Probiotic India

Probiotics and Health Claims

In the past fifty years, probiotics have undergone scientific scrutiny for their ability to prevent and cure a variety of diseasesand there has been an upsurge in research for probiotics, as well as profound interest in the probiotic food concept. This increased research has resulted in significant advances in understanding and characterize specific probiotic organisms, as well as attempts to verify their health claims. Current evidence indicates that probiotic health claims are strain-specific, therefore, a beneficial effect attributed to one strain might not be extrapolated for another strain, even if it belongs to the same species. Genomic, transcriptomic and proteomic studies reveal genes and proteins involved in probiotic adaptation in the host while exerting their beneficial effects. Probiotics have a broad scope in general health interventions like managing lactose intolerance, immunomodulation in chronic inflammatory and infectious conditions, managing oral absorption syndromes, allergies, diabetes, arthritis, prevention of colon cancer, and for cardio protection by lowering blood pressure and cholesterol levels which are discussed below.

Lactose maldigestion/intolerance
About two-thirds of the world’s adult population suffers from lactose maldigestion, with the prevalence particularly high in Africa and Asia. Lactose maldigestion occurs frequently, especially in adults (primary lactose maldigestion) and in persons with bowel resection or enteritis (secondary lactose maldigestion). Symptoms include loose stools, abdominal bloating, pain, flatulence and nausea. Individuals with lactose maldigestion can tolerate lactose present in yoghurt to a much greater degree than the same amount of lactose in raw milk. Yoghurt and probiotic lactic acid bacteria contain high levels of lactase (β-galactosidase), which is released within the intestinal lumen when these bacteria are lysed by bile secretions. Lactase/ β-galactosidase then acts on the ingested lactose, thus relieving maldigestion symptoms. The reduced intestinal transit time of yoghurt might also allow slower digestion of lactose, thereby reducing the symptomatology associated with lactose intolerance.
Intestinal disorders

Gastroinestinal disorders occur when the digestive tract (gastrointestinal) does not function properly due to microbial imbalance and disturbance in host microbe interaction. GI infections particularly diarrheal diseases are the major cause of morbidity and mortality in children and adults across the world particularly in the third world countries. Several probiotic strains have proven effective against gastrointestinal abnormalities however benefits are dose dependent.

S.No.

Disease

Effective probiotic strains

1

Diarrhea

  • Antibiotic-associated diarrhea
  • Traveller’s diarrhea
  • Rotavirus diarrhea

L.rehamnosus GG (LGG),

S. boulardii

2

Irritable bowel syndrome

VSL#3  (B. longum, B. infantis, B. breve, L. acidophilus, L. casei, L. delbrueckii ssp. bulgaricus, L. plantarum and Streptococcus thermophilus)

3

Inflammatory bowel disease

Saccharomyces boulardii

4

Pouchitis

VSL#3 

5

Helicobacter pylori infection

L. johnsonii La1, Saccharomyces boulardii

Various meta-analyses showed an overall reduction in Gastric inflammation during administration of different strains of L. casei, L. reuteri, L. plantarum, L. acidophilus, B. animalis, B. infantis andS. boulardii.

Inflammatory bowel diseases (IBD)
Inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease are serious intestinal disorders that can eventually necessitate the surgical removal of the colon. The causes are diverse, but are often related to depletion of beneficial gut bacteria. IBD refers to a group of disorders of unknown aetiology that are characterized by chronic or recurrent mucosal inflammation. Probiotic administration, either through regulation of the inflammatory response or modulation of gut microbiota composition and/or activity might bring about relief in IBD symptoms or maintain remission from symptoms. VSL#3 is a mixture of four lactobacilli (L. acidophilus, L. bulgaricus, L. casei and L. plantarum), three bifidobacteria (B. breve, B. infantis and B. longum) and S. thermophilus. The mixture has proven quite effective in reducing the recurrence of chronic relapsing pouchitis.

