Guru Nanak Institute of Pharmaceutical Science and

Technology
157/ F, Nilgunj Road, Panihati, Kolkata 700114

Title of Work: Probiotics and Prebiotics

Paper Code: R21_PT319

Paper Name: Pharmaceutical Microbiology

Report Submitted for the Evaluation of Continuous Assessment II

Submitted by

Name: Somali Sengupta

Roll No.: 186012101067

Program: B. Pharm

Semester: 3

1
ABSTRACT
In the following report a short discussion on prebiotics and probiotics is done. Probiotics are defined as “live
microorganisms that when administered in adequate amounts confer a health benefit on the host”. Many
people believe that the ideal probiotic should remain viable at the level of the intestine and should adhere to
the intestinal epithelium for conferring a significant health benefit. A prebiotic is “a selectively fermented
ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal
microflora that confers benefits upon host well-being and health.” Criteria like resistance, fermentation and
selective stimulation that are used for classifying a food ingredient as a prebiotic were discussed along with
the efficacy of probiotics in prevention and treatment of diseases. Current technological and methodological
developments offer exciting future possibilities for both probiotics and prebiotics research and applications.
Light was also thrown on the future perspectives of these probiotics and prebiotics.

1. Introduction
Probiotics are defined as “live microorganisms that when administered in adequate amounts confer a health
benefit on the host” [1]. Many people believe that the ideal probiotic should remain viable at the level of the
intestine and should adhere to the intestinal epithelium for conferring a significant health benefit. Some
evidence supports the importance of bacteria viability in human studies, with viable bacteria having greater
immunologic effects than nonviable bacteria and killed bacteria being associated with certain adverse effects
in some cases [2-3]. Some of the best characterized probiotics have been found to adhere strongly to
intestinal epithelium in both in vitro and in vivo studies [4]. Probiotics are resistant to gastric acid digestion
and to bile salts to reach the intestinal intact, and they are non-pathogenic. Most of them are strains
of Bifidobacterium or Lactobacillus species. Some probiotics are derived from the intestinal microbiota of
healthy humans, and others are non-human strains used in the fermentation of dairy products. Species from
other bacterial genus such as Streptococcus, Bacillus, and Enterococcus have also been used as probiotics,
but there are concerns surrounding the safety of such probiotics because these genera contain many
pathogenic species, particularly Enterococcus [1]. Nonbacterial microorganisms such as yeasts from the
genus Saccharomyces are also used as probiotics since many years.

Fig 1: Lactobacillus
2
A prebiotic is “a selectively fermented ingredient that allows specific changes, both in the composition
and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health.” A
prebiotic was first defined as [5] “a nondigestible food ingredient that beneficially affects the host by
selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon, and
thus improves host health.” Since its introduction, the concept of prebiotics has attracted much attention,
stimulating both scientific and industrial interest. However, many food components like food
oligosaccharides, polysaccharides and some dietary fibres, have prebiotic activity without any due
consideration to the criteria required.

2. Criteria
All dietary carbohydrates are not prebiotics. There are some clear criteria for classifying a food ingredient as
a prebiotic. These criteria are [6]:
1) resistance to gastric acidity, hydrolysis by mammalian enzymes and gastrointestinal absorption 
2) fermentation by intestinal microflora
3) selective stimulation of the growth and/or activity of those intestinal bacteria that contribute to health and
well-being.
Resistance does not necessarily mean that the prebiotic is completely indigestible. However, it should
guarantee that a significant amount of the compound is available in the intestine, especially the large
intestine to serve as a fermentation substrate. Although each of these criteria is important, the third is the
most difficult to fulfil.
Simply reporting fermentation in pure cultures of single microbial strains or an increase in a limited number
of bacterial genera in complex mixtures of bacteria (e.g., faecal slurries) either in vitro or in vivo cannot be
accepted as demonstrating a prebiotic effect because it does not take bacterial interactions into account.
Demonstrating a selective stimulation of growth and/or activity of these intestinal bacteria that contribute to
health and well-being requires anaerobic sampling of faeces followed by reliable and quantitative
microbiological analysis of a wide variety of bacterial genera, e.g., total aerobes/anaerobes, clostridia,
enterobacteria, eubacteria, and lactobacilli. Molecular-based microbiological methodologies have been
developed and should make prebiotic demonstration easier. To monitor the stimulation of bacterial activity,
patterns of production of organic acids, gases, and enzymes have been used. However, these have not yet
been validated as biomarkers of specific bacterial genera.
As required for all functional food ingredients [7], the final demonstration of a prebiotic effect must be
carried out in vivo through appropriate nutritional intervention trials in the targeted species (i.e., humans,
livestock, or companion animals), using validated methodologies to produce correct scientific data.

