Probiotics and Prebiotics PDF

Probiotics and prebiotics  What are probiotics? Probiotics are friendly microbes that provide health benefits The concept of probiotics was born through Elie Metchnikoff’s observation (early 900s): the large consumption of fermented foods...

Probiotics and prebiotics  What are probiotics? Probiotics are friendly microbes that provide health benefits The concept of probiotics was born through Elie Metchnikoff’s observation (early 900s): the large consumption of fermented foods prolonged life of nomads in Bulgaria and in the Russian Steppes At present, the most accepted definition of probiotics is that elaborated by a joint WHO/FAO expert consultation: “probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host” Which microbes are probiotics? Most probiotics are comprised in the bacterial groups of Lactobacilli and Bifidobacteria, though even some strains of Bacilli, Enterococci, the gram negative Escherichia coli and some yeast type (i.e. Saccharomyces boulardii) are claimed probiotic, too. lactobacilli bifidobacteria bacilli Saccharomyces yeasts lactobacilli enterococci Where do we find probiotics? Several probiotics are natural members of our gut microbiome, i.e. they are steady commensals which live in symbiosis with us (e.g. the probiotic Enterococcus faecium). Some other can be introduced through the diet, so that they have a chance to colonize, at least transiently, our gut where they can exert their beneficial actions. Probiotics are naturally present as live cultures in diverse foods, i.e. typically traditional fermented food sauerkraut pickles femented milk, Kefir and yoghurt miso kombucha kimchi brined olives Probiotics are also available as pharmaceutical supplements (capsules, tablets, solutions) or in range of probiotic-enriched functional food. These products deliver high amounts of selected beneficial microbes What do probiotics do? HI, THERE! Aid digestion and nutrient assimilation Improve bowel function probiotics Reach the intestine alive Prevent intestinal colonization Promote health by harmful bacteria How do probiotics exert health benefits? MODULATE INTESTINAL MICROBIOTA & gut ANTAGONIZE PATHOGENS microbiota Competition/cooperation for nutrients Competitive exclusion Production of antimicrobials probiotics REINFORCE MUCOSAL BARRIER ↑barrier function Intestinal Metabolic interaction epithelial Anti-apoptosis cells ↑ Tight junctions METABOLIC ACTIVITIES ↑mucin, ↑ defensins Improve digestion and bioavalability of nutrients Digest otherwise undigestable MODULATE & ENHANCE IMMUNE nutrients & residues RESPONSE Produce vitamins, aminoacids and Regulate cytokine expression other helpful metabolites (e.g. SCFA, Regulate phagocytosis lactic acid, exopolysaccharides,…) Modulate immune cell differentiation and Detoxify from harmful chemicals maturation immune cells What do probiotics have to comply with? Some requisites of probiotics… Well assessed identity (genus, species, strain level) Well assessed safety: probiotic strain should be genetically stable and safe for human consuption (i.e. devoid of transmissible antibiotic resistance genes) and without contamination in its delivery form Health effect substantiated by rigorous scientific (clinical and pre-clinical) studies … some requisites of probiotics During preliminary screening for potential probiotics, in vitro tests should assess desirable probiotic properties such as: resistance to gastric acidity, bile and digestive enzymes: this allows them to reach viable and in high numbers the intestine Digestive bile enzyme good adhesion to IEC: this enhances gut mucosa colonization, prolongs gut residence time, thus extending their beneficial effects probiotics Intestinal epithelial cells antimicrobial/antagonistic activity against potentially pathogenic bacteria intestinal technological robustness: strain stability, resistance to mucosa industrial, food storage and food processing conditions Here’s a list of health benefits ascribed to probiotics by scientific and clinical studies Alleviate milk and lactose intolerance in kids and adults Improve gastrointestinal (GIT) function Prevent and treat GIT infections Prevent and ease intestinal constipation Inhibit colonization by Helicobacter pylori (which has been linked to chronic gastritis, ulcers and gastric cancer) Anti-inflammatory and anti-allergenic effects Reduce LDL-cholesterol plasma level Prevent, reduce and shorten rotavirus diarrhea