[Probiotics and prebiotics in primary care for colon cancer]

Fructooligosaccharides on inflammation, immunomodulation, oxidative stress, and gut immune response: a systematic review

CONTEXT

Evidence shows that fructooligosaccharides (FOSs) can modulate inflammatory, oxidative, and immune activity in the gut, possibly leading to a systemic response, improving human health.

OBJECTIVE

To assess the present knowledge of the effects of FOSs on inflammation, immunomodulation, oxidative stress, and gut immune response.

DATA SOURCES

Studies published between December 2000 and January 2020 were systematically searched in four databases: MEDLINE, LILACS, Web of Science, and Scopus. After the screening of 1316 articles, 8 human studies and 20 animal models were included.

DATA EXTRACTION

Data were extracted separately by 2 reviewers. For each study, the design, population, exposures, main results, and conclusion were extracted. The research questions and the risk-of-bias information were also extracted. Additionally, the risk-of-bias were analyzed to guarantee the reliability of this review.

DATA ANALYSIS

A qualitative analysis revealed that FOSs can increase bifidobacteria counts and short-chain fatty acids in the gut, stimulate IgA secretion in the colon, and decrease proinflammatory cytokines, thus influencing metabolic diseases.

CONCLUSION

Studies suggest that FOS supplementation is positively associated with an anti-inflammatory and antioxidant effect, thus enhancing the gut immune system, which may be beneficial for the host's health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration nos 42020209865 and 42020220369.

Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial

Periampullary neoplasms are rapidly progressive tumors with a poor prognosis and high morbidity and mortality rates, which have a negative influence on patient outcomes. Some probiotics and prebiotics have the ability to protect the intestinal barrier and prevent bacterial translocation, infection, and postoperative complications. We evaluated the use of synbiotics in a prospective, double-blind study of patients undergoing surgery for periampullary neoplasms (PNs) and assessed the effect of these agents on nutritional status, postoperative complications, antibiotic use, length of hospital stay, and mortality. Patients were randomized to receive probiotics and prebiotics-synbiotics--group S [Lactobacillus acidophilus 10, 1 × 10(9)CFU, Lactobacillus rhamnosus HS 111, 1 × 10(9) CFU, Lactobacillus casei 10, 1 × 10(9) CFU, Bifidobacterium bifidum, 1 × 10(9)CFU, and fructooligosaccharides (FOS) 100 mg]--or placebo-controls--group C, twice daily, for a total of 14 days. Risk, clinical status, and postoperative complication rates were assessed. Twenty-three patients were allocated to each group. The incidence of postoperative infection was significantly lower in group S (6 of 23 patients, 26.1%) than in group C (16 of 23 patients, 69.6%) (P = 0.00). Duration of antibiotic therapy was also shorter in group S (mean = 9 days vs. 15 days in group C; P = 0.01). Noninfectious complications were less common in group S (6 of 23 vs. 14 of 23 patients in group C; P = 0.03). Mean length of hospital stay was 12 ± 5 days in group S vs. 23 ± 14 days in group C (P = 0.00). No deaths occurred in group S, whereas 6 deaths occurred in group C (P = 0.02). Perioperative administration of synbiotics reduces postoperative mortality and complication rates in patients undergoing surgery for PNs.

The therapeutic use of symbiotics

INTRODUCTION

Functional foods are health promoters and their use is associated with reduced risk of chronic degenerative and non-transmissible diseases. Examples are symbiotic. The association of one (or more) probiotic with a one (or more) prebiotic is called symbiotic, being the prebiotics complementary and probiotics synergistic, thus presenting a multiplicative factor on their individual actions.

OBJECTIVE

To assess the evidences on the benefits of the use of symbiotics in the treatment of clinical and surgical situations.

METHODS

The headings symbiotic, probiotic and prebiotic were searched in Pubmed/Medline in the last 15 years, and were selected 25 articles, used for database.

RESULTS

The use of symbiotic may promote an increase in the number of bifidobacteria, glycemic control, reduction of blood cholesterol, balancing the intestinal flora which aids in reducing constipation and/or diarrhea, improves intestinal permeability and stimulation of the immune system. Clinical indications for these products has been expanded, in order to maximize the individual's physiological functions to provide greater. So, with the high interest in the clinical and nutritional control of disease, many studies have been conducted demonstrating the effectiveness of using symbiotic in improving and/or preventing various and/or symptoms of gastrointestinal diseases.

CONCLUSION

Symbiotic behave differently and positively in various pathological situations.

