Exploring the Gut Microbiome's Role in Inflammatory Bowel Disease: Insights and Interventions.

Inflammatory Bowel Disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic and relapsing inflammatory condition of the intestine that significantly impairs quality of life and imposes a heavy burden on healthcare systems globally. While the exact etiology of IBD is unclear, it is influenced by genetic, environmental, immunological, and microbial factors. Recent advances highlight the gut microbiome's pivotal role in IBD pathogenesis. The microbial dysbiosis characteristic of IBD, marked by a decline in beneficial bacteria and an increase in pathogenic microbes, suggests a profound connection between microbial imbalance and disease mechanisms. This review explores diagnostic approaches to IBD that integrate clinical assessment with advanced microbiological analyses, highlighting the potential of microbiome profiling as a non-invasive diagnostic tool. In addition, it evaluates conventional and emerging treatments and discusses microbiome-targeted intervention prospects, such as probiotics, symbiotics, and faecal microbiota transplantation. The necessity for future research to establish their efficacy and safety is emphasised.

Evaluation of the effect of probiotics on septic complications in patients with severe acute pancreatitis. A systematic review and meta-analysis.

Introduction: Severe acute pancreatitis (SAP) with major complications such as necrosis and multiple organ dysfunction syndrome (MODS) often leads to high mortality rates despite intensive treatment. Aim: To evaluate the effect of symbiotics (probiotics) on septic complications in patients with SAP. Material and methods: We searched the PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science databases for relevant clinical trials and excluded observational studies. Quality appraisal was evaluated according to GRADE, and we assessed the risk of bias using Cochrane's risk of bias tool. We included the following outcomes: C-reactive protein (CRP), APACHE II score, hospital stay, multiorgan failure (MOF), systemic inflammatory response syndrome, infected pancreatic necrosis, septicaemia, need for operation, and death. We performed the analysis of homogeneous data under a fixed-effects model, while analysis of heterogeneous data were analysed under a random-effects model. We performed the analysis of dichotomous outcomes using the risk ratio (RR) and relative 95% confidence interval (CI). Results: We included a total of 7 clinical trials. We found that there was no significant difference between both groups regarding MOF (RR = 0.60 (0.25, 1.44), p = 0.26), septicaemia (RR = 0.66 (0.29, 1.50), p = 0.32), death (RR = 0.66 (0.19, 2.26), p = 0.51), infected pancreatic necrosis (RR = 0.50 (0.18, 1.38), p = 0.18), SIRS (RR = 0.81 (0.29, 2.23), p = 0.68), CRP, APACHE II score, and hospital stay. Conclusions: Contrary to some published trials, our meta-analysis concludes that the use of probiotics in patients with SAP is not effective in reducing the mortality rate, septic complications, and need for operation.

Sensory characterization of functional guava symbiotic petit cheese product.

The consumption of functional dairy products continues to rise due to consumer needs. This study aimed to develop a dairy guava functional symbiotic petit cheese product that included probiotics (Bifidobacterium animalis subsp. lactis BB-12, Chr. Hansen, Denmark) and prebiotics (inulin), which had adequate organoleptic characteristics. Moreover, adequate physicochemical, microbiological, and sensory characteristics during its shelf life were expected. A pasteurized skim milk curd flavored with a guava pulp was stabilized with gelatin to formulate this product. As sweeteners, iso maltol, erythritol, and Luo Han Guo extract from monk fruit (Siraitia Grosvenorii) were added. The prebiotic used was inulin, and the probiotic (Bifidobacterium animalis subsp. lactis BB-12, Chr. Hansen, Denmark). The product was kept refrigerated (4 °C) during the shelf life of 28 days. For the organoleptic analysis (100 consumers), the evaluations performed were: (1) overall liking (OL), (2) CATA (Check all that apply) testing 19 attributes, and (3) purchase intention was evaluated. Results were analyzed with FIZZ Software Biosystèmes. During shelf life, (1) physicochemical, microbiological, and sensory tests were performed. The product was evaluated as "liked much'' (7.16 out of 9); it was described as a creamy (71 %) natural product (73 %) with a fruity odor (57 %). It could be suitable for marketing because 82 % of the consumers would buy it. The product's probiotic character (over 1 × 106) was established through a microbiological count. On day one, the CFU was found to be 4.15 × 108, and after 28 days, 1.98 × 108 CFU of viable Bifidobacterium animalis subsp. lactis BB-12, leading us to establish its probiotic characteristics. The shelf life was estimated at 21 days.

