Use Of Probiotics In Treatment Research Articles

Impact of the gut-lung axis on tuberculosis susceptibility and progression.

Tuberculosis (TB) has remained at the forefront of the global infectious disease burden for centuries. Concerted global efforts to eliminate TB have been hindered by the complexity of Mycobacterium tuberculosis (Mtb), the emergence of antibiotic resistant Mtb strains and the recent impact of the ongoing pandemic of coronavirus disease 2019 (COVID19). Examination of the immunomodulatory role of gastrointestinal microbiota presents a new direction for TB research. The gut microbiome is well-established as a critical modulator of early immune development and inflammatory responses in humans. Recent studies in animal models have further substantiated the existence of the 'gut-lung axis', where distal gastrointestinal commensals modulate lung immune function. This gut microbiome-lung immune crosstalk is postulated to have an important correlation with the pathophysiology of TB. Further evaluation of this gut immunomodulation in TB may provide a novel avenue for the exploration of therapeutic targets. This mini-review assesses the proposed mechanisms by which the gut-lung axis impacts TB susceptibility and progression. It also examines the impact of current anti-TB therapy on the gut microbiome and the effects of gut dysbiosis on treatment outcomes. Finally, it investigates new therapeutic targets, particularly the use of probiotics in treatment of antibiotic resistant TB and informs future developments in the field.

Use of Probiotics in Treatment and Rehabilitation of Patients after a New Coronavirus Infection

As of January 2022, 343 million cases of SARS-CoV-2 were reported globally. COVID-19 is a multi-faceted, multi-systemic illness in which all age groups are susceptible. A number of research findings have shown that COVID-19 is associated with dysbiosis, leading to the development of local and systemic pathologies. It was found that the use of probiotics in the complex therapy of patients with COVID19 reduces the severity of the disease and the development of complications. According to the researchers, several mechanisms could explain the therapeutic effect of probiotics, including the ability to suppress proinflammatory cytokine formation and modulate the functional activity of the immune system. In Russia, probiotics in the treatment of COVID-19 patients are only used to correct diarrhea, while literature suggests that probiotics have much greater therapeutic potential. Introducing oral bacterial therapy into the treatment and rehabilitation of COVID-19 patients requires further clinical trials.

Impact of Concurrent Use of Probiotics on Risk of Antibiotic Associated Diarrhoea in Adults

Antibiotics are one of the most prescribed medications worldwide. It is given to treat a wide range of infections and diseases. However, usage of antibiotics is associated with several side effects. The most frequently reported side effect is diarrhoea since antibiotics affect the gastrointestinal microbial environment. Antibiotic associated diarrhoea refers to the diarrhoea that develops at the initiation of the antibiotic therapy and can extend even up to six or more weeks after termination of the therapy. The prevalence of antibiotic associated diarrhoea ranges from 5% to 39% and is associated with significant morbidity and mortality. Antibiotic associated diarrhoea can be caused by any antibiotic used although the risk is higher for broad-spectrum antibiotics since they primarily target anaerobes and are poorly absorbed. Probiotics aid in reducing the risk of antibiotic associated diarrhoea. The purpose of this research is to review the available information about the impact of concurrent use of probiotics on risk of antibiotic-associated diarrhoea in adults. Various studies in the literature suggest of concurrent use of probiotics in treatment and prevention of antibiotic associated diarrhoea. Probiotics have been widely recommended as a robust and reliable strategy to lessen the negative effects of antibiotics on gastrointestinal function. Probiotics have a beneficial role in improving the gut health thus lowering the incidence of antibiotic associated diarrhoea if administered concurrently. Probiotics are generally well-tolerated and have minimum side effects. However more clinical research is needed to establish the guidelines for their concurrent use with antibiotic therapy to prevent antibiotic associated diarrhoea.

Prevention of Infantile Colic Using Probiotics

Objective: Infantile colic is a frustrating impasse that affects up to 20% of infants. Even though its pathogenesis is currently unknown, some hypotheses are food hypersensitivity or allergy, gut dysmotility, inflammation, and visceral pain. The use of probiotics in treatment and prevention of infantile colic is a relatively new topic. Method: Literature searches were conducted using Ovid MEDLINE®, EMBASE®, and the Cochrane Central Register of Controlled Trials. Randomised controlled trials including the terms “neonate(s)”, “infant(s)”, “probiotics”, “synbiotics”, “Lactobacillus”, “Bifidobacterium”, “colic”, and “prevention” were included. Results: Three studies showed the different composition of intestinal microbiota between colicky infants and control groups. In six of the studies, probiotic and/or synbiotic supplementation significantly decreased the rate of crying and pain in colicky infants compared with placebo; however, in two studies, no effect on the incidence and frequency of colic-related restlessness was detected. In all, the reviewed studies demonstrated that probiotic and/or symbiotic treatment regimens were effective for infantile colic prevention. Conclusions: There is much evidence suggestive of diversity in the intestinal microbiota among colicky and healthy infants. Based on recent research, using probiotics and synbiotics is a practical and favourable strategy for prevention and treatment of fussiness in colicky infants.

