Different Types Of Probiotics Research Articles

Choosing an appropriate probiotic product for your patient: An evidence-based practical guide.

IntroductionClinicians and patients face a daunting task when choosing the most appropriate probiotic for their specific needs. Available preparations encompass a diverse and continuously expanding product base, with most available products lacking evidence-based trials that support their use. Even when evidence exists, not all probiotic products are equally effective for all disease prevention or treatment indications. At this point in time, drug regulatory agencies offer limited assistance with regard to guidance and oversight in most countries, including the U.S.MethodsWe reviewed the current medical literature and sources on the internet to survey the types of available probiotic products and to determine which probiotics had evidence-based efficacy data. Standard medical databases from inception to June 2018 were searched and discussions with experts in the field were conducted. We graded the strength of the evidence for probiotics having multiple, randomized controlled trials and developed a guide for the practical selection of current probiotic products for specific uses.ResultsWe found the efficacy of probiotic products is both strain-specific and disease-specific. Important factors involved in choosing the appropriate probiotic include matching the strain(s) with the targeted disease or condition, type of formulation, dose used and the source (manufacturing quality control and shelf-life). While we found many probiotic products lacked confirmatory trials, we found sufficient evidence for 22 different types of probiotics from 249 trials to be included. For example, several types of probiotics had strong evidence for the prevention of antibiotic-associated diarrhea [Saccharomyces boulardii I-745, a three-strain mixture (Lactobacillus acidophilus CL1285, L. casei Lbc80r, L. rhamnosus CLR2) and L. casei DN114001]. Strong evidence was also found for four types of probiotics for the prevention of a variety of other diseases/conditions (enteral-feed associated diarrhea, travellers’ diarrhea, necrotizing enterocolits and side-effects associated with H. pylori treatments. The evidence was most robust for the treatment of pediatric acute diarrhea based on 59 trials (7 types of probiotics have strong efficacy), while an eight-strain multi-strain mixture showed strong efficacy for inflammatory bowel disease and two types of probiotics had strong efficacy for irritable bowel disease. Of the 22 types of probiotics reviewed, 15 (68%) had strong-moderate evidence for efficacy for at least one type of disease.ConclusionThe choice of an appropriate probiotic is multi-factored, based on the mode and type of disease indication and the specific efficacy of probiotic strain(s), as well as product quality and formulation.Trial registrationThis review was registered with PROSPERO: CRD42018103979.

Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis.

As the use and diversity of probiotic products expands, the choice of an appropriate type of probiotic is challenging for both medical care professionals and the public alike. Two vital factors in choosing the appropriate probiotic are often ignored, namely, the probiotic strain-specificity and disease-specificity for efficacy. Reviews and meta-analyses often pool together different types of probiotics, resulting in misleading conclusions of efficacy. A systematic review of the literature (1970-2017) assessing strain-specific and disease-specific probiotic efficacy was conducted. Trials were included for probiotics with an identifiable strain (either single strain or mixtures of strains) that had at least two randomized, controlled trials for each type of disease indication. The goal was to determine if probiotic strains have strain and/or disease-specific efficacy. We included 228 trials and found evidence for both strain specificity and disease specificity for the efficacy of specific probiotic strains. Significant efficacy evidence was found for 7 (70%) of probiotic strain(s) among four preventive indications and 11 (65%) probiotic strain(s) among five treatment indications. Strain-specific efficacy for preventing adult antibiotic-associated diarrhea was clearly demonstrated within the Lactobacillus species [e.g., by the mixture of Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, and Lactobacillus rhamnosus CLR2 (Bio-K+®), by L. casei DN114001 (Actimel®) and by Lactobacillus reuteri 55730], while other Lactobacillus strains did not show efficacy. Significant disease-specific variations in efficacy was demonstrated by L. rhamnosus GG and Saccharomyces boulardii CNCM I-745, as well as other probiotic strains. Strong evidence was found supporting the hypothesis that the efficacy of probiotics is both strain-specific and disease-specific. Clinical guidelines and meta-analyses need to recognize the importance of reporting outcomes by both specific strain(s) of probiotics and the type of disease. The clinical relevance of these findings indicates that health-care providers need to take these two factors into consideration when recommending the appropriate probiotic for their patient.

