<Emphasis Type="Italic">Saccharomyces boulardii</Emphasis> in childhood

Introduction  Probiotics are live microorganisms which confer a health benefit on the host. Saccharomyces boulardii, a yeast, has been found to be an effective probiotic in double-blind placebo-controlled randomized clinical studies. Materials and methods  We reviewed the established mechanisms of actions and clinical efficacy in children of S. boulardii. Conclusions  The mechanisms of action of S. boulardii depend mainly on the inhibition of some bacterial toxins, anti-inflammatory effects, and on stimulating effects on the intestinal mucosa such as trophic effects on the brush border enzymes and immunostimulatory effects. At present, in pediatric populations, there is evidence that S. boulardii is beneficial for the treatment of acute gastroenteritis and the prevention of antibiotic-associated diarrhea. More data are needed in other indications such as traveller’s diarrhea, Helicobacter pylori eradication, and inflammatory bowel disease. S. boulardii is a yeast strain that has been extensively studied in vitro and in vivo. Recent data have opened the door for new therapeutic indications. An erratum to this article can be found at     

Therapeutic effects of four strains of probiotics on experimental colitis in mice

AIM： To investigate the therapeutic effects of four strains of probiotics （E. feacalis, L. acidophilus, C. butyricum and B. adolescentis） on dextran sulphate sodium （DSS）-induced experimental colitis in Balb/c mice. METHODS： Eighty Balb/c mice were randomly divided into 8 groups. Weight-loss, fecal character, fecal occult blood and hematochezia were recorded daily. Disease activity index （DAI） scores were also evaluated everyday. Length of colon was measured and histological scores were evaluated on the 13th day. Myeloperoxidase （MPO） activity was detected. Interleukin-1 （IL-1） and IL-4 expression was detected by ELISA and RT-PCR. RESULTS： The four strains of probiotics relieved the inflammatory condition of DSS-induced experimental colitis in mice. Weight loss was slowed down in all probiotics-treated mice. Even weight gain was observed by the end of probiotics treatment. The DAI and histological scores of probiotics-treated mice were lower than those of mice in the control group （1.9 ± 0.2 vs 8.6 ± 0.4, P 〈 0.05 for E. faecalis）. The length of colon of probiotics-treated mice was longer than that of mice in the control group （10.3 ± 0.34 vs 8.65 ± 0.77, P 〈 0.05 for E. faecalis）. The four strains of probiotics decreased the MP activity and the IL-1 expression, but increased the IL-4 expression. E. faecalis had a better effect on DSS-induced experimental colitis in mice than the other three strains. CONCLUSION： The four strains of probiotics have beneficial effects on experimental colitis in mice, E. faecalis has a better effect on DSS-induced experimental colitis in mice than the other three strains. Supplement of probiotics provides a new therapy for UC.     

Probiotics in infectious diarrhoea in children: are they indicated?

Infectious gastroenteritis continues to be a leading cause of mortality and morbidity worldwide. The cornerstone of treatment remains replacement of water and electrolyte losses with oral rehydration solution. Until a few years ago, probiotics were discussed primarily in the context of alternative medicine, but they are now entering mainstream medical practice since a decrease of the severity and duration of infectious gastroenteritis in approximately 24 hours has been shown for some strains. Therefore, probiotics are a potential add-on therapy in acute gastro-enteritis. The shortening of the duration of diarrhoea and the reduction in hospital stay result in a social and economic benefit. Evidence found in viral gastroenteritis is more convincing than in bacterial or parasitic infection. Mechanisms of action are strain specific and only those commercial products for which there is evidence of clinical efficacy should be recommended. Timing of administration is also of importance. In acute gastroenteritis, there is evidence for efficacy of some strains of lactobacilli (e.g. Lactobacillus caseii GG and Lactobacillus reuteri) and for Saccharomyces boulardii. Probiotics are “generally regarded as safe”, but side effects such as septicaemia and fungaemia have very rarely been reported in high-risk situations. Although most studies conclude in a statistically significant shortening of the duration of diarrhea, the clinical relevance of this finding is limited. In conclusion, selected strains of probiotics result in a statistically significant but clinically moderate benefit in shortening the duration of diarrhoea caused by acute infectious gastroenteritis. An erratum to this article can be found at     

儿童抗生素相关性腹泻诊断、治疗和预防专家共识

抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)是抗菌药物使用后最常见的不良反应,尤其是儿童。AAD会延长原发疾病的恢复时间、增加医疗费用,重者可引起死亡。儿科医师对AAD关注不够,现组织国内呼吸、感染和消化领域专家,制定本共识,以提高我国儿童AAD诊治及预防水平,保障儿童健康。     

Probiotics and the prevention of necrotizing enterocolitis

Background

Immaturity of the host immune system and alterations in the intestinal microbiome appear to be key factors in the pathogenesis of necrotizing enterocolitis (NEC). The aim of this paper is to weigh the evidence for the use of probiotics to prevent NEC in premature infants.

