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Freitas SM, Franco B, Saragiotto G, Morais MA, Simabuco FM, Cunha DT, Esteves AM, Antunes AEC. Effect of a probiotic fermented milk supplementation on behavior and sleep. Nutr Neurosci 2024; 27:607-619. [PMID: 37496309 DOI: 10.1080/1028415x.2023.2240990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
This study attempted to analyze the effect of supplementing Wistar-Kyoto rats with fermented milk containing the probiotic Bifidobacterium animalis BB-12 and pomegranate juice on the microbiota-gut-brain axis of rats, with special focus on their behavior, sleep patterns, and response to stress. This study was divided into two experiments: (1) For the behavioral analysis the animals were divided into two groups: Fermented probiotic milk (BB + 1) and control (BB-). (2) For the sleep analysis the animals were divided into two groups: Fermented probiotic milk (BB + 2) and control (H2O). For the behavioral analysis, the open field method was used, which evaluates the behavior after ten, twenty, and thirty days of supplementation. For sleep analysis, the animals were submitted to implantation of electrodes and 24 h polysomnography, followed by 48 h sleep deprivation (REM) and 48 h polysomnography, then euthanized 100 days after the beginning of the experiment. In addition, animal feces were collected before and after sleep deprivation to assess its effects on the microbiota. A decrease in anxiety-related behaviors was observed in the supplemented animals and an increase in sleep efficiency and a reduction in the number of awakenings of the animals before deprivation. It has also been observed that sleep deprivation decreased the amount of total bacterial DNA. The number of copies of genomes of the genus Bifidobacterium did not differ in both groups.
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Affiliation(s)
- Samara M Freitas
- School of Applied Sciences, University of Campinas, Limeira, Brazil
| | - Beatriz Franco
- School of Physical Education, University of Campinas, Campinas, Brazil
| | | | - Milca A Morais
- School of Applied Sciences, University of Campinas, Limeira, Brazil
| | | | - Diogo T Cunha
- School of Applied Sciences, University of Campinas, Limeira, Brazil
| | - Andrea M Esteves
- School of Applied Sciences, University of Campinas, Limeira, Brazil
- School of Physical Education, University of Campinas, Campinas, Brazil
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Hasanian-Langroudi F, Ghasemi A, Hedayati M, Siadat SD, Tohidi M. Novel Insight into the Effect of Probiotics in the Regulation of the Most Important Pathways Involved in the Pathogenesis of Type 2 Diabetes Mellitus. Probiotics Antimicrob Proteins 2024; 16:829-844. [PMID: 37162668 DOI: 10.1007/s12602-023-10056-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 05/11/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is considered one of the most common disorders worldwide. Although several treatment modalities have been developed, the existing interventions have not yielded the desired results. Therefore, researchers have focused on finding treatment choices with low toxicity and few adverse effects that could control T2DM efficiently. Various types of research on the role of gut microbiota in developing T2DM and its related complications have led to the growing interest in probiotic supplementation. Several properties make these organisms unique in terms of human health, including their low cost, high reliability, and good safety profile. Emerging evidence has demonstrated that three of the most important signaling pathways, including nuclear factor kappa B (NF-κB), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), and nuclear factor erythroid 2-related factor 2 (Nrf2), which involved in the pathogenesis of T2DM, play key functions in the effects of probiotics on this disease. Hence, we will focus on the clinical applications of probiotics in the management of T2DM. Then, we will also discuss the roles of the involvement of various probiotics in the regulation of the most important signaling pathways (NF-κB, PI3K/Akt, and Nrf2) involved in the pathogenesis of T2DM.
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Affiliation(s)
- Farzaneh Hasanian-Langroudi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box, Tehran, 19395-4763, Iran
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.
- Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran.
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box, Tehran, 19395-4763, Iran.
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3
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Penha Rodrigues Pereira E, Silva da Graça J, Manfrinato Ferreira B, Fasura Balthazar C, Xavier-Santos D, França Bezerril F, Magnani M, Sant'Ana AS. What are the main obstacles to turning foods healthier through probiotics incorporation? a review of functionalization of foods by probiotics and bioactive metabolites. Food Res Int 2024; 176:113785. [PMID: 38163702 DOI: 10.1016/j.foodres.2023.113785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
Functional foods are gaining significant attention from people all over the world. When added to foods, probiotic bacteria can turn them healthier and confer beneficial health effects, such as improving the immune system and preventing cancer, diabetes, and cardiovascular disease. However, adding probiotics to foods is a challenging task. The processing steps often involve high temperatures, and intrinsic food factors, such as pH, water activity, dissolved oxygen, post-acidification, packaging, and cold storage temperatures, can stress the probiotic strain and impact its viability. Moreover, it is crucial to consider these factors during food product development to ensure the effectiveness of the probiotic strain. Among others, techniques such as microencapsulation and lyophilization, have been highlighted as industrial food functionalization strategies. In this review, we present and discuss alternatives that may be used to functionalize foods by incorporating probiotics and/or delivering bioactive compounds produced by probiotics. We also emphasize the main challenges in different food products and the technological characteristics influencing them. The knowledge available here may contribute to overcoming the practical obstacles to food functionalization with probiotics.
