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Mysore Saiprasad S, Moreno OG, Savaiano DA. A Narrative Review of Human Clinical Trials to Improve Lactose Digestion and Tolerance by Feeding Bifidobacteria or Galacto-Oligosacharides. Nutrients 2023; 15:3559. [PMID: 37630749 PMCID: PMC10459152 DOI: 10.3390/nu15163559] [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: 07/10/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Supplementation with the probiotic Bifidobacterium and prebiotic galacto-oligosaccharides (GOS) could improve gut health and benefit lactose intolerant individuals. A narrative review was conducted to identify human clinical trials that evaluated lactose digestion and/or tolerance in response to consumption of Bifidobacterium, GOS, or both. A total of 152 studies on Bifidobacterium and GOS or both were published between 1983 and 2022. Out of the 152 studies, 20 were human clinical trials conducted in lactose intolerant subjects; 8 studies were conducted with Bifidobacterium supplementation and 3 studies involved GOS supplementation. Five studies reported favorable outcomes of Bifidobacterium supplementation in managing lactose intolerance (LI). Similarly, three studies reported favorable outcomes with GOS supplementation. The other three studies reported neutral outcomes. In conclusion, most studies reported a favorable effect of Bifidobacterium and GOS on managing the symptoms of LI. No study has examined the effects of combined supplementation with Bifidobacterium and GOS in lactose intolerant subjects. Future research could examine if co-supplementation with Bifidobacterium and GOS is a more effective strategy to reduce the dairy discomfort in LI individuals.
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Affiliation(s)
- Sindusha Mysore Saiprasad
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN 47907, USA;
| | | | - Dennis A. Savaiano
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN 47907, USA;
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Gao H, Li X, Chen X, Hai D, Wei C, Zhang L, Li P. The Functional Roles of Lactobacillus acidophilus in Different Physiological and Pathological Processes. J Microbiol Biotechnol 2022; 32:1226-1233. [PMID: 36196014 PMCID: PMC9668099 DOI: 10.4014/jmb.2205.05041] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022]
Abstract
Probiotics are live microorganisms that can be consumed by humans in amounts sufficient to offer health-promoting effects. Owing to their various biological functions, probiotics are widely used in biological engineering, industry and agriculture, food safety, and the life and health fields. Lactobacillus acidophilus (L. acidophilus), an important human intestinal probiotic, was originally isolated from the human gastrointestinal tract and its functions have been widely studied ever since it was named in 1900. L. acidophilus has been found to play important roles in many aspects of human health. Due to its good resistance against acid and bile salts, it has broad application prospects in functional, edible probiotic preparations. In this review, we explore the basic characteristics and biological functions of L. acidophilus based on the research progress made thus far worldwide. Various problems to be solved regarding the applications of probiotic products and their future development are also discussed.
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Affiliation(s)
- Huijuan Gao
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, 308 Ningxia Road, Qingdao 266071, P.R. China
| | - Xin Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, 308 Ningxia Road, Qingdao 266071, P.R. China
| | - Xiatian Chen
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, 308 Ningxia Road, Qingdao 266071, P.R. China
| | - Deng Hai
- Department of Chemistry, University of Aberdeen, Aberdeen, AB243UE, UK
| | - Chuang Wei
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, 308 Ningxia Road, Qingdao 266071, P.R. China
| | - Lei Zhang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, 308 Ningxia Road, Qingdao 266071, P.R. China,Corresponding authors L. Zhang Phone +86 18660263885 E-mail:
| | - Peifeng Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, 308 Ningxia Road, Qingdao 266071, P.R. China,
P. Li E-mail:
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Improvement in Lactose Tolerance in Hypolactasic Subjects Consuming Ice Creams with High or Low Concentrations of Bifidobacterium bifidum 900791. Foods 2021; 10:foods10102468. [PMID: 34681517 PMCID: PMC8535838 DOI: 10.3390/foods10102468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/24/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022] Open
Abstract
Although Bifidobacterium bifidum expresses lactase activity, no clinical trials have determined its impact on lactose-intolerant subjects. This study evaluated whether acute and chronic ingestion of ice creams containing B. bifidum 900791 at high (107 CFU/g) or low (105 CFU/g) concentrations improved lactose tolerance in hypolactasic subjects. Fifty subjects were selected based on a positive lactose (20 g) hydrogen breath test (HBT0) and the presence of digestive symptoms. The recruited subjects were required to perform breath tests after the acute ingestion of: (1) ice cream containing 20 g of lactose without a probiotic (HBT1); (2) the same ice cream, accompanied by a lactase tablet (HBT2); (3) the same ice cream containing the low or high dose of probiotic (HBT3-LD and HBT3-HD); and (4) after the chronic consumption of the ice cream without (placebo) or with the low concentration of probiotic for 1 month (HBT4). Significant decreases in H2 excretion during HBT2 and HBT3-HD as well as digestive symptoms during HBT2, HBT3-HD and HBT3-LD were observed compared to HBT0 and HBT1, while the orocecal transit time increased. Chronic consumption of the probiotic ice cream did not enhance lactose tolerance compared to the placebo. These results suggest that the acute ingestion of ice cream containing high or low concentrations of B. bifidum 900791 improves lactose tolerance in hypolactasic subjects.
