Effect of probiotics on patulin removal from synbiotic apple juice.

BACKGROUND: Studies have reported the occurrence of the mycotoxin patulin in apple products. The aim of this study was to produce synbiotic apple juice and investigate the detoxification of patulin by Lactobacillus acidophilus and Lactobacillus plantarum as probiotic strains. The impact of seven process variables on efficiency of toxin removal was investigated using Plackett-Burman design and presence of the surface-layer proteins as binding site of probiotics to patulin was confirmed during 6 weeks of cold storage. RESULTS: Results showed that the removal of patulin by probiotic bacteria from apple juice depends significantly (P < 0.05) on the fructooligosaccharide content (as a prebiotic), concentration of patulin and the addition of ascorbic acid. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of cell surface proteins of probiotic strains revealed that surface layer proteins have an important role in patulin removal from apple juice. In the best conditions, 91.23% of initial patulin concentration was removed from juice during 6 weeks refrigerated storage. No significant difference was observed in organoleptic properties of the synbiotic apple juice and raw sample. CONCLUSION: In the best condition reported in this study, contaminated synbiotic apple juice by patulin will be safe for consumers after the first day of probiotic inoculation. © 2016 Society of Chemical Industry.

Microbiota e barreira intestinal: implicações para obesidade / Microbiota and intestinal barrier: implications for obesity

A epidemia da obesidade é considerada um importante problema de saúde pública na sociedade ocidental, pois ela se relaciona a comorbidades como síndrome metabólica, diabetes mellitus e hipertensão. A microbiota intestinal pode contribuir para o desenvolvimento da obesidade através do aumento da extração energética dos componentes da dieta, da lipogênese, da permeabilidade intestinal e da endotoxemia, mediada especialmente pelos lipopolissacarídeos. Estudos têm demonstrado diferenças na composição da microbiota intestinal entre indivíduos obesos e magros. Ao que parece, o aumento na proporção de Firmicutes em relação a Bacteroidetes parece estar presente na obesidade, podendo ser alterado à medida que ocorre perda de peso. Assim, o objetivo deste estudo foi revisar a literatura acerca dos mecanismos que relacionam a microbiota e a barreira intestinal ao desenvolvimento ou agravamento da obesidade (AU)

The epidemic of obesity is considered an important public health problem in the Western society and is related to comorbidities such as metabolic syndrome, diabetes mellitus, and hypertension. The intestinal microbiota may contribute to the development of obesity by increasing energy extraction from the dietary components, lipogenesis, intestinal permeability, and endotoxemia, especially mediated by lipopolysaccharides. Studies have demonstrated differences in composition of the intestinal microbiota between obese and lean individuals. Apparently, the increase in the proportion of Firmicutes in relation to Bacteroidetes seems to be present in obesity and can be changed during weight loss. The aim of this study was to review the mechanisms that relate microbiota and intestinal barrier to the development or worsening of obesity (AU)

Synbiotics-supplemented amino acid-based formula supports adequate growth in cow's milk allergic infants.

BACKGROUND: Children with cow's milk allergy (CMA) are at risk for inadequate nutritional intake and growth. Dietary management of CMA, therefore, requires diets that are not only hypoallergenic but also support adequate growth in this population. This study assessed growth of CMA infants when using a new amino acid-based formula (AAF) with prebiotics and probiotics (synbiotics) and evaluated its safety in the intended population. METHODS: In a prospective, randomized, double-blind controlled study, full-term infants with diagnosed CMA received either an AAF (control; n = 56) or AAF with synbiotics (oligofructose, long-chain inulin, acidic oligosaccharides, Bifidobacterium breve M-16V) (test; n = 54) for 16 wk. Primary outcome was growth, measured as weight, length and head circumference. Secondary outcomes included allergic symptoms and stool characteristics. RESULTS: Average age (±SD) of infants at inclusion was 4.5 ± 2.4 months. Both formulas equally supported growth according to WHO 2006 growth charts and resulted in similar increases of weight, length and head circumference. At week 16, differences (90% CI) in Z-scores (test-control) were as follows: weight 0.147 (-0.10; 0.39, p = 0.32), length -0.299 (-0.69; 0.09, p = 0.21) and head circumference 0.152 (-0.15; 0.45, p = 0.40). Weight-for-age and length-for-age Z-scores were not significantly different between the test and control groups. Both formulas were well tolerated and reduced allergic symptoms; the number of adverse events was not different between the groups. CONCLUSIONS: This is the first study that shows that an AAF with a specific synbiotic blend, suitable for CMA infants, supports normal growth and growth similar to the AAF without synbiotics. This clinical trial is registered as NCT00664768.

