Lactic Ferments: Benefits, Dosage, Contraindications
Other name(s)
Probiotics
Family or group:
Probiotics
Active ingredients:
Lactobacilli
Bifidobacteria
Indications
Rating methodology
EFSA approval.
Diarrhea ✪✪✪✪✪
Diarrhea can be caused by infections (viruses, parasites, bacteria) including acute diarrhea (gastroenteritis) and traveler's diarrhea caused by E. coli. According to studies, the consumption of at least 10 CFUs of lactic cultures (mixtures of lactobacilli and bifidobacteria) can prevent and/or treat (reduce the duration of) these diarrheas. Some clinical research shows that taking 250 ml of fermented milk containing a minimum of Lactobacillus rhamnosus GG 108 colony-forming units (CFU)/mL, Lactobacillus acidophilus La-5 107 CFU/mL, and Bifidobacterium Bb-12 108 CFU/mL orally every day for 14 days reduces the relative risk of antibiotic-associated diarrhea by 79% compared to the same dairy product containing heat-killed bacteria. Other clinical research shows that taking 49 grams of fermented milk containing at least 50 x 109 CFU of Lactobacillus acidophilus CL1285 and Lactobacillus casei (Bio-K+ CL1285, Bio-K+ International Inc) orally every day for 2 days, followed by 98 grams per day until the end of antibiotic treatment, reduces the relative percentage of patients experiencing antibiotic-associated diarrhea by 55% compared to placebo in hospitalized patients receiving systemic antibiotics. a0 UI: billions of CFU
Posologie
Orally
108 CFU
Fermented milk
Traveller's 'funny tummy' - reviewing the evidence for complementary medicine.
Effect of a fermented milk combining Lactobacillus acidophilus Cl1285 and Lactobacillus casei in the prevention of antibiotic-associated diarrhea: a randomized, double-blind, placebo-controlled trial
Prevention of antibiotic-associated diarrhoea by a fermented probiotic milk drink
Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials.
Meta-analysis of probiotics for the prevention of traveler's diarrhea
Efficacy of probiotic use in acute diarrhea in children: a meta-analysis
Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis.
Probiotics for treating infectious diarrhoea
Vaginal Infections ✪✪✪✪✪
Vaginal infections (bacterial or candida) are marked by a disruption of the vaginal flora. Studies have shown that conventional treatments are more effective when supplemented with lactic cultures. The consumption of lactic cultures reduces the risks of vaginal infections in pregnant women by 81%. A meta-analysis of 10 clinical studies conducted on patients with bacterial vaginosis shows that taking a probiotic alone or with antibiotics increases the chances of recovery by 39% around the thirtieth day after intervention, compared to the control group. Various probiotic species have been evaluated; it is not clear exactly which species, if any, might be most beneficial.
Posologie
Orally
Fermented milk
Efficacy of oral metronidazole with vaginal clindamycin or vaginal probiotic for bacterial vaginosis: randomised placebo-controlled double-blind trial
Treatment of bacterial vaginosis with lactobacilli
Human lactobacilli as supplementation of clindamycin to patients with bacterial vaginosis reduce the recurrence rate; a 6-month, double-blind, randomized, placebo-controlled study
Effects of oral probiotic supplements on vaginal microbiota during pregnancy: a randomised, double-blind, placebo-controlled trial with microbiome analysis
Probiotics for the Treatment of Bacterial Vaginosis: A Meta-Analysis
Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis
Therapy of bacterial vaginosis using exogenously-applied Lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric clinical trial
Eczema ✪✪✪✪✪
Intestinal microflora plays a major protective role against allergy development as it reduces antigen transport across the intestinal mucosa and helps induce oral tolerance. Therefore, probiotics could have a protective role in the prevention and/or management of atopic dermatitis and eczema due to their proposed actions. A number of clinical trials have studied probiotic therapy to prevent the development of atopic eczema, and some have evaluated the effectiveness of probiotic therapy in the treatment of eczema. Pelucchi et al. (2012) conducted a meta-analysis of randomized controlled trials to determine if the use of probiotics during pregnancy and early life decreases the incidence of atopic eczema and IgE-associated atopic eczema in infants and young children. Eighteen publications based on 14 studies were included in the analysis. The meta-analysis showed that the use of probiotics decreased the incidence of atopic dermatitis. While the overall evidence supports the use of