Improvement of growth performance, immunity and disease resistance in Nile tilapia, Oreochromis niloticus, by using dietary probiotics supplementation

This study evaluated the effect of probiotics on the growth performance, some immunological, biochemical and hematological parameters of Nile tilapia. Eight weeks feeding trials were conducted to examine the effect of three types of probiotics, multi-strain probiotics (6×107 cfu/g), Bacillus subtilis (1×1011 cfu/g) and Saccharomyces cerevisiae (2.6×1010 cfu/g) in commercial names Protexin, Biogen-S and Diamond V respectively. Nile tilapia (24±0.02 g) was fed probiotic-incorporated diets as well as control diet (free of probiotics) in triplicates. At 4th and 8th week of feeding trial, the growth performance of fish fed different probiotics was higher than those fed the control diet. No significant difference was observed among fish fed different probiotics for 4 or 8 weeks. Blood profile showed an increase in hemoglobin (Hb), red blood cell (RBCs), packed cell volume (PCV), total protein, and globulin while aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels decreased in fish fed different types of probiotics. Probiotics supplementation improved fish innate immunity based on lysozyme and respiratory burst activities over the control diet evaluated at 4th and 8th week. Likewise, significant up-regulation of the expression of cytokine genes, interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF α) estimated at 8th week by using quantitative RT-PCR were significantly higher than the control. After experimental period (8 weeks) fish from each group were challenged by pathogenic Aeromonas hydrophila (4×108 cfu/ml) which exhibited better relative survival percentages than the controls. Dietary supplementation of probiotics improves growth performance, immune status and disease resistance in Nile tilapia. Also, the best results related to growth obtained from groups fed multi-strain probiotic.

Viability of Probiotics in Frozen Yogurt Supplemented with Inulin and Glycerol

To evaluate the effect of inulin and glycerol supplementation on the viability of probiotic and yogurt bacterial cultures in frozen yogurt, this study was conducted. The frozen yogurt mixture was prepared with different types of probiotics (<i>Lactobacillus acidophilus</i> and <i>Bifidobacterium lactis</i>) along with commercial yogurt starter culture (<i>Streptococcus thermophilus</i> and <i>Lactobacillus bulgaricus</i>). Different concentrations of inulin (2%, 4%, and 6%) and glycerol (1%, 2%, 3%, and 4%) were also supplemented. The cultural survival rates before and after freezing and with 3 weeks regular intervals up to 12 weeks were examined. The viability loss during freezing process of <i>S. thermophilus</i> and <i>L. bulgaricus</i> were recorded 0.2-0.3 log cycles. While, in probiotic cultures this was observed 0.2-0.5 log cycles in <i>L. acidophilus</i> and 0.1-0.2 log cycles in <i>B. lactis</i> concentration. The glycerol 4% supplementation in this study has shown most significant improvement in viability (P<0.05).

A Summary of a Cochrane Review: Probiotics to Prevent Acute Upper Respiratory Tract Infections.

Review authors in the Cochrane Collaboration conducted a systematic review to evaluate the effects of probiotics to prevent acute upper respiratory tract infections (URTIs) such as the common cold and acute sinusitis in people at average risk of a URTI. After extensive searching for all relevant studies, the authors identified 12 randomized controlled trials that tested the effects of different types of probiotics on the development or duration of a URTI episode. Six studies were in children, 3 in adults, and 2 in older people. This summary presents the findings from this review. Probiotics are live microorganisms, primarily bacteria, that are believed to provide health benefits when ingested. There are several different types and strains of probiotics that are commonly used, such as Lactobacillus, Streptococcus, and Bifidobacterium. Probiotics can be taken with milk products, as a powder, or in capsules and do not require a prescription. There has been some research into whether taking probiotics could p...