Efficacy of probiotics used as a periodontal treatment aid: A pilot study

Gingivitis is the inflammation of the soft tissue surrounding the tooth that may progress to a more destructive disease called periodontitis (Carranza and Newman, 2012). The onset and progression of gingivitis is dependent on systemic and genetic factors; however, the main etiological factor for gingivitis is the accumulation of plaque and the harmful bacteria found attached to it (Carranza and Newman, 2012). The oral cavity is normally colonized by more than 500 bacterial species most of which are relatively harmless commensal bacteria; however, it can also host potentially pathogenic bacteria (Jakubovics and Palmer, 2013, Suzuki et al., 2005). The accumulation of plaque can increase the predominance of pathogenic bacteria, alter the homeostasis, and induce disease. The first line of periodontal therapy is mechanical removal of accumulated plaque/calculus through scaling, root planning and polishing accompanied by oral hygiene instruction for the maintenance of oral health (Carranza and Newman, 2012, Jakubovics and Palmer, 2013). Additionally, chemical antimicrobial agents can play a significant role in supporting standard mechanical procedures by temporarily controlling the microbial load. Antimicrobial agents such as chlorhexidine, cetylpyridinium chloride (CPC), essential oils, chlorine dioxide, hydrogen peroxide, and triclosan are the commonly used (Tartaglia et al., 2017). Chlorhexidine is considered the most effective agent used in plaque control and in periodontal therapy; however, side effects such as tooth discoloration, oral mucosal erosion and taste alteration can be observed (da Costa et al., 2017, Justus et al., 2015). Probiotics are living microorganisms, mainly bacteria, that are safe for human consumption and positively influence health (Gupta, 2011, Haukioja, 2010). Various strains of Lactobacillus and Bifidobacterium are commonly used to promote gastrointestinal health. Recently, it has been suggested that some of these strains, as well as strains of Streptococcus, can colonize the oral cavity and reduce the concentration of pathogenic bacteria responsible for caries, periodontal disease and halitosis (Haukioja, 2010, Hillman et al., 2009, Maekawa and Hajishengallis, 2014). Clinical trials have been performed to assess the effect of probiotics on pathogenic oral bacteria after systemic and topic application of the probiotics with promising results (Karuppaiah et al., 2013, Zahradnik et al., 2009); however, publications that include controlled clinical assessment after treatment with probiotics are not abundant. Probiotic products specifically formulated for oral health are limited and Probiora 3 is the only one containing three strains of streptococci. The purpose of this study is to assess the effect of Probiora 3 mouthwash used for the treatment of plaque induced gingivitis and produce controlled clinical data to support or reject the use of probiotics for treatment of gongivitis. The study also aims to compare the effect of the probiotic mouthwash relative to chlorhexidine, since it is considered the most effective chemical aid in the management of periodontal disease. The clinical signs of gingivitis were assessed and compared to conventional periodontal treatment protocols.

Probiotics for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objective: Atopic dermatitis (AD) is a prevalent, burdensome, and psychologically important pediatric concern. Probiotics have been suggested as a treatment for AD. Some reports have explored this topic; however, the utility of probiotics for AD remains to be firmly established.Methods: To assess the effects of probiotics on AD in children, the PubMed/Medline, Cochrane Library Scopus, and OVID databases were searched for reports published in the English language.Results: Thirteen studies were identified. Significantly higher SCORAD values favoring probiotics over controls were observed (mean difference [MD], −3.07; 95% confidence interval [CI], −6.12 to −0.03; P < 0.001). The reported efficacy of probiotics in children < 1 year old was −1.03 (95%CI, −7.05 to 4.99) and that in children 1–18 years old was −4.50 (95%CI, −7.45 to −1.54; P < 0.001). Subgroup analyses showed that in Europe, SCORAD revealed no effect of probiotics, whereas significantly lower SCORAD values were reported in Asia (MD, −5.39; 95%CI, −8.91 to −1.87). Lactobacillus rhamnosus GG (MD, 3.29; 95%CI, −0.30 to 6.88; P = 0.07) and Lactobacillus plantarum (MD, −0.70; 95%CI, −2.30 to 0.90; P = 0.39) showed no significant effect on SCORAD values in children with AD. However, Lactobacillus fermentum (MD, −11.42; 95%CI, −13.81 to −9.04), Lactobacillus salivarius (MD, −7.21; 95%CI, −9.63 to −4.78), and a mixture of different strains (MD, −3.52; 95%CI, −5.61 to −1.44) showed significant effects on SCORAD values in children with AD.Conclusions: Our meta-analysis indicated that the research to date has not robustly shown that probiotics are beneficial for children with AD. However, caution is needed when generalizing our results, as the populations evaluated were heterogeneous. Randomized controlled trials with larger samples and greater power are necessary to identify the species, dose, and treatment duration of probiotics that are most efficacious for treating AD in children.