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Affiliation(s)
| | - Juliana Silva da Graça
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Campinas, Brazil
| | - Beatriz Manfrinato Ferreira
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Campinas, Brazil
| | - Celso Fasura Balthazar
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Campinas, Brazil
| | - Douglas Xavier-Santos
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Campinas, Brazil
| | - Fabrícia França Bezerril
- Department of Food Engineering, Center of Technology, Federal University of Paraíba, Paraíba, Brazil
| | - Marciane Magnani
- Department of Food Engineering, Center of Technology, Federal University of Paraíba, Paraíba, Brazil.
| | - Anderson S Sant'Ana
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Campinas, Brazil
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Arriaga-Morales JJ, Ordaz-Pichardo C, Castro-Muñoz R, Durán-Páramo E. Attenuation of Hyperglycemia in Diabetic Rats Assisted by Immobilized Probiotic in Sodium Alginate. Probiotics Antimicrob Proteins 2023:10.1007/s12602-023-10166-3. [PMID: 37816987 DOI: 10.1007/s12602-023-10166-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/12/2023]
Abstract
Diabetes mellitus type 2 (DM2) is the most common chronic disease worldwide, characterized mainly by increased glucose concentration in the blood and affecting several organs' functionality. The daily consumption of probiotic bacteria can help control diabetes and reduce the damage caused. Cell immobilization techniques are a powerful tool that provides physical cell protection to such probiotic bacteria against gastrointestinal conditions. We suggest that cell immobilization could be a significant vector for delivering a high quantity of viable probiotics to the gut, helping attenuate hyperglycemia in diabetic rats. Seventy male Wistar rats were used in this work. Nicotinamide was administrated via intraperitoneal injection 15 minutes before inducing type 2 diabetes (DM2), followed by a second intraperitoneal injection of streptozotocin to induce DM2. Rats were divided into seven groups. For 45 days, a specific treatment was applied to each group. The group of rats, supplied with immobilized Lactobacillus casei, showed a serum glucose concentration of 137 mg/dL, which was close to the one observed in the groups of healthy rats (117 mg/dL) and rats treated with metformin (155 mg/dL). The diabetic rats without treatment presented a higher serum glucose concentration (461 mg/dL). In the rats treated with immobilized L. casei, there was no biochemical parameter alteration, and the cell morphology of the analyzed tissues was similar to those of the healthy group. The consumption of immobilized L. casei could allow a high quantity of viable probiotics to be delivered to the gut, reducing serum glucose concentration by up to 70% compared to diabetic rats and reducing organ damage caused by diabetes.
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Affiliation(s)
- José J Arriaga-Morales
- Laboratorio de Bioconversiones, Unidad Profesional Interdisciplinaria de Biotecnología, Instituto Politécnico Nacional, Av. Acueducto s/n, Col. La Laguna, Gustavo A. Madero, 07340, CDMX, Mexico
| | - Cynthia Ordaz-Pichardo
- Laboratorio de Biología Celular y Productos Naturales, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Guillermo Massieu Helguera 239, Col. La Escalera, Gustavo A. Madero, 07320, CDMX, Mexico
| | - Roberto Castro-Muñoz
- Tecnologico de Monterrey, Campus Toluca. Av. Eduardo Monroy Cárdenas 2000 San Antonio Buenavista, 50110, Toluca de Lerdo, Mexico.
- Department of Sanitary Engineering, Faculty of Civil and Environmental Engineering, Gdansk University of Technology, G. Narutowicza St. 11/12, 80 - 233, Gdansk, Poland.
| | - Enrique Durán-Páramo
- Laboratorio de Bioconversiones, Unidad Profesional Interdisciplinaria de Biotecnología, Instituto Politécnico Nacional, Av. Acueducto s/n, Col. La Laguna, Gustavo A. Madero, 07340, CDMX, Mexico.
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Gomes de Oliveira LI, Clementino JR, Salgaço MK, de Oliveira SPA, Dos Santos Lima M, Mesa V, de Souza EL, Vinderola CG, Magnani M, Sivieri K. Revealing the beneficial effects of a dairy infant formula on the gut microbiota of early childhood children with autistic spectrum disorder using static and SHIME® fermentation models. Food Funct 2023; 14:8964-8974. [PMID: 37724612 DOI: 10.1039/d3fo01156a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
This study evaluated the impact of the Milnutri Profutura® (MNP) dairy infant formula on the gut microbiota of early childhood children (three to five years) with Autistic Spectrum Disorder (ASD) using static fermentation (time zero, 24, and 48 h) and the Simulator of the Human Intestinal Microbiol Ecosystem (SHIME®) (time zero, 72 h, and 7 days). The relative abundance of selected intestinal bacterial groups, pH values, organic acids, and sugars were verified at time zero, 24, and 48 h using flow cytometry and measurements. In addition, the diversity and changes in the gut microbiota, and the amounts of acetic, butyric, and propionic acids and ammonium ions (NH4+) in fermentation using the SHIME® were measured at time zero, 72 h, and 7 days. MNP increased Lactobacillus/Enterococcus and Bifidobacterium populations and decreased Bacteroides/Prevotella, Clostridium histolyticum and Eubacterium rectale/Clostridium coccoides populations (p < 0.05) at 24 and 48 h of static fermentation, showing a positive prebiotic activity score (65.18 ± 0.07). The pH, fructose and glucose decreased, while lactic, butyric, and propionic acids increased (p < 0.05) at 48 h of static fermentation. MNP increased (p < 0.05) the Firmicutes phylum during the fermentation in SHIME®. MNP decreased the diversity at 72 h of fermentation, mostly by the increase (p < 0.05) in the Lactobacillus genus. Microbial groups considered harmful such as Lachnospiraceae, Negativicoccus, and Lachnoclostridium were inhibited after administration with MNP. Propionic and butyric acids increased at 72 h and NH4+ decreased (p < 0.05) at the end of fermentation with MNP. The results indicate MNP as an infant formula which may benefit the gut microbiota of children with ASD.