3
 Fig 2: Sources and production of major prebiotics

3. Efficacy of Probiotics in Preventing and Treating Disease

Probiotics helps in the prevention and treatment of a diverse range of disorders, from acute gastroenteritis to
intestinal neoplasia [8]. The evidence for their efficiency in many such disorders is not strong, but there are
well-established benefits in a small number of conditions. The management of diarrhoeal diseases provides
the strongest evidence for the use of probiotics. For example, a meta-analysis of random controlled trials has
shown that many probiotics are effective in preventing antibiotic-associated diarrhoea [9]. Another such trial
has shown a variety of probiotics (including Lactobacillus species, Enterococcus species, and S. boulardii)
to be effective in the treatment of infective diarrhoea in both adults and children [10]. In this analysis,
probiotics were found to reduce the mean duration of diarrhoea by >30 h [11-12]. Probiotic therapy has also
been explored in non-gastrointestinal diseases, including the treatment and prevention of atopic eczema [13-
14]. Nevertheless, the evidence to date suggests that the major clinical effects of probiotics are seen in
gastrointestinal disorders.

4. Future Perspectives
Current technological and methodological developments offer exciting future possibilities for both probiotics
and prebiotics research and applications. Innovative tools that allow real-time studies in humans and tracking
a microbe as it integrates into an existing microbiota, as well as systems that can improve quality levels of
health, will drive this field forward. In the future, read-outs on what microbes are present, their interaction
with the host and the influence of environmental factors like drugs, nutrients, etc will be standardized when
going for a physical examination.
Novel sampling systems will illustrate how an applied probiotic or prebiotic interacts with the host at various
levels, including metabolism, the immune system and all components of the microbiome. An integrative

4
approach in the future will support a form of personalized medicine so as to establish a unique dose-response
relationships needed for treatment, determining which probiotics or prebiotics deliver the best desired
effects. Emerging concepts such as postbiotics will have a well-lit path paved by the mechanistic insights
into effector molecules.
Early career scientists want to be a part of a society that uses beneficial microbes to help solve global
problems, such as reducing the risk and impact of disease (including viruses and pandemics) and removing
drugs and toxins from human food and environment. These will be exciting times with many career paths
open for probiotics and prebiotics research in the sciences and applied to many other disciplines.

5. Conclusion
Probiotics are increasingly being used by humans because of their health benefits and are advocated by
many health care professionals. They are commonly used in a wide range of scenarios in which their
efficacy is not well established although the evidence base for their use in specific clinical scenarios is
strong. Although probiotics are safe for use in otherwise healthy persons, they should be used with caution in
some persons because of the risk of sepsis. Newly developed probiotic strains should be thoroughly
evaluated before being marketed so as to ensure safety. Although much remains unknown regarding the
mechanisms of action and the appropriate administration of probiotic strains, it is certain that different
strains can have very specific effects. Moreover, their effects may vary in health and disease, in different
disease states for different age groups. Thus, clinical trial data from one probiotic strain in one population
cannot be used for generalization pertaining to other strains or to different populations. Further studies are
needed to explore various mechanistic issues and probiotic interactions that occurs. In view of the increasing
use of probiotics as health supplements and therapeutic agents, doctors need to be aware of the risks and
benefits of such type of treatments.
Currently, the most popular targets for prebiotic use are Lactobacilli and Bifidobacteria. However, as our
knowledge of the gut flora diversity improves, it may become apparent that other microorganisms should be
fortified through their use. One example may be the Clostridium coccoides–Eubacterium rectale cluster that
includes bacteria producing butyric acid which is a metabolite that is beneficial for gut functionality and
potentially protective against bowel cancer [15]. Other bacteria, both of known and unknown genera, may
also likely have a prebiotic effect and must be put in perspective with our increasing understanding of the
bacterial diversity in the gut microflora.

