Effects of probiotic Lactobacillus paracasei-enriched artichokes on constipated patients: a pilot study

Potential Prebiotic Effect of Inulin-Enriched Pasta after In Vitro Gastrointestinal Digestion and Simulated Gut Fermentation

In the current study, the prebiotic potential of an innovative functional pasta enriched with 12% (w/w) inulin was investigated. To this aim, pasta was subjected to in vitro gastrointestinal digestion followed by simulated gut fermentation compared to the control pasta (CTRL) not containing inulin. The incorporation of inulin positively (p < 0.05) affected some organoleptic traits and the cooking quality of the final product, giving an overall score significantly higher than CTRL. The resultant essential amino acid content was similar in both pasta samples while the total protein content was lower in inulin-enriched pasta for the polymer substitution to durum wheat flour. The prebiotic potential of chicory inulin was preliminarily tested in in vitro experiments using seven probiotic strains and among them Lacticaseibacillus paracasei IMPC2.1 was selected for the simulated gut fermentation studies. The positive prebiotic activity score registered with the probiotic strain suggested the suitability of the inulin-enriched pasta with respect to acting as a prebiotic source favoring the growth of the probiotic strain and short chain fatty acid (SCFA) production. The present study contributes to broadening knowledge on the prebiotic efficacy of inulin when incorporated into a complex food matrix.

Lactobacillus paracasei Relieves Constipation by Acting on the Acetic Acid-5-HT-Intestinal Motility Pathway

Constipation is a major health concern worldwide and requires effective and safe treatment options. In this study, we selected ten strains of two species of lactobacilli to identify whether they were effective against constipation induced by loperamide administration in BALB/c mice. Monitoring of constipation-related indicators indicated that Lactobacillus paracasei (L. paracasei) mainly acted on the whole intestinal peristalsis to relieve constipation. Furthermore, through the detection of biological, chemical, mechanical, and immune barriers in mice, it was discovered that L. paracasei changed the relative abundance of bacteria related to the levels of acetic acid and 5-hydroxytryptamine (5-HT) (such as by increasing the relative abundance of Odoribacter and Clostridium, and reducing the relative abundance of Mucispirillum, Ruminococcus, Coprobacillus, and Dorea), increased the concentration of acetic acid in the intestine, which stimulated enterochromaffin cells, promoted 5-HT synthesis in the colon, enhanced intestinal motility, and relieved constipation. In conclusion, this study provides a theoretical foundation for the development of personalized products for the treatment of constipation.

The postbiotic of hawthorn-probiotic ameliorating constipation caused by loperamide in elderly mice by regulating intestinal microecology

Background

Constipation is common gastrointestinal disorder with high prevalence and recurrence, making people suffering. However, the treatment for constipation remains ineffectual. We aimed to the study the effects and mechanisms of postbiotic of hawthorn-probiotic on loperamide modeled old KM mice.

Methods

Constipated mice were grouped and treated with 10% lactulose (Y), hawthorn group (S), probiotic group (F) and postbiotic of hawthorn-probiotic (FS). Fecal changes were observed. AQP3 and Enac-γ were measured by RT-qPCR and Western blotting, intestinal barrier by H&E and immunofluorescence staining, cell proliferation and apoptosis by CCK8 and flow cytometry. Gut microbiota was further determined by 16 s rRNA sequence of feces.

Results

Postbiotic of hawthorn-probiotic improved intestinal movement and pathomorphology, elevated AQP3, Enac-γ and mucin-2 expression, accompanied by decreased serum TNF-α and cell apoptosis, but increased proliferation. Furthermore, it modified the gut microbiota of constipated mice, featured by upregulation of Lactobacillaceae.

Conclusion

Postbiotic of hawthorn-probiotic relieved constipation by combined effects of regulating intestinal water and sodium metabolism, maintain intestinal barrier and gut microflora.Graphical Abstract.

