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Probiotics. The species of Lactobacillus
Rating : 8
| Evaluation | N. Experts | Evaluation | N. Experts |
|---|---|---|---|
| 1 | 6 | ||
| 2 | 7 | ||
| 3 | 8 | ||
| 4 | 9 | ||
| 5 | 10 |
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Antibacterial (1)247 pts from Handy23
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 | "Descrizione" about Probiotics. The species of Lactobacillus Review Consensus 247 by Handy23 (4270 pt) | 2020-Nov-12 12:07 |  |
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The genus Lactobacillus is a taxonomically complex and is composed of over 170 species that cannot be easily differentiated phenotypically and often require molecular identification.
Although they are part of the normal human gastrointestinal flora, they can also be occasional human pathogens.
They are extensively used in a variety of commercial products including probiotics.
Their antimicrobial susceptibilities are poorly defined in part because of their taxonomic complexity and are compounded by the different methods recommended by Clinical Laboratory Standards Institute and International Dairy Foundation.
Their use as probiotics for prevention of Clostridium difficile infection is prevalent among consumers worldwide but raises the question of will the use of any concurrent antibiotic effect their ability to survive.
Lactobacillus species are generally acid resistant and are able to survive ingestion. They are generally resistant to metronidazole, aminoglycosides and ciprofloxacin with Lactobacillus acidophilus being susceptible to penicillin and vancomycin, whereas Lactobacillus rhamnosus and Lactobacillus casei are resistant to metronidazole and vancomycin.
These are the most common species
What are the health benefits of Lactobacillus species?
Clinical indication :
Diarrhea.
Antibiotics can disturb gastrointestinal microbiota which may lead to reduced resistance to pathogens such as Clostridium difficile. Probiotics are live microbial preparations that, when administered in adequate amounts, may confer a health benefit to the host, and are a potential Clostridium difficile prevention strategy. Recent clinical practice guidelines do not recommend probiotic prophylaxis, even though probiotics have the highest quality evidence among cited prophylactic therapies. The short-term use of probiotics appears to be safe and effective when used along with antibiotics in patients who are not immunocompromised or severely debilitated. Despite the need for further research, hospitalized patients, particularly those at high risk of CDAD, should be informed of the potential benefits and harms of probiotics (2).
Effectiveness :
Clinical indication :
Infantile Colic
Probiotics have been suggested as a potential strategy for infantile colic, and the specific species that have been studied in healthy infants are considered to be safe.
Supplementation with the probiotic Lactobacillus reuteri in breastfed infants appears to be safe and effective for the management of infantile colic. Further research is needed to determine the role of probiotics in infants who are formula-fed (3).
Effectiveness :
Clinical indication :
Ulcerative colitis
Intestinal dysbiosis seems to be the leading cause of inflammatory bowel diseases, and probiotics seems to represent the proper support against their occurrence. Actually, probiotic blends and anti-inflammatory drugs represent a weapon against inflammatory bowel diseases. The present study evaluates the long-term (2 years) effects of combination therapy (mesalazine plus a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4) on ulcerative colitis activity.
RESULTS:
All patients treated with combination therapy showed better improvement compared to the controls. In particular, the beneficial effects of probiotics were evident even after two years of treatment.
CONCLUSIONS:
A long-term treatment modality of anti-inflammatory drugs and probiotics is viable and could be an alternative to corticosteroids in mild-to moderate ulcerative colitis (4).
Effectiveness :
Clinical indication :
Pediatric antibiotic-associated diarrhea
Antibiotics are frequently prescribed in children. They alter the microbial balance within the gastrointestinal tract, commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora
AUTHORS' CONCLUSIONS:
Moderate quality evidence suggests a protective effect of probiotics in preventing AAD. Our pooled estimate suggests a precise (RR 0.46; 95% CI 0.35 to 0.61) probiotic effect with a NNT of 10. Among the various probiotics evaluated, Lactobacillus rhamnosus or Saccharomyces boulardii at 5 to 40 billion colony forming units/day may be appropriate given the modest NNT and the likelihood that adverse events are very rare. It is premature to draw conclusions about the efficacy and safety of other probiotic agents for pediatric AAD. Although no serious adverse events were observed among otherwise healthy children, serious adverse events have been observed in severely debilitated or immuno-compromised children with underlying risk factors including central venous catheter use and disorders associated with bacterial/fungal translocation. Until further research has been conducted, probiotic use should be avoided in pediatric populations at risk for adverse events. Future trials would benefit from a standard and valid outcomes to measure AAD (5).