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Abstract
The aim of this review was to present various topics related to lactose intolerance with special attention given to the role of fermented foods and probiotics in alleviating gastrointestinal symptoms. Lactose intolerance is a common digestive problem in which the human body is unable to digest lactose, known as milk sugar. Lactose intolerance can either be hereditary or a consequence of intestinal diseases. Recent work has demonstrated that fermented dairy products and probiotics can modify the metabolic activities of colonic microbiota and may alleviate the symptoms of lactose intolerance. We suggest that, lactose free dairy products could be recommended as alternatives for the alleviation of lactose intolerance and for the promotion of human health and wellness.
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Masoumi SJ, Mehrabani D, Saberifiroozi M, Fattahi MR, Moradi F, Najafi M. The effect of yogurt fortified with Lactobacillus acidophilus and Bifidobacterium sp. probiotic in patients with lactose intolerance. Food Sci Nutr 2021; 9:1704-1711. [PMID: 33747481 PMCID: PMC7958570 DOI: 10.1002/fsn3.2145] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
This study assessed the effect of probiotic yogurt fortified with Lactobacillus acidophilus and Bifidobacterium sp. in patients with lactose intolerance. Fifty-five patients suffering from lactose intolerance were randomly divided into control group of 28 lactose intolerance patients who received nonprobiotic yogurt (100 ml) and experimental group consisted of 27 lactose intolerance patients who received probiotic yogurt fortified (100 ml) with L. acidophilus and Bifidobacterium sp. Each individual received yogurt for one week. Lactose intolerance was confirmed when the patients received 75 g lactose and were positive after 30 min until 3 hr for lactose intolerance symptoms and by hydrogen breath test (HBT). After intervention, the hydrogen level was lower in experimental group in comparison with the control group. Lactose intolerance symptoms in experimental group were much less than the control group. Our findings revealed that probiotic yogurt fortified with L. acidophilus and Bifidobacterium sp. could safely and effectively decrease lactose intolerance symptoms and HBT, so our probiotic can be recommended as a treatment of choice in lactose intolerance patients.
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Affiliation(s)
- Seyed Jalil Masoumi
- Nutrition Research CenterSchool of Nutrition and Food SciencesShiraz University of Medical ScienceShirazIran
- Gastroenterohepatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Davood Mehrabani
- Stem Cell Technology Research CenterShiraz University of Medical SciencesShirazIran
- Burn and Wound Healing Research CenterShiraz University of Medical SciencesShirazIran
- Comparative and Experimental Medicine CenterShiraz University of Medical SciencesShirazIran
| | - Mehdi Saberifiroozi
- Digestive Disease Research CenterDigestive Disease Research InstituteTehran University of Medical ScienceTehranIran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Fariba Moradi
- Office of Vice President for Health AffairsShiraz University of Medical SciencesShirazIran
| | - Masoud Najafi
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
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Leis R, de Castro MJ, de Lamas C, Picáns R, Couce ML. Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials. Nutrients 2020; 12:nu12051487. [PMID: 32443748 PMCID: PMC7284493 DOI: 10.3390/nu12051487] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023] Open
Abstract
Lactose intolerance (LI) is characterized by the presence of primarily gastrointestinal clinical signs resulting from colonic fermentation of lactose, the absorption of which is impaired due to a deficiency in the lactase enzyme. These clinical signs can be modified by several factors, including lactose dose, residual lactase expression, concurrent ingestion of other dietary components, gut-transit time, and enteric microbiome composition. In many of individuals with lactose malabsorption, clinical signs may be absent after consumption of normal amounts of milk or, in particular, dairy products (yogurt and cheese), which contain lactose partially digested by live bacteria. The intestinal microbiota can be modulated by biotic supplementation, which may alleviate the signs and symptoms of LI. This systematic review summarizes the available evidence on the influence of prebiotics and probiotics on lactase deficiency and LI. The literature search was conducted using the MEDLINE (via PUBMED) and SCOPUS databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included randomized controlled trials. For each study selected, the risk of bias was assessed following the Cochrane Collaboration methodology. Our findings showed varying degrees of efficacy but an overall positive relationship between probiotics and LI in relation to specific strains and concentrations. Limitations regarding the wide heterogeneity between the studies included in this review should be taken into account. Only one study examined the benefits of prebiotic supplementation and LI. So further clinical trials are needed in order to gather more evidence.
