic eczema, allergic rhinitis and asthma, has been described as the epidemic of the 21st century in Western societies. New approaches in the fight against allergic diseases are clearly called for, the target being the persistence of the allergic responder pattern beyond infancy. The advantage afforded by elimination diets lies in the silencing of specific allergic inflammation induced by an offending food. Novel nutritional approaches, beyond the treatment of food allergies, have recently attracted research interest subsequent to the identification of the immunomodulatory potential of specific dietary compounds. Dietary lipids as immunomodulators may prevent allergic sensitization by down-regulating inflammatory response whilst protecting the epithelial barrier. Probiotic bacteria have been shown to reinforce the different lines of gut defence: immune exclusion, immune elimination and immune regulation. On this basis, the strategy against allergic disease proposed here is based on the administration of tolerogenic gut-processed peptide fragments of a specific protein, in addition to the use of specific dietary compounds such as fatty acids and antioxidants, and introducing a microbial stimulus for the immature immune system by means of cultures of beneficial live micro-organisms characteristic of the healthy infant gut microbiota.

Use of mouse models to evaluate the persistence, safety, and immune modulation capacities of lactic acid bacteria.

Recent clinical and experimental observations showed that specific probiotic microorganisms may provide therapeutic benefits in inflammatory bowel disease. However, a rigorous screening for new candidate probiotic strains with optimized therapeutic properties necessitates also determining possible adverse interactions with the host, particularly in individuals who are not healthy. We have evaluated the persistence of strains of lactic acid bacteria (LAB) in the digestive tracts of mice, their immunomodulation capacity, and their safety in healthy animals and in a colitis model. Following daily administration of 10(9) CFU of viable LAB orally, intragastrically, or intrarectally, the animals' feces were examined for bacterial excretion and cytokines were quantified in intestinal samples by quantitative reverse transcription-PCR. The level of bacterial translocation was assessed in healthy mice and in mice suffering from colitis induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS). Irrespective of the route of administration, the potential probiotic strain Lactobacillus plantarum NCIMB8826 was found to persist for up to 10 days in the digestive tracts of mice. This strain did not induce detrimental effects in healthy or in TNBS-treated animals, as was reflected by the absence of weight loss, intestinal inflammation, modification of cytokine levels in the ileum and colon (healthy mice), and bacterial dissemination (healthy and colitic animals). Moreover, the translocation of endogenous microflora to the mesenteric lymph nodes and spleen was greatly reduced in the TNBS-treated mice after administration of LAB. This property, together with the strain's persistence capacity and innocuousness renders L. plantarum NCIMB8826 an attractive candidate as a probiotic to be used in the prevention or treatment of chronic inflammation.