Recent advances in developing butyrogenic functional foods to promote gut health

As one of the major short-chain fatty acids produced via microbial fermentation, butyrate serves as not only a preferred energy substrate but also an important signaling molecule. Butyrate concentrations in circulation, tissues, and gut luminal contents have important pathophysiological implications. The genetic capacity of butyrate biosynthesis by the gut microbiota is frequently compromised during aging and various disorders, such as inflammatory bowel disease, metabolic disorders and colorectal cancer. Substantial efforts have been made to identify potent butyrogenic substrates and butyrate-hyperproducing bacteria to compensate for butyrate deficiency. Interindividual butyrogenic responses exist, which are more strongly predicted by heterogeneity in the gut microbiota composition than by ingested prebiotic substrates. In this review, we catalog major food types rich in butyrogenic substrates. We also discuss the potential of butyrogenic foods with proven properties for promoting gut health and disease management using findings from clinical trials. Potential limitations and constraints in the current research are highlighted. We advocate a precise nutrition approach in designing future clinical trials by prescreening individuals for key gut microbial signatures when recruiting study volunteers. The information provided in this review will be conducive to the development of microbiota engineering approaches for enhancing the sustained production of butyrate.

Potential Modulation of Inflammation by Probiotic and Omega-3 Supplementation in Elderly with Chronic Low-Grade Inflammation—A Randomized, Placebo-Controlled Trial

Probiotic and omega-3 supplements have been shown to reduce inflammation, and dual supplementation may have synergistic health effects. We investigated if the novel combination of a multi-strain probiotic (containing B. lactis Bi-07, L. paracasei Lpc-37, L. acidophilus NCFM, and B. lactis Bl-04) alongside omega-3 supplements reduces low-grade inflammation as measured by high-sensitivity C-reactive protein (hs-CRP) in elderly participants in a proof-of-concept, randomized, placebo-controlled, parallel study (NCT04126330). In this case, 76 community-dwelling elderly participants (median: 71.0 years; IQR: 68.0–73.8) underwent an intervention with the dual supplement (n = 37) or placebo (n = 39) for eight weeks. In addition to hs-CRP, cytokine levels and intestinal permeability were also assessed at baseline and after the eight-week intervention. No significant difference was seen for hs-CRP between the dual supplement group and placebo. However, interestingly, supplementation did result in significant increases in the level of the anti-inflammatory marker IL-10. In addition, dual supplementation increased levels of valeric acid, further suggesting the potential of the supplements in reducing inflammation and conferring health benefits. Together, the results suggest that probiotic and omega-3 dual supplementation exerts modest effects on inflammation and may have potential use as a non-pharmacological treatment for low-grade inflammation in the elderly.

A Predictive Growth Model for Pro-technological and Probiotic Lacticaseibacillus paracasei Strains Fermenting White Cabbage

Bacterial strains belonging to Lacticaseibacillus paracasei species are generally used as starters in food fermentations and/or as probiotics. In the current study, the growth cardinal parameters of four L. paracasei strains (IMPC2.1, IMPC4.1, P40 and P101), isolated from table olives or human source, were determined. Strains were grown in liquid medium and incubated at several temperatures (10 values from 5.5°C–40°C) and pH (15 values from 3.2 to 9.1) along the growth range. The cardinal temperature model was used to describe temperature effects on the maximum specific growth rate of L. paracasei whereas new equations were developed for the effect of pH. The estimated T_min values ranged between −0.97°C and 1.95°C and were lower than 0°C for strains IMPC4.1 and P101. Strain P40 was able to grow in the most restricted range of temperature (from 1.95°C to 37.46°C), while strain IMPC4.1 was estimated to survive at extreme conditions showing the lowest pH_min. Maximum specific growth rates of L. paracasei IMPC2.1 in white cabbage (Brassica oleracea var. capitata) were used to calculate the correction factor (C_f) defined as the bias between the bacterial maximum specific growth rate in broth and in the food matrix. A simple bi-linear model was also developed for the effect of temperature on the maximum population density reached in white cabbage. This information was further used to simulate the growth of L. paracasei strains in cabbage and predict the time to reach the targeted probiotic level (7 log₁₀ CFU/g) using in silico simulations. This study demonstrates the potential of the predictive microbiology to predict the growth of beneficial and pro-technological strains in foods in order to optimize the fermentative process.

A multiple-strain probiotic product provides a better enzymatic antioxidant response in individuals with constipation in a double-blind randomized controlled trial

OBJECTIVES

Probiotics may have beneficial effects on intestinal dysbiosis. However, the effects of probiotics on redox and inflammatory responses in intestinal constipation remain unknown. The aim of this study was to investigate the effect of a multiple-strain probiotic on the redox and inflammatory responses in individuals with intestinal constipation.