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Affiliation(s)
- Rosaura Leis
- Department of Pediatrics, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain; (M.-J.d.C.); (R.P.); (M.L.C.)
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain
- CIBEROBN, Instituto Salud Carlos III, 28029 Madrid, Spain
- Facultad de Medicina, Departamento de Pediatría, Universidad de Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Correspondence: ; Tel.: +34-981-951-116
| | - María-José de Castro
- Department of Pediatrics, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain; (M.-J.d.C.); (R.P.); (M.L.C.)
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain
- CIBERER, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Carmela de Lamas
- Facultad de Medicina, Departamento de Pediatría, Universidad de Santiago de Compostela, 15704 Santiago de Compostela, Spain;
| | - Rosaura Picáns
- Department of Pediatrics, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain; (M.-J.d.C.); (R.P.); (M.L.C.)
| | - María L. Couce
- Department of Pediatrics, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain; (M.-J.d.C.); (R.P.); (M.L.C.)
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain
- Facultad de Medicina, Departamento de Pediatría, Universidad de Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- CIBERER, Instituto Salud Carlos III, 28029 Madrid, Spain
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A combination of acid lactase from Aspergillus oryzae and yogurt bacteria improves lactose digestion in lactose maldigesters synergistically: A randomized, controlled, double-blind cross-over trial. Clin Nutr 2015; 34:394-9. [DOI: 10.1016/j.clnu.2014.06.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 05/29/2014] [Accepted: 06/27/2014] [Indexed: 01/24/2023]
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Pyar H, Liong MT, Peh K. Recent Advances in Probiotics and Biomedical Applications. JOURNAL OF MEDICAL SCIENCES 2013. [DOI: 10.3923/jms.2013.601.614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Influence of lactose and lactate on growth and β-galactosidase activity of potential probiotic Propionibacterium acidipropionici. Anaerobe 2012; 18:25-30. [DOI: 10.1016/j.anaerobe.2011.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 12/01/2011] [Accepted: 12/06/2011] [Indexed: 11/22/2022]
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Abstract
Malabsorption syndrome encompasses numerous clinical entities that result in chronic diarrhea, abdominal distention, and failure to thrive. These disorders may be congenital or acquired and include cystic fibrosis and Shwachman-Diamond syndrome; the rare congenital lactase deficiency; glucose-galactose malabsorption; sucrase-isomaltase deficiency; adult-type hypolactasia leading to acquired lactose intolerance. The pathology may be due to impairment in absorption or digestion of nutrients resulting in Nutritional deficiency, gastrointestinal symptoms, and extra gastrointestinal symptoms. Treatment is aimed at correcting the deficiencies and symptoms to improve quality of life. Common disorders of malabsorption celiac disease, pernicious anemia, and lactase deficiency are discussed in this article.
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Affiliation(s)
- Zafreen Siddiqui
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5909 Harry Hines Boulevard, Suite 100, Dallas, TX 75390-9067, USA.
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Rabot S, Rafter J, Rijkers GT, Watzl B, Antoine JM. Guidance for substantiating the evidence for beneficial effects of probiotics: impact of probiotics on digestive system metabolism. J Nutr 2010; 140:677S-89S. [PMID: 20107147 DOI: 10.3945/jn.109.113738] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Probiotic bacteria have been studied for their potential impact on the metabolism of dietary components in the small intestine lumen including lactose digestion, metabolism of lipids such as cholesterol, and oxalate metabolism. In the large intestine, they contribute to the metabolism of otherwise indigestible dietary carbohydrates (e.g., prebiotics) and have a favorable effect on colonic protein and ammonia metabolism, although their effect on the digestive fate of phytochemicals and xenobiotics is still uncertain. Probiotics also influence metabolism in the host tissues, in particular the gastrointestinal mucosa and the liver. Underlying mechanisms include supply of additional enzymatic activities in the gut lumen and alterations of the composition or metabolic pattern of the gut resident microbiota. For future studies, selection of probiotic strains should include assessment of their metabolic activities, and the outcome of the intervention studies should also take into account the composition of the probiotic matrix and the background diet of the target population. New technologies such as metabolomics hold great promise for assessment of probiotics functionality.
