Probiotics

PROBIOTICS AND ANTIMICROBIALS
Synbiotics
Definition
• A probiotic organism in combination with
its prebiotic food
• Providing both the organism and substrate
at the time of ingestion may offer improved
chance of survival in GI tract
Dysbiosis
• Dysbiosis is an
intestinal imbalance
where pathogenic
microorganisms
outnumber
beneficial bacterial
species.
• Digestive diseases
are often caused in
part by or result in
dysbiosis.
Prebiotics
Definition
• Nondigestible food ingredients

– Fructo-oligosaccharides (chicory, inulin)
– Lactulose
• Positively affect the endogenous flora
• Stimulate the growth of one or a limited
number of bacterial species
– FOSBifidobacteria
– LactuloseLactobacilli
Probiotics
Definition
• Nutritional supplement
• Contains 1 or more
cultures of living "live microorganisms which
organisms when administered in
– Typically bacteria or adequate amounts confer a
yeast health benefit on the host."
• Modify the endogenous

microflora
• Have a positive effect on
the host
Probiotics
Candidates
• Lactobacillus
– acidophilus, reuteri, casei, planatarum,
rhamnosus “GG”
• Bifidobacteria
– bifidum, breve, infantis, longum
• Streptococcus
– thermophilus
• Saccharomyces
• Several combinations on the market
Probiotics
Potential Mechanisms of Action
• Inhibition of adhesion
• Immunomodulation
• Production of antimicrobial substances
• Modification of toxins or toxin receptors
• Competition for nutrients
• Reduction in bacterial translocation
• Anti-inflammatory signaling within the
epithelium
PREBIOTICS
Supplements not digested by human enzymes that
stimulate growth of beneficial bacteria
• Fructo-oligosaccharides
• Inulin
• Galacto-,galactosyllactose-,xylo-,isomalto-and
soya oligosaccharides
• Pyrodextrins (glucose oligosaccharides)
• Lactulose
• Breast milk oligosaccharides
Oligosaccharides
• Usual pleasant slight sweet taste
• Add texture to foods
• Naturally occurs in artichoke, onion,garlic,
chicory, leek, and to a lesser degree in
cereals
• Raffinose and stachynose are major CHO
of beans and peas
• Commercially produced (FOS)
Benefits of Oligosaccharides
• Promote the growth of bifido-and
lactobacilli
• Lower colon pH
• Discourage growth of Clostridia
• Prevent constipation and diarrhea
• Have low glycemic index
• Water-soluble and of low viscosity
• Do not bind minerals
Inulin
• Naturally occurs in fruits and vegetables
• Longer chain length than FOS
• Provides a fat mimicking texture when
added to food
• Now available in a supplement
Bifidobacteria
• At least 4g/day of FOS are needed to
increase counts
• Effect increases with increased doses
• Ferment oligosaccharides to SCFA
• Produce B vitamins and some amino acids
• Restore flora after antibiotics
• Inhibit the growth of pathogenic bacteria
PROBIOTICS
Lactobacillus acidophilus
Floch,Gastro Clin NA 2005;34:517 : Huebner Gastro Clin NA 2006 :35;355
Elie Metchnikoff
• 1845-1916 , Nobel Prize Winner
• Phagocytosis and Ageing
• “Intoxication from the gut flora”
• Putrefactive bacteria produced toxic substances
absorbed from the gut affecting the nervous and
vascular systems causing ageing
• His radical solution for autointoxication was
removal of the flora by colectomy
• Another approach was to replace putrefactive
bacteria with carbohydrate fermenting bacteria
PROBIOTICS
• Live microbial food supplements which
beneficially affect the host animal by
improving its intestinal microbial balance.
• Usually strains of bacteria (lactobacilli or
bifidobacteria) or yeasts (Saccharomyces)
• Administered in yogurts or capsules
• Survive passage thru the gut
PROPERTIES of PROBIOTICS
• Human origin
• Resist upper GI tract secretions
• Adhere to human intestinal cells
• Colonize the human intestinal tract
• Production of antimicrobial substances
• Antagonize carcinogenic/ pathogenic flora
• Safe in clinical use at > 1010
• Stimulate immune process
• Fermentation
Dose of Probiotic
• Varies greatly with product
• Live and active cultureYogurts must
contain >108 [100 million]
• L.rhamnosus GG has 10 billion
• VSL#3 has 300 to 450 billion per packet
• Common OTC have millions
IMMUNOREGULATION (A/B)
• Increase IgA production
• Increase anti-rotaviral IgA
• Production of gamma intereferon, TNF-
alph,IL-1 by mononuclear cells incubated with
Lactobacillus.
• Adherant Lactobacilli and Bifidobacteria
significantly increase phagacytosis.
• Lactobacillus GG has been used to treat cow
milk allergy and atopic eczema
Probiotic Organisms in USE
• Bifidobactor sp. • Lactobaciilli sp.
(bifidum, longum, (casei, acidophilus,
breve,animalis, bulgaricus, gaseri)
infantis,adolescentis) • L.rhamnosus, GG
• Streptoccus • Lactococcus sp.
thermophilus (lactis,cremaris)
• Saccharomyces
boulardii,cerevisiae
• Enerococcus faecium
CLAIMS FOR PROBIOTICS
• Increase resistance to infection
• Decrease duration of diarrhea disease
• Stimulate immunity, modulate cytokine gene
expression, stimulate phagocytosis
• Beneficial effect on blood pressure,serum
cholesterol, diabetes mellitus,lactose digestion
and allergy
• Regression of tumors and reduction in
carcinogens
Antibiotics
Common antibiotics used to promote growth, feed efficiency
Trade name Active ingredient