Ligilactobacillus salivarius 7247 Strain: Probiotic Properties and Anti-Salmonella Effect with Prebiotics.

The Ligilactobacillus salivarius 7247 (LS7247) strain, originally isolated from a healthy woman's intestines and reproductive system, has been studied for its probiotic potential, particularly against Salmonella Enteritidis (SE) and Salmonella Typhimurium (ST) as well as its potential use in synbiotics. LS7247 showed high tolerance to gastric and intestinal stress and effectively adhered to human and animal enterocyte monolayers, essential for realizing its probiotic properties. LS7247 showed high anti-Salmonella activity. Additionally, the cell-free culture supernatant (CFS) of LS7247 exhibited anti-Salmonella activity, with a partial reduction upon neutralization with NaOH (p < 0.05), suggesting the presence of anti-Salmonella factors such as lactic acid (LA) and bacteriocins. LS7247 produced a high concentration of LA, reaching 124.0 ± 2.5 mM after 48 h of cultivation. Unique gene clusters in the genome of LS7247 contribute to the production of Enterolysin A and metalloendopeptidase. Notably, LS7247 carries a plasmid with a gene cluster identical to human intestinal strain L. salivarius UCC118, responsible for class IIb bacteriocin synthesis, and a gene cluster identical to porcine strain L. salivarius P1ACE3, responsible for nisin S synthesis. Co-cultivation of LS7247 with SE and ST pathogens reduced their viability by 1.0-1.5 log, attributed to cell wall damage and ATP leakage caused by the CFS. For the first time, the CFS of LS7247 has been shown to inhibit adhesion of SE and ST to human and animal enterocytes (p < 0.01). The combination of Actigen prebiotic and the CFS of LS7247 demonstrated a significant combined effect in inhibiting the adhesion of SE and ST to human and animal enterocytes (p < 0.001). These findings highlight the potential of using the LS7247 as a preventive strategy and employing probiotics and synbiotics to combat the prevalence of salmonellosis in animals and humans caused by multidrug resistant (MDR) strains of SE and ST pathogens.

Targeting the Gut-Eye Axis: An Emerging Strategy to Face Ocular Diseases.

The human microbiota refers to a large variety of microorganisms (bacteria, viruses, and fungi) that live in different human body sites, including the gut, oral cavity, skin, and eyes. In particular, the presence of an ocular surface microbiota with a crucial role in maintaining ocular surface homeostasis by preventing colonization from pathogen species has been recently demonstrated. Moreover, recent studies underline a potential association between gut microbiota (GM) and ocular health. In this respect, some evidence supports the existence of a gut-eye axis involved in the pathogenesis of several ocular diseases, including age-related macular degeneration, uveitis, diabetic retinopathy, dry eye, and glaucoma. Therefore, understanding the link between the GM and these ocular disorders might be useful for the development of new therapeutic approaches, such as probiotics, prebiotics, symbiotics, or faecal microbiota transplantation through which the GM could be modulated, thus allowing better management of these diseases.

Alternative to antibiotic growth promoters: beneficial effects of Saccharomyces cerevisiae and/or Lactobacillus acidophilus supplementation on the growth performance and sustainability of broilers' production.

Although antibiotics growth promoters (AGPs), including zinc-bacitracin (ZnB), can threaten human health due to developing antimicrobial resistance, as well as drug residue in animal and poultry products, ZnB is still widely used, particularly in developing countries, for the sustainability of poultry farming. The present investigation aims to assess the use of Saccharomyces cerevisiae and Lactobacillus acidophilus, with or without a prebiotic (mannooligosaccharide, MOS), as alternatives to ZnB. For this reason, 150 one-day-old chicks were grouped into six groups, designated negative control, LA, SC, ZnB, SA + MOS, and LA + MOS (5 replicates of 5 chicks for each group). Chicks kept in the control group were fed the basal diet. Chickens kept in LA and SC groups received L. acidophilus, S. cerevisiae at a 1 g/kg diet and 2 g/Kg, respectively. Chickens kept in ZnB received ZnB at 0.5 g/kg. Chicks kept in the SC + MOS and LA + MOS were fed a basal diet containing 2 g S. cerevisiae + 1 g MOS/kg or 1 g L. acidophilus + 1 g MOS /kg, respectively. The efficacy was assessed based on the growth performance, carcass traits, meat quality, nutrient digestibility, and blood biochemistry composition during the entire trial 1-36 days of age. Results showed that chicks kept in the SC group had greater BW than the control (p < 0.05). Chicks kept in the SC, LA, SC + MOS, and LA + MOS consumed less feed than the control and Zn-B groups (p < 0.05). Supplementation with S. cerevisiae resulted in a better (p < 0.05) feed conversion rate (FCR) than the control group. Supplementation with L. acidophilus + MOS significantly increased (p < 0.05) the relative liver weight compared to those supplemented with ZnB, S. cerevisiae, and L. acidophilus. In addition, supplementation with ZnB-induced spleen hypertrophy compared to S. cerevisiae and L. acidophilus-supplemented groups (p < 0.05). Plasma, meat, and liver cholesterol, as well as the cholesterol-to-lipid ratio of meat and liver, were significantly decreased (p < 0.05) in both SC and LA groups compared to the control group. Our research indicates that adding 2 g/kg of S. cerevisiae to broiler feed can effectively replace ZnB and enhance productive performance and economic profits, making it a viable and sustainable option for broiler farming.