Cost/benefit of synbiotics in acute infectious gastroenteritis: spend to save.

The cost/benefit ratio of probiotics in the ambulatory treatment of acute infectious gastro-enteritis with or without a synbiotic food supplement (containing fructo-oligosaccharides and probiotic strains of Streptoccoccus thermophilus, Lactobacillus rhamnosus, Lactobacillus acidophilus, Bifidobacterium lactis and Bifidobacterium infantis) has been studied. 111 children (median age 37 and 43 months for the synbiotic and placebo group, respectively) with acute infectious gastroenteritis were included in a randomised, prospective placebo-controlled trial performed in primary health care. All children were treated with an oral rehydration solution and with the synbiotic food supplement (n=57) or placebo (n=54). Physicians were allowed to prescribe additional medication according to what they considered as 'necessary'. Cost of add-on medication and total healthcare cost were calculated. Median duration of diarrhoea was 1 day shorter (95% confidence interval -0.6 to -1.9 days) in the symbiotic than in the placebo group (P<0.005). Significantly more concomitant medication (antibiotics, antipyretics, antiemetics) was prescribed in the placebo group (39 prescriptions in 28 patients) compared to the synbiotic group (12 prescriptions in 7 patients) (P<0.001). The difference was most striking for antiemetics: 28 vs. 5 prescriptions. The cost of add-on medication in the placebo group was evaluated at € 4.04/patient (median 4.97 (interquartile (IQ) 25-75: 0-4.97)) vs. € 1.13 /patient in the synbiotic arm (P<0.001). If the cost of the synbiotic is considered, median cost raised to € 7.15/patient (IQ 25-75: 7.15-7.15) (P<0.001). The extra consultations needed to prescribe the concomitant medication resulted in a higher health care cost in the placebo group (€ 14.41 vs. € 10.74/patient, P<0.001). Synbiotic food supplementation resulted in a 24 h earlier normalisation of stool consistency. Although use of the synbiotic supplementation increased cost, add-on medication and extra consultations were reduced, resulting in a reduction of health care cost of 25%.

Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut in patients with severe acute pancreatitis: a prospective feasibility study.

BACKGROUND: Experience with administration of synbiotics (prebiotics/probiotics) in patients with severe acute pancreatitis (SAP) has demonstrated immunomodulatory capacity. The aim of this trial was evaluation of the feasibility and perspective of early clinical application of oral synbiotic/prebiotic supplements in patients with SAP. METHODS: 90 SAP patients were enrolled during the period from 2005-2008. Patients were stratified according to the feeding mode. CONTROL (n = 32) group received standard whole protein feeding formula. SYNBIO (n = 30) and FIBRE groups (n = 28) received early (within first 24-48 hours) synbiotic or prebiotic supplements. Oral administration of synbiotics or prebiotics was commenced when patients were able to sip water. RESULTS: Daily provided average volume and calories of synbiotic/prebiotic blends were smaller compared to the CONTROL, p = 0.001. Oral administration of synbiotic/prebiotic supplements was associated with lower infection rate (pancreatic and peripancreatic necrosis) compared to the CONTROL, (p = 0.03; p = 0.001), lower rate of surgical interventions, p = 0.005, shorter ICU (p = 0.05) and hospital stay (p = 0.03). Synbiotic supplemented enteral stimulation of the gut resulted in reduced mortality rate compared to the CONTROL, p = 0.02. CONCLUSION: Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut seems to be a potentially valuable complement to the routine treatment protocol of SAP.