probiotics to decrease the incidence of atopic dermatitis in infants and young children, some strains were not effective. For example, the LAVRI-A1 strain of Lactobacillus acidophilus was not effective in reducing the incidence of atopic dermatitis development. In another randomized, placebo-controlled, double-blind trial, the efficacy of Lactobacillus paracasei F-19 was evaluated. In this trial, the probiotic was administered directly to the infant (n = 179) at the time of weaning (mixed with food). Infants consumed the probiotic agent (1 d7 108 CFU/day) from 4 to 13 months of age. Probiotic supplementation resulted in a significant reduction in the cumulative incidence of eczema at 13 months of age and an improvement in the Th1/Th2 ratio. In another double-blind trial, women (n = 415) were randomized to receive either a placebo or probiotic milk (containing Lactobacillus rhamnosus GG, Lactobacillus acidophilus La5, and Bifidobacterium lactis Bb12) from 36 weeks of gestation to 3 months postnatally during breastfeeding. Probiotic milk reduced the child's likelihood of developing atopic dermatitis by about 52% at 6 years of age compared to placebo milk. No significant effects on asthma or atopic sensitization rates were observed.
Posologie
Orally
108 CFU
Fermented milk
Effect of Lactobacillus sakei supplementation in children with atopic eczema-dermatitis syndrome.
Effects of Lactobacillus salivarius LS01 (DSM 22775) treatment on adult atopic dermatitis: a randomized placebo-controlled study
Children with atopic dermatitis show clinical improvement after Lactobacillus exposure.
Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood--a meta-analysis.
Physiological effect of a probiotic on skin
A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years.
Treatment efficacy of probiotics on atopic dermatitis, zooming in on infants: a systematic review and meta-analysis.
Preliminary results on clinical effects of probiotic Lactobacillus salivarius LS01 in children affected by atopic dermatitis
A randomized trial of Lactobacillus plantarum CJLP133 for the treatment of atopic dermatitis.
Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial
Lactobacillus paracasei CNCM I-2116 (ST11) inhibits substance P-induced skin inflammation and accelerates skin barrier function recovery in vitro
Oral Lactobacillus paracasei improves skin barrier function recovery and reduces local skin inflammation
Cold ✪✪✪✪✪
A clinical study conducted on children aged 3 to 6 years attending a daycare center shows that the intake of a fermented dairy product containing Lactobacillus casei at a rate of 200 g per day for 3 months reduces the risk of developing a cold, the most common URTI in these children, by about 18.5% compared to a control dairy product. In healthy middle-aged male office employees, a preliminary clinical study shows that the consumption of a fermented milk based on Lactobacillus casei Shirota for 12 weeks reduces the incidence and duration of colds by 59% compared to a control milk. a
Posologie
Orally
fermented milk
Helicobacter pylori Infection ✪✪✪✪✪
Oral probiotics, associated with most standard H. pylori eradication treatments, seem beneficial to improve eradication rates. Several meta-analyses show that taking probiotics in conjunction with standard H. pylori eradication treatment can increase the eradication rate by 1.1 to 2 times compared to the standard eradication treatment alone. Clinical research shows that Saccharomyces boulardii, lactobacilli species, and bifidobacteria species can improve eradication rates. However, this effect seems to depend on the probiotic species or strain used, as well as the eradication therapy regimen. A meta-analysis shows that the greatest benefit is obtained when a probiotic is added to quadruple therapies containing bismuth. Some research shows that taking a combination of lactobacilli and bifidobacteria along with eradication treatment can multiply the eradication rate by 2, while taking a probiotic containing lactobacilli along with eradication treatment improves the eradication rate by 1.2. However, the efficacy of lactobacillus seems to depend on the eradication therapy regimen. Taking lactobacillus along with an eradication treatment composed of a proton pump inhibitor, clarithromycin, and amoxicillin seems to improve eradication rates, but taking lactobacillus along with a quadruple therapy, sequential therapy, or a therapy that does not include amoxicillin does not seem to improve eradication. Similarly, taking lactobacilli without antibiotics does not improve eradication rates in adults. Research on the use of yogurt or dairy products containing probiotics is more mixed.