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Affiliation(s)
- Louise Iara Gomes de Oliveira
- Post-Graduate Program in Nutritional Sciences, Health Sciences Center, Federal University of Paraíba (Universidade Federal da Paraíba - UFPB), Brazil.
| | - Jéssika Rodrigues Clementino
- Post-Graduate Program in Nutritional Sciences, Health Sciences Center, Federal University of Paraíba (Universidade Federal da Paraíba - UFPB), Brazil.
| | - Mateus Kawata Salgaço
- Department of Food and Nutrition, Laboratory of Food Microbiology, School of Pharmaceutical Sciences, São Paulo State University, Brazil
| | - Sônia Paula Alexandrino de Oliveira
- Post-Graduate Program in Nutritional Sciences, Health Sciences Center, Federal University of Paraíba (Universidade Federal da Paraíba - UFPB), Brazil.
| | - Marcos Dos Santos Lima
- Department of Food Technology, Federal Institute of Sertão de Pernambuco, Campus Petrolina, Brazil
| | - Victoria Mesa
- Food and Human Nutrition Research Group, School of Nutrition and Dietetics, Universidad de Antioquia (UdeA), Medellín 050010, Colombia
| | - Evandro Leite de Souza
- Post-Graduate Program in Nutritional Sciences, Health Sciences Center, Federal University of Paraíba (Universidade Federal da Paraíba - UFPB), Brazil.
| | - Celso Gabriel Vinderola
- Department of Biotechnology and Food Technology, Faculty of Chemical Engineering, Universidad Nacional del Litoral
| | - Marciane Magnani
- Post-Graduate Program in Nutritional Sciences, Health Sciences Center, Federal University of Paraíba (Universidade Federal da Paraíba - UFPB), Brazil.
| | - Katia Sivieri
- Department of Food and Nutrition, Laboratory of Food Microbiology, School of Pharmaceutical Sciences, São Paulo State University, Brazil
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Barajas-Álvarez P, Haro-González JN, González-Ávila M, Espinosa-Andrews H. Gum Arabic/Chitosan Coacervates for Encapsulation and Protection of Lacticaseibacillus rhamnosus in Storage and Gastrointestinal Environments. Probiotics Antimicrob Proteins 2023:10.1007/s12602-023-10152-9. [PMID: 37668856 DOI: 10.1007/s12602-023-10152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
Probiotics, such as Lacticaseibacillus rhamnosus, are essential to the food industry for their health benefits to the host. The Lcb. rhamnosus strain is susceptible to processing, gastrointestinal, and storage conditions. In this study, Lcb. rhamnosus strains were encapsulated by complex coacervation in a gum arabic/chitosan or gum arabic/trehalose/chitosan and cross-linked with sodium tripolyphosphate. The physicochemical properties (zeta potential, water activity, water content, and hygroscopicity), encapsulation efficiency, and probiotic survival under storage conditions and simulated gastrointestinal fluids were evaluated. The results showed that crosslinking improves the encapsulation efficiency after drying; however, this result was remarkable when trehalose was used as a cryoprotectant. Furthermore, the encapsulation matrix preserved the viability of probiotics during 12 weeks with probiotic counts between 8.7-9.5, 7.5-9.0, and 5.2-7.4 log10 CFU g-1 at -20, 4, and 20 °C, respectively. After 12 days of digestion in an ex vivo simulator, acetic, butyric, propionic, and lactic acid production changed significantly, compared to free probiotic samples. This work shows that encapsulation by complex coacervation can promote the stability of probiotic bacteria in storage conditions and improve the viability of Lcb. rhamnosus HN001 during consumption so that they can exert their beneficial action in the organism.
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Affiliation(s)
- Paloma Barajas-Álvarez
- Food Technology, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A. C. Camino Arenero #1227, El Bajío del Arenal, 45019, Zapopan, Jalisco, Mexico
| | - José Nabor Haro-González
- Food Technology, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A. C. Camino Arenero #1227, El Bajío del Arenal, 45019, Zapopan, Jalisco, Mexico
| | - Marisela González-Ávila
- Medical and Pharmaceutical Biotechnology, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A. C. Av. Normalistas #800, Colinas de La Normal, 44270, Guadalajara, Jalisco, Mexico
| | - Hugo Espinosa-Andrews
- Food Technology, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A. C. Camino Arenero #1227, El Bajío del Arenal, 45019, Zapopan, Jalisco, Mexico.