METHODS

A randomized, double-blind, placebo controlled clinical trial was conducted with individuals diagnosed with constipation (defined according to the Rome IV criteria). The participants were randomized into two groups to receive either a probiotic capsule (PC; n = 25) containing probiotic strains or to receive a control capsule (CC; n = 20) containing a matching placebo for 30 d. In the baseline and at the end of the study, biomarkers of the redox (malondialdehyde, carbonylated protein, antioxidant enzymes, and ferric-reducing antioxidant power) and inflammatory responses, and Rome IV criteria for constipation were analyzed.

RESULTS

The consumption of a multiple-strain probiotic attenuated the reduction of glutathione peroxidase (PC = -9.41 and CC = -19.60; P = 0.041) and glutathione-s-transferase activity (PC = -3.28 and CC = -12.08, P < 0.0001) in erythrocytes and marginally improved the symptom of feeling incomplete defecation in ≥25% of bowel movements, compared with the placebo group. No changes were observed in total antioxidant capacity, oxidative damage, and levels of inflammatory markers in the serum.

CONCLUSIONS

Our data suggested that a multiple-strain probiotic may provide a better enzymatic antioxidant response and partially alleviate the feeling of incomplete defecation in ≥25% of bowel movements in individuals with intestinal constipation.

Prebiotic UG1601 mitigates constipation-related events in association with gut microbiota: A randomized placebo-controlled intervention study

BACKGROUND

Constipation is a common functional gastrointestinal disorder and its etiology is multifactorial. Growing evidence suggests that intestinal dysbiosis is associated with the development of constipation. Prebiotics are subjected to bacterial fermentation in the gut to produce short-chain fatty acids (SCFAs), which can help relieve constipation symptoms. The prebiotic UG1601 consists of inulin, lactitol, and aloe vera gel, which are known laxatives, but randomized, controlled clinical trials that examine the effects of this supplement on gut microbiota composition are lacking.

AIM

To assess the efficacy of the prebiotic UG1601 in suppressing constipation-related adverse events in subjects with mild constipation.

METHODS

Adults with a stool frequency of less than thrice a week were randomized to receive either prebiotics or a placebo supplement for 4 wk. All participants provided their fecal and blood samples at baseline and at the end of intervention. Gastrointestinal symptoms and stool frequency were evaluated. The concentrations of serum endotoxemia markers and fecal SCFAs were determined. The relative abundance of SCFA-producing bacteria and the gut microbial community in the responders and non-responders in the prebiotics supplementation group were evaluated.

RESULTS

There were no significant differences in gastrointestinal symptoms between groups, although the prebiotic group showed greater symptom improvement. However, after prebiotic usage, serum cluster of differentiation (CD) 14 and lipopolysaccharide (LPS) concentrations were significantly decreased (CD14, P = 0.012; LPS, P < 0.001). The change in LPS concentration was significantly larger in the prebiotic group than in the placebo group (P < 0.001). Fecal SCFAs concentrations did not differ between groups, while the relative abundance of Roseburia hominis, a major butyrate producer, was significantly increased in the prebiotic group (P = 0.045). The abundances of the phylum Firmicutes and the family Lachnospiraceae (phylum Firmicutes, class Clostridia) (P = 0.009) were decreased in the responders within the prebiotic group. In addition, the proportions of the phylum Firmicutes, the class Clostridia, and the order Clostridiales were inversely correlated with several fecal SCFAs (P < 0.05).

CONCLUSION

Alterations in gut microbiota composition, including a decrease in the phylum Firmicutes and an increase in butyrate-producing bacteria, following prebiotic UG1601 supplementation might help alleviate symptom scores and endotoxemia.

Probiotics and constipation: mechanisms of action, evidence for effectiveness and utilisation by patients and healthcare professionals

The aim of this narrative review is to assess and present evidence on the mechanisms of action of probiotics in constipation, their effectiveness and their utilisation by patients and healthcare professionals. Chronic constipation is a common bothersome disorder that has a considerable impact on patients' quality of life. Probiotics have been increasingly investigated for their effectiveness in various disorders, including chronic constipation. Probiotics may affect gut motility and constipation through their impact on the gut microbiota and fermentation, the central and enteric nervous system and the immune system. However, evidence for the effectiveness of probiotics in the management of constipation remains varied, with some strains demonstrating improvements, while others show no effect. Despite the uncertainty in evidence and the fact that the majority of healthcare professionals do not recommend probiotics for constipation, an increased prevalence of probiotic use by people with constipation has been shown. Therefore, there is a need for public health strategies to inform the public about where strong evidence of probiotic effectiveness exist, and where evidence is still weak. Education of healthcare professionals on the increased utilisation of probiotics for constipation by the public and on current evidence for the effectiveness of specific strains is also required.