Aureomycin chlortetracycline
Terramycin oxytetracycline
Bacitracin bacitracin
Gallimycin gallimycin
Tylan tylosin
steroids
• General classifications
– Estrogens – estradiol and estrone
– Non-steroidal compounds with estrogenic activity -diethylstilbestrol

(DES) and zeranol
– Androgens – testosterone and trenbolone acetate (TBA)
– Progestagens – progesterone and melengestrol acetate (MGA)
– ß-adrenergic, ß agonists, repartitioning agents

• lipolysis (fat mobilization), protein synthesis eg clenbuterol,
cimaterol ractopamine
Probiotics
• Lactobacillus sp.
– reuteri
– casei
– ramnosus
– acidophilus
• Streptococcus sp.
• Bifidobacterium sp.
– infantis
– lactis
– longum
– breve
– bifidum
• Sacharomyces boulardii (non-
human)
• VSL no.3
Dysbiosis
• Dysbiosis is an
intestinal imbalance
where pathogenic
microorganisms
outnumber
beneficial bacterial
species.
• Digestive diseases
are often caused in
part by or result in
dysbiosis.
Dysbiosis
Major Causes
•Decreased immune function •Intestinal infection
•Poor diet—excessive •Decreased intestinal motility (aka
carbohydrates, sugar and trans fat constipation)
•Drugs—especially antibiotics, oral •Stress—including long-term
contraceptives and cortisone-like emotional stress
medications •Maldigestion and malabsorbtion
Dysbiosis
Common Symptoms
•Abdominal pain or •Bad Breath •Irritable bowel
cramps •Body Odor syndrome
•Colon cancer •Food Allergy •Itchy anus
•Constipation or •Hypoglycemia •Leaky gut syndrome
diarrhea •Inability to lose •Poor complexion
•Distention/bloating weight •Poor digestion
•Fatigue •Irregular bowel •Rheumatoid arthritis
•Fatigue after eating movements •Spastic colon
•Flatulence
Probiotics: Proposed uses
• Infectious diarrhea
• Antibiotic-associated diarrhea
• IBD, IBS, and pouchitis
• Necrotizing Enterocolitis
• Bacterial vaginosis
• Recurrent UTI’s
• Atopic diseases
• Immune system enhancement
• H pylori infections
• Dental caries
• Radiation induced diarrhea
• Cardiovascular risk reduction
• Constipation
• Rheumatoid arthritis
Probiotics: proposed
mechanisms
• Adherence and subsequent stimulation of gut immune
system
– Up-regulation of mucin gene
– Enhance secretory IgA
– Maintain normal macrophage function
• Competition for essential nutrients
• Production of antimicrobial factors
• Provide favorable environment for growth of other
beneficial bacteria
• Production of short-chain fatty acids with anti-
inflammatory properties
Why should YOU care?
• Chemical farming and pesticides have
lead to sterilization of soil and water
(chlorination).
• Antibiotics, hormones, and other drugs are
given to chickens and cattle used for food.
• Stress, medications, and typical American
diet all promote dysbiosis.
Special Probiotics
• Homeostatic Soil Organisms (HSO’s) are
specific probiotic strains of microorganisms
found in the soil.
• In nature, HSO’s help plants digest inorganic
substances, protect roots from parasites, yeast,
and fungi, and provide growth factors and
different hormones.
• When ingested orally in a probiotic formulation,
may have advantages over non-HSO probiotic
formulas, due to ability to implant and survive in
the gut.

Probiotics

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PROBIOTICS AND ANTIMICROBIALS

• Nondigestible food ingredients

• Modify the endogenous

Common antibiotics used to promote growth, feed efficiency

Trade name Active ingredient

– Estrogens – estradiol and estrone

– Non-steroidal compounds with estrogenic activity -diethylstilbestrol

– Androgens – testosterone and trenbolone acetate (TBA)

– Progestagens – progesterone and melengestrol acetate (MGA)

– ß-adrenergic, ß agonists, repartitioning agents

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