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7
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Functional Fermented Milk with Fruit Pulp Modulates the In Vitro Intestinal Microbiota. Foods 2022; 11:foods11244113. [PMID: 36553855 PMCID: PMC9778618 DOI: 10.3390/foods11244113] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
The effect of putative probiotic fermented milk (FM) with buriti pulp (FMB) or passion fruit pulp (FMPF) or without fruit pulp (FMC) on the microbiota of healthy humans was evaluated. FM formulations were administered into a simulator of the human intestinal microbial ecosystem (SHIME®) to evaluate the viability of lactic acid bacteria (LAB), microbiota composition, presence of short-chain fatty acids (SCFA), and ammonium ions. The probiotic LAB viability in FM was affected by the addition of the fruit pulp. Phocaeicola was dominant in the FMPF and FMB samples; Bifidobacterium was related to FM formulations, while Alistipes was associated with FMPF and FMB, and Lactobacillus and Lacticaseibacillus were predominant in FMC. Trabulsiella was the central element in the FMC, while Mediterraneibacter was the central one in the FMPF and FMB networks. The FM formulations increased the acetic acid, and a remarkably high amount of propionic and butyric acids were detected in the FMB treatment. All FM formulations decreased the ammonium ions compared to the control; FMPF samples stood out for having lower amounts of ammonia. The probiotic FM with fruit pulp boosted the beneficial effects on the intestinal microbiota of healthy humans in addition to increasing SCFA in SHIME® and decreasing ammonium ions, which could be related to the presence of bioactive compounds.
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Santos D, Frota EG, Vargas BK, Tonieto Gris CC, Santos LFD, Bertolin TE. What is the role of phenolic compounds of yerba mate (Ilex paraguariensis) in gut microbiota? PHYTOCHEMISTRY 2022; 203:113341. [PMID: 35952769 DOI: 10.1016/j.phytochem.2022.113341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 06/15/2023]
Abstract
Diet actively influences gut microbiota and body homeostasis. The predominance of beneficial species results in symbiosis, while dysbiosis is characterized by an imbalance between microbial communities. Food plays a key role in this dynamic and in promoting the health of individuals. Ilex paraguariensis, also known as yerba mate, is a traditional plant from Latin America that has a complex matrix of bioactive substances, including methylxanthines, triterpenes, saponins, and phenolics. The consumption of yerba mate is associated with antioxidant, cardioprotective, anti-inflammatory, and anti-obesity effects. However, to the best of our knowledge, there have been no studies on yerba mate as a modulating agent of intestinal microbiota. Phenolics are the major compounds in yerba mate and have been reported to act in modulating the microbiome. In this review, we explore the activity of yerba mate as a possible stimulant of gut microbiota and present its main phenolics and their biological effects. We also propose different mechanisms of action of these phenolics and possible doses for their effectiveness.
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Affiliation(s)
- Daiane Santos
- Graduate Program in Food Science and Technology, University of Passo Fundo (UPF), Campus I, km 171, BR 285, CEP: 99001-970, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Elionio Galvão Frota
- Graduate Program in Food Science and Technology, University of Passo Fundo (UPF), Campus I, km 171, BR 285, CEP: 99001-970, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Bruna Krieger Vargas
- Graduate Program in Food Science and Technology, University of Passo Fundo (UPF), Campus I, km 171, BR 285, CEP: 99001-970, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Cintia Cassia Tonieto Gris
- Graduate Program in Food Science and Technology, University of Passo Fundo (UPF), Campus I, km 171, BR 285, CEP: 99001-970, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Lára Franco Dos Santos
- Graduate Program in Food Science and Technology, University of Passo Fundo (UPF), Campus I, km 171, BR 285, CEP: 99001-970, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Telma Elita Bertolin
- Graduate Program in Food Science and Technology, University of Passo Fundo (UPF), Campus I, km 171, BR 285, CEP: 99001-970, Passo Fundo, Rio Grande do Sul, Brazil.