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Affiliation(s)
- Sylvie Rabot
- INRA, UR 910 Ecology and Physiology of the Digestive Tract, F-78350 Jouy-en-Josas, France
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Wang CY, Ng CC, Su H, Tzeng WS, Shyu YT. Probiotic potential of noni juice fermented with lactic acid bacteria and bifidobacteria. Int J Food Sci Nutr 2009; 60 Suppl 6:98-106. [DOI: 10.1080/09637480902755095] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rishi P, Mavi SK, Bharrhan S, Shukla G, Tewari R. Protective efficacy of probiotic alone or in conjunction with a prebiotic in Salmonella-induced liver damage. FEMS Microbiol Ecol 2009; 69:222-30. [PMID: 19496820 DOI: 10.1111/j.1574-6941.2009.00703.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In view of the increasing interest in the bioecological and nutritional control of diseases, use of probiotics alone or in combination with prebiotics (synbiotics) appears as a therapeutic option for various diseases. In this study, an attempt was made to explore the protective potential of Lactobacillus acidophilus as a probiotic, inulin as a prebiotic and both L. acidophilus and inulin as synbiotic against Salmonella-induced liver damage in a murine model. The probiotic, prebiotic and synbiotic supplementation resulted in decreased bacterial translocation in the liver of mice challenged with Salmonella typhimurium and decreased levels of serum aminotransferases, suggesting their protective role against Salmonella infection. Mice supplemented with these preparations before Salmonella challenge also revealed decreased levels of lipid peroxidation, increased levels of superoxide dismutase and glutathione, along with reduced levels of nitric oxide. Thus, bacteriological and biochemical alterations correlated well with the histological evidence. Protection afforded by supplementation with the probiotic alone was found to be more effective. None of the observations was suggestive of the synergistic effect in the synbiotic-supplemented animals. Thus, it is indicated that the probiotic and the prebiotic used in the present study may act by different mechanisms involved in affording protection against Salmonella-induced liver damage.
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Affiliation(s)
- Praveen Rishi
- Department of Microbiology, Panjab University, Chandigarh, India.
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Abstract
BACKGROUND Probiotics, defined as live micro-organisms with beneficial effects for the host, are widely applied in gastrointestinal and liver diseases. AIM AND METHOD To review the available evidence of clinical trials on probiotics in gastrointestinal and liver diseases, with a major focus on irritable bowel syndrome, inflammatory bowel disease, pancreatitis and chronic liver diseases. RESULTS Evidence for the therapeutic or preventive application of particular probiotic strains is available for antibiotic-associated diarrhoea, rota-virus-associated diarrhoea and pouchitis. Results are encouraging for irritable bowel syndrome, ulcerative colitis and for reducing side effects by Helicobacter pylori eradication therapies, but are less clear for Crohn's disease, lactose intolerance and constipation. In general, for most of these patient groups, more placebo-controlled methodologically well-designed studies that pay attention to both clinical outcome and mechanistic aspects are required. The application in liver disease and pancreatitis is promising, but more human trials have to be awaited. Possible mechanisms of probiotics include modulation of the intestinal microbiota and the immune system, but different bacterial may have different effects. CONCLUSION Further insight into disease entities and the functioning of probiotic strains is required to be able to select disease-specific strains, which have to be tested in well-designed placebo-controlled studies.
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Affiliation(s)
- D Jonkers
- Div. Gastroenterology-Hepatology, University Hospital Maastricht, Maastricht, The Netherlands.
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Deloris Alexander A, Orcutt RP, Henry JC, Baker J, Bissahoyo AC, Threadgill DW. Quantitative PCR assays for mouse enteric flora reveal strain-dependent differences in composition that are influenced by the microenvironment. Mamm Genome 2006; 17:1093-104. [PMID: 17091319 DOI: 10.1007/s00335-006-0063-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Accepted: 07/06/2006] [Indexed: 01/09/2023]
Abstract
The mammalian gastrointestinal (GI) tract is inhabited by over a hundred species of symbiotic bacteria. Differences among individuals in the composition of the GI flora may contribute to variation in in vivo experimental analyses and disease susceptibility. To investigate potential interindividual differences in GI flora composition, we developed real-time quantitative PCR-based assays for the detection of the eight members of the Altered Schaedler Flora (ASF) as representative members of different bacterial niches within the mammalian GI tract. Quantitative and reproducible strain-specific variations in the numbers of the ASF members were observed across 23 different barrier-housed inbred mouse strains, suggesting that the ASF assays can be used as sentinels for changes in GI flora composition. A significant cage effect was also detected. Isogenic mice that cohabited at weaning, whether from the same or different litters, showed little variation in ASF profiles. Conversely, litters split among different cages at weaning showed divergence in ASF profiles after three weeks. Individual ASF profiles, once established, were highly stable over time in the absence of environmental perturbation. Furthermore, cohabitation of different inbred strains maintained most of the interstrain variation in the GI flora, supporting a role of host genetics in determining GI flora composition.