Symbiotic Supplementation (E. faecium and Agave Inulin) Improves Spatial Memory and Increases Plasticity in the Hippocampus of Obese Rats: A Proof-of-Concept Study.

Obesity has been linked to cognitive impairment through systemic low-grade inflammation. High fat and sugar diets (HFSDs) also induce systemic inflammation, either by induced Toll-like receptor 4 response, or by causing dysbiosis. This study aimed to evaluate the effect of symbiotics supplementation on spatial and working memory, butyrate concentration, neurogenesis, and electrophysiological recovery of HFSD-fed rats. In a first experiment, Sprague-Dawley male rats were given HFSD for 10 weeks, after which they were randomized into 2 groups (n = 10 per group): water (control), or Enterococcus faecium + inulin (symbiotic) administration, for 5 weeks. In the fifth week, spatial and working memory was analyzed through the Morris Water Maze (MWM) and Eight-Arm Radial Maze (RAM) tests, respectively, with 1 week apart between tests. At the end of the study, butyrate levels from feces and neurogenesis at hippocampus were determined. In a second experiment with similar characteristics, the hippocampus was extracted to perform electrophysiological studies. Symbiotic-supplemented rats showed a significantly better memory, butyrate concentrations, and neurogenesis. This group also presented an increased firing frequency in hippocampal neurons [and a larger N-methyl-d-aspartate (NMDA)/α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) current ratio] suggesting an increase in NMDA receptors, which in turn is associated with an enhancement in long-term potentiation and synaptic plasticity. Therefore, our results suggest that symbiotics could restore obesity-related memory impairment and promote synaptic plasticity.

Functional foods and dietary supplements in the management of non-alcoholic fatty liver disease: A systematic review and meta-analysis.

Objective: In this systematic review and meta-analysis, we aimed to clarify the overall effects of functional foods and dietary supplements in non-alcoholic fatty liver disease (NAFLD) patients. Methods: Randomized controlled trials (RCTs) published in PubMed, ISI Web of Science, Cochrane library, and Embase from January 1, 2000 to January 31, 2022 were systematically searched to assess the effects of functional foods and dietary supplements in patients with NAFLD. The primary outcomes were liver-related measures, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and hepatic fibrosis and steatosis, while the secondary outcomes included body mass index (BMI), waist circumference (WC), triacylglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). These indexes were all continuous variables, so the mean difference (MD) was used for calculating the effect size. Random-effects or fixed-effects models were used to estimate the mean difference (MD). The risk of bias in all studies was assessed with guidance provided in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Twenty-nine articles investigating functional foods and dietary supplements [antioxidants (phytonutrients and coenzyme Q10) = 18, probiotics/symbiotic/prebiotic = 6, fatty acids = 3, vitamin D = 1, and whole grain = 1] met the eligibility criteria. Our results showed that antioxidants could significantly reduce WC (MD: -1.28 cm; 95% CI: -1.58, -0.99, P < 0.05), ALT (MD: -7.65 IU/L; 95% CI: -11.14, -4.16, P < 0.001), AST (MD: -4.26 IU/L; 95% CI: -5.76, -2.76, P < 0.001), and LDL-C (MD: -0.24 mg/dL; 95% CI: -0.46, -0.02, P < 0.05) increased in patients with NAFLD but had no effect on BMI, TG, and TC. Probiotic/symbiotic/prebiotic supplementation could decrease BMI (MD: -0.57 kg/m2; 95% CI: -0.72, -0.42, P < 0.05), ALT (MD: -3.96 IU/L; 95% CI: -5.24, -2.69, P < 0.001), and AST (MD: -2.76; 95% CI: -3.97, -1.56, P < 0.0001) levels but did not have beneficial effects on serum lipid levels compared to the control group. Moreover, the efficacy of fatty acids for treating NAFLD was full of discrepancies. Additionally, vitamin D had no significant effect on BMI, liver transaminase, and serum lipids, while whole grain could reduce ALT and AST but did not affect serum lipid levels. Conclusion: The current study suggests that antioxidant and probiotic/symbiotic/prebiotic supplements may be a promising regimen for NAFLD patients. However, the usage of fatty acids, vitamin D, and whole grain in clinical treatment is uncertain. Further exploration of the efficacy ranks of functional foods and dietary supplements is needed to provide a reliable basis for clinical application. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier: CRD42022351763.