Prevent antibiotic-associated diarrhoea Reduce risk factors for cardiovascular disease Relief from IBD and gastro-intestinal immunological disorders Reduce recurrence of bladder cancer Reinforce body’s natural defense mechanisms Protect from toxins Improve efficacy of oral vaccination Promote the development of a beneficial gut microbiota, dominated by bifidobacteria, in newborns Reduce risk of respiratory tract infections Lower risk of eczema and other allergic diseases in kids Improve dental health and reduce risk of caries What are prebiotics? Prebiotics are non-digestible food components that stimulate growth and/or activity of a single type or a limited amount of gut microorganisms, leading to improve the host health [Gibson and Roberfroid, 1995]. Later, this definition was updated into “selectively fermented components allowing specific changes in the composition and/or activity of microorganisms in the gastrointestinal tract, beneficial for host’s health and wellbeing” [Gibson et al., 2004]. In 2007, FAO/WHO experts have described prebiotics as nonviable food components that confer a health benefit on the host associated with a positive modulation of the gut microbiota. In practice, prebiotics serve as food for probiotics! Because they are not digested in the upper GI tract, prebiotics make their way down to the colon where they feed our gut microbes, especially the healthy ones. This fermentation process selectively promotes the growth of beneficial bacteria which help support intestinal and overall good health.  Which is prebiotic and where do we find prebiotics? From a chemical point of view, pebiotics are carbohydrates that are non-digestible by human enzymes. They include hydrosoluble oligosaccharides, such as inulin, fructooligosaccharide (FOS) and xylo-oligosaccharides (XOS) (from plant and fruits) and galactooligosaccharides (GOS) (from mammalian milk). Polysaccharides such as cellulose, hemicellulose, resistant starch, pectins, gums and other from plant and microbial origin are being investigated as potential prebiotic, too. Chicory roots, leek, asparagus, tubers, garlic, onions, dandelion green, Jerusalem artichoke, oat, unrefined wheat and barley, flaxseeds, apples and bananas are examples of natural sources rich in prebiotics. We can find them also in «unsuspected» food such as chocolate, apple cider vinegar and microalgae!! …as well as in specific dietary supplements. What do prebiotics have to comply with? Some requisites of prebiotics… Prebiotic substances should be: not digested (or only partially digested) by human upper GI tract; not absorbed in the small intestine; poorly fermented by bacteria in the oral cavity; well fermented by seemingly beneficial intestinal bacteria; poorly fermented by potential pathogens in the bowel What do prebiotics do? Energy source for colonocytes and related trophic action Growth balancing effect on colon SCFA mucosa /proliferative effect on caecum and colon Modulate energy and lipid metabolism Modulate appetite signals Lower pH and act as antimicrobial that control and inhibit growth of opportunistic flora Because prebiotics selectively feed beneficial gut microbes (i.e. probiotics such as bifdobacteria and lactobacilli) they sustain their growth, metabolism and diverse activities. Therefore prebiotics undirectly support all the benefits associated to probiotics consumption and to a balanced healthy gut microbiota. In detail, prebiotics provide the fuel for the production of SCFA, which in turn exert several positive effects What do prebiotics do? Prebiotics not only nourish helpful microbes in the gut, they also: stabilize and protect them from the adverse conditions encountered during preparation and storage of the probiotic food formulation, as well as upon its ingestion (e.g. the strong acidity of the stomach) enhance their fitness to the gut niche by -modulating the cross-talk between bacteria and host cells, hence inducing an immune reaction that favors the persistence of the probiotic microbes (i.e. immunotolerance) -protecting probiotic cells from host immune factors -potentiating probiotic adhesion on intestinal mucosa, hence improving intestinal colonization -helping probiotics to displace potential pathogens from the mucosal surface In simple words, prebiotics enhance the overall performance of probiotics! Here’s a list of health benefits ascribed to prebiotics by scientific and clinical studies Reduce risk of