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Affiliation(s)
- A Deloris Alexander
- Department of Genetics and Center for Gastrointestinal Biology and Disease, University of North Carolina, CB# 7264, Chapel Hill, North Carolina 27599, USA
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Abstract
Despite the swift escalation in research regarding the use of live bacterial cells for therapeutic purposes, the prophylactic and curative use of probiotic microorganisms still remains a wide and controversial field. In addition, the acknowledgement that live bacterial cells can be genetically engineered to synthesise products that have therapeutic potential has generated substantial interest among clinicians and health professionals. Clinical trials have increasingly provided an insightful scientific derivation for the use of live bacterial cells in medicinal practice in diseases such as diarrhoea, cancer, Crohn's disease, enhancement of the host's immune response, and numerous other diseases. A key constraint in the use of live bacterial cells, however, is the complexity of delivering them to the correct target sites. Oral delivery of free live cells, lyophilised cells and immobilised cells has been attempted, but with restricted success, chiefly because bacterial cells are unable to survive passage through the gastrointestinal tract in sufficient dosage. On many occasions, when given orally, these cells have been found to provoke immunogenic responses that are undesirable. Recent studies show that these problems can be overcome by delivering live bacterial cells using artificial cell microcapsules. This review abridges recent developments in the therapeutic use of live bacterial cells, addresses the potential and restrictions for their application in therapy, and provides insights into the future course of this emerging therapy.
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Affiliation(s)
- Satya Prakash
- Department of Biomedical Engineering and Artificial Cells, Organs Research Centre, Faculty of Medicine, McGill University, Montreal, Québec, H3A 2B4, Canada.
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Savaiano DA, Boushey CJ, McCabe GP. Lactose intolerance symptoms assessed by meta-analysis: a grain of truth that leads to exaggeration. J Nutr 2006; 136:1107-13. [PMID: 16549489 DOI: 10.1093/jn/136.4.1107] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A meta-analysis was conducted to compare the lactose intolerance symptoms of lactose maldigesters after consuming lactose (as milk, lactose dissolved in water, milk products, or commercial product) with responses after a placebo under masked conditions. An English language MEDLINE search was conducted using the medical subject heading of "lactose intolerance" from 1966 to January 2002. From an initial 1,553 citations, 2 independent reviewers selected 21 studies based on study design (randomized, crossover, blind) and use of an amount of lactose likely to be found in a meal (7-25 g) and a placebo among subjects free of gastrointestinal problems and >4 years old. Mean severity of symptom responses were analyzed as standardized differences, and the presence or absence of a symptom was estimated as pooled incidence differences (ID). For severity of flatulence, the standardized difference was 0.18 (95% confidence interval [CI] -0.16 to +0.52). The CIs for abdominal bloating and pain, degree of diarrhea, frequency of bowel movements per day, and frequency of diarrhea per day also included 0. For abdominal bloating, the ID was 5.9 more people per 100 with symptoms after lactose than placebo (CI -0.07 to +0.19). This same nonsignificant relationship was found for abdominal pain. The ID for diarrhea or loose stools was 0.15 (CI 0.03 to 0.28). Although the incidence of diarrhea was significantly higher, the size of the effect was very small. The results indicate that lactose is not a major cause of symptoms for lactose maldigesters following usual intakes of dairy foods, that is, 1 cup.
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Affiliation(s)
- Dennis A Savaiano
- Department of Foods and Nutrition, Purdue University, West Lafayette, Indiana, USA.
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Abstract
Probiotic bacteria are found in the intestines of humans and other mammals where they provide health benefits to the host. They do so by (1) providing nutrients and cofactors, (2) successfully competing with pathogens, and (3) stimulating host immune responses by producing specific polysaccharides. These bacteria can also alleviate the symptoms of disease-related metabolic disorders. Prebiotics are substances, usually poorly metabolized polysaccharides and oligosaccharides, that cannot be ingested effectively by the animal. They stimulate the growth of intestinal probiotic bacteria, which can utilize these carbohydrates, thereby promoting health of the organism. Genetic engineering has proven useful for the design of probiotic bacteria that counteract the symptoms of genetic and age-related diseases. Can these bacteria be engineered, through human-promoted accelerative evolution, so that they stimulate their own growth and that of other probiotic bacteria so as to crowd pathogens out of the intestine?