Posologie
Orally
fermented milk
Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection
Systematic review with meta-analysis: Saccharomyces boulardii supplementation and eradication of Helicobacter pylori infection
Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials.
Meta-analysis: Lactobacillus containing quadruple therapy versus standard triple first-line therapy for Helicobacter pylori eradication.
Efficacy and safety of probiotics in eradicating Helicobacter pylori: A network meta-analysis
Lactobacillus gasseri Suppresses the Production of Proinflammatory Cytokines in Helicobacter pylori-Infected Macrophages by Inhibiting the Expression of ADAM17
Antagonistic activities of lactobacilli against Helicobacter pylori growth and infection in human gastric epithelial cells
Effect of Lactobacillus acidophilus and Bifidobacterium bifidum supplementation to standard triple therapy on Helicobacter pylori eradication and dynamic changes in intestinal flora.
Lactobacillus-containing probiotic supplementation increases Helicobacter pylori eradication rate: evidence from a meta-analysis
Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans
Meta-analysis of the efficacy and safety of Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation in Helicobacter pylori eradication therapy
Effects of multistrain probiotic-containing yogurt on second-line triple therapy for Helicobacter pylori infection
Efficacy of Probiotic Supplementation Therapy for Helicobacter pylori Eradication: A Meta-Analysis of Randomized Controlled Trials
Antagonistic activity of probiotic lactobacilli and bifidobacteria against entero- and uropathogens
Lactobacillus reuteri strain combination in Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study
Meta-analysis of the efficacy and safety of Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation in Helicobacter pylori eradication therapy.
Effect of pretreatment with Lactobacillus gasseri OLL2716 on first-line Helicobacter pylori eradication therapy
Lactobacillus gasseri OLL2716 as a probiotic in clarithromycin-resistant Helicobacter pylori infection
Irritable Bowel Syndrome ✪✪✪✪✪
Several species of probiotics have been evaluated for improving IBS symptoms. In general, clinical research shows that probiotics moderately improve IBS symptoms, particularly abdominal pain. The best evidence to date concerns a specific strain of bifidobacteria called Bifidobacterium infantis 35624 (Align or Bifantis). Clinical research shows that taking this strain reduces abdominal pain, bloating, and difficulty in bowel movements within a week of treatment. Clinical research also shows that daily intake of Bacillus coagulans for 56 to 90 days improves quality of life and reduces bloating, vomiting, abdominal pain, and stool frequency compared to a placebo. The American College of Gastroenterology conditionally recommends the use of probiotics, especially combined probiotics, to improve overall symptoms, as well as bloating and flatulence, in patients with IBS.
Posologie
Orally
fermented milk
Efficacy and safety of Bacillus coagulans LBSC in irritable bowel syndrome: A prospective, interventional, randomized, double-blind, placebo-controlled clinical study [CONSORT Compliant]
American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome
Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome
A meta-analysis of probiotic efficacy for gastrointestinal diseases
Meta-analysis of probiotics for the treatment of irritable bowel syndrome.
Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS
Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study
Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles
A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome.
Efficacy of probiotics in irritable bowel syndrome: a meta-analysis of randomized, controlled trials.
The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review.