Relationship among intestinal flora, high-fat diets, and hyperlipidemia

In recent years, research has found close associations among intestinal flora, high-fat diets, and hyperlipidemia. Intestinal flora may regulate blood lipids by producing cholesterol oxidase, inhibiting the activity of liver lipase, regulating the distribution of cholesterol in the blood and liver, and affecting biliary enterohepatic circulation. High-fat diets and hyperlipidemia can influence the composition of intestinal flora by reducing intestinal nutrient source, changing redox state, and destroying the microenvironment in which intestinal flora survive. Molecular mechanisms by which intestinal flora regulates lipid metabolism include directly regulating fat storage genes of the host (inhibiting the activity of fasting-induced adipose factor gene, enhancing the expression of sterol regulatory element binding protein-1 and carbohydrate response element binding protein, and reducing the activity of AMP-activated protein kinase) and modulating the activity of lipopolysaccharide to change the body's chronic low inflammation state. Prevention of hyperlipidemia by regulating the intestinal flora or prevention and treatment of related diseases by adjusting the diet and reducing blood fat to change the composition of intestinal flora are becoming research hotspots.

Study of the effect exerted by fructo-oligosaccharides from yacon (Smallanthus sonchifolius) root flour in an intestinal infection model with Salmonella Typhimurium

Beneficial effects of prebiotics like inulin and fructo-oligosaccharides (FOS) have been proven in health and nutrition. Yacon (Smallanthus sonchifolius), an Andean crop, contains FOS (50–70 % of its dry weight) and, therefore, is considered a prebiotic. Commercial FOS can up-regulate total secretory IgA (S-IgA) in infant mice, prevent infection with Salmonella in swine or enhance immune response for Salmonella vaccine in a mouse model. Previously, we found that administration of yacon root flour regulates gut microbiota balance and has immunomodulatory effects without inflammatory responses. The aim of the present paper is to analyse if yacon prevents enteric infection caused by a strain of Salmonella enteritidis serovar Typhimurium (S. Typhimurium) in a mouse model. BALB/c mice were supplemented with yacon flour (45 d), challenged with S. Typhimurium and killed to study pathogen translocation, total and specific IgA production by ELISA, presence of IgA and other cytokines and Toll-like receptor 4 (TLR4) and clustor of differentiation 206 (CD206) receptors positive cells by immunofluorescence and histological changes. Yacon flour administration had a protective effect from 15 to 30 d of treatment. We found a peak of total S-IgA production without translocation of the pathogen for these periods. At 30 d, there was an increase in IL-6 and macrophage inflammatory proteins-1α+ cells and expression of the receptors CD206 and TLR4. Yacon flour did not have incidence in pathogen-specific S-IgA production. Longer periods (45 d) of administration had no protective effect. Therefore, yacon can prevent enteric infection caused by S. Typhimurium when given up to 30 d; this effect would be mediated by enhancing non-specific immunity, such as total S-IgA, that improves the immunological intestinal barrier.

Intake of a high-fat diet alters intestinal flora in rats

AIM: To investigate the possible effect of intake of a high-fat diet on intestinal flora in rats.

METHODS: Twenty Sprague-Dawley rats were randomly divided into two groups: group A and group B. Group A was fed a normal diet, while group B was fed a diet rich in oil and fat. The fecal microbial population was analyzed on days 1, 15 and 30. The rats were killed on day 30 to analyze the small intestinal flora.

RESULTS: Serum total cholesterol (TC) level on day 30 was significantly lower in group A than in group B (1.8186 mmol/L ± 0.39 mmol/L vs 2.6213 mmol/L ± 0.28 mmol/L, P < 0.05). The fecal microbial population changed greatly in Group B: the counts of Lactobacillus acidophilus, Bifidobacterium, and Enterococcus were significantly lower on day 30 than on day 1 (6.1353 ± 0.23 vs 7.0203 ± 0.36, 5.3010 ± 0.23 vs 6.8531 ± 0.30 and 3.3269 ± 0.24 vs 5.4740 ± 0.25, all P < 0.05); the counts of Bacteroides on days 15 and 30 were 7.2339 ± 0.32 and 5.7979 ± 0.40, respectively, showing an "initially increased then decreased]trend (P < 0.05) when compared with that on day 1 (6.4933 ± 0.38). In contrast, the small intestinal flora was relatively stable.

CONCLUSION: High-fat diet intake for 30 days results in great changes in intestinal flora that mainly occur in the colon and are considered to be able to accelerate the development of obesity and hyperlipidemia.