P478 The current place of probiotics in treatment of pouchitis: systematic review

Abstract Background: Pouchitis is a common complication in patients undergoing restorative proctocolectomy for ulcerative colitis. Therapeutic attempts include manipulations of pouch flora composition. In this systematic review, we aimed to score the evidence supporting the use of probiotics and prebiotics in pouchitis patients, to clarify the place of these treatments in current therapeutic regimens. Methods: We conducted extensive electronic searches of the PubMed and SCOPUS databases, from their earliest records through Nov 2016, for MESH terms “probiotics” and “pouchitis”. Results: The electronic search retrieved 20 citations [1–20]. Six published RCTs [2,3,9,10,13,14] and a RCT presented as an abstract [12] evaluated clinical, endoscopic end/or histological effect of probiotics as a primary outcome; other reports ranged in level of evidence between meta-analyses [16–19] (4), open-labeled trials [1,4–8,11,15] (8) and letters [20] (1). Conclusions: Prevention of onset of pouchitis/Primary prevention. Three studies examined the ability of various probiotic regimens to prevent the onset of pouchitis after the restorative proctocolectomy [1–3]. Primary preventive effect of VSL#3 was indicated by a single RCT, with calculated effect ratio of 1.50 [1.02, 2.21] [16]. Table 1. Use of probiotics for prevention of onset of pouchitis Study No. of patients Duration (months) probiotic strain Strain Control Pouchitis-free survival Gosselink (2004) 117 36 LGG No treatment (historical control) 93% vs. 71% (p=0.011) Gionchetti (2003) [2] 40 12 VSL#3 Placebo 90% vs. 60% (p&amp;lt;0.05) Yasueda (2015) [3] 17 24 Clostridium butyricum Placebo 89% vs. 50% (NS) Treatment of acute episode. Seven – mostly open-labeled and uncontrolled – trials examined the use of probiotics for treatment of acute pouchitis episode [4–10]. Efficacy of probiotics in acute episodes of pouchitis needs to be proved in randomized controlled trials. Table 2. Use of probiotics for treatment of active pouchitis Study No. of patients Duration (months) Strain Control Outcome Gionchetti et al. (2007) [4] 23 1 VSL#3 Open-labeled; uncontrolled 69% remission rate Laake et al. (2005) [5] 51 (10 with active disease) 1 Cultura® fermented milk product Open-labeled; uncontrolled Symptomatic and endoscopic improvement in patients with active disease Laake et al. (1999) [21] Cultura® fermented milk product Open-labeled; uncontrolled Symptomatic improvement Laake et al. (2003) [7] 10 ½ month Cultura® fermented milk product Open-labeled; uncontrolled Endoscopic improvement Laake et al. (2004) [8] 41 UC + 10 FAP 1 Cultura® fermented milk product Open-labeled; uncontrolled Symptomatic remission and endoscopic improvement Tomasz et al. (2014) [9] 43 (14 with active disease) 9 Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. Bulgaricus, Bifidobacterium bifidus Placebo 43% remission rate vs 0% on placebo Kuisma (2003) [10] 20 3 LGG Placebo No benefit Seven studies aimed to determine the efficacy of probiotic strains in preventing recurrences in patients with previous episode/s of pouchitis [4,9,11–15]. Probiotic mixture VSL#3 effectively prevents relapses after successful antibiotic treatment of active inflammation, with calculated effect ratio of 20.24 [4.28, 95.81] [16]. Side effects may affect the adherence of the patients with the long-term treatment [15,16]. Table 3. Use of probiotics for prevention of recurrences of pouchitis Study No. of patients Duration (months) Probiotic strain Control Outcome Pronio (2008) [11] 31 12 VSL#3 No treatment Small reduction of PDAI scores Brown (2004) [12] (abstract) 17 6 Bifidobacterium longum BB-536 Placebo Pouchitis-free survival 86% vs. 60% on placebo (NS); small reduction of PDAI scores Tomasz et al. (2014) [9] 43 9 Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. Bulgaricus, Bifidobacterium bifidus Placebo 43% in remission vs 0% on placebo Gionchetti et al. (2007) [4] 16 6 VSL#3 Open-labeled; uncontrolled 69% remission rate Gionchetti (2000) [13] 40 9 VSL#3 Placebo Pouchitis-free survival 85% vs. 0% on placebo (P&amp;lt;0.001) Mimura (2004) [14] 36 12 VSL#3 Placebo Pouchitis-free survival 85% vs. 6% on placebo (P&amp;lt;0.0001) Shen (2005) [15] 31 8 VLS#3 (self administration) Open-labeled compliance trial 80% non-adherence; 74% self-reported recurrence of symptoms

