The Effects of Kefir and Kefir Components on Immune and Metabolic Physiology in Pre-Clinical Studies: A Narrative Review

Kefir, a fermented beverage made from kefir grains, has gained immense popularity around the world due to its potential health-promoting properties. Kefir beverages are both marketed commercially and brewed privately by individuals. Both milk and sugar solutions can be used as substrates with various additives included based on consumer preference. Fermentation occurs via microorganisms including lactic acid bacteria, acetic acid bacteria, and yeasts, which are naturally present in kefir grains. Health-promoting effects of kefir are thought to occur through immune, gastrointestinal, and metabolic regulation. Both clinical trials and mechanistic studies in cell culture and animal models have explored these effects. Studies in vitro and in animals have shown the ability of kefir and kefir components to antagonize pathogens, reduce proinflammatory cytokine production, contribute to cytotoxicity of tumor cell lines and reduce tumor burden, and improve serum glycemic and lipid profiles. However, some data from clinical trials are conflicting, and the precise mechanisms by which kefir promotes well-being are not completely defined. This review summarizes the current body of evidence in both cell culture and animal models that provide insight into the mechanisms by which kefir beverages may protect consumers from enteric infections and improve immune and metabolic health. We believe that readers will gain knowledge helpful for both developing more targeted mechanistic studies and selecting informative outcomes when designing clinical studies.

Summary of Probiotic Potential of the Kefir for the Prevention and Alleviation of Functional GI Diseases

Background:

Functional Gastrointestinal (GI) disease is a term that refers to a range of disease conditions involving chronic diarrhea, irritable bowel syndrome, constipation, inflammatory bowel disease (IBD), and lactose intolerance. Statistical reports have documented >40% of the world's population is being afflicted by functional GI disorders. Consequences of frequent intake of antibiotics include mortality of gut microflora, antibiotic-associated diarrhea, the establishment of antibiotic resistance, and inference with healthy bodily functions. To overcome the harms of antibiotics, studies are being conducted to determine the potential of probiotics as alternatives to antibiotics.

Aim of Study:

The purpose of constructing this literature review is to outline the potential attributes of Kefir and to assess the solitary efficiency of this beverage in the amelioration of GI disease conditions.

Methodology:

Extraction of data entailed digging of literature hubs including PubMed, PubMed Central, Research Gate, Science Direct, and Google Scholar, employing a different combination of keywords to retrieve substantial details. Selection criteria of the articles involved the published reports of preceding 10 years (2012-2021) that exhibited relevancy with the topic

Conclusion:

Kefir grains having different origins provide a distinct array of antimicrobial spectrums and are found to be effective against different pathogens. IBDs, diarrheal sicknesses, and constipation can be alleviated by the consumption of this beverage. Moreover, the probioticantibiotic combination is also essential for the mitigation of several diseases. The synergistic impact of several microbial strains is vital for the treatment of celiac disease. Lactose maldigestion can be relieved by the consumption of kefir having β-galactosidase enzyme activity.

The effect of Lacticaseibacillus casei on inflammatory cytokine (IL-8) gene expression induced by exposure to Shigella sonnei in Zebrafish (Danio rerio)

ABSTRACT This study aimed to evaluate the protective function of probiotics against Shigella sonnei pathogenicity. For this purpose, 400 zebrafish were divided into four groups with two replications: (T1): receiving Lacticaseibacillus casei for 27 days, (T2): receiving L. casei for 27 days followed by 72 hr exposure to S. sonnei, (T3): receiving basal diet for 27 days followed by 72 hr exposure to S. sonnei, and control group (C): receiving basal diet without exposure to the pathogen. According to the results, feeding with L. casei for 27 days reduced the interleukin-8 (IL-8) expression significantly (P<0.05). The results showed a decrease in IL-8 expression in the group exposed to the pathogen and fed with the probiotic compared to the group only fed with the basal diet (P<0.05). Considering the role of IL-8 as a pro-inflammatory cytokine, our results indicated that feeding with L. casei could modulate inflammatory responses.