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9
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Impact of orange juice containing potentially prebiotic ingredients on human gut microbiota composition and its metabolites. Food Chem 2022; 405:134706. [DOI: 10.1016/j.foodchem.2022.134706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022]
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Gibbons SM, Gurry T, Lampe JW, Chakrabarti A, Dam V, Everard A, Goas A, Gross G, Kleerebezem M, Lane J, Maukonen J, Penna ALB, Pot B, Valdes AM, Walton G, Weiss A, Zanzer YC, Venlet NV, Miani M. Perspective: Leveraging the Gut Microbiota to Predict Personalized Responses to Dietary, Prebiotic, and Probiotic Interventions. Adv Nutr 2022; 13:1450-1461. [PMID: 35776947 PMCID: PMC9526856 DOI: 10.1093/advances/nmac075] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 01/28/2023] Open
Abstract
Humans often show variable responses to dietary, prebiotic, and probiotic interventions. Emerging evidence indicates that the gut microbiota is a key determinant for this population heterogeneity. Here, we provide an overview of some of the major computational and experimental tools being applied to critical questions of microbiota-mediated personalized nutrition and health. First, we discuss the latest advances in in silico modeling of the microbiota-nutrition-health axis, including the application of statistical, mechanistic, and hybrid artificial intelligence models. Second, we address high-throughput in vitro techniques for assessing interindividual heterogeneity, from ex vivo batch culturing of stool and continuous culturing in anaerobic bioreactors, to more sophisticated organ-on-a-chip models that integrate both host and microbial compartments. Third, we explore in vivo approaches for better understanding of personalized, microbiota-mediated responses to diet, prebiotics, and probiotics, from nonhuman animal models and human observational studies, to human feeding trials and crossover interventions. We highlight examples of existing, consumer-facing precision nutrition platforms that are currently leveraging the gut microbiota. Furthermore, we discuss how the integration of a broader set of the tools and techniques described in this piece can generate the data necessary to support a greater diversity of precision nutrition strategies. Finally, we present a vision of a precision nutrition and healthcare future, which leverages the gut microbiota to design effective, individual-specific interventions.
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Affiliation(s)
| | - Thomas Gurry
- Pharmaceutical Biochemistry group, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland (PSI-WS), University of Geneva/University of Lausanne, Geneva, Switzerland
| | - Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Veerle Dam
- Sensus BV (Royal Cosun), Roosendaal, The Netherlands
| | - Amandine Everard
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université Catholique de Louvain, Brussels, Belgium
| | - Almudena Goas
- Department of Food, Nutrition, and Exercise Sciences, University of Surrey, Guildford, United Kingdom
| | - Gabriele Gross
- Medical and Scientific Affairs, Reckitt| Mead Johnson Nutrition Institute, Nijmegen, The Netherlands
| | - Michiel Kleerebezem
- Host Microbe Interactomics Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Jonathan Lane
- Health and Happiness Group, H&H Research, Cork, Ireland
| | | | - Ana Lucia Barretto Penna
- Department of Food Engineering and Technology, São Paulo State University, São José do Rio Preto, Brazil
| | - Bruno Pot
- Yakult Europe BV, Almere, The Netherlands
| | - Ana M Valdes
- Nottingham NIHR Biomedical Research Centre at the School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Gemma Walton
- Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Adrienne Weiss
- Yili Innovation Center Europe, Wageningen, The Netherlands
| | | | - Naomi V Venlet
- International Life Sciences Institute, European Branch, Brussels, Belgium
| | - Michela Miani
- International Life Sciences Institute, European Branch, Brussels, Belgium
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11
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Winiarska-Mieczan A, Tomaszewska E, Donaldson J, Jachimowicz K. The Role of Nutritional Factors in the Modulation of the Composition of the Gut Microbiota in People with Autoimmune Diabetes. Nutrients 2022; 14:2498. [PMID: 35745227 PMCID: PMC9227140 DOI: 10.3390/nu14122498] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 12/14/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) is a disease marked by oxidative stress, chronic inflammation, and the presence of autoantibodies. The gut microbiota has been shown to be involved in the alleviation of oxidative stress and inflammation as well as strengthening immunity, thus its' possible involvement in the pathogenesis of T1DM has been highlighted. The goal of the present study is to analyze information on the relationship between the structure of the intestinal microbiome and the occurrence of T1DM. The modification of the intestinal microbiota can increase the proportion of SCFA-producing bacteria, which could in turn be effective in the prevention and/or treatment of T1DM. The increased daily intake of soluble and non-soluble fibers, as well as the inclusion of pro-biotics, prebiotics, herbs, spices, and teas that are sources of phytobiotics, in the diet, could be important in improving the composition and activity of the microbiota and thus in the prevention of metabolic disorders. Understanding how the microbiota interacts with immune cells to create immune tolerance could enable the development of new therapeutic strategies for T1DM and improve the quality of life of people with T1DM.