Influence of Lactitol and Psyllium on Bowel Function in Constipated Indian Volunteers: A Randomized, Controlled Trial

Psyllium and lactitol have been reported to increase fecal volume, moisture content and bowel movement frequency (BMF). However, the benefits of their combined use on constipation has not been examined. The aim of this study was to evaluate the effects of a 4-week intervention with lactitol and/or psyllium on bowel function in constipated volunteers. Adults (N = 172) who were diagnosed with functional constipation per Rome III criteria were randomized to four treatment groups: 10 g lactitol, 3.5 g psyllium, a combination of 10 g lactitol and 3.5 g psyllium, or placebo. The primary endpoint was change in BMF from Day 0 to 28 as compared to placebo. Secondary endpoints were assessed by inventories, including stool consistency, patient assessment of constipation symptoms and quality of life, relief of constipation, 24-h food recall, physical activity, product satisfaction and adverse events (AE). BMF increased by 3.0 BMs with lactitol, by 2.9 with psyllium, and by 3.1 with the combination, but was not different from placebo (3.7 BMs). Other clinical endpoints were similar between treatments. No serious AEs were reported. In conclusion, this study showed a similar effect on relief of constipation in all treatment groups. The treatments that were administered to the volunteers were well tolerated.

Quality of ready-to-eat swordfish fillets inoculated with Lactobacillus paracasei IMPC 2.1

BACKGROUND

The quality of marinated ready-to-eat (RTE) swordfish fillets, with or without inoculation with the probiotic strain Lactobacillus paracasei IMPC 2.1, was assessed over 3 months of refrigerated storage at 4 °C. RTE probiotic and control fish fillets were sampled after 7, 14, 30, 60, and 90 days of storage. Microbiological tests were performed, and fatty acid (FA) profiles and malondialdehyde content were examined. Microbiological counts, including total viable count, lactic acid bacteria (LAB), yeasts, moulds, Enterobacteriaceae, and Pseudomonadaceae were determined.

RESULTS

Inoculation successfully ensured the growth of the probiotic strain and prevented the growth of other LAB. The two RTE products showed significant differences in lipid profile and lipid oxidation during storage. In particular, inoculation with L. paracasei IMPC 2.1 increased the amount of polyunsaturated FAs and limited the amount of monounsaturated FAs and oleic acid, as well as lipid oxidation. It thus represents an interesting strategy for preserving the chemical quality of fish fillets and an alternative means of delivering probiotics.

CONCLUSION

Probiotic inoculation with Lactobacillus paracasei seemed to delay lipid oxidation of the fish flesh and increase the retention of polyunsaturated FAs, suggesting a potential application for this strain in the seafood industry. © 2018 Society of Chemical Industry.

Colonization and Gut Flora Modulation of Lactobacillus kefiranofaciens ZW3 in the Intestinal Tract of Mice

This study evaluated the distribution and colonization of Lactobacillus kefiranofaciens ZW3 and determined its capacity to modulate the gut microbiota in an animal model. Based on (1) fluorescence imaging, (2) flow cytometry, and (3) qPCR, we found that ZW3 successfully adhered to mouse mucous tissue and colonized the mouse ileum. Gut microbiota profiling was performed using high-throughput sequencing. After continuous intubation with ZW3 for 1 week, the proportion of Lachnospiraceae, a family of butyric acid-producing bacteria, increased at day 7 (11.9% at day 0 versus 18.4% at day 7). In addition, Lactobacillaceae showed an increasing trend (4% at day 0 versus 13% at day 7) that was accompanied by an observable decline in the Rikenellaceae family (1.58% at day 7, 0.14% at day 14, and 0.75% at day 21) in the tested mouse. The results demonstrate that ZW3 could successfully adhere to and colonize the mouse gut throughout the course of the experiment. The profiling analysis of the gut microbiota also provided evidence supporting the function of ZW3 in improving the intestinal flora of mice.