Metagenomic analysis of microflora structure and functional capacity in probiotic Tibetan kefir grains

Tibetan kefir grains (TKGs) are distinctive and complex mixtures with protein-lipid-polysaccharide matrices and multiple microorganism species. The objective of this study was to evaluate the microflora composition, probiotic species and functional genes within TKGs. Metagenomic analysis was used to evaluate communities of three TKGs, revealing the presence of 715 species, with Lactobacillus kefiranofaciens as the most dominant species. The relative abundances of acetic acid bacteria and yeast significantly differed among the three TKGs (acetic acid bacteria: p < 0.01; yeast: p < 0.05), and the dominant yeast species also varied across three TKGs. Lactobacillus helveticus was the most abundant listed probiotic species, and its abundance did not significantly differ across three TKGs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that ko01501 was the most abundant pathway that related to human disease. There are 16 different KOs (KEGG Orthology) in the ko01501 pathway were annotated in TKGs, which helps to resist β-lactam. This study provided a new insight into the microbial community structures and the presence of probiotic species within TKGs and provides a foundation for further targeted studies.

Advancements in the Use of Fermented Fruit Juices by Lactic Acid Bacteria as Functional Foods: Prospects and Challenges of Lactiplantibacillus (Lpb.) plantarum subsp. plantarum Application

Lactic acid fermentation of fresh fruit juices is a low-cost and sustainable process, that aims to preserve and even enhance the organoleptic and nutritional features of the raw matrices and extend their shelf life. Selected Lactic Acid Bacteria (LAB) were evaluated in the fermentation of various fruit juices, leading in some cases to fruit beverages, with enhanced nutritional and sensorial characteristics. Among LAB, Lactiplantibacillus (Lpb.) plantarum subsp. plantarum strains are quite interesting, regarding their application in the fermentation of a broad range of plant-derived substrates, such as vegetables and fruit juices, since they have genome plasticity and high versatility and flexibility. L. plantarum exhibits a remarkable portfolio of enzymes that make it very important and multi-functional in fruit juice fermentations. Therefore, L. plantarum has the potential for the production of various bioactive compounds, which enhance the nutritional value and the shelf life of the final product. In addition, L. plantarum can positively modify the flavor of fruit juices, leading to higher content of desirable volatile compounds. All these features are sought in the frame of this review, aiming at the potential and challenges of L. plantarum applications in the fermentation of fruit juices.

Supplementation of kefir ameliorates azoxymethane/dextran sulfate sodium induced colorectal cancer by modulating the gut microbiota

The aim of this study was to investigate the efficacy of kefir on colorectal cancer (CRC) via regulating the microbiota structure in the colon using the azoxymethane/dextran sulfate sodium (AOM/DSS) induced CRC mouse model. Mice in the treatment group were orally administered with milk or kefir. The gut microbiota composition was assessed by internally transcribed spacer 2 (ITS2) and 16S rRNA high-throughput sequencing. Furthermore, the biomarkers associated with the gut barrier, inflammation, and cell proliferation regulators were evaluated. The results indicated that the size and the amount of tumor were decreased and the immunity regulators (TNF-α, IL-6, and IL-17a) and oncocyte proliferation indicator (Ki67, NF-κB, and β-catenin) were all decreased. Increased short chain fatty acids (SCFAs) lowered the pH in the colon and helped enhance the intestinal barrier. The Firmicutes/Bacteroidetes ratio and Ascomycota/Basidiomycota ratio were decreased at the phylum level; the relative abundance of probiotics was increased and the pathogenic bacterium (Clostridium sensu stricto, Aspergillus and Talaromyces) were decreased after supplementation of kefir. Consequently, kefir could regulate the gut microbiota composition and ameliorate AOM/DSS induced colorectal cancer.