Allergies
Probiotics direct modulation of the immune system through the induction of antiinflammatory cytokines or through switching the production of secretory IgA. Probiotics can potentially modulate the toll-like receptors and the proteoglycan recognition proteins of enterocytes, leading to activation of dendritic cells and a Th1 response. The resulting stimulation of Th1 cytokines can suppress Th2 responses. Pediatric studies suggest that probiotic use in children with atopic conditions such as atopic dermatitis results in enhancement of IFN-production and decrease d IgE and antigen-induced TNF-α, IL-5, and IL-10 secretion. Studies involving L. casei, L. reuteri, L. paracasei, L. acidophilus, B. animalis and B. infantis reported that probiotics shows variable effects in different clinical trials. Probiotic effects in allergies are limited to initiation of improvement in mild allergic diseases like atopic dermatitis and rhinitis.
Metabolic syndrome
Metabolic syndrome is a group of metabolic abnormalities, increases an individual’s risk of developing obesity, type 2 diabetes and cardiovascular disease. This syndrome is influenced by more than one factors i.e. genetic, lifestyle and environmental factors (gut microbiota). Altered dietary intake not only affects our energy balance but also has a major impact upon gut microbial composition, which results in altered gut microbiota, increased energy harvest, increased inflammatory tone and altered intestinal endocrine function. 

Obesity: Different studies show the relation between body weight and gut microbiota. In obese people the ratio of Bacteroidetes, Firmicutes and archea is altered in obese individuals. However human studies gave controversial data on this fact. In overweight human adults lower ratio of Firmicutes to Bacteroidetes is also found as well as weight loss diets, found no proof of the link between the proportion of Bacteroidetes and Firmicutes and human obesity.

Type 2 diabetes:  Compared to non-diabetics, reduction in the relative abundance of Firmicutes is observed with increase in the proportion of Bacteroidetes and Proteobacteria in diabetics. The level of probiotic Bifidobacterium significantly and positively correlated with improved glucose-tolerance and low-grade inflammation in mice model.

Cardiovascular diseases: It is an inflammatory metabolic syndrome because high-fat diet has mainly been attributed to the inflammatory properties of dietary fatty acids (i.e., palmitic acid). It trigger an inflammatory response by acting via LPS receptor [TLR-4]) signalling in adipocytes and macrophages, inflammation of adipose tissue in obesity. Metabolic endotoxaemia increases adipose TNF-α and IL-6 concentrations, insulin resistance and stimulates vascular inflammation which results in hypertension and CVD. Probiotics strongly promote SCFA production from undigestive carbohydrates (prebiotics) and are also associated with changes in ingestive behaviour by mechanisms linked to the modulation of gut peptide production and secretion which changes the food intake behaviour.
Respiratory infections
A few studies have shown that certain strains of probiotic bacteria may prevent viral respiratory tract infections (common cold and influenza), alleviate complaints and/or shorten the duration of the disease. L. rhamnosus L. casei strain, a vitamin-mineral-mixture plus L. gasseri, B. longum and B. bifidum (verum) have been found to be effective in winter-infections in children and elderly subjects. L. acidophilus NCFM and Bifidobacterium animalis ssp. lactis Bi 07 have also been shown to reduce the incidence of fever, cough and sneezing, their duration and the incidence of application of antibiotics. Meta-analysis on probiotics and respiratory infections showed a significant decrease in the number of days with fever, clinical visits and antibiotic prescriptions. However, the efficacy of probiotics was found to be strain and dose dependent and also exhibited variable results in different studies.

Urogenital infections

A number of human clinical studies have demonstrated that probiot­ics strains including Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus reuteri, L. gasseri, L. jhonsenii and Lactobacillus cris­patus cured bacterial vaginosis. Intravaginally administration of probiotics were found to be more effective in these studies. Curing of vulvuvaginal candidasis, urogenital tract infection and bacterial vaginosis is related to acid and H2O2 production and concentration of applied probiotic.

Cancer
In vitro systems and animal models provide considerable evidence that probiotics, prebiotics and synbiotics exert anti-neoplastic effects e.g. - the polysaccharide fraction of B. bifidum BGN4 inhibited the growth of HT-29 and HCT-116 cells but did not inhibit the growth of Caco-2 cells. The probiotic strains L. rhamnosus, B. lactis and L. reuteri ATCC 6475activate caspase proteins in cancerous cell lineThe consumption of probiotics  may be beneficial in preventing the onset of cancer, but also in the treatment of existing tumors. However, evidence from human studies is still limited.

Generic health claims
Probiotics are beneficial microorganisms and habitat in our body with other commensal flora. Beside all specific health effects, they have role in maintenance of normal health status of host. Probiotics are involved in different processes such the improvement of nutrient bioavailability and degradation of non-digestible dietary compounds, the supply of new nutrients, and the removal of harmful, toxic and non-nutritional compounds and suppress the growth of pathogens besides enhancing immune status.