English

The effects of overrun and glycerol as a cryoprotectant on viability of probiotics in frozen yogurt were investigated. Frozen yogurt was prepared with different types of probiotics (Lactobacillus acidophilus and Bifidobacterium lactis) along with normal yogurt starter culture (Streptococcus salivarius ssp. thermophiles and L. delbrueckii ssp. bulgaricus). Frozen yogurt mixture was supplemented with 1.5, 3 and 4.5% glycerol and was frozen with 60, 80 and 100% overrun. Viability of probiotic bacteria after freezing and during storage period of 12 weeks was investigated. Supplementation of glycerol in the mixture has improved the survival of L. acidophilus and B. lactis during the frozen storage. At the end of storage period the overall loss in viability of the L. acidophilus with 60, 80 and 100% overrun was 1.81, 1.96 and 2.24 log CFU/g, respectively. The B. lactis viability loss with 60, 80 and 100% overrun was 2.11, 2.26 and 2.26 log CFU/g, respectively. All the supplemented probiotics maintained the minimum concentration of 10 7 CFU/g in frozen yogurt during frozen storage, which is required for beneficial health effects in the host. © 2015 Friends Science Publishers

Deciphering meta-analytic results: a mini-review of probiotics for the prevention of paediatric antibiotic-associated diarrhoea and Clostridium difficile infections.

Meta-analyses are used to evaluate pooled effects of a wide variety of investigational agents, but the interpretation of the results into clinical practices may be difficult. This mini-review offers a three-step process to enable healthcare providers to decipher pooled meta-analysis estimates into results that are useful for therapeutic decisions. As an example of how meta-analyses should be interpreted, a recent meta-analysis of probiotics for the prevention of paediatric antibiotic-associated diarrhoea (AAD) and the prevention of Clostridium difficile infections (CDI) will be used. First, the pooled results of this meta-analysis indicates a significant protective efficacy for AAD is found when the 16 different types of probiotics are combined (pooled relative risk (RR) = 0.43, 95% confidence interval (CI)=0.33-0.56) and also a significant reduction of paediatric CDI (pooled RR=0.34, 95%CI=0.16-0.74) was found pooling four different types of probiotics. Secondly, because the efficacy of probiotics is strain-specific, it is necessary to do a sensitivity analysis, restricting the meta-analysis to one specific strain. Two strains, Saccharomyces boulardii lyo and Lactobacillus rhamnosus GG showed significant efficacy for paediatric AAD when pooled (pooled RR for S. boulardii = 0.43, 95%CI=0.21-0.86 and pooled RR for L. rhamnosus GG = 0.44, 95%CI=0.20-0.95). Thirdly, if studies within probiotic types have different results, it is prudent to examine these studies individually to determine the reasons why non-significant differences in efficacy were found. By drilling down through these three analytic layers, physicians will be confident in recommending the correct probiotic strain to their patients.

A 10-patient case study on the influence of two different probiotics on individual intestinal microbiota.

Probiotics increase beneficial microbiota and improve chronic conditions, such as atopic diseases, irritable bowel disease, and obesity. However, because there are so many probiotics, it is unknown which probiotics might have more of an effect on intestinal microbiota. To understand how two different types of probiotics influence human intestinal microbiota, human fecal microbiota were analyzed after ingestion of each of the probiotics. Ten outpatients were enrolled. Study A: Five patients took Lactobacillus buchneri (SU) for 4 weeks and mixed probiotics (NS) for the following 4 weeks. Study B: One year after study A, the other five patients took NS for 4 weeks at first and SU for the following 4 weeks. Fecal samples were collected before and after the outpatients took each of the two probiotics and were then analyzed. Study A: Three of the five patients had a decreased percentage of beneficial bacteria (Lactobacillales, Bifidobacteria species) after taking SU (change [expressed as mean±standard deviation] from 13.7%±7.1% to 4.0%±3.5%), whereas the remaining two patients showed an increased percentage (from 16.8%±3.4% to 30.4%±4.6%). After taking NS, the three patients who had a decreased percentage of beneficial bacteria after taking SU increased (from 4.0%±3.5% to 8.0%±2.1%), whereas the two patients who had increased beneficial bacteria after taking SU showed a decreased percentage (from 30.4%±4.6% to 16.4%±7.4%). Study B: All five patients had increased beneficial bacteria after taking NS (from 9.9%±2.9% to 14.5%±4.8%). After taking SU, all five patients had decreased bacteria (14.5%±4.8% to 10.9%±5.8%). The two probiotics studied had different influences. Probiotics should be selected not only for their quality but also for compatibility with each intestinal bacterial flora.