Effectiveness :
Clinical indication :
Hepatic encephalopathy
Hepatic encephalopathy is a disorder of brain function as a result of liver failure or portosystemic shunt or both. Both hepatic encephalopathy (clinically overt) and minimal hepatic encephalopathy (not clinically overt) significantly impair patient's quality of life and daily functioning, and represent a significant burden on healthcare resources. Probiotics are live micro-organisms, which when administered in adequate amounts, may confer a health benefit on the host.
AUTHORS' CONCLUSIONS:
The majority of included trials suffered from a high risk of systematic error ('bias') and a high risk of random error ('play of chance'). Accordingly, we consider the evidence to be of low quality. Compared with placebo or no intervention, probiotics probably improve recovery and may lead to improvements in the development of overt hepatic encephalopathy, quality of life, and plasma ammonia concentrations, but probiotics may lead to little or no difference in mortality. Whether probiotics are better than lactulose for hepatic encephalopathy is uncertain because the quality of the available evidence is very low. High-quality randomised clinical trials with standardised outcome collection and data reporting are needed to further clarify the true efficacy of probiotics (6).
Effectiveness :
Clinical indication :
Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) is a devastating intestinal disease in preterm infants characterized by barrier disruption, intestinal microbial dysbiosis, and persistent inflammation of the colon, which results in high mortality rates. Current strategies used to manage this disease are not sufficient, although the use of human breast milk reduces the risk of Necrotizing enterocolitis. Mother's milk is regarded as a fundamental nutritional source for neonates, but pasteurization of donor breast milk affects the composition of bioactive compounds. Current research is evaluating the benefits and potential pitfalls of adding probiotics and prebiotics to pasteurized milk so as to improve the functionality of the milk and thereby reduce the burden of illness caused by NEC. Probiotics (live micro-organisms that confer health to the host) and prebiotics (nondigestible oligosaccharides that stimulate the growth of healthy bacteria) are functional foods known to mediate immune responses and modulate microbial populations in the gut. Clinical research shows strain- and compound-specific responses when probiotics or prebiotics are administered in conjunction with donor breast milk for the prevention of Necrotizing enterocolitis. Despite ongoing controversy surrounding optimal treatment strategies, randomized controlled studies are now investigating the use of synbiotics to reduce the incidence and severity of Necrotizing enterocolitis. Synbiotics, a combination of probiotics and prebiotics, have been proposed to enhance beneficial health effects in the intestinal tract more than either agent administered alone. This review considers the implications of using probiotic-, prebiotic-, and synbiotic-supplemented breast milk as a strategy to prevent Necrotizing enterocolitis and issues that could be encountered with the preparations (7).
Effectiveness :
Clinical indication :
Helicobacter pylori
Helicobacter pylori (H. pylori) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of gastrointestinal disorders including chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue lymphoma.
Probiotics are recommended to supplement triple therapy in pediatrics, and the effectiveness of triple therapy is associated with specific probiotic supplementation (8).
Effectiveness :
Clinical indication :
Dental caries
Members of the Streptococcus genus, especially S. mutans and S. sobrinus, are the main causal pathogens of early dental caries owing to their ability to produce insoluble glucan and fructan and to attach to the tooth surface. Streptococci are also known to aggregate to form oral biofilms; for instance, S. mutans rapidly increases biofilm thickness by producing surface-associated and biofilm regulatory proteins. As such, reducing the size of cariogenic bacterial populations and suppressing biofilm formation are essential strategies for the prevention of oral diseases.