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Affiliation(s)
- Milton H Saier
- Division of Biological Sciences, University of California at San Diego, La Jolla, CA 92093, USA.
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Montalto M, Curigliano V, Santoro L, Vastola M, Cammarota G, Manna R, Gasbarrini A, Gasbarrini G. Management and treatment of lactose malabsorption. World J Gastroenterol 2006; 12:187-91. [PMID: 16482616 PMCID: PMC4066025 DOI: 10.3748/wjg.v12.i2.187] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Lactose malabsorption is a very common condition characterized by intestinal lactase deficiency. Primary lactose malabsorption is an inherited deficit present in the majority of the world’s population, while secondary hypolactasia can be the consequence of an intestinal disease. The presence of malabsorbed lactose in the colonic lumen causes gastrointestinal symptoms. The condition is known as lactose intolerance. In patients with lactase nonpersistence, treatment should be considered exclusively if intolerance symptoms are present. In the absence of guidelines, the common therapeutic approach tends to exclude milk and dairy products from the diet. However, this strategy may have serious nutritional disadvantages. Several studies have been carried out to find alternative approaches, such as exogenous β-galactosidase, yogurt and probiotics for their bacterial lactase activity, pharmacological and non pharmacological strategies that can prolong contact time between enzyme and substrate delaying gastrointestinal transit time, and chronic lactose ingestion to enhance colonic adaptation. In this review the usefulness of these approaches is discussed and a therapeutic management with a flow chart is proposed.
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Affiliation(s)
- Massimo Montalto
- Department of Internal Medicine, Catholic University, Rome, Italy.
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Abstract
Probiotic micro-organisms have been used for many years. Originating as food supplements, they are now most often administered orally and offer an attractive alternative for treating of intestinal disorders. A better understanding of the mechanisms by which these micro-organisms act has now opened up possibilities for designing new probiotic strains. Through genetic engineering, it is possible not only to strengthen the effects of existing strains, but also to create completely new probiotics. These need not necessarily be composed only of bacterial products but can also include elements of regulatory systems or enzymes derived from a foreign-human-source. If designed carefully and with absolute attention to biological safety in its broadest sense, the development of genetically modified probiotics has the potential to revolutionize alimentary health.
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Affiliation(s)
- Lothar Steidler
- Department of Medicine, Alimentary Pharmabiotic Center, University College Cork, Western Road, Cork, Ireland.
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22
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Labayen I, Forga L, González A, Lenoir-Wijnkoop I, Nutr R, Martínez JA. Relationship between lactose digestion, gastrointestinal transit time and symptoms in lactose malabsorbers after dairy consumption. Aliment Pharmacol Ther 2001; 15:543-9. [PMID: 11284784 DOI: 10.1046/j.1365-2036.2001.00952.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The relationship of symptoms with objective measurements, as well as some of the mechanisms involved in lactose tolerance after yoghurt consumption, remain unclear. METHODS The trial had a double-blind design in which 22 lactose malabsorbers received 25 g daily lactose in fresh (living bacteria > 108 cfu/g) yoghurt or heated (< 102 cfu/g) yoghurt for 15 days, followed by a cross-over (15 days) after a wash-out period (14 days). The lactose digestion was determined by the breath H2 test, the gastric emptying (GE) with a 13C-acetate breath test and the revealed transit time (OCTT) by 15N-lactose-ureide test. Subjects reported their gastrointestinal symptoms (GIS) in a validated questionnaire. RESULTS Breath H2 test indicated more effective lactose digestion after fresh yoghurt intake. The OCTT was shorter after heated yoghurt ingestion as compared with the fresh. There was lower severity of GIS (P < 0.05) after fresh yoghurt intake, and this showed an inverse correlation with OCTT (P < 0.05). CONCLUSIONS Delayed orocoecal transit time was associated with fewer gastrointestinal symptoms. The improved lactose digestion and tolerance of fresh yoghurt should be mainly attributed to the presence of living bacteria.