Lactobacillus rhamnosus postbiotic-induced immunomodulation as safer alternative to the use of live bacteria

Many attempts have been made to search for safer immunomodulatory agents that enhance the immune response and reduce the number and severity of infections in at-risk populations. The use of postbiotics, non-viable microbial cells or cell fractions that confer a health benefit to the consumer, represents a safe and attractive way to modulate and enhance the immune function in order to improve human health. Therefore, the aim of this work is to evaluate the immunoregulatory effect of Lactobacillus rhamnosus CRL1505 postbiotics in a complex culture system using human intestinal epithelial cells (IECs) and dendritic cells (DCs) differentiated from peripheral blood mononuclear cells. First, we demonstrated that L. rhamnosus CRL1505 differentially modulate human IECs and DCs after the challenge with the TLR4 agonist LPS. The CRL1505 strain down-regulated CD40, CD80 and CD86 expression in DCs, and increased their production of TNF-α, IL-1β, IL-6 and IL-10. Interestingly, the non-viable strain was able to modulate the immune response of both types of human cells. Then, we showed that cell wall (CW1505) and peptidoglycan (PG1505) from L. rhamnosus CRL1505 modulated TLR4-triggered immune response in IECs and DCs. Of interest, CW1505 showed a strong stimulatory effect while the PG1505 presented immune characteristics that were more similar to viable and non-viable CRL1505. To date, several molecules of immunobiotics were identified, that can be connected to specific host-responses. We hereby demonstrated that peptidoglycan of L. rhamnosus CRL1505 is a key molecule for the immunobiotic properties of this strain in human IECs and DCs. Likewise, the result of these studies could provide predictive tools for the in vivo efficacy of postbiotics and the scientific basis for their future applications in immunocompromised patients.

Potential beneficial effects of kefir and its postbiotic, kefiran, on child food allergy

Food allergies are known as the public health problem, affecting people of all age groups, but more commonly in babies and children, with consequences for nutritional status and quality of life. The increase in the consumption of healthy foods has consequently led to an increased demand for functional foods with specific health benefits. Thus, the pharmaceutical industry's interest in natural products has grown every time and is therefore considered as an alternative to synthetic drugs. Kefir has been outstanding for several years as promising in the manufacture of various pharmaceutical products, due to its nutritional and therapeutic properties for the treatment of many diseases. Currently, a wide variety of new functional foods are appearing on the market, representing an important segment. Postbiotics, for example, has stood out for being a product with action similar to probiotics, without offering side effects. The kefiran is the postbiotic from kefir that promotes potential beneficial effects on food allergy from the intestinal microbiome to the immune system. In this context, it is necessary to know the main promoting component of this functional effect. This review compiles the benefits that kefir, and especially its postbiotic, kefiran, can bring to food allergy. In addition, it serve as a subsidy for studies on the development of innovative nutraceutical products, including the use of kefiran as an alternative therapy in food allergy.

Kefir and Its Biological Activities

Kefir is a fermented beverage with renowned probiotics that coexist in symbiotic association with other microorganisms in kefir grains. This beverage consumption is associated with a wide array of nutraceutical benefits, including anti-inflammatory, anti-oxidative, anti-cancer, anti-microbial, anti-diabetic, anti-hypertensive, and anti-hypercholesterolemic effects. Moreover, kefir can be adapted into different substrates which allow the production of new functional beverages to provide product diversification. Being safe and inexpensive, there is an immense global interest in kefir’s nutritional potential. Due to their promising benefits, kefir and kefir-like products have a great prospect for commercialization. This manuscript reviews the therapeutic aspects of kefir to date, and potential applications of kefir products in the health and food industries, along with the limitations. The literature reviewed here demonstrates that there is a growing demand for kefir as a functional food owing to a number of health-promoting properties.