Sensory Assessment by Consumers of Traditional and Potentially Probiotic Green Spanish-Style Table Olives

This work presents the sensory characterization by consumers of traditionally and potentially probiotic green Spanish-style table olives. To this aim, green Manzanilla olives from the same lot were debittered, washed, and brined in the same way; then, one sub-lot was allowed fermenting spontaneously while another one was inoculated with a putative probiotic bacterium (Lactobacillus pentosus TOMC-LAB2). After fermentation, the olives from both sub-lots were packed with fresh brine to reach 5.5 g/100 mL NaCl and 0.6 g lactic acid/100 mL in the equilibrium. The stabilized olives were then subjected to sensory evaluation by 200 consumers, and the results were analyzed by ANOVA and multivariate statistical techniques. In a first approach, consumers perceived the spontaneously fermented olives as similar to the potentially probiotic product. However, a biplot based on Canonical Variate Analysis (CVA) showed differences between them in the Salty and Overall score. When data from the consumer test were assessed by PLS analysis, regardless of the fermentation system, Overall score, and Buying predisposition were significantly driven by Appearance, Odor, Salty (negatively), Hardness, and Crispness.

Polyphenol-rich Mango (Mangifera indica L.) Ameliorate Functional Constipation Symptoms in Humans beyond Equivalent Amount of Fiber

SCOPE

Chronic constipation is a common gastrointestinal condition associated with intestinal inflammation and considerably impaired quality of life, affecting about 20% of Americans. Dietary fiber and laxatives aid in its treatment but do not fully address all symptoms, such as intestinal inflammation. Mango (Mangifera indica L.), a fiber- and polyphenol-rich fruit may provide anti-inflammatory effects in constipation.

METHODS AND RESULTS

The 4 week consumption of mango fruit (300 g) or the equivalent amount of fiber is investigated in otherwise healthy human volunteers with chronic constipation who are randomly assigned to either group. Blood and fecal samples and digestive wellness questionnaires are collected at the beginning and end of the study. Results show that mango consumption significantly improve constipation status (stool frequency, consistency, and shape) and increase gastrin levels and fecal concentrations of short chain fatty acid (valeric acid) while lowering endotoxin and interleukin 6 concentrations in plasma.

CONCLUSION

In this pilot study, the consumption of mango improves symptoms and associated biomarkers of constipation beyond an equivalent amount of fiber. Larger follow-up studies would need to investigate biomarkers for intestinal inflammation in more detail.

Gut microbiota varies by opioid use, circulating leptin and oxytocin in African American men with diabetes and high burden of chronic disease

Objective

The gut microbiota is known to be related to type 2 diabetes (T2D), psychiatric conditions, and opioid use. In this study, we tested the hypothesis that variability in gut microbiota in T2D is associated with psycho-metabolic health.

Methods

A cross-sectional study was conducted among African American men (AAM) (n = 99) that were outpatients at a Chicago VA Medical Center. The main outcome measures included fecal microbiota ecology (by 16S rRNA gene sequencing), psychiatric disorders including opioid use, and circulating leptin and oxytocin as representative hormone biomarkers for obesity and psychological pro-social behavior.

Results

The study subjects had prevalent overweight/obesity (78%), T2D (50%) and co-morbid psychiatric (65%) and opioid use (45%) disorders. In the analysis of microbiota, the data showed interactions of opioids, T2D and metformin with Bifidobacterium and Prevotella genera. The differential analysis of Bifidobacterium stratified by opioids, T2D and metformin, showed significant interactions among these factors indicating that the effect of one factor was changed by the other (FDR-adjusted p [q] < 0.01). In addition, the pair-wise comparison showed that participants with T2D not taking metformin had a significant 6.74 log2 fold increase in Bifidobacterium in opioid users as compared to non-users (q = 2.2 x 10⁻⁸). Since metformin was not included in this pair-wise comparison, the significant ‘q’ suggested association of opioid use with Bifidobacterium abundance. The differences in Bifidobacterium abundance could possibly be explained by opioids acting as organic cation transporter 1 (OCT1) inhibitors. Analysis stratified by lower and higher leptin and oxytocin (divided by the 50^th percentile) in the subgroup without T2D showed lower Dialister in High-Leptin vs. Low-Leptin (p = 0.03). Contrary, the opposite was shown for oxytocin, higher Dialister in High-Oxytocin vs. Low-Oxytocin (p = 0.04).

Conclusions

The study demonstrated for the first time that Bifidobacterium and Prevotella abundance was affected by interactions of T2D, metformin and opioid use. Also, in subjects without T2D Dialister abundance varied according to circulating leptin and oxytocin.