Respiratory Infections ✪✪✪✪✪
Probiotics are considered effective in boosting the immune system and combating seasonal respiratory infections. A double-blind placebo-controlled study was conducted on 479 healthy individuals over more than three months, taking orally a blend of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5. The aim was to clinically evaluate the influence of these probiotic strains to alleviate the severity of symptoms and duration of colds. The results revealed that the group treated with probiotics showed a reduced duration of symptoms with milder symptoms. Additionally, their cytotoxic T lymphocytes and CD8+ were significantly enhanced compared to the control group. The study thus shows that L. gasseri, combined with other lactic ferments, decreases the duration and severity of symptoms of seasonal viral respiratory illnesses. Preliminary studies suggest that the consumption of lactobacilli reduces the incidence of colds by about 12% in adults and reduces the incidence of respiratory disorders and infections in cystic fibrosis patients from 37 to 3%. Certain strains of lactobacilli (rhamnosus GG) notably reduce pulmonary exacerbations and hospital admissions in children with cystic fibrosis, particularly through anti-inflammatory action.
Posologie
Orally
fermented milk
Probiotic supplementation affects pulmonary exacerbations in patients with cystic fibrosis: a pilot study
Lactobacillus reuteri ATCC55730 in cystic fibrosis
Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections.
Probiotic effects on cold and influenza-like symptom incidence and duration in children
Daily intake of fermented milk with Lactobacillus casei strain Shirota reduces the incidence and duration of upper respiratory tract infections in healthy middle-aged office workers
A new chance of preventing winter diseases by the administration of synbiotic formulations
Prospective study of probiotic supplementation results in immune stimulation and improvement of upper respiratory infection rate
Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: a double blind, randomized, controlled trial
Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized, placebo-controlled trial
Colic in Children ✪✪✪✪✪
Clinical research indicates that L. reuteri DSM 17938 might be beneficial for the TREATMENT of colic in breastfed infants. Administering this specific strain for 21 to 28 days may reduce daily crying time in breastfed infants. Symptoms seem to improve within a week following treatment. In some clinical studies, the reduction in colic symptoms was greater in infants receiving this strain than with simethicone 60 mg once or twice daily over a 28-day period. A meta-analysis of available clinical research indicates that probiotics do not seem to PREVENT the development of colic in infants. Research evaluating other species of lactobacilli or other probiotics is lacking.
Posologie
Oral route
fermented milk
Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial
Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study
Antitussive effect of a fixed combination of Justicia adhatoda, Echinacea purpurea and Eleutherococcus senticosus extracts in patients with acute upper respiratory tract infection: A comparative, randomized, double-blind, placebo-controlled study
Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial
Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938
Probiotics to prevent infantile colic
Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial
Constipation ✪✪✪✪✪
A meta-analysis of clinical research in adults with functional constipation indicates that taking probiotics increases stool frequency compared to placebo. A specific species of probiotic, L. reuteri DSM 17938 (BioGaia), has the best evidence of benefit. Other single-strain or combined probiotic products containing lactobacillus and/or bifidobacteria species have also shown benefits in clinical research. Overall, evidence for using probiotics to reduce constipation symptoms in adults is promising. However, as most available studies evaluate different probiotic strains, further research is needed to confirm which strains might be most beneficial. However, research conducted in children shows that taking probiotics does not improve constipation symptoms compared to placebo, as demonstrated by a meta-analysis of four clinical studies.
Posologie
Oral route
fermented milk
Effect of Bifidobacterium longum BB536 administration on the intestinal environment, defecation frequency and fecal characteristics of human volunteers
The effect of Lactobacillus reuteri supplementation in adults with chronic functional constipation: a randomized, double-blind, placebo-controlled trial.
Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial.
Systematic review and meta-analysis of the effect of probiotic supplementation on functional constipation in children
Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation.
Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study
The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials
The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials.
Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study.