Probiotics: current evidences and new perspectives

Probiotics are viable microorganisms that can exert potential benefits to human health. Use of probiotics in different human diseases and clinical conditions has gained much attention in the last decades. Several data exist about the potential benefits of probiotics in pediatric age for the management of some clinical conditions, with different and sometimes contrasting results. Currently, strong evidences support the use of probiotics for treatment of acute infectious diarrhoea and prevention of antibiotic-associated diarrhoea: bacteria belonging to the genus of lactobacilli and Saccharomyces boulardii showed the stronger evidences of benefits in different clinical trials and meta-analysis [1,2]. For other pediatric diseases and clinical conditions, evidences of the benefits of a probiotic supplementation are still not so strong. The recommendation to administer a probiotics supplementation in preterm, very low birth weight neonates at risk of developing necrotizing enterocolitis has recently been criticized by a critical review of the literature that conclude that well-designed clinical trials are still needed for suggesting its routinely use in these neonates [3]. Discussion is still ongoing about the benefits of probiotics in prevention or treatment of other pediatric diseases such as respiratory tract infections, urinary tract infections, Helicobacter pylori infection or allergic diseases. Clinical trials and meta-analysis about the use of probiotics in these pediatric clinical conditions have been published and still continued to be published; however, study designs are not always comparable and sometimes inadequate, species of probiotics used in the studies are different and the benefits demonstrated for one microorganism are not generalizable to other bacteria, results of the studies are still often not unequivocal or contrasting so that strong recommendations are still lacking. The use of probiotics has been suggested to be potentially beneficial for the management of gastrointestinal functional disorders, such as irritable bowel syndrome, again, with different results. These clinical conditions are supposed to be the result of a perturbation of the microbiota balance that leads to dysbiosis, responsible for the appearance of the characteristic symptoms. However, pathogenesis of gastrointestinal functional disorders appear to be much more complex and involve the nervous system and its bidirectional interactions with the intestine. Moreover, it has been hypothesized that intestinal microbial composition may itself influence end-points related to mood state, brain function, and mental outlook. A new fascinating perspective in studies about microbiota and probiotics is the characterization of the alterations of intestinal microbiome and their correlation with abnormalities in the bidirectional gut-brain interactions.

Prospectus of probiotics in modern age diseases

In India food reflects the warmth, hospitality, status, symbol of wealth and aesthetics. The synergistic combination of pre and probiotics is known as synbiotics. Regular consumption of synbiotics in diets imparts health benefits like improved immune response, maintain intestinal integrity, decrease intestinal infections and down regulate the allergic response, influence digestion and gastric motility. Because of the changes in life styles due to globalization, unhealthy diets, lack of physical activity and exposure to tobacco smoke or harmful use of alcohol non communicable diseases are disproportionately affecting the 80% of low and middle income countries. This review covers the mechanism of probiotic action, use of probiotics in treatment and prevention of diseases of modern age, progress in delivery systems for the administration and finally some regulatory considerations. In conclusion, combined skills of the microbiologist, food technologist and clinician are necessary to sustain effect of probiotics. The role of probiotic organisms as alternative or complementary therapy in combating a large number of disorders can be achieved with balance and healthy life style as well as clean external environmental conditions. It is hoped that more detailed research will be conducted regarding the efficacy of probiotics so that clinically well documented and simplest formulation will be developed and can be regarded as effective for everyone. With validated results strong market will be formed and expanded in near future.

Use of Probiotics for Treatment of Chemotherapy‐induced Diarrhea: Is It a Myth?

Use of Probiotics for Treatment of Chemotherapy‐induced Diarrhea: Is It a Myth?