Analysis of short-chain fatty acids in human feces: A scoping review

Short-chain fatty acids (SCFAs) play a crucial role in maintaining homeostasis in humans, therefore the importance of a good and reliable SCFAs analytical detection has raised a lot in the past few years. The aim of this scoping review is to show the trends in the development of different methods of SCFAs analysis in feces, based on the literature published in the last eleven years in all major indexing databases. The search criteria included analytical quantification techniques of SCFAs in different human clinical and in vivo studies. SCFAs analysis is still predominantly performed using gas chromatography (GC), followed by high performance liquid chromatography (HPLC), nuclear magnetic resonance (NMR) and capillary electrophoresis (CE). Performances, drawbacks and advantages of these methods are discussed, especially in the light of choosing a proper pretreatment, as feces is a complex biological material. Further optimization to develop a simple, cost effective and robust method for routine use is needed.

Evaluation of clinical safety and beneficial effects of stachyose-enriched α-galacto-oligosaccharides on gut microbiota and bowel function in humans

This is the first study providing clinical bases for developing DSG as a novel and safe agent against functional constipation.

The effect of polydextrose and probiotic lactobacilli in a Clostridium difficile-infected human colonic model

BACKGROUND

Clostridium difficile is a natural resident of the intestinal microbiota; however, it becomes harmful when the normal intestinal microbiota is disrupted, and overgrowth and toxin production occurs. The toxins can cause bloating and diarrhoea, which may cause severe disease and have the potential to cause outbreaks in hospitals and other healthcare settings. Normally, antibiotic agents are used for treatment, although for some of the patients, these treatments provide only a temporary relief with a recurrence of C. difficile-associated diarrhoea.

OBJECTIVE

The effects of polydextrose (PDX), Lactobacillus acidophilus NCFM, and L. paracasei Lpc-37 on the growth of C. difficile were investigated in an in vitro model of infected human large intestine.

DESIGN

The semi-continuous colonic model is composed of four connected vessels inoculated with human faecal microbes and spiked with pathogenic C. difficile (DSM 1296). PDX in two concentrations (2 and 4%), NCFM, and Lpc-37 were fed to the system during the 2-day simulation, and the growth of C. difficile and several other microbial groups were monitored using quantitative polymerase chain reaction (qPCR) and 16S rDNA sequencing.

RESULTS

The microbial community structure of the simulation samples was closely grouped according to treatment, and the largest shifts in the microbial composition were seen with PDX. The microbial diversity decreased significantly with 4% PDX, and the OTU containing C. difficile was significantly (p<0.01) decreased when compared to control and lactobacilli treatments. The mean numbers of C. difficile also decreased as detected by qPCR, although the reduction did not reach statistical significance.

CONCLUSIONS

The treatments influenced the colonic microbiota, and a trend for reduced numbers of C. difficile as well as alterations of several microbial groups could be detected. This suggests that PDX may be able to modulate the composition and/or function of the colonic microbiota in such manner that it affects the pathogenic C. difficile.

Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation

Background/Aims

We investigated gut flora characteristics in patients with functional constipation (FC) and influences of short-term treatment with VSL#3 probiotic on flora and symptom improvement.

Methods

Thirty patients fulfilling Rome III criteria for FC and 30 controls were enrolled. Fecal samples were obtained before and after VSL#3 intake (one sachet twice daily for 2 weeks) and flora were examined by quantitative real-time polymerase chain reaction (qRT-PCR). Symptom changes were also investigated.

Results

The fold differences in Bifidobacterium and Bacteroides species were significantly lower in feces from FC, compared to in controls (P = 0.030 and P = 0.021). After taking VSL#3, the fold differences in Lactobacillus, Bifidobacterium and Bacteroides species increased in controls (P = 0.022, P = 0.018, and P = 0.076), but not in FC. Mean Bristol scores and complete spontaneous bowel movements (CSBMs)/week increased significantly in FC after ingesting VSL#3 (both P < 0.001). Relief of subjective CSBM frequency, stool consistency and abdominal bloating were reported in 70%, 60%, and 47% of patients. After VSL#3 cessation, 44.4% of patients with symptom improvement experienced constipation recurrence mostly within one month.

Conclusions

Bifidobacterium and Bacteroides species might be quantitatively altered in FC. A short-term VSL#3 treatment can improve clinical symptoms of FC. Further studies are needed to investigate VSL#3’s additional effects beyond altering gut flora to allevate constipation.