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Affiliation(s)
- Anna Winiarska-Mieczan
- Department of Bromatology and Nutrition Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Akademicka St. 13, 20-950 Lublin, Poland;
| | - Ewa Tomaszewska
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Akademicka St. 12, 20-950 Lublin, Poland
| | - Janine Donaldson
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa;
| | - Karolina Jachimowicz
- Department of Bromatology and Nutrition Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Akademicka St. 13, 20-950 Lublin, Poland;
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12
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Barros de Medeiros VP, Salgaço MK, Pimentel TC, Rodrigues da Silva TC, Sartoratto A, Lima MDS, Sassi CFDC, Mesa V, Magnani M, Sivieri K. Spirulina platensis biomass enhances the proliferation rate of Lactobacillus acidophilus 5 (La-5) and combined with La-5 impact the gut microbiota of medium-age healthy individuals through an in vitro gut microbiome model. Food Res Int 2022; 154:110880. [PMID: 35337549 DOI: 10.1016/j.foodres.2021.110880] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022]
Abstract
This study first evaluated the stimulatory effect of S. platensis biomass on the growth of L. acidophilus and the metabolic activity during fermentation (37 °C, 72 h) in a culture medium. The results demonstrated a higher impact of S. platensis biomass than fructooligosaccharide (FOS), an established prebiotic. Higher L. acidophilus proliferation rates and metabolic activity were observed (lower pH values and higher concentrations of acetic, lactic, and propionic acids) in the presence of S. platensis. Then, we evaluated the effects of the S. platensis biomass (1.5 g, twice a day, 5 days) in association with L. acidophilus (106 CFU/g) on the gut microbiota composition of medium-age healthy individuals through the Simulator of Human Intestinal Microbial Ecosystem (SHIME®) and measurement of metabolites. L. acidophilus (La5) and L. acidophilus + S. platensis (Spi-La5) could positively modulate the intestinal microbiota. The administration of La5 resulted in increases in Bacteroides, Megasphaera, Lactobacillus, and Parabacteroides genus abundance, with a consequent decrease in ammonium ions. The administration of Spi-La5 increased the abundance of the genus Erysipelatoclostridium, Roseburia, Enterococcus, Bifidobacterium, Coriobacteriaceae UCG-003, Enterobacter, and Paraclostridium. The results demonstrate that the intestinal microbiota was differently modified by administrating La5 and Spi-La5 and indicate the latter as an alternative for microbiota positive modulation in healthy individuals.
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Affiliation(s)
| | - Mateus Kawata Salgaço
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | | | | | - Adilson Sartoratto
- Pluridisciplinary Center for Chemical, Biological and Agricultural Research (CPQBA), UNICAMP, Brazil
| | - Marcos Dos Santos Lima
- Departament of Food Technology, Federal Institute of Sertão Pernambucano, Pernambuco, Brazil
| | | | - Victoria Mesa
- Food and Human Nutrition Research Group, University of Antioquia, Medellín, Colombia
| | - Marciane Magnani
- Department of Food Engineering, Center of Technology, Federal University of Paraíba, PB, Brazil.
| | - Katia Sivieri
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
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13
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Sharma H, Ozogul F, Bartkiene E, Rocha JM. Impact of lactic acid bacteria and their metabolites on the techno-functional properties and health benefits of fermented dairy products. Crit Rev Food Sci Nutr 2021:1-23. [PMID: 34845955 DOI: 10.1080/10408398.2021.2007844] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
After conversion of lactose to lactic acid, several biochemical changes occur such as enhanced protein digestibility, fatty acids release, and production of bioactive compounds etc. during the fermentation process that brings nutritional and quality improvement in the fermented dairy products (FDP). A diverse range of lactic acid bacteria (LAB) is being utilized for the development of FDP with specific desirable techno-functional attributes. This review contributes to the knowledge of basic pathways and changes during fermentation process and the current research on techniques used for identification and quantification of metabolites. The focus of this article is mainly on the metabolites responsible for maintaining the desired attributes and health benefits of FDP as well as their characterization from raw milk. LAB genera including Lactobacillus, Streptococcus, Leuconostoc, Pediococcus and Lactococcus are involved in the fermentation of milk and milk products. LAB species accrue these benefits and desirable properties of FDP producing the bioactive compounds and metabolites using homo-fermentative and heterofermentative pathways. Generation of metabolites vary with incubation and other processing conditions and are analyzed and quantified using highly advanced and sophisticated instrumentation including nuclear magnetic resonance, mass-spectrometry based techniques. Health benefits of FDP are mainly possible due to the biological roles of such metabolites that also cause technological improvements desired by dairy manufacturers and consumers.
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Affiliation(s)
- Heena Sharma
- Food Technology Lab, Dairy Technology Division, ICAR-National Dairy Research Institute, Karnal, Haryana, India
| | - Fatih Ozogul
- Department of Seafood Processing Technology, Faculty of Fisheries, University of Cukurova, Adana, Turkey
| | - Elena Bartkiene
- Institute of Animal Rearing Technologies, Faculty of Animal Sciences, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - João Miguel Rocha
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Department of Chemical Engineering (DEQ), Faculty of Engineering, University of Porto FEUP), Porto, Portugal
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14
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Pimentel TC, de Oliveira LIG, de Souza RC, Magnani M. Probiotic ice cream: A literature overview of the technological and sensory aspects and health properties. INT J DAIRY TECHNOL 2021. [DOI: 10.1111/1471-0307.12821] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Tatiana Colombo Pimentel
- Federal Institute of Paraná Campus Paranavaí Paranavaí PR 87736‐536Brazil
- State University of Maringá Food Engineering Post‐Graduation Maringá PR 87020‐900Brazil
| | | | | | - Marciane Magnani
- Department of Food Engineering University of Paraíba João Pessoa PB 58051‐900 Brazil
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15
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Duque ALRF, Demarqui FM, Santoni MM, Zanelli CF, Adorno MAT, Milenkovic D, Mesa V, Sivieri K. Effect of probiotic, prebiotic, and synbiotic on the gut microbiota of autistic children using an in vitro gut microbiome model. Food Res Int 2021; 149:110657. [PMID: 34600659 DOI: 10.1016/j.foodres.2021.110657] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/29/2022]
Abstract
Imbalances in gut microbiota composition occur in individuals with autism spectrum disorder (ASD). The administration of probiotics, prebiotics, and synbiotics is emerging as a potential and promising strategy for regulating the gut microbiota and improving ASD-related symptoms. We first investigated the survival of the probiotics Limosilactobacillus (L.) reuteri and Bifidobacterium (B.) longum alone, mixed and combined with a galacto-oligosaccharide (GOS) under simulated gastrointestinal conditions. Next, we evaluated the impact of probiotics (L. reuteri + B. longum), prebiotic (GOS), and synbiotic (L. reuteri + B. longum + GOS) on gut microbiota composition and metabolism of children with ASD using an in vitro fermentation model (SHIME®). The combination of L. reuteri, B. longum, and GOS showed elevated gastrointestinal resistance. The probiotic, prebiotic, and synbiotic treatments resulted in a positive modulation of the gut microbiota and metabolic activity of children with ASD. More specifically, the probiotic treatment increased the relative abundance of Lactobacillus, while the prebiotic treatment increased the relative abundance of Bifidobacterium and decreased the relative abundance of Lachnoclostridium. Changes in microbial metabolism were associated with increased short-chain fatty acid concentrations and reduced ammonium levels, particularly in the prebiotic and synbiotic treatments.