The Role of Probiotics in Inflammation Associated with Major Surgery: A Narrative Review.

BACKGROUND: Gut microbiota is well-known for its ability to maintain intestinal homeostasis. However, the disruption of this homeostasis, known as dysbiosis, leads to multiple consequences, including local and systemic inflammation. Surgery-induced inflammation is a major concern for patients, as it leads to many infectious and non-infectious complications. OBJECTIVE: The purpose of this review was to explore the role of probiotics and symbiotics in surgery-induced inflammation and to determine if their use is effective in combatting inflammation and its complications Methods and Materials: A literature search was conducted, and articles published only in English, until December 2022 were included. The results are reported in the form of a narrative review. RESULTS: The perioperative use of probiotics and/or symbiotics results in lower risk of infectious complications, including reduced rates of surgical site infections, respiratory and urinary tract infections, shorter hospital stays, and fewer days of antibiotic administration. It also contributes to reducing non-infectious complications, as it mitigates systemic and local inflammation via maintenance of the intestinal barrier, improves intestinal mobility, and is associated with lower rates of postoperative pain and anastomotic leak. CONCLUSIONS: Restoring gut microbiota after disruptions caused by surgery may accelerate local healing processes, attenuate systemic inflammation, and may thus prove beneficial to certain populations.

Surgical Prehabilitation in Patients with Gastrointestinal Cancers: Impact of Unimodal and Multimodal Programs on Postoperative Outcomes and Prospects for New Therapeutic Strategies-A Systematic Review.

The advantages of prehabilitation in surgical oncology are unclear. This systematic review aims to (1) evaluate the latest evidence of preoperative prehabilitation interventions on postoperative outcomes after gastrointestinal (GI) cancer surgery and (2) discuss new potential therapeutic targets as part of prehabilitation. Randomized controlled trials published between January 2017 and August 2022 were identified through Medline. The population of interest was oncological patients undergoing GI surgery. Trials were considered if they evaluated prehabilitation interventions (nutrition, physical activity, probiotics and symbiotics, fecal microbiota transplantation, and ghrelin receptor agonists), alone or combined, on postoperative outcomes. Out of 1180 records initially identified, 15 studies were retained. Evidence for the benefits of unimodal interventions was limited. Preoperative multimodal programs, including nutrition and physical activity with or without psychological support, showed improvement in postoperative physical performance, muscle strength, and quality of life in patients with esophagogastric and colorectal cancers. However, there was no benefit for postoperative complications, hospital length of stay, hospital readmissions, and mortality. No trial evaluated the impact of fecal microbiota transplantation or oral ghrelin receptor agonists. Further studies are needed to confirm our findings, identify patients who are more likely to benefit from surgical prehabilitation, and harmonize interventions.

Diet Composition and Using Probiotics or Symbiotics Can Modify the Urinary and Faecal Nitrogen Ratio of Broiler Chicken's Excreta and Also the Dynamics of In Vitro Ammonia Emission.

The objective of this research was to determine whether diet composition, or adding probiotic or symbiotic feed additives to broiler diets can modify the N composition of the excreta and the dynamics of ammonia volatilization from the manure. A total of 574 one-day-old Ross 308 broiler chickens were fed four different diets. The treatments included a corn and soybean meal-based control diets (C), wheat-based and wheat bran containing diets (W), a multi-strain probiotic treatment (Broilact®; Br), and a symbiotic additive containing Bacillus subtilis, inulin, and Saccharomices cerevisiae (Sy). Feeding the wheat-based diet significantly improved the weight gain and FCR of chickens. Treatment W also significantly increased the dry matter content of the excreta compared with the probiotic and symbiotic treatments. Both Br and Sy tended to decrease the amount of excreted uric acid, which is the main substrate of ammonia. Treatment Sy reduced the urinary N ratio of the excreta in comparison with treatment W. The symbiotic additive resulted in significantly higher ammonia emission in the first two hours. On the other hand, the dynamics of the emission was slow at the beginning and increased steeply after 15 h when the wheat-based diets were fed. Based on our results, the wheat-based diets, containing soluble arabinoxylans, and the symbiotic treatments of broiler diets have an impact on the urinary and faecal nitrogen composition of the excreta, and also on the dynamics of ammonia release from the manure.