Suitability of a probiotic Lactobacillus paracasei strain as a starter culture in olive fermentation and development of the innovative patented product "probiotic table olives"

Probiotic bacteria are generally available for consumers as concentrated preparations or incorporated in milk-based foods. Due to an increased interest of the market for probiotic foods as well as to meet a demand of industry for innovation, a new kind of probiotic food has been developed using table olives as a carrier. Green table olives, produced according to the Spanish-style, are obtained by a fermentation which can be carried out by spontaneous microflora, even if the use of starter cultures is desirable to obtain a more controlled process. In this regard, the selected strain Lactobacillus paracasei IMPC 2.1 of human origin was used in the dual role of starter and probiotic culture, and here we describe the different aspects which have been evaluated and solved to utilize that strain for the development of a new table olive-based probiotic food. These aspects include selection of the strain on the basis of its probiotic properties, molecular characterization, compatibility with the carrier food, and efficacy as starter. The final product meets commercial and functional requirements throughout its shelf-life.

Randomised clinical trial: efficacy of Lactobacillus paracasei-enriched artichokes in the treatment of patients with functional constipation--a double-blind, controlled, crossover study

BACKGROUND

The role of probiotics in the management of constipation is uncertain.

AIMS

To evaluate the effects of probiotic-enriched artichokes on treatment preference, symptom profile and short-chain fatty acid (SCFA) production in constipated subjects when compared with ordinary artichokes.

METHODS

Twenty constipated patients (3M/17F; 38.8 ± 14.4 years) were studied using a double-blind method and a computer-generated randomisation list. Each patient consumed 180 g per day of ordinary artichokes or artichokes enriched with Lactobacillus paracasei IMPC 2.1 for 15 days (daily dose of 2 × 10(10) CFU). Relief of symptoms was evaluated using a visual analogue scale. The stool consistency and symptom profile of patients were investigated using the Bristol stool form chart and the Gastrointestinal Symptom Rating Scale questionnaire (GSRS). SCFA production in faecal samples was evaluated using HPLC.

RESULTS

Eighty per cent of patients preferred probiotic-enriched artichokes to ordinary ones (P = 0.011). Satisfactory relief of symptoms was significantly higher (P = 0.0014) during the probiotic-enriched artichoke period. Bristol chart cluster scores were significantly higher (3.3 ± 1.2, 2.9 ± 1.3 2.2 ± 1.2, baseline, ordinary artichokes and probiotic-enriched ones, respectively; P = 0.009) and GSRS constipation was significantly lower (13.9 ± 0.9, 10.2 ± 0.8, 8.3 ± 0.9; P = 0.032) in the probiotic group compared with the baseline. As for SCFA production, propionic acid was significantly higher (2.2 ± 1.4, 2.1 ± 1.53, 1.5 ± 1.2; P = 0.035) in the probiotic group compared with baseline.

CONCLUSION

This trial shows a positive effect on symptoms in constipated patients after intake of probiotic-enriched artichokes.

Distinct immunomodulatory properties of Lactobacillus paracasei strains

AIMS

This study was performed to ascertain the immunomodulatory effect of Lactobacillus paracasei strains. These strains were also genetically characterized.

METHODS AND RESULTS

The strains were genetically differentiated by using the fluorescent-amplified fragment length polymorphism technique, which led to the identification of several molecular markers unique to each strain. To determine the immunomodulatory properties, we evaluated the effect of strains on dendritic cell maturation, dextran uptake, ability to induce proliferation of allogenic T cells and cytokine secretion. The results indicated that all the strains stimulated phenotypic maturation of dendritic cells (DCs), but they acted differently on DCs in relation to the other tested properties; notably, a different effect on cytokine secretion was detected.

CONCLUSIONS

The results of this study revealed different immunomodulatory properties of strains of the species Lact. paracasei. Strain IMPC 4.1 showed an interesting anti-inflammatory ability. Probiotic strains IMPC 2.1 and LMG P-17806 were characterized by a similar and intermediate ability to induce cytokine secretion in contrast to the very low ability of strain LMG 23554.

SIGNIFICANCE AND IMPACT OF STUDY

Our results confirm that each single strain of a bacterial species appears to influence the immune system in a peculiar manner. The evaluation of the different types and/or levels of cytokines whose secretion is induced by each strain could be relevant to define its pro- or anti-inflammatory properties and its more appropriate clinical use.

Reliability and validity of a modified Bristol Stool Form Scale for children

OBJECTIVES

This study sought to: evaluate the ability of children to reliably use a modified Bristol Stool Form Scale for Children (mBSFS-C), evaluate criterion-related validity of the mBSFS-C, and identify the lower age limit for mBSFS-C use.