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Affiliation(s)
- Ana Luiza Rocha Faria Duque
- Department of Food and Nutrition, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | - Fernanda Manaia Demarqui
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | - Mariana Marchi Santoni
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | - Cleslei Fernando Zanelli
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | - Maria Angela Tallarico Adorno
- Department of Hydraulics and Sanitation, School of Engineering of São Carlos, University of São Paulo (USP), São Carlos, Brazil
| | - Dragan Milenkovic
- Department of Internal Medicine, UC Davis School of Medicine, University of California, Davis, United States; INRAE, UNH, Université Clermont Auvergne, St Genes Champanelle, France
| | - Victoria Mesa
- Faculty of Pharmacy, Paris University, Paris, France; Food and Human Nutrition Research Group, University of Antioquia, Medellín, Colombia
| | - Katia Sivieri
- Department of Food and Nutrition, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil.
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16
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Puntillo M, Spotti J, Salminen S, Vinderola G. Narrowing down the number of potential plant-based probiotic candidates by successive in vitro, technological and in vivo assays. Benef Microbes 2021; 12:45-58. [PMID: 34259617 DOI: 10.3920/bm2020.0228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The interest on plant-based fermented food is in raise in Western countries. The aim of this study was to select interleukin (IL)-10 inducing strains for the development of potential probiotic plant-based fermented foods. Departing from a collection of 52 lactic acid bacteria (LAB) strains derived from plant material, in vitro co-culture with murine macrophages allowed us to narrow down the number of candidates to 21 strains able to induce IL-10 secretion. 14 of these strains were able to promote the production of tumour necrosis factor-α too. The capacity to induce IL-6 was used to further reduce the number of strains to 4, from which Lactiplantibacillus plantarum subsp. plantarum LpAv was selected to ferment oat and carrots. L. plantarum LpAv was able to ferment oat and carrots until reaching counts of ca. 108 and 109 cfu/ml. Fermented oat and carrots were orally administered to mice for 10 consecutive days and challenged with a single infective dose of Salmonella enterica serovar. Typhimurium. Counts of L. plantarum LpAv in fermented carrots were 9.23±0.05 cfu/ml and 9.27±0.01 cfu/ml, at day 1 and 10 of the feeding period. Fermented carrots were able to confer enhanced protection (80% of survival) against infection, when compared to control mice (less than 25% of survival). However, L. plantarum LpAv administered as pure culture was not able to confer protection against Salmonella infection. L. plantarum LpAv was selected among 52 plant-derived LAB and it was able to ferment oat and carrots, being only fermented carrots able to confer enhanced protection against Salmonella infection. A succession of in vitro to in vivo tests is proposed as a tool to narrow down the number of candidates when searching for potential novel probiotics from a collection of autochthonous strains.