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Affiliation(s)
- I Labayen
- Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain
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23
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Marteau PR, de Vrese M, Cellier CJ, Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics. Am J Clin Nutr 2001; 73:430S-436S. [PMID: 11157353 DOI: 10.1093/ajcn/73.2.430s] [Citation(s) in RCA: 271] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Probiotics are nonpathogenic microorganisms that, when ingested, exert a positive influence on the health or physiology of the host. They can influence intestinal physiology either directly or indirectly through modulation of the endogenous ecosystem or immune system. The results that have been shown with a sufficient level of proof to enable probiotics to be used as treatments for gastrointestinal disturbances are 1) the good tolerance of yogurt compared with milk in subjects with primary or secondary lactose maldigestion, 2) the use of Saccharomyces boulardii and Enterococcus faecium SF 68 to prevent or shorten the duration of antibiotic-associated diarrhea, 3) the use of S. boulardii to prevent further recurrence of Clostridium difficile-associated diarrhea, and 4) the use of fermented milks containing Lactobacillus rhamnosus GG to shorten the duration of diarrhea in infants with rotavirus enteritis (and probably also in gastroenteritis of other causes). Effects that are otherwise suggested for diverse probiotics include alleviation of diarrhea of miscellaneous causes; prophylaxis of gastrointestinal infections, which includes traveler's diarrhea; and immunomodulation. Trials of gastrointestinal diseases that involve the ecosystem are currently being performed, eg, Helicobacter pylori infections, inflammatory bowel disease, and colon cancer.
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Affiliation(s)
- P R Marteau
- Gastroenterology Department, Hôpital Europèen Georges Lompidou, Assistance Publique des Hôpitaux de Paris and Paris V University, Paris
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Stanton C, Gardiner G, Meehan H, Collins K, Fitzgerald G, Lynch PB, Ross RP. Market potential for probiotics. Am J Clin Nutr 2001; 73:476S-483S. [PMID: 11157361 DOI: 10.1093/ajcn/73.2.476s] [Citation(s) in RCA: 169] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
"Functional foods" as a marketing term was initiated in Japan in the late 1980s and is used to describe foods fortified with ingredients capable of producing health benefits. This concept is becoming increasingly popular with consumers because of a heightened awareness of the link between health, nutrition, and diet. Food manufacturers are enthusiastic about developing such products because the added ingredients give increased value to food. The global market for functional foods in the coming years is predicted to grow rapidly. Although Japan currently accounts for about one-half of this market, the fastest rate of growth is expected to be in the United States. Probiotic products represent a strong growth area within the functional foods group and intense research efforts are under way to develop dairy products into which probiotic organisms such as Lactobacillus and Bifidobacterium species are incorporated. Such probiotic foods may modulate gut microbial composition, thereby leading to improved gut health, for example, through improved tolerance to lactose in lactose-intolerant individuals or improved resistance to pathogenic bacteria. Large numbers of viable microorganisms are likely to be required in the food product, which should be consumed regularly to experience the health effect. The probiotic market, especially dairy products such as yogurts and fermented milks, has experienced rapid growth in Europe. The long-term exploitation of probiotics as health promoters is dependent on several factors, including sound, scientifically proven clinical evidence of health-promoting activity; accurate consumer information; effective marketing strategies; and, above all, a quality product that fulfills consumer expectations.
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Affiliation(s)
- C Stanton
- Teagasc, Dairy Products Research Centre and Pig Production Department, Fermoy, Ireland
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25
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Sanders ME, Klaenhammer TR. Invited review: the scientific basis of Lactobacillus acidophilus NCFM functionality as a probiotic. J Dairy Sci 2001; 84:319-31. [PMID: 11233016 DOI: 10.3168/jds.s0022-0302(01)74481-5] [Citation(s) in RCA: 222] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Lactobacillus acidophilus NCFM is a probiotic strain available in conventional foods (milk, yogurt, and toddler formula) and dietary supplements. Its commercial availability in the United States since the mid-1970s is predicated on its safety, its amenability to commercial manipulation, and its biochemical and physiological attributes presumed to be important to human probiotic functionality. The strain has been characterized in vitro, in animal studies, and in humans. NCFM is the progenitor of the strain being used for complete chromosome sequencing and therefore will be a cornerstone strain for understanding the relationship between genetics and probiotic functionality. Both phenotypic and genotypic techniques have verified its taxonomic status as a type A1 L. acidophilus strain. It adheres to Caco-2 and mucus-secreting HT-29 cell culture systems, produces antimicrobial compounds, and is amenable to genetic manipulation and directed DNA introduction. NCFM survives gastrointestinal tract transit in both healthy and diseased populations. NCFM inhibits aberrant crypt formation in mutagenized rats, indicative of activity that could decrease the risk of colon cancer. A blend of probiotic strains containing NCFM decreased the incidence of pediatric diarrhea. NCFM led to a significant decrease in levels of toxic amines in the blood of dialysis patients with small bowel bacterial overgrowth. At adequate daily feeding levels, NCFM may facilitate lactose digestion in lactose-intolerant subjects. Further validation of the probiotic properties of NCFM in humans and clarification of its mechanisms of probiotic action are needed to better understand the role this strain might play in promoting human health.