Efeito do uso de probióticos e simbióticos no controle metabólico em pacientes com diabetes Mellitus tipo 2 e pré-diabetes: uma revisão sistemática de literatura / Effect of probiotics and symbotics on metabolic control in patients with type 2 diabetes Mellitus and pre-diabetes: a systematic literature review / Efecto del uso de probióticos y simbióticos sobre el control metabólico en pacientes con diabetes Mellitus tipo 2 y prediabetes: una revisión sistemática de la literatura

O diabetes mellitus constitui um distúrbio clínico heterogêneo, apresentando comumente hiperglicemia e estado inflamatório crônico. Tais condições se relacionam com a microbiota intestinal, compreendida como um conjunto de microrganismos que interagem com o hospedeiro de maneira benéfica ou maléfica. Nos pacientes diabéticos, a modulação microbiológica do intestino é bastante intrigante, pois o uso de probióticos tem auxiliado na redução da endotoxemia metabólica e de mediadores inflamatórios. Dessa forma, o objetivo deste trabalho é realizar uma revisão sistemática de literatura, buscando verificar a relação entre o uso de probióticos e simbióticos e a melhora metabólica em indivíduos diabéticos ou em risco de desenvolver tal patologia. Para tanto, foi realizada uma revisão sistemática, com coleta de dados realizada nas bases de dados PubMed, LILACS e ScienceDirect, com o objetivo de localizar ensaios clínicos que contemplassem a relação entre o uso de probióticos e simbióticos e a melhora metabólica (glicêmica e no tocante aos marcadores inflamatórios) na população-alvo. Os artigos coletados foram publicados entre janeiro de 2017 e fevereiro de 2022, e os estudos incluídos na revisão se restringiram ao idioma inglês. Foram avaliados quatro estudos, a maioria demonstrando uma redução significativa na glicemia em jejum e melhora metabólica geral, com redução dos níveis de marcadores inflamatórios após introdução de probióticos e simbióticos. Dessa forma, foi possível concluir que, apesar de muitos estudos serem inconclusivos em relação ao efeito dos probióticos sobre o controle glicêmico, pode haver espaço para tais suplementos no tratamento do diabetes mellitus tipo 2 e pré-diabetes. Entretanto, mais estudos são necessários para confirmar esses resultados.

Diabetes mellitus is a heterogeneous clinical disorder, commonly presenting hyperglycemia and chronic inflammatory state. These conditions are related to the intestinal microbiota, understood as a set of microorganisms that interact with the host in a beneficial or harmful way. Microbiological modulation of the intestine in diabetic patients is quite interesting, as probiotics have helped reduce metabolic endotoxemia and inflammatory mediators. Thus, this systematic literature review sought to verify the relationship between use of probiotics and symbiotics and glycemic/metabolic control in patients with type 2 Diabetes Mellitus and pre-diabetes. Bibliographic search was conducted in the PubMed, LILACS and ScienceDirect databases to identify clinical trials on the effect of probiotics and symbiotics on glycemic/metabolic improvement/control in the targeted patients. Retrieved articles were published between January 2017 and February 2022, but only papers in English were included in the review, resulting in four articles evaluated. Most studies showed a significant reduction in fasting blood glucose and general metabolic improvement, with reduced levels of inflammatory markers, after introduction of probiotics and symbiotics. Although many studies are inconclusive regarding the effect of probiotics and symbiotics on glycemic control, such supplements may have space in DM2 and pre-DM treatment. Further studies are needed to confirm these results.