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Affiliation(s)
- M Puntillo
- Instituto de Lactología Industrial (CONICET-UNL), Facultad de Ingeniería Química, Universidad Nacional del Litoral, Santiago del Estero 2829, Santa Fe, 3000, Argentina
| | - J Spotti
- Instituto de Tecnología de Alimentos, Facultad de Ingeniería Química, Universidad Nacional del Litoral, 1 de Mayo 3250, Santa Fe, 3000, Argentina
| | - S Salminen
- Functional Foods Forum, Faculty of Medicine, University of Turku, Itäinenpitkäkatu 4 A, Turku, 20014, Finland
| | - G Vinderola
- Instituto de Lactología Industrial (CONICET-UNL), Facultad de Ingeniería Química, Universidad Nacional del Litoral, Santiago del Estero 2829, Santa Fe, 3000, Argentina
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Machado Ribeiro TR, Salgaço MK, Adorno MAT, da Silva MA, Piazza RMF, Sivieri K, Moreira CG. Human microbiota modulation via QseC sensor kinase mediated in the Escherichia coli O104:H4 outbreak strain infection in microbiome model. BMC Microbiol 2021; 21:163. [PMID: 34078285 PMCID: PMC8170955 DOI: 10.1186/s12866-021-02220-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/06/2021] [Indexed: 01/01/2023] Open
Abstract
Background The intestinal microbiota plays a crucial role in human health, adjusting its composition and the microbial metabolites protects the gut against invading microorganisms. Enteroaggregative E. coli (EAEC) is an important diarrheagenic pathogen, which may cause acute or persistent diarrhea (≥14 days). The outbreak strain has the potent Shiga toxin, forms a dense biofilm and communicate via QseBC two-component system regulating the expression of many important virulence factors. Results Herein, we investigated the QseC histidine sensor kinase role in the microbiota shift during O104:H4 C227–11 infection in the colonic model SHIME® (Simulator of the Human Intestinal Microbial Ecosystem) and in vivo mice model. The microbiota imbalance caused by C227–11 infection affected ỿ-Proteobacteria and Lactobacillus spp. predominance, with direct alteration in intestinal metabolites driven by microbiota change, such as Short-chain fatty acids (SCFA). However, in the absence of QseC sensor kinase, the microbiota recovery was delayed on day 3 p.i., with change in the intestinal production of SCFA, like an increase in acetate production. The higher predominance of Lactobacillus spp. in the microbiota and significant augmented qseC gene expression levels were also observed during C227–11 mice infection upon intestinal depletion. Novel insights during pathogenic bacteria infection with the intestinal microbiota were observed. The QseC kinase sensor seems to have a role in the microbiota shift during the infectious process by Shiga toxin-producing EAEC C227–11. Conclusions The QseC role in C227–11 infection helps to unravel the intestine microbiota modulation and its metabolites during SHIME® and in vivo models, besides they contribute to elucidate bacterial intestinal pathogenesis and the microbiota relationships. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02220-3.
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Affiliation(s)
- Tamara Renata Machado Ribeiro
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Mateus Kawata Salgaço
- Department of Food and Nutrition, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Maria Angela Tallarico Adorno
- Department of Hydraulics and Sanitation, School of Engineering of São Carlos, University of São Paulo (USP), São Carlos, SP, Brazil
| | | | | | - Katia Sivieri
- Department of Food and Nutrition, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Cristiano Gallina Moreira
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, SP, Brazil.
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18
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Salgaço MK, Perina NP, Tomé TM, Mosquera EMB, Lazarini T, Sartoratto A, Sivieri K. Probiotic infant cereal improves children's gut microbiota: Insights using the Simulator of Human Intestinal Microbial Ecosystem (SHIME®). Food Res Int 2021; 143:110292. [PMID: 33992391 DOI: 10.1016/j.foodres.2021.110292] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/27/2021] [Accepted: 02/27/2021] [Indexed: 02/08/2023]
Abstract
Infant́s gut microbiota can be modulated by many factors, including mode of delivery, feeding regime, maternal diet/weight and probiotic and prebiotic consumption. The gut microbiota in dysbiosis has been associated with innumerous diseases. In this sense, early childhood intestinal microbiome modulation can be a strategy for disease prevention. This study had the purpose to evaluate the effect of an infant cereal with probiotic (Bifidobacterium animalis ssp. lactis BB-12®) on infant́s intestinal microbiota using SHIME®, which simulates human gastrointestinal conditions. The ascending colon was inoculated with fecal microbiota from three children (2-3 years old). NH4+, short chain fatty acids (SCFASs) and microbiota composition were determined by selective ion electrode, GC/MS and 16S sequencing, respectively. After treatment, butyric acid production increased (p < 0.05) 52% and a decrease in NH4+ production was observed (p < 0.01). The treatment stimulated an increase (p < 0.01) of Lactobacillaceae families, more precisely L. gasseri and L. kefiri. L. gasseri has been associated with the prevention of allergic rhinitis in children and L. kefiri in the prevention of obesity. Thus, infant cereal with BB-12® is able to stimulate the growth of L. gasseri and L. kefiri in a beneficial way, reducing NH4+ and increasing the production of SCFAs, especially butyric acid, in SHIME®.
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Affiliation(s)
- Mateus Kawata Salgaço
- Department of Food and Nutrition, School of Pharmaceutical Science, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Natália Partis Perina
- Medical, Scientific and Regulatory Affairs - Nestlé Nutrition/Nestlé Brazil Ltda, São Paulo, Brazil
| | - Thaís Moreno Tomé
- Medical, Scientific and Regulatory Affairs - Nestlé Nutrition/Nestlé Brazil Ltda, São Paulo, Brazil
| | | | - Tamara Lazarini
- Medical, Scientific and Regulatory Affairs - Nestlé Nutrition/Nestlé Brazil Ltda, São Paulo, Brazil
| | | | - Katia Sivieri
- Department of Food and Nutrition, School of Pharmaceutical Science, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil.
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Pimentel TC, Gomes de Oliveira LI, Carvalho de Souza R, Magnani M. Probiotic non-dairy frozen dessert: Technological and sensory aspects and industrial challenges. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2020.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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