5
 Reference
[1] FAO/WHO. Guidelines for the evaluation of probiotics in food. 2002.
[2] Kaila M, Isolauri E, Saxelin M, Arvilommi H, Vesikari T. Viable versus inactivated lactobacillus strain
GG in acute rotavirus diarrhoea. Arch Dis Child 1995;72:51–3.
[3] Kirjavainen PV, Salminen SJ, Isolauri E. Probiotic bacteria in the management of atopic disease:
underscoring the importance of viability. J Pediatr Gastroenterol Nutr 2003;36:223–7.
[4] Alander M, Satokari R, Korpela R, et al. . Persistence of colonization of human colonic mucosa by a
probiotic strain, Lactobacillus rhamnosus GG, after oral consumption. Appl Environ Microbiol
1999;65:351–4.
[5] Gibson GR, Roberfroid MB. Dietary modulation of the colonic microbiota: Introducing the concept of
prebiotics. J Nutr. 1995;125:1401–12.
[6] Gibson GR, Probert HM, Van Loo JAE, Roberfroid MB. Dietary odulation of the human colonic
microbiota: Updating the concept of prebiotics. Nutr Res Rev. 2004;17:257–9.
[7] Diplock AT, Aggett PJ, Ashwell M, Bornet F, Fern EB, Roberfroid MB. Scientific concepts of functional
foods in Europe: consensus document. Br J Nutr. 1999;81: Suppl 1:s1–s28.
[8] Marteau PR. Probiotics in clinical conditions. Clin Rev Allergy Immunol 2002;22:255–73
[9] D’Souza AL, Rajkumar C, Cooke J, Bulpitt CJ. Probiotics in prevention of antibiotic associated
diarrhoea: meta-analysis. BMJ 2002;324:1361.
[10] Allen SJ, Okoko B, Martinez E, Gregorio G, Dans LF. Probiotics for treating infectious diarrhea.
Cochrane Database Syst Rev 2003;CD003048.
[11] Gionchetti P, Rizzello F, Venturi A, et al. . Oral bacteriotherapy as maintenance treatment in patients
with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000;119:305–9.
[12] Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers:
comparison of two probiotic agents. Pediatrics 2005;115:5–9.
[13] Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary
prevention of atopic disease: a randomised placebo-controlled trial. Lancet 2001;357:1076–9.
[14] Rosenfeldt V, Benfeldt E, Nielsen SD, et al. . Effect of probiotic Lactobacillus strains in children with
atopic dermatitis. J Allergy Clin Immunol 2003;111:389–95.
[15] Kleessen B, Hartman L, Blaut M. Oligofructose and long chain inulin influence the gut microbial
ecology of rats associared with a human faecal flora. Br J Nutr. 2001;86:291–300

6
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ABSTRACT
In the following report a short discussion on prebiotics and probiotics is done. Probiotics are defined as “live
microorganisms that when administered in adequate amounts confer a health benefit on the host”. Many
people believe that the ideal probiotic should remain viable at the level of the intestine and should adhere to
the intestinal epithelium for conferring a significant health benefit. A prebiotic is “a selectively fermented
ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal
7
microflora that confers benefits upon host well-being and health.” Criteria like resistance, fermentation and
selective stimulation that are used for classifying a food ingredient as a prebiotic were discussed along with
the efficacy of probiotics in prevention and treatment of diseases. Current technological and methodological
developments offer exciting future possibilities for both probiotics and prebiotics research and applications.
Light was also thrown on the future perspectives of these probiotics and prebiotics.

1. Introduction
Probiotics are defined as undefined Many people believe that the ideal probiotic should remain viable at

the level of the intestine and should adhere to the intestinal epithelium for conferring a significant health

benefit. Some evidence supports the importance of bacteria viability in human studies, with viable

bacteria having greater immunologic effects than nonviable bacteria and killed bacteria being associated

with certain adverse effects in some cases [2-3]. Some of the best characterized probiotics have been

found to adhere strongly to intestinal epithelium in both in vitro and in vivo studies [4]. Probiotics are

resistant to gastric acid digestion and to bile salts to reach the intestinal intact, and they are non-

pathogenic. Most of them are strains of Bifidobacterium or Lactobacillus species. Some probiotics are

derived from the intestinal microbiota of healthy humans, and others are non-human strains used in the

fermentation of dairy products. Species from other bacterial genus such as Streptococcus, Bacillus, and

Enterococcus have also been used as probiotics, but there are concerns surrounding the safety of such

probiotics because these genera contain many pathogenic species, particularly Enterococcus [1].

Nonbacterial microorganisms such as yeasts from the genus Saccharomyces are also used as probiotics

since many years.

A prebiotic is "a selectively fermented ingredient that allows specific changes, both in the composition

and/or activity in the gastrointestinal microflora that confers benefits upon host well- being and health." A

prebiotic was first defined as [5] "a nondigestible food ingredient that beneficially affects the host by

selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon, and

thus improves host health." Since its introduction, the concept of prebiotics has attracted much attention,

stimulating both scientific and industrial interest.

However, many food components like food oligosaccharides, polysaccharides and some dietary fibres,

have prebiotic activity without any due consideration to the criteria required.

2. Criteria
All dietary carbohydrates are not prebiotics. There are some clear criteria for classifying a food ingredient as

a prebiotic. These criteria are [6]:

1) resistance to gastric acidity, hydrolysis by mammalian enzymes and gastrointestinal

absorption
8
 2) fermentation by intestinal microflora

3) selective stimulation of the growth and/or activity of those intestinal bacteria that

contribute to health and well-being.

Resistance does not necessarily mean that the prebiotic is completely indigestible. However, it should

guarantee that a significant amount of the compound is available in the intestine, especially the large

intestine to serve as a fermentation substrate. Although each of these criteria is important, the third is the

most difficult to fulfil.