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Affiliation(s)
- M E Sanders
- Dairy and Food Culture Technologies, Littleton, CO 80122-2526, USA.
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26
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Armstrong DW, Schneiderheinze JM, Kullman JP, He L. Rapid CE microbial assays for consumer products that contain active bacteria. FEMS Microbiol Lett 2001; 194:33-7. [PMID: 11150662 DOI: 10.1111/j.1574-6968.2001.tb09442.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Recent advances in high efficiency separation methods of bacteria allow their rapid identification and quantitation in some cases. A specific capillary electrophoresis (CE) technique is used to identify and quantitate Lactobacillus acidophilus in both pill and syrup health products as well as Bifidobacterium infantis in a powdered formula supplement. Cell viability can be evaluated as well. In some cases, both the living and dead bacterial cells as well as the molecular excipients can be evaluated in a single run.
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Affiliation(s)
- D W Armstrong
- Department of Chemistry, Iowa State University, Ames, IA 50011, USA.
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27
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Abstract
Lactose maldigestion has been under intensive research since its discovery in the 1960's. We know the prevalence of lactose maldigestion in a great number of countries and ethnic groups. However, there is often no provision made for the secondary type of maldigestion, and the study populations have sometimes been selected rather than picked at random. New methods for the measurement of lactose digestion have been developed, and its genetic mechanisms have received a great deal of attention during the last few years. However, in many studies the measurement and/or reporting of symptoms has quite often been overlooked. In this review, various topics related to lactose intolerance are discussed with a special emphasis on its symptoms.
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Affiliation(s)
- T H Vesa
- Foundation for Nutrition Research, Helsinki, Finland
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28
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29
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Hosono A. Viability of Lactobacillus gasseri and its cholesterol-binding and antimutagenic activities during subsequent refrigerated storage in nonfermented milk. J Dairy Sci 1999; 82:2536-42. [PMID: 10629798 DOI: 10.3168/jds.s0022-0302(99)75507-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The effect storage at 4 degrees C on the viability of Lactobacillus gasseri and its sodium taurocholate-deconjugating and cholesterol-binding abilities as well as desmutagenic activity was investigated. Unfermented milks containing L. gasseri strains SBT0274 and SBT0270 at 10(9) cfu/ml were prepared using 10% skim milk. Total and bile-tolerant lactobacilli for strains SBT0274 and SBT0270 generally decreased after 14 d of storage at 4 degrees C; however, viable cells of these strains were still at 10(8) cfu/ml after 28 d of storage. The amounts of cholic acid released and of cholesterol bound by strains SBT0274 and SBT0270 declined over time, especially at 21 d of storage. Antimutagenic activity of unfermented milk made from both strains was attributed to the bacterial cells, and the activity was stable during storage at 4 degrees C for 28 d.
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30
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Lin MY, Yen CL. Reactive oxygen species and lipid peroxidation product-scavenging ability of yogurt organisms. J Dairy Sci 1999; 82:1629-34. [PMID: 10480088 DOI: 10.3168/jds.s0022-0302(99)75391-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The antioxidative activity of the intracellular extracts of yogurt organisms was investigated. All 11 strains tested, including five strains of Streptococcus thermophilus and six strains of Lactobacillus delbrueckii ssp. bulgaricus, demonstrated an antioxidative effect on the inhibition of linoleic acid peroxidation. The antioxidative effect of intracellular extracts of 10(8) cells of yogurt organisms was equivalent to 25 to 96 ppm butylated hydroxytoluene, which indicated that all strains demonstrated excellent antioxidative activity. The scavenging of reactive oxygen species, hydroxyl radical, and hydrogen peroxide was studied for intracellular extracts of yogurt organisms. All strains showed reactive oxygen species-scavenging ability. Lactobacillus delbrueckii ssp. bulgaricus Lb demonstrated the highest hydroxyl radical-scavenging ability at 234 microM. Streptococcus thermophilus MC and 821 and L. delbrueckii ssp. bulgaricus 448 and 449 scavenged the most hydrogen peroxide at approximately 50 microM. The scavenging ability of lipid peroxidation products, t-butylhydroperoxide and malondialdehyde, was also evaluated. Results showed that the extracts were not able to scavenge the t-butylhydroperoxide. Nevertheless, malondialdehyde was scavenged well by most strains.
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Affiliation(s)
- M Y Lin
- Department of Food Science, National Chung Hsing University, Taichung, Taiwan
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31
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Szilagyi A. Prebiotics or probiotics for lactose intolerance: a question of adaptation. Am J Clin Nutr 1999; 70:105-6. [PMID: 10393148 DOI: 10.1093/ajcn/70.1.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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