Allergic Rhinitis ✪✪✪✪✪
Some clinical research shows that fermented milk can decrease certain symptoms of allergic rhinitis in adults. Consuming 100 ml of heat-treated fermented milk containing L-92 strain of Lactobacillus acidophilus 3 x 1010 colony-forming units (CFU)/100 ml per day for 8 weeks appears to reduce subjective nasal symptoms, but not ocular symptoms, compared to placebo in patients with allergic rhinitis. A clinical study conducted in adults with allergic rhinitis caused by Japanese cedar pollen shows that consuming 80 ml of fermented milk containing Shirota strain of Lactobacillus casei 4 x 108 CFU/ml per day for 8 weeks does not improve allergic nasal symptoms compared to consuming non-fermented milk. Other studies suggest that fermented milk may also decrease the incidence of allergic rhinitis in children and adolescents. A clinical study conducted among preschool children with allergic rhinitis shows that taking 100 ml of fermented milk containing Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophilus orally once daily for 12 months reduces the annual number of rhinitis episodes by 1.6 compared to placebo. While other clinical research shows that consuming 200 to 400 ml of fermented milk containing Streptococcus thermophilus and Lactobacillus bulgaricus for 30 days does not improve rhinitis symptoms in children and adolescents with allergic rhinitis, fortifying the product with Lactobacillus paracasei improves quality of life compared to consuming fermented milk not containing Lactobacillus paracasei. Fermented milk has also been studied for preventing allergic rhinitis in newborns. Clinical research conducted among pregnant women shows that consuming 250 ml of fermented milk containing Lactobacillus rhamnosus GG, Lactobacillus acidophilus, and Bifidobacterium animalis during pregnancy, from the 36th week of gestation until 3 months post-delivery, does not reduce the risk of the child developing allergic rhinitis by age 6, compared to placebo milk.
Posologie
Oral route
fermented milk
Treatment of perennial allergic rhinitis with lactic acid bacteria
Clinical effects of Lactobacillus acidophilus strain L-92 on perennial allergic rhinitis: a double-blind, placebo-controlled study
Effects of probiotics on allergic rhinitis induced by Japanese cedar pollen: randomized double-blind, placebo-controlled clinical trial
A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis
Chronic Inflammatory Bowel Diseases ✪✪✪✪✪
Probiotics are used as an adjunct therapy for Crohn's disease and ulcerative colitis. Overall, current research indicates a limited role of probiotics in Crohn's disease; results concerning ulcerative colitis are more promising, and there seems to be a beneficial effect on pouchitis (inflammation of the ileal pouch). Meta-analyses of clinical research show that taking probiotics increases the remission rate by 1.4 to 1.8 times compared to placebo. The best evidence concerns a probiotic formulation containing lactobacillus, bifidobacteria, and streptococcus species (VSL#3). A meta-analysis also suggests that combined products containing bifidobacteria might be more effective than probiotics without bifidobacteria. Although a meta-analysis of three clinical trials shows that taking probiotics prevents relapse in 40% more patients than taking a placebo, most clinical research shows that probiotics containing lactobacillus or bifidobacteria, including VSL#3, do not prevent relapses in patients in remission. Given that most available studies are small and of poor quality, and some have shown no benefit for inducing remission or preventing relapses, further research is needed to confirm which probiotics, if any, might be beneficial for this use.
Posologie
Oral route
VSL#3
The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis
Effect of probiotics on inducing remission and maintaining therapy in ulcerative colitis, Crohn's disease, and pouchitis: meta-analysis of randomized controlled trials
VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis
A randomized double-blind placebo-controlled trial with Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis BB-12 for maintenance of remission in ulcerative colitis
Effect of probiotics on inducing remission and maintaining therapy in ulcerative colitis, Crohn's disease, and pouchitis: meta-analysis of randomized controlled trials
Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults-A Meta-Analytical Study
Low-dose balsalazide plus a high-potency probiotic preparation is more effective than balsalazide alone or mesalazine in the treatment of acute mild-to-moderate ulcerative colitis
Efficacy of Bifidobacterium breve Fermented Milk in Maintaining Remission of Ulcerative Colitis
Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis
Properties
Gastroprotective
It has been found that a number of probiotic strains increase the production of mucin in the intestine by increasing the expression of the mucin gene, which provides a protective coating between the lumen and intestinal epithelial cells. Probiotics are also capable of directly strengthening the intestinal barrier. A strain of Lactobacillus plantarum (WCSF1) was found to decrease paracellular intestinal permeability by increasing the relocalization of occludin and zonulin proteins at the tight junction between duodenal epithelial cells. Occludin and zonulin are essential for maintaining the intestinal wall cells tightly bonded. Other strains appear to enhance barrier function by preserving the cytoskeleton architecture of enterocytes and strengthening the protein structures of the tight junction. These strains are expected to be useful in the treatment and prevention of intestinal permeability.