Gut Microbiota and Inflammation

Systemic and local inflammation in relation to the resident microbiota of the human gastro-intestinal (GI) tract and administration of probiotics are the main themes of the present review. The dominating taxa of the human GI tract and their potential for aggravating or suppressing inflammation are described. The review focuses on human trials with probiotics and does not include in vitro studies and animal experimental models. The applications of probiotics considered are systemic immune-modulation, the metabolic syndrome, liver injury, inflammatory bowel disease, colorectal cancer and radiation-induced enteritis. When the major genomic differences between different types of probiotics are taken into account, it is to be expected that the human body can respond differently to the different species and strains of probiotics. This fact is often neglected in discussions of the outcome of clinical trials with probiotics.

Probiotics for Preventive Health

Gut flora and probiotics have potential to affect health and disease far beyond the gut. There is increasing evidence that probiotics have beneficial effects in preventing a wide range of conditions and improving health. Randomized, double-blind studies have provided evidence of the effectiveness of probiotics for preventing various diarrheal illnesses as well as allergic disorders. Evidence for their efficacy for use in the prevention and treatment of bacterial vaginosis and urinary tract infections is also mounting. In addition, probiotics may be useful for preventing respiratory infections, dental caries, necrotizing enterocolitis, and certain aspects of inflammatory bowel disease. Data also suggest that probiotics may promote good health in day care and work settings, and may enhance growth in healthy as well as ill and malnourished children. Results from meta-analyses and systematic reviews that combine results of studies from different types of probiotics to examine the effects in any disease state should be interpreted with caution. Specific strains are effective in specific disease states. No 2 probiotics are exactly alike; we should not expect reproducible results from studies that employ different species or strains, variable formulations, and diverse dosing schedules.

Meta-Analysis of Probiotics for the Prevention of Antibiotic Associated Diarrhea and the Treatment of Clostridium difficile Disease

Antibiotic-associated diarrhea (AAD) is a common complication of most antibiotics and Clostridium difficile disease (CDD), which also is incited by antibiotics, is a leading cause of nosocomial outbreaks of diarrhea and colitis. The use of probiotics for these two related diseases remains controversial. To compare the efficacy of probiotics for the prevention of AAD and the treatment of CDD based on the published randomized, controlled clinical trials. PubMed, Medline, Google Scholar, NIH registry of clinical trials, metaRegister, and Cochrane Central Register of Controlled Trials were searched from 1977 to 2005, unrestricted by language. Secondary searches of reference lists, authors, reviews, commentaries, associated diseases, books, and meeting abstracts. Trials were included in which specific probiotics given to either prevent or treat the diseases of interest. Trials were required to be randomized, controlled, blinded efficacy trials in humans published in peer-reviewed journals. Trials that were excluded were pre-clinical, safety, Phase 1 studies in volunteers, reviews, duplicate reports, trials of unspecified probiotics, trials of prebiotics, not the disease being studied, or inconsistent outcome measures. Thirty-one of 180 screened studies (totally 3,164 subjects) met the inclusion and exclusion criteria. One reviewer identified studies and abstracted data on sample size, population characteristics, treatments, and outcomes. From 25 randomized controlled trials (RCTs), probiotics significantly reduced the relative risk of AAD (RR = 0.43, 95% CI 0.31, 0.58, p < 0.001). From six randomized trials, probiotics had significant efficacy for CDD (RR = 0.59, 95% CI 0.41, 0.85, p = 0.005). A variety of different types of probiotics show promise as effective therapies for these two diseases. Using meta-analyses, three types of probiotics (Saccharomyces boulardii, Lactobacillus rhamnosus GG, and probiotic mixtures) significantly reduced the development of antibiotic-associated diarrhea. Only S. boulardii was effective for CDD.