La diabetes mellitus es un trastorno clínico heterogéneo, caracterizada comúnmente por la hiperglucemia y un estado inflamatorio crónico. Esta condición está relacionada con la microbiota intestinal, que abarca un conjunto de microorganismos que viven con el huésped benéfica o maléficamente. En pacientes diabéticos, la modulación microbiológica del intestino es muy intrigante, puesto que el uso de probióticos ha ayudado a reducir la endotoxemia metabólica y los mediadores inflamatorios. Así, el objetivo de este trabajo es realizar una revisión sistemática de la literatura para verificar la relación entre el uso de probióticos y simbióticos y la mejoría metabólica en diabéticos y prediabéticos. Por lo tanto, se realizó una revisión sistemática, con recolección de datos en las bases de datos PubMed, LILACS y ScienceDirect, con el objetivo de localizar ensayos clínicos que contemplaran la relación entre el uso de probióticos y simbióticos y la mejora metabólica (glucémica y en cuanto a marcadores inflamatorios) en el público objetivo. Los artículos habían sido publicados entre enero de 2017 y febrero de 2022 y  se restringieron al idioma inglés. Se evaluaron cuatro estudios, la mayoría demostró una reducción significativa en la glucosa en sangre en ayunas y una mejora metabólica general, con niveles reducidos de marcadores inflamatorios, después de la introducción de probióticos y simbióticos. Así, fue posible concluir que, aunque muchos estudios no son concluyentes en cuanto al efecto de los probióticos en el control glucémico, hay espacio para tales suplementos en el tratamiento de la diabetes mellitus y la prediabetes. Sin embargo, se necesitan más estudios para confirmar estos resultados.

Synbiotic microencapsulation of Enterococcus faecium Rp1: a potential probiotic isolated from ragi porridge with antiproliferative property against colon carcinoma cell line.

Ragi porridge, commonly consumed in South India is made from finger millet and noiyee (broken rice), and it is one of the excellent sources for probiotic bacteria. In vitro assays provided the proof that the probiotic strains isolated from ragi porridge can survive during the intestinal passage. Also, it showed antioxidant activity and antagonistic activity against foodborne pathogens including Shigella flexineri, Staphylococcus aureus, Salmonella typhii and Escherichia coli. Enterococcus faecium Rp1 isolated from ragi porridge was susceptible to vancomycin and showed to cease the progression of HCT116 (colon carcinoma) cell line. Further, Enterococcus faecium was microencapsulated using sodium alginate and aloe vera gel as binding agents and onion extract as a source of prebiotic to perform symbiotic encapsulation. In short, this study concludes that the fermented Ragi porridge is a rich source of probiotics with anti-microbial, antioxidant and antiproliferative property hence can be suggested for improving gut microbiota. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-022-05415-2.

A study on the effect of symbiotic fermented milk products on human gastrointestinal health: Double-blind randomized controlled clinical trial.

Several studies have claimed that the consumption of fermented dairy products can improve human gastrointestinal (GI) health. However, the numbers of systematic clinic trials are limited. In this study, a yogurt containing both probiotics and prebiotics was developed and a double-blind randomized controlled clinical trial was carried out to evaluate the effect of the product on human gastrointestinal health in three different aspects: (1) the effect on functional constipation (FC) and functional diarrhea (FD); (2) the effect on gastrointestinal (GI) tract immune system; and (3) the changes in GI tract microbiota. Participants who suffered FC or FD were randomized into three groups (n = 66 each group): the first group was treated with fermented milk with Lactobacillus plantarum ST-III (7 mg/kg) and inulin (1.5%), the second group was treated with L. plantarum ST-III (7 mg/kg) and inulin (1.0%), and the third group (control group) was treated without probiotics and prebiotics. Half of the participants stopped the treatment after 14 days and the rest of the group continued the trial to the full 28 days. The fecal samples of participants were analyzed regarding their short-chain fatty acids (SCFAs), secretory immunoglobulin A (sIgA), and microbiota. A survey on GI tract health was conducted and the Bristol stool scale was recorded. The results showed that the consumption of the symbiotic yogurt for 14 days and 28 days can both improve the digestive system, with the continual consumption of product containing L. plantarum ST-III (7 mg/kg) and inulin (1.5%) for 28 days showing the most significance. The consumption of this product may be used as a potential functional food.