Usages associés
Antibacterial
In vitro research suggests that fermented dairy products contain antimicrobial compounds that inhibit the growth of salmonella and shigella. Lactic bacteria present in fermented dairy products can release compounds that prevent pathogenic bacteria from colonizing the digestive tract. It is believed that the probiotic can prevent pathogenic bacteria from finding a place on the host tissue to attach and grow. For example, lactobacilli attach and colonize the intestinal or urogenital tract, reducing epithelial attachment by pathogenic bacteria. Lactobacilli are thought to achieve this partly by increasing the production of epithelial mucus and competing with pathogens for binding sites on the mucosa. According to human research, regular consumption of fermented milk can reduce potentially pathogenic bacteria in the upper respiratory tract.
Usages associés
Immunomodulatory
A number of evidence suggest that certain probiotic strains are capable of modulating the immune system at the systemic and mucosal level. Certain probiotic strains may influence the immune system, affecting epithelial cells (lining cells), dendritic cells, and natural killer cells. They can stimulate the production of immunoglobulin A (IgA) and increase the activities of natural killer cells and macrophages. Additionally, dendritic cells located in the tissue under the mucosae can interact with these probiotics to promote a balanced immune response. This includes the maturation of dendritic cells and the regulation of helper T cells (Th1, Th2, Th3/Tr1) response.
Usages associés
Antiallergic
Animal and human studies suggest that lactic bacteria, commonly found in fermented dairy products, alleviate allergic diseases. The mechanism could involve enhancing Th1 immune responses in patients with high serum immunoglobulin E (IgE) concentrations. It is noted that IgE plays a key role in allergies by triggering the release of histamine and other chemicals that cause allergic symptoms.
Usages associés
Cardiovascular
Alterations in intestinal microflora induced by the ingestion of fermented milk can influence systemic lipid metabolism. Fermented milk formulations significantly reduce total cholesterol and low-density lipoproteins (LDL) levels in some hypercholesterolemic patients. Bacteria from fermented milk that settle in the large intestine can ferment indigestible carbohydrates, leading to increased production of short-chain fatty acids, which reduce circulating cholesterol concentrations either by inhibiting hepatic cholesterol synthesis or by redistributing cholesterol from the plasma to the liver. Furthermore, increased bacterial activity in the large intestine may promote bile acid deconjugation. Deconjugated bile acids are not well absorbed by the intestinal mucosa and are excreted. Cholesterol, a precursor of bile acids, is then used to a greater extent for the de novo synthesis of bile acids.
Digestive Effect
There is evidence that probiotics containing certain bacterial cultures can affect Helicobacter pylori infection or its activity and the emergence of upper gastrointestinal symptoms in adults and children. Human studies have shown that fermented milk may be effective in treating and maintaining remission of ulcerative colitis, pouchitis, irritable bowel syndrome, and constipation. Consumption of fermented milk increases the total number of Bifidobacterium and Lactobacillus in feces or colon and decreases clostridia and other pathogenic bacteria. Consumption of fermented milk containing Bifidobacterium animalis DN-173 010 shortens colonic transit time in healthy women. However, the effect does not seem to be due to changes in fecal bacterial mass or secondary bile acids. Fermented dairy products have also been shown to slow gastric emptying.