Simply reporting fermentation in pure cultures of single microbial strains or an increase in a limited

number of bacterial genera in complex mixtures of bacteria (e.g., faecal slurries) either in vitro or in vivo

cannot be accepted as demonstrating a prebiotic effect because it does not take bacterial interactions into

account. Demonstrating a selective stimulation of growth and/or activity of these intestinal bacteria that

contribute to health and well-being requires anaerobic sampling of faeces followed by reliable and

quantitative microbiological analysis of a wide variety of bacterial genera,

e.g. , total aerobes/anaerobes, clostridia, enterobacteria, eubacteria, and lactobacilli. Molecular- based

microbiological methodologies have been developed and should make prebiotic demonstration easier.

To monitor the stimulation of bacterial activity, patterns of production of organic acids, gases, and

enzymes have been used. However, these have not yet been validated as biomarkers of specific

bacterial genera.

As required for all functional food ingredients [7], the final demonstration of a prebiotic effect must be

carried out in vivo through appropriate nutritional intervention trials in the targeted species (i.e., humans,

livestock, or companion animals), using validated methodologies to produce correct scientific data.

3. Efficacy of Probiotics in Preventing and Treating Disease

Probiotics helps in the prevention and treatment of a diverse range of disorders, from acute gastroenteritis to

intestinal neoplasia [8]. The evidence for their efficiency in many such disorders is not strong, but there are

well-established benefits in a small number of conditions. The management of diarrhoeal diseases provides

the strongest evidence for the use of probiotics. For example, a meta-analysis of random controlled trials has

shown that many probiotics are effective in preventing antibiotic-associated diarrhoea [9]. Another such trial

has shown a variety of probiotics (including Lactobacillus species, Enterococcus species, and S. boulardii) to

be effective in the treatment of infective diarrhoea in both adults and children [10]. In this analysis,

probiotics were found to reduce the mean duration of diarrhoea by >30 h [11-12]. Probiotic therapy has also

been explored in non-gastrointestinal diseases, including the treatment and prevention of atopic eczema [13-

9
14]. Nevertheless, the evidence to date suggests that the major clinical effects of probiotics are seen in

gastrointestinal disorders.

4. Future Perspectives

Current technological and methodological developments offer exciting future possibilities for both

probiotics and prebiotics research and applications. Innovative tools that allow real-time studies in

humans and tracking a microbe as it integrates into an existing microbiota, as well as systems that can

improve quality levels of health, will drive this field forward. In the future, read-outs on what microbes

are present, their interaction with the host and the influence of environmental factors like drugs, nutrients,

etc will be standardized when going for a physical examination.

Novel sampling systems will illustrate how an applied probiotic or prebiotic interacts with the host at

various levels, including metabolism, the immune system and all components of the microbiome. An

integrative approach in the future will support a form of personalized medicine so as to establish a

unique dose-response relationships needed for treatment, determining which probiotics or prebiotics

deliver the best desired effects. Emerging concepts such as postbiotics will have a well-lit path paved by

the mechanistic insights into effector molecules.

Early career scientists want to be a part of a society that uses beneficial microbes to help solve global

problems, such as reducing the risk and impact of disease (including viruses and pandemics) and

removing drugs and toxins from human food and environment. These will be exciting times with many

career paths open for probiotics and prebiotics research in the sciences and applied to many other

disciplines.

5. Conclusion
Probiotics are increasingly being used by humans because of their health benefits and are advocated by

many health care professionals. They are commonly used in a wide range of scenarios in which their

efficacy is not well established although the evidence base for their use in specific clinical scenarios is

strong. Although probiotics are safe for use in otherwise healthy persons, they should be used with

caution in some persons because of the risk of sepsis. Newly developed probiotic strains should be

thoroughly evaluated before being marketed so as to ensure safety. Although much remains unknown

regarding the mechanisms of action and the appropriate administration of probiotic strains, it is certain

that different strains can have very specific effects. Moreover, their effects may vary in health and

disease, in different disease states for different age groups. Thus, clinical trial data from one probiotic

strain in one population cannot be used for generalization pertaining to other strains or to different

10
populations. Further studies are needed to explore various mechanistic issues and probiotic interactions

that occurs. In view of the increasing use of probiotics as health supplements and therapeutic agents,

doctors need to be aware of the risks and benefits of such type of treatments.

Currently, the most popular targets for prebiotic use are Lactobacilli and Bifidobacteria. However, as our

knowledge of the gut flora diversity improves, it may become apparent that other microorganisms should

be fortified through their use. One example may be the Clostridium coccoides–Eubacterium rectale

cluster that includes bacteria producing butyric acid which is a metabolite that is beneficial for gut

functionality and potentially protective against bowel cancer [15]. Other bacteria, both of known and

unknown genera, may also likely have a prebiotic effect and must be put in perspective with our

increasing understanding of the bacterial diversity in the gut microflora.

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11