The effect of probiotic fermented milk products on blood lipid concentrations: A systematic review and meta-analysis of randomized controlled trials

AimFermented milk products are suggested as a supplementary therapy to help reduce blood lipid levels. However, the results of clinical studies are conflicting.Data synthesisThis study systematically reviewed 39 randomized controlled trials (n = 2237 participants) to investigate the effect of probiotic fermented milk products on blood lipids. A meta-analysis was performed using random effects models, with weighted mean differences (WMDs) and 95% confidence interval (CI). Statistically significant reductions in blood low-density lipoprotein cholesterol (LDL-C) (WMD: ?7.34 mg/dL, 95% CI: from ?10.04 to ?4.65, and P < 0.001) and total cholesterol (TC) concentrations (WMD: ?8.30 mg/dL, 95% CI: from ?11.42 to ?5.18, and P < 0.001) were observed. No statistically significant effect of probiotic fermented milk was observed on blood high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TAG) levels. The effect on TC and LDL-C level was more pronounced in men, and a greater reduction in TAG was observed in trials with longer interventions (≥8 weeks) as compared to their counterparts.ConclusionsAvailable evidence suggests that probiotic fermented milk products may help to reduce serum TC and LDL-C cholesterol levels, particularly in men and when they are consumed for ≥8 weeks.     

Prevention of enteric bacterial infections and modulation of gut microbiota with conjugated linoleic acids producing Lactobacillus in mice

ABSTRACT

Probiotics are recognized for outcompeting pathogenic bacteria by competitive receptor-mediated colonization and secretion of functional metabolites which are antimicrobial against certain microbes as well as improving host’s gut health and immunity. Recently, we have constructed a bioactive Lactobacillus casei (LC) strain, LC^+mcra , by inserting mcra (myosin cross-reactive antigen) gene, which stimulates the conversion of conjugated linoleic acids. In this study, we evaluated the modulation of gut microbiome and protective roles of LC^+mcra against pathogenic Salmonella enterica serovar Typhimurium (ST) and enterohemorrhagic E. coli (EHEC) infections in BALB/cJ mice. We observed that LC^+mcra colonized efficiently in mice gut intestine and competitively reduced the infection with ST and EHEC in various locations of small and large intestine, specifically cecum, jejunum, and ileum (p < 0.05). Positive modulation of the cecal microbiota, for example, higher relative abundances of Firmicutes, lower relative abundances of Proteobacteria, and increased bacterial species diversity/richness, was detected in ST-challenged mice pretreated with LC^+mcra based on 16S metagenomic sequencing. Cytokine gene expression analysis indicated that mice pretreated with LC^+mcra associated with attenuated bacterial pathogen-induced gut inflammation. Furthermore, mice fed daily with LC^+mcra for one week could protect themselves from the impairments caused by enteric infections with ST or EHEC. These impairments include weight loss, negative hematological changes, intestinal histological alterations, and potential death. This in vivo study suggests that daily consumption of novel conjugated linoleic acids over-producing probiotic effectively improves intestinal microbiota composition and prevents/combats foodborne enteric bacterial infections with pathogenic Salmonella and diarrheagenic E. coli.     

Recent advances and remaining gaps in our knowledge of associations between gut microbiota and human health

The complex gut microbial flora harbored by individuals （microbiota） has long been proposed to contribute to intestinal health as well as disease. Preand probiotic products aimed at improving health by modifying microbiota composition have already become widely available and acceptance of these products appears to be on the rise. However, although required for the development of effective microbiota based interventions, our basic understanding of microbiota variation on a population level and its dynamics within individuals is still rudimentary. Powerful new parallel sequence technologies combined with other efficient molecular microbiota analysis methods now allow for comprehensive analysis of microbiota composition in large human populations. Recent findings in the field strongly suggest that microbiota contributes to the development of obesity, atopic diseases, inflammatory bowel diseases and intestinal cancers. Through the ongoing National Institutes of Health Roadmap ＇Human Microbiome Project＇ and similar projects in other parts of the world, a large coordinated effort is currently underway to study how microbiota can impact human health. Translating findings from these studies into effective interventions that can improve health, possibly personalized based on an individuals existing microbiota, will be the task for the next decade（s）.     

Effect of addition of inulin and fenugreek on the survival of microencapsulated Enterococcus durans 39C in alginate-psyllium polymeric blends in simulated digestive system and yogurt

The use of biopolymers for probiotic microencapsulation has been investigated in this paper. The objectives are to enhance its survival rate, colonic release, and stability of these probiotic cultures in digestive condition during storage time. Nine types of biopolymers (alginate-psyllium) blend with different concentration of prebiotic; (inulin or fenugreek) were used as candidate for microencapsulation matrix. One strain of probiotic candidates, namely; Enterococcus durans 39C was used in this study. The microencapsulation of this strain with the respective polymer blend was performed by using a simple extrusion method. All blend of formulations have recorded high encapsulation efficiency at value >98%. The survival rate of viable probiotic cells under simulated digestive conditions was also high with value above 47% as compared to non-microencapsulated cells. These nine gel formulations also displayed the high survival rate of viable probiotic cells during storage time (28 d). Their release occurred after 2 h in colonic condition and sustained until 12th h of incubation period. An increase of prebiotic effect value added was observed in incorporated inulin and fenugreek formulations. In short, this study revealed that a new herbal-based psyllium and fenugreek polymers have suitable potential as a matrix for probiotic microencapsulation.