Impacto da suplementação com probióticos, prebióticos e simbióticos na microbiota intestinal em pacientes com doença hepática gordurosa não alcoólica: uma revisão sistemática / Probiotic, prebiotic or symbiotic supplementation impacts on intestinal microbiota in patients with nonalcoholic fatty liver disease: a systematic review

ABSTRACT Background Supplementation with probiotics, prebiotics and symbiotics has shown positive effects on clinical markers and risk factors for non-alcoholic fatty liver disease (NAFLD). Objective To evaluate the effect of supplementation with probiotic, prebiotic or symbiotic on intestinal microbiota in NAFLD patients. Methods Two investigators conducted independently search for articles in the Medline databases, via PubMed, Web of Science, Embase, Scopus, Lilacs, Central Cochrane Library, Clinical Trials.gov and on the Ovid platform for the gray literature search. Results A total of 3,423 papers were identified by searching the electronic databases; 1,560 of them were duplicate and they were excluded; 1,825 articles were excluded after reading the title and abstract. A total of 39 articles were select to reading, however only four articles met the eligibility criteria to include in this systematic review. Three of the included studies that used prebiotic or symbiotic supplementation showed that after the intervention there were changes in the intestinal microbiota pattern. Only in one study such changes were not observed. A high risk of bias was observed in most assessments. Conclusion Although there is a possible change in the gut microbiota of individuals with NAFLD after supplementation with symbiotics or prebiotics, a clinical indication as part of NAFLD treatment is not yet possible.

RESUMO Contexto A suplementação com probióticos, prebióticos e simbióticos mostrou efeitos positivos sobre marcadores clínicos e fatores de risco para doença hepática gordurosa não alcoólica (DHGNA). Objetivo Avaliar o efeito da suplementação com probióticos, prebióticos ou simbióticos na microbiota intestinal em pacientes com DHGNA. Métodos Dois pesquisadores realizaram buscas independentes de artigos nas bases de dados Medline, via PubMed, Web of Science, Embase, Scopus, Lilacs, Biblioteca Central Cochrane, Clinical Trials.gov e na plataforma Ovid para busca de literatura cinza. Os títulos e resumos foram lidos para excluir artigos irrelevantes. Em seguida, os artigos selecionados foram lidos na íntegra e avaliados de acordo com os critérios de elegibilidade. O risco de viés foi avaliado de acordo com a Cochrane. Resultados Um total de 3.423 artigos foram identificado por meio de busca nas bases de dados eletrônicas; 1.560 deles eram duplicados e foram excluídos; 1.825 artigos foram excluídos após a leitura do título e do resumo. Um total de 39 artigos foram selecionado para leitura, porém apenas quatro artigos atenderam aos critérios de elegibilidade para inclusão nesta revisão sistemática. Três dos estudos incluídos que utilizaram suplementação de prebióticos ou simbióticos mostraram que após a intervenção ocorreram mudanças no padrão da microbiota intestinal. Apenas em um estudo tais mudanças não foram observadas. Um elevado risco de viés foi observado na maioria das avaliações. Conclusão Embora haja uma possível alteração na microbiota intestinal de indivíduos com DHGNA após a suplementação com simbióticos ou prebióticos, uma indicação clínica como parte do tratamento da DHGNA ainda não é possível.

Common Inflammatory Mechanisms in COVID-19 and Parkinson's Diseases: The Role of Microbiome, Pharmabiotics and Postbiotics in Their Prevention.

In the last decade, metagenomic studies have shown the key role of the gut microbiome in maintaining immune and neuroendocrine systems. Malfunction of the gut microbiome can induce inflammatory processes, oxidative stress, and cytokine storm. Dysfunction of the gut microbiome can be caused by short-term (virus infection and other infectious diseases) or long-term (environment, nutrition, and stress) factors. Here, we reviewed the inflammation and oxidative stress in neurodegenerative diseases and coronavirus infection (COVID-19). Here, we reviewed the renin-angiotensin-aldosterone system (RAAS) involved in the processes of formation of oxidative stress and inflammation in viral and neurodegenerative diseases. Moreover, the coronavirus uses ACE2 receptors of the RAAS to penetrate human cells. The coronavirus infection can be the trigger for neurodegenerative diseases by dysfunction of the RAAS. Pharmabiotics, postbiotics, and next-generation probiotics, are considered as a means to prevent oxidative stress, inflammatory processes, neurodegenerative and viral diseases through gut microbiome regulation.

Nutrition and Cancer Risk from the Viewpoint of the Intestinal Microbiome.