colorectal carcinoma Promote the establishment of healthy gut microbiota through a bifidogenic effect Reduce blood LDL (low-density lipoprotein) level Increase absorbability of calcium Stimulate immune system and exert anti-inflammatory effect Prevent infections by pathogens Decrease serum cholesterol level and ameliorate lipid metabolism Protect gastro-intestinal mucosa Attenuate gastro-intestinal infections Anti-oxidant activities Detoxify from harmful metabolites and bacterial toxins Synbiotics Because prebiotics sustain metabolism and activity of probiotics, the best way to consume them is in a combination of both, which is referred to as a synbiotic. probiotic prebiotic synbiotic Within a synbiotic formulation, pre- and pro- biotics act synergistically, so that their final health effect is enhanced! Where do we find synbiotics? We can make up probiotic synergistic food combinations/synbiotic food by blending a source of probiotics with prebiotics What about a nice pot of yoghurt, banana plus oat flakes or unrefined wheat and barley flakes? Or a salad with feta, onions and pickles… Otherwise, we can assume a synbiotic dietary supplement, which is extremely rich in selected beneficial microbes and prebiotic compounds and that should have been already tested for efficacy Functional food When a food provides a specific health benefit beyond its basic nutrition value, this is referred to as functional food [Clydesdale, 1997]. For example, functional foods (FF) are those with high content of specific dietary fibers, and/or biologically active substances such as vitamins, phytochemicals, antioxidants, minerals, etc. Such components promote health and well-being, hence FF activity resembles that of pharmaceuticals 'Let food be thy medicine and medicine be thy food‘ [Hippocrates] The “food as medicine” philosophy of Hippocrates has been re-evaluated and is receiving a growing interest. The science of functional foods opens up therapeutic possibilities based on our diet style! FF contain essential nutrients and health-promoting non-nutrients. This table reports the functional components found in some common FF. Foods that are either naturally rich in or artificially fortified with probiotics, prebiotics or their combinations are also classified as functional. Foods rich in probiotics Probiotic-fortified foods Effects of dietary probiotics on obesity: evidences from studies on mice and humans Bifidobacterium infantis, B. ↓intestinal endotoxin Bifidum Lactobacillus rhamnosus ↓ body weight and white adipose tissue VSL#3 (a commercial mix of Improved HFD-induced steatosis and insulin probiotic Bifidobacterium and resistance Lactobacillus strains) Bifidobacterial strains derived ↓ body weight and fat accumulation, improved from healthy human gut lipid profiles and glucose-insulin homeostasis fermented milk containing probiotic Lactobacillus gasseri ↓ abdominal visceral and subcutaneous fat; strain ↓ body weight and waist circumference L. rhamnosus GG (to mothers prevent excessive weight gain of children from 4 weeks prior to delivery during a 10 year follow-up to month 6 post-birth) Effects of dietary prebiotics on obesity: evidences from studies on mice and humans ↑ intestinal homeostasis modulate gut microbiota so that high fat diet (HFD)-induced Prebiotic oligofructose inflammation and related metabolic disorders are counteracted Prebiotics (inulin and ↓ weight gain and fat mass development oligofructose) ↑ satiety (through hormonal modulation) ↓ energy intake modulate gut microbiota (↑bacteroidetes, ↑lactobacilli, hence normalizing obese-associated dysbiosis) ↓ hunger and ↑satiety ↓ body weight ↓ fasting insulin and LDL–cholesterol Prebiotics (oligofructose) ↓ waist circumference and BMI ↓ secretion of ghrelin (hunger signal) ↑ PYY levels (satiety) ↓ calories intake ↓ plasma glucose and insulin If it seems like you're waiting a lifetime for a bowel movement, then you might want to ask your doctor about probiotics  BB12, LA5 e L. casei 431 L. casei shirota Conad AC Yogurt Probiotico Flora Plus: benessere Bryogo Yogurt Probiotico quotidiano Meno di 80 calorie per porzione, gustoso e capace di rinforzare le difese naturali del tuo organismo. È lo Snack-Biscotto con Cacao Magro Alixir Immunitas™, lo spuntino ideale in qualsiasi momento della giornata. Una pausa golosa di biscotto ricoperto di cioccolato magro, che contiene una miscela di due ceppi probiotici (Bifidobacterium longum e Lactobacillus