Usages associés
Anti-inflammatory
It has been demonstrated that probiotic strains have anti-inflammatory effects through a number of different mechanisms. They can secrete metabolites with anti-inflammatory properties (anti-tumor necrosis factor-b1 [TNF-b1] effects), interact with Toll-like receptors, downregulate the transcription of a number of genes encoding pro-inflammatory effectors, and upregulate the production of anti-inflammatory cytokines. a0
Usages associés
Anticancer
In vivo and in vitro research shows antitumor activity of lactobacilli in colon cancer, and some epidemiological studies have indicated a reduced risk of breast cancer in women who consume fermented dairy products. In a study evaluating the effect of milk fermented by five strains of bacteria (Bifidobacterium infantis, Bifidobacterium bifidum, Bifidobacterium animalis, Lactobacillus acidophilus, and Lactobacillus paracasei) on the growth of breast cancer cells, all fermented dairy products showed growth inhibition, although Bifidobacterium infantis and Lactobacillus acidophilus were the most effective (85% inhibition after 9 days). It has been proposed that the mechanism involved a compound produced by the bacteria during the fermentation process or the microbial transformation of certain milk components into a biologically active form. It has also been demonstrated that fermented milk enhances the tumoricidal activity of natural killer cells. a0
Safety dosage
Adult from 18 years: 1 IU
Probiotic doses are generally standardized in terms of the quantity of live bacteria per unit volume. Each live bacterium is called a colony forming unit or CFU. 1 IU = 1 billion CFU (Colony Forming Unit). The minimum concentration of probiotic bacteria necessary for therapeutic effects seems to somewhat depend on the strain, in that, for some strains (e.g., L. reuteri MM53), 10 Million bacteria is a sufficient quantity to produce beneficial effects, while for other strains, 1 billion CFU viable bacteria are necessary (e.g., L. rhamnosus GG). This situation makes it difficult to formulate firm dosage recommendations, as the minimum effective dosage seems to differ by strain. The best practice is therefore to ensure that supplements contain bacteria in concentrations >1 billion CFU per dose, unless research has shown that the specific strain contained in the supplement is effective in lower quantities.
Pregnant woman:
The strain L. rhamnosus GG has been used with apparent safety during pregnancy, from 2 to 4 weeks before childbirth. The strain L. rhamnosus HN001 has been used with apparent safety from 14 to 16 weeks of gestation until 6 months after childbirth. L. salivarius has been used with apparent safety from the diagnosis of gestational diabetes until childbirth. Combinations of L. rhamnosus or L. paracasei with Bifidobacterium longum from 2 months before childbirth until the breastfed infant is 2 months old have been used with apparent safety during pregnancy and breastfeeding. A combination of L. acidophilus, L. casei, and Bifidobacterium bifidum has been used with apparent safety for 6 weeks starting from the 24th to the 28th week of gestation. The safety of using other strains in pregnant women is unknown.
Breastfeeding woman:
The strain L. rhamnosus GG has been used with apparent safety in breastfeeding women for a period of up to six months. Combinations of L. rhamnosus or L. paracasei with Bifidobacterium longum from 2 months before childbirth until the breastfed infant is 2 months old have been used with apparent safety during pregnancy and breastfeeding. The safety of using other strains in breastfeeding women is unknown.
Child from 1 to 18 years:
The strain L. rhamnosus GG has been used safely in. L. acidophilus, L. brevis, L. johnsonii, and L. reuteri have been used without danger for 12 weeks. A specific probiotic combination containing strains of lactobacilli (some of these strains have been reclassified), Bifidobacterium, and Streptococcus salivarius (VSL#3, sold under the name VIVOMIXX) has been used safely for one year in children aged 1 to 16 years. A specific probiotic combination containing L. acidophilus and Bifidobacterium animalis has been used safely for up to 6 months in children aged 3 to 5 years. A combination of L. acidophilus and Bifidobacterium bifidum has been used safely for 6 weeks. L. paracasei, L. fermentum, or a combination of the two species has been used with apparent safety for 3 months in children aged 1 to 18 years.
Infant up to 12 months:
Infants have safely consumed probiotics in the form of drops. See studies with BioGaia.
Precautions
Valvular heart disease: avoid
Patients with valvular heart disease who use probiotics containing lactobacillus may be at risk of endocardial inflammation. Cases of lactobacillus endocarditis have been reported in patients with valvular heart disease who used probiotics containing lactobacillus prior to dental surgery, upper endoscopy, or colonoscopy. It is advised for patients with valvular heart disease to stop using probiotics before dental surgery or other invasive gastrointestinal procedures.
Immune deficiency: use with caution
Lactobacillus-based preparations could provoke pathogenic colonization, especially in immunocompromised patients.