There are various important factors in reducing the risk of cancer development and progression; these factors may correct an unbalanced intake of nutrients to maintain the living body's homeostasis, detoxify toxic materials, acting as an external factor, and maintain and strengthen the body's immune function. In a normal cell environment, nutrients, such as carbohydrates, lipids, proteins, vitamins, and minerals, are properly digested and absorbed into the body, and, as a result, an environment in which cancer can develop and progress is prevented. It is necessary to prevent toxic materials from entering the body and to detoxify poisons in the body. If these processes occur correctly, cells work normally, and genes cannot be damaged. The most important factor in the fight against cancer and prevention of the development and progression of cancer is the immune system. This requires a nutritional state in which the immune system works well, allowing the intestinal microbiome to carry out all of its roles. In order to grow intestinal microbiota, the consumption of prebiotics, such as organic vegetables, fruits, and dietary fiber, and probiotics of effective intestinal microbiota, such as fermented foods and supplements, is required. Symbiosis, in which these organisms work together, is an effective means of reducing the risk of cancer. In addition, fecal microbiota transplantation (FMT) using ultrafine bubble water, produced specially by the Association for Clinical Research of Fecal Microbiota Transplantation Japan, is also useful for improving the nutritional condition and reducing the risk of cancer.

Gut Microbiota Modulation as a Potential Target for the Treatment of Lung Infections.

The gastrointestinal and respiratory systems are colonized by a complex ecosystem of microorganisms called the microbiota. These microorganisms co-evolved over millions of years with the host, creating a symbiotic relationship that is fundamental for promoting host homeostasis by producing bioactive metabolites and antimicrobial molecules, and regulating the immune and inflammatory responses. Imbalance in the abundance, diversity, and function of the gut microbiota (known as dysbiosis) have been shown to increase host susceptibility to infections in the lungs, suggesting crosstalk between these organs. This crosstalk is now referred to as the gut-lung axis. Hence, the use of probiotics, prebiotics, and synbiotics for modulation of gut microbiota has been studied based on their effectiveness in reducing the duration and severity of respiratory tract infections, mainly owing to their effects on preventing pathogen colonization and modulating the immune system. This review discusses the role and responses of probiotics, prebiotics, and synbiotics in the gut-lung axis in the face of lung infections.

Lights and Shadows of Microbiota Modulation and Cardiovascular Risk in HIV Patients.

Human immunodeficiency virus (HIV) infection is associated with premature aging and the development of aging-related comorbidities, such as cardiovascular disease (CVD). Gut microbiota (GM) disturbance is involved in these comorbidities and there is currently interest in strategies focused on modulating GM composition and/or functionality. Scientific evidence based on well-designed clinical trials is needed to support the use of prebiotics, probiotics, symbiotics, and fecal transplantation (FT) to modify the GM and reduce the incidence of CVD in HIV-infected patients. We reviewed the data obtained from three clinical trials focused on prebiotics, 25 trials using probiotics, six using symbiotics, and four using FT. None of the trials investigated whether these compounds could reduce CVD in HIV patients. The huge variability observed in the type of compound as well as the dose and duration of administration makes it difficult to adopt general recommendations and raise serious questions about their application in clinical practice.

The role of pro-, pre- and symbiotics in cancer: A systematic review.

WHAT IS KNOWN AND OBJECTIVE: Cancer is one of the most important causes of morbidity and mortality worldwide. Pro-, pre- and symbiotics can modulate host metabolism and gut microbiota and potentially help prevent cancer and modulate the adverse effects (AEs) of treatments. Numerous studies on this role for pro-, pre- and symbiotics have reported inconsistent results. The purpose of this review was to examine current scientific evidence from randomized controlled trials (RCTs) on the effects of pro-, pre- and symbiotics on the incidence of complications and AEs, especially diarrhoea, in cancer management. METHODS: A systematic literature search was implemented in MEDLINE using the MeSH terms "probiotics", "prebiotics", "symbiotics" and "neoplasms", according to PRISMA guidelines. Reference lists were also handsearched to identify additional eligible RCTs. Three reviewers independently assessed the eligibility of each RCT. Of 714 retrieved abstracts, 22 articles with 2287 participants were included in the analysis. RESULTS AND DISCUSSION: The most studied bacteriotherapies were probiotics and symbiotics, in 10 and 7 studies, respectively. Both Lactobacillus and Bifidobacterium strains were used in 18 studies, while Lactobacillus and Bifidobacterium strains were individually used in 9 and 2 studies, respectively. Diarrhoea incidence rates were 3.2%-39.1% in intervention groups and 6.7%-60.9% in control groups, while infection incidence rates were 11.1%-22.7% in intervention groups and 17.3%-28.7% in control groups. WHAT IS NEW AND CONCLUSIONS: Pro-, pre- and symbiotics may potentially be efficacious in reducing complications associated with chemotherapy, radiotherapy and surgery in patients with cancer.