acidophilus), in grado di arricchire la flora batterica intestinale Probiotici: la nuova linea Alixir di Barilla Latte per lattanti utilizzabile dalla nascita fino a 6 mesi. Alimento probiotico, contiene Bifidob. Neolatte 1 Neolatte 2 10.00 € 10,00EUR Latte di proseguimento dopo il 6 mese. Alimento probiotico, contiene Bifidobatteri naturali che favoriscono una sana digestione. Confezione: 800 g (2 buste da 400 g) La ricottina probiotica, la ricotta di pecora dell'alto maceratese con probiotici Il Tomino fresco probiotico, il formaggio di pecora dell'alto maceratese con probiotici 1. IL GELATO PROBIOTICO, SALUTARE E TUTTO VEGETALE - linea Probioticus Light PROBIOSNACK® : particolarità della barretta sarà quella di dare un apporto di una particolare fibra prebiotica (Frutto-oligosaccaride per il confort digestivo e/o Gluco- oligosaccaride ad azione immunomodulante) e soprattutto di apportare cellule vive probiotiche e fibre prebiotiche in grado di colonizzare l’intestino……. Simbiontici integratore biologico-vitaminico a base di Vitamine B1, B2, B6 L’ultima frontiera dei gadget, “Il Tempo” regala pillole insieme al giornale Scritto Domenica 28 Giugno 2009 da Andrea Tirone  yogurt probiotico magro fragola/albicocca Ingredienti: *yogurt magro, *latte fermentato con Lactobacillus Acidophilus, Bifidobacterium Lactis, *mirtillo, *zucchero di canna, aromi naturali  Pastoncino + Probiotici Gli estrusi per roditori di tale linea sono arricchiti di vitamine, minerali, aminoacidi, probiotici, antiossidanti omega 3 e omega 6. Probiotics cleaning  Strange Chocolate Dark Harmony e Cioccolato Probiotico, speciali miscele di cacao dai gusti esotici. Vero Which microorganisms are probiotics? Lactobacillus species Bifidobacterium species L. acidophilus B. adolescentis L. plantarum B. bifidum L. casei ssp rhamnosus B. longum L. brevis B. infantis L. delbreuckii ssp bulgaricus B. breve Which microorganisms are probiotics? But also: Streptococcus salivarius ssp. thermophilus Lactococcus lactis ssp. lactis Lactococcus lactis ssp. cremoris Enterococcus faecium Leuconostoc mesenteroides ssp. dextranicum Propionibacterium freudenreichii Saccharomyces boulardii Kluyveromyces marxianus Bacillus clausii e B. coagulans – spore forming bacteria Which are guiderlines to evaluate microorganism as probiotics? FAO/WHO Guidelines, 2002  Microorganism Identification (Genus, Specie and Strain) Functional characterization (in vitro and/or animal study) Safety Assesment (in vitro and/or animal study, Phase 1 Human study) Efficacy Assesment (Phase 2 Human study) Effectiveness Assesment (Phase 3 Human study, compare probiotic with standard treatments of specific condition) (Adapted from FAO/WHO, 2002) How do PROBIOTICS work? INTESTINAL EPITHELIUM PROBIOTIC PATHOGENS and interaction with MICROBIOTA IMMUNE SYSTEM (GALT ) Interaction 1 Interaction PROBIOTIC- INTESTINAL EPITHELIUM - ADHESION and COLONIZATION - MONOLAYER BARRIER - MUCUS STIMULATION - METABOLIC FUNCTION (short-chain fatty acid) Probiotic – intestinal epithelium interaction : Adhesion and colonization In vitro studies using Caco-2 cells model Probiotic Caco-2 cells Probiotic – intestinal epithelium interaction : Adhesion and colonization 25 20 Adhesion (%) 15 10 5 0 Lp WCFS1 La5 Lp4 Lp8 Lp10 Lfm11 Lfm16 Lfm11.5 Strains Interaction 2 PROBIOTIC – GUT ASSOCIATED LYMPHOID TESSUTE (GALT) - IMMUNOMODULATION - HOMEOSTASIS - ORAL TOLLERATION Probiotic – GALT : Immunomodulation Genes to be analysed : IL-1β IL-6 Pro-inflammatory Cytokines IL-8 IL-12 TNF-α IL-10 Anti-inflammatory Cytokines NF-kB Trascription factor TLR-4 Receptor GAPDH β -actin Housekeeping SDHA or HPRT1 Interaction 3 PROBIOTIC – PATHOGENS - INHIBITION AND COMPETITION - ANTIMICROBIAL MOLECULES Pathogens bacteria Probiotics and fungi Probiotic – Pathogens : Antimicrobial activity Lfm 8 Method Lfm 10 Lfm 11 E. coli O157:H7  alone ray (cm) 0.20 0.40 0.60 0.80 0.00 LpWCFS1 La5 Lp4 Lp8 Lp10 Lfm11 L. monocytogenes Lfm16 Lfm11.5 LpWCFS1 La5 Lp4 Lp8 Lp10 E. coli O157:H7 Lfm11 Lfm16 Lfm11.5 LpWCFS1 Probiotic – Pathogens : Antimicrobial activity La5 Lp4 Lp8 Lp10 S. enterica Lfm11.5 Lfm11 Lfm16  alone ray (cm) 0.20 0.40 0.60 0.80 0.00 LpWCFS1 La5 Lp4 Lp8 Lp10 Lfm11 L. monocytogenes Lfm16 Lfm11.5 LpWCFS1 La5 Lp4 Lp8 Lp10 E. coli O157:H7 Lfm11 Lfm16 Lfm11.5 LpWCFS1 Probiotic – Pathogens : Antimicrobial activity La5 Lp4 Lp8 Lp10 S. enterica Lfm11.5 Lfm11 Lfm16 Probiotic – Pathogens : Competition Co-inoculation 1.60 * = p