STUDY DESIGN

The mBSFS-C comprises 5 stool form types described and depicted in drawings. Children 3 to 18 years old rated stool form for 10 stool photographs. Because of low reliability when stool form descriptors were not read aloud (n = 119), a subsequent sample of children (n = 191) rated photographs with descriptors read.

RESULTS

Intraclass correlation coefficients for descriptor-unread versus -read samples were 0.62 and 0.79, respectively. Children were increasingly reliable with age. Percentage of correct ratings varied with stool form type, but generally increased with age. With descriptors unread, children 8 years and older demonstrated acceptable interobserver reliability, with >78% of ratings correct. With descriptors read, children 6 years and older demonstrated acceptable reliability, with >80% of ratings correct.

CONCLUSIONS

The mBSFS-C is reliable and valid for use by children, with age 6 years being the lower limit for scale use with descriptors read and age 8 years being the lower limit without descriptors read. We anticipate that the mBSFS-C can be effectively used in pediatric clinical and research settings.

Slow transit constipation associated with excess methane production and its improvement following rifaximin therapy: a case report

Constipation, a common problem in gastroenterology practice, may result from slow colonic transit. Therapeutic options for slow transit constipations are limited. Excessive methane production by the methanogenic gut flora, which is more often found in patients with constipation, slows colonic transit. Thus, reduction in methane production with antibiotic treatment directed against methanogenic flora of the gut may accelerate colonic transit resulting in improvement in constipation. However, there is not much data to prove this hypothesis. We, therefore, report a patient with slow transit constipation associated with high methane production both in fasting state and after ingestion of glucose, whose constipation improved after treatment with non-absorbable antibiotic, rifaximin, which reduced breath methane values.

The enteric microbiota in the pathogenesis and management of constipation

For centuries, fiber has been recommended on an empirical basis for the management of constipation; it has only been in recent decades that the mechanisms whereby fiber and related products may influence colonic function have begun to be elucidated. The interaction between fiber and the microbiota of the human colon appears to play a major role in generating the beneficial effects of fiber. The microbiota is also the target for the other therapeutic interventions discussed in this chapter: prebiotics and probiotics. While a scientific basis for a role for these approaches in the management of constipation continues to develop, evidence from high-quality clinical trials to support their use in daily practice continues to lag far behind. While benefits for fiber and, perhaps, for certain prebiotic and probiotic preparations in constipation appear to be extant there is a real need for large well-conducted clinical trials in this important area of human medicine.

Probiotic table olives: microbial populations adhering on olive surface in fermentation sets inoculated with the probiotic strain Lactobacillus paracasei IMPC2.1 in an industrial plant

This study reports the dynamics of microbial populations adhering on the surface of debittered green olives cv. Bella di Cerignola in fermentation sets inoculated with the probiotic strain Lactobacillus paracasei IMPC2.1 in different brining conditions (4% and 8% (w/v) NaCl) at room temperature and 4 degrees C. The probiotic strain successfully colonized the olive surface dominating the natural LAB population and decreasing the pH of brines to <or=5.0 after 30 days until the end of fermentation. The dynamics of microbial populations associated with olive surface and belonging to the different groups indicated that inoculated olives held at room temperature did not host Enterobacteriaceae at the end of fermentation. Yeast populations were present in a low number (<or=log(10) 5.7 CFU/g) throughout the process. A considerable genetic diversity of LAB species colonizing the olive surface was found mainly in inoculated set brined in 8% NaCl, as indicated by the Shannon diversity index calculated for each set. Generally, strains of Lactobacillus coryniformis, L. paracasei, L. plantarum, L. pentosus, L. rhamnosus, L. brevis, L. mali, L. vaccinostercus, L.casei, Leuconostoc mesenteroides, Leuc. pseudomesenteroides, Lactococcus lactis, Weissella paramesenteroides, W. cibaria, Enterococcus casseliflavus group and E. italicus were identified during the whole process. In particular, L. pentosus was the most frequently isolated species and it showed a high strain diversity throughout fermentation in all processes except for the one held at 4 degrees C. Also a notable incidence of Leuc. mesenteroides on olives was highlighted in this study during all fermentation. Results indicated that the human strain L. paracasei IMPC2.1 can be considered an example of a strain used in the dual role of starter and probiotic culture which allowed the control of fermentation processes and the realization of a final probiotic product with functional appeal.