El-Seedi H. The Many Faces of Kefir Fermented Dairy Products: Quality Characteristics, Flavour Chemistry, Nutritional Value, Health Benefits, and Safety

Kefir is a dairy product that can be prepared from different milk types, such as goat, buffalo, sheep, camel, or cow via microbial fermentation (inoculating milk with kefir grains). As such, kefir contains various bacteria and yeasts which influence its chemical and sensory characteristics. A mixture of two kinds of milk promotes kefir sensory and rheological properties aside from improving its nutritional value. Additives such as inulin can also enrich kefir's health qualities and organoleptic characters. Several metabolic products are generated during kefir production and account for its distinct flavour and aroma: Lactic acid, ethanol, carbon dioxide, and aroma compounds such as acetoin and acetaldehyde. During the storage process, microbiological, physicochemical, and sensory characteristics of kefir can further undergo changes, some of which improve its shelf life. Kefir exhibits many health benefits owing to its antimicrobial, anticancer, gastrointestinal tract effects, gut microbiota modulation and anti-diabetic effects. The current review presents the state of the art relating to the role of probiotics, prebiotics, additives, and different manufacturing practices in the context of kefir's physicochemical, sensory, and chemical properties. A review of kefir's many nutritional and health benefits, underlying chemistry and limitations for usage is presented.

Analysis of Health Benefits Conferred by Lactobacillus Species from Kefir

Lactobacilli are among the most common microorganisms found in kefir; a traditional fermented milk beverage produced locally in many locations around the world. Kefir has been associated with a wide range of purported health benefits; such as antimicrobial activity; cholesterol metabolism; immunomodulation; anti-oxidative effects; anti-diabetic effects; anti-allergenic effects; and tumor suppression. This review critically examines and assesses these claimed benefits and mechanisms with regard to particular Lactobacillus species and/or strains that have been derived from kefir; as well as detailing further potential avenues for experimentation.

Microbial Succession and Flavor Production in the Fermented Dairy Beverage Kefir

Traditional fermented foods represent relatively low-complexity microbial environments that can be used as model microbial communities to understand how microbes interact in natural environments. Our results illustrate the dynamic nature of kefir fermentations and microbial succession patterns therein. In the process, the link between individual species, and associated pathways, with flavor compounds is revealed and several genes that could be responsible for the purported gut health-associated benefits of consuming kefir are identified. Ultimately, in addition to providing an important fundamental insight into microbial interactions, this information can be applied to optimize the fermentation processes, flavors, and health-related attributes of this and other fermented foods.

Kefir is a putatively health-promoting dairy beverage that is produced when a kefir grain, consisting of a consortium of microorganisms, is added to milk to initiate a natural fermentation. Here, a detailed analysis was carried out to determine how the microbial population, gene content, and flavor of three kefirs from distinct geographic locations change over the course of 24-h fermentations. Metagenomic sequencing revealed that Lactobacillus kefiranofaciens was the dominant bacterial species in kefir during early stages of fermentations but that Leuconostoc mesenteroides became more prevalent in later stages. This pattern is consistent with an observation that genes involved in aromatic amino acid biosynthesis were absent from L. kefiranofaciens but were present in L. mesenteroides. Additionally, these shifts in the microbial community structure, and associated pathways, corresponded to changes in the levels of volatile compounds. Specifically, Acetobacter spp. correlated with acetic acid; Lactobacillus spp. correlated with carboxylic acids, esters and ketones; Leuconostoc spp. correlated with acetic acid and 2,3-butanedione; and Saccharomyces spp. correlated with esters. The correlation data suggest a causal relationship between microbial taxa and flavor that is supported by observations that addition of L. kefiranofaciens NCFB 2797 increased the levels of esters and ketones whereas addition of L. mesenteroides 213M0 increased the levels of acetic acid and 2,3-butanedione. Finally, we detected genes associated with probiotic functionalities in the kefir microbiome. Our results illustrate the dynamic nature of kefir fermentations and microbial succession patterns therein and can be applied to optimize the fermentation processes, flavors, and health-related attributes of this and other fermented foods.

IMPORTANCE Traditional fermented foods represent relatively low-complexity microbial environments that can be used as model microbial communities to understand how microbes interact in natural environments. Our results illustrate the dynamic nature of kefir fermentations and microbial succession patterns therein. In the process, the link between individual species, and associated pathways, with flavor compounds is revealed and several genes that could be responsible for the purported gut health-associated benefits of consuming kefir are identified. Ultimately, in addition to providing an important fundamental insight into microbial interactions, this information can be applied to optimize the fermentation processes, flavors, and health-related attributes of this and other fermented foods.

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