Beneficial effects of a synbiotic supplement on self-perceived gastrointestinal well-being and immunoinflammatory status of healthy adults.

The use of synbiotics as health promoters is still poorly defined, and human intervention studies are scarce. This study was designed to evaluate the effects of a commercialized synbiotic product containing Lactobacillus acidophilus La5, Bifidobacterium animalis ssp. lactis Bb-12, Lactobacillus delbrueckii ssp. bulgaricus, Lactobacillus paracasei ssp. paracasei, Streptococcus thermophilus, and fructooligosaccharides on the self-reported gastrointestinal well-being and the immunoinflammatory status of healthy human subjects. In this randomized, double-blind, placebo-controlled study, 20 women and 16 men (25-45 years old) received either three tablets per day of the synbiotic product (2.4 × 10(9) colony-forming units/day) or placebo during 6 weeks. Gastrointestinal symptoms and bowel habits were evaluated through a self-administered questionnaire. In those subjects suffering from any kind of digestive disturbance (mild dyspepsia, flatulence, postprandial bloating, constipation, etc.), improvements in symptoms after product consumption were also evaluated. Blood lymphocyte subsets, phagocytic activity, serum C-reactive protein, ceruloplasmin, and adhesion molecules concentrations were analyzed prior and after treatment. A significant improvement in overall self-reported gastrointestinal symptoms and bowel habit was found in the synbiotic group. A marginal effect of treatment (analysis of variance P = .050) was observed with L-selectin, which showed a significant decrease in the synbiotic group (P = .019). In addition, basal L-selectin levels correlated with final intercellular adhesion molecule (ICAM)-1 levels (r = 0.468; P = .050), and basal ICAM-1 levels tended to correlate negatively with final L-selectin concentration (r = -0.457; P = .056). None of these correlations was found in the placebo group. The rest of the immunological parameters studied were not modified by the intervention. In conclusion, consumption of the synbiotic product improves self-perceived bowel habits and might facilitate a better profile of adhesion molecules in healthy adults.

Effects of synbiotic treatment on serum level of p-cresol in haemodialysis patients: a preliminary study.

BACKGROUND: para-Cresol, which is present in the blood mainly as p-cresyl sulphate, is a protein-bound uraemic toxin that is produced in the intestine by certain intestinal bacteria, and its production is affected by various intestinal environmental factors. Patients with end-stage renal disease who are undergoing haemodialysis (HD) often have defective bowel function leading to abnormal defecation. Since treatment with synbiotics (SYN), which are a combination of probiotics and prebiotics, is reported to improve bowel habit, we examined the effects of SYN on the serum p-cresol level in HD patients. METHODS: Nine HD patients received SYN (Lactobacillus casei strain Shirota and Bifidobacterium breve strain Yakult as probiotics and galacto-oligosaccharides as prebiotics) three times a day for 2 weeks. The duration of the study was 4 weeks (2 weeks of pretreatment observation and 2 weeks of treatment). The subjects were asked to complete a questionnaire about their bowel habits (defecation frequency, stool quantity, stool form and ease of defecation) during the study period. Serum p-cresol levels before and after SYN treatment were determined. RESULTS: According to the questionnaire conducted during the pretreatment observation period, HD patients with a high serum p-cresol level tended to have hard stools with difficulty in defecation. With SYN treatment, stool quantity increased significantly and hard, muddy or soft stools tended to be replaced by normal ones. The serum p-cresol level also decreased significantly. CONCLUSIONS: It was found that uraemic toxin, p-cresol, was associated with constipation and that SYN treatment resulted in normalization of bowel habits and a decrease of serum p-cresol levels in HD patients. Therefore, SYN treatment may be anticipated to reduce the toxic effect of p-cresol in HD patients.