Lactobacillus kefiranofaciens DD2 showed three oral probiotic attributes in an artificial oral model system: (i) excellent oral survivability, (ii) growth inhibition against oral streptococci, and (iii) anti-biofilm formation capacity against oral streptococci via inhibition of associated genes. These findings indicate that L. kefiranofaciens DD2 potentially can be developed as a novel oral probiotic agent (9).
Effectiveness
Clinical indication :
Allergic rhinitis
Probiotics have proven beneficial in a number of immune-mediated and allergic diseases. Several human studies have evaluated the efficacy of probiotics in allergic rhinitis; however, evidence for their use has yet to be firmly established. The current systematic review seeks to synthesize the results of available randomized trials.
Probiotics may be beneficial in improving symptoms and quality of life in patients with allergic rhinitis; however, current evidence remains limited due to study heterogeneity and variable outcome measures. Additional high-quality studies are needed to establish appropriate recommendations (10).
Effectiveness :
Clinical indication :
Staphylococcus aureus
Staphylococcus aureus (S. aureus) is an organism of great public health importance, causing 20,000 deaths annually. Decolonization of patients with S. aureus may prevent infections, yet current options are limited to antimicrobials that promote antibiotic resistance and can cause adverse side effects. Probiotics have potential to reduce colonization of pathogenic bacteria, representing a promising alternative for S. aureus decolonization, but thus far lack rigorous evaluation (11).
Effectiveness
Clinical indication :
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a chronic, recurring, and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain, distention, and changes in bowel habits.
With regards to therapies restoring intestinal permeability, multiple studies with prebiotics and probiotics[263] are ongoing, even if to date their efficacy has been limited. In parallel, much progress has been made in targeting low-grade inflammation, especially through the introduction of drugs such as mesalazine and rifaximin, even if a better knowledge of the mechanisms underlying the low-grade inflammation in IBS may support the design of clinical trials aimed at evaluating the efficacy and safety of such drugs.
On the other hand, the non-pharmacological treatment of IBS is often viewed as attractive. Faecal microbiota transfer, dietary interventions, holistic and integrative medicine approaches currently represent possible future therapeutic alternatives in this setting.
In conclusion, long-term studies and comparative studies with pharmacotherapy, as well as elucidation of the underlying mechanisms of action, are still needed to find the correct algorithm to manage IBS patients (12).
Effectiveness
Clinical indication :
Depression
Depression is a common mental disorder, which can be long-lasting or recurrent, substantially impairing an individual’s ability to function in their daily life. People with a depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed or restless. They may lose interest in physical activities, have a loss of appetite or overeating, have problems concentrating, remembering details or making decisions and, even more seriously, may attempt or commit suicide. It is also increasingly recognized that sub-clinical levels of depressive symptoms are found in healthy populations.
This systematic review supports the potential role of probiotics in reducing the risk of depression. Further evidence from larger samples and more rigorous randomized controlled trials are needed to determine whether probiotics can significantly reduce the overall risk of depression (13).
Effectiveness :
Clinical indication :
Functional constipation
Some studies consider probiotics to be effective towards constipation, while others have found no differences with placebo (14).
Effectiveness
Clinical indication :
Obesity
The increase in the prevalence of obesity observed over the last few decades has favoured the numerous investigations that have contributed to better understand the effects of a modern lifestyle on energy balance, body composition and metabolic health. Among the studied potential determinants of obesity, the intestinal microbiota has been proposed to have an impact on energy balance in both animals and humans.
This study demonstrates that Lactobacillus rhamnosus supplementation can accentuate body-weight loss in women submitted to energy restriction. This effect persisted in the subsequent maintenance phase when energy restriction was not imposed further. Thus, Lactobacillus rhamnosus supplementation seems to help obese women to maintain healthy body weight. Further research is needed to provide mechanistic explanations of this effect on energy balance (15).
Effectiveness
References_______________________________________
(1) Lactobacillus species: taxonomic complexity and controversial susceptibilities.
Goldstein EJ, Tyrrell KL, Citron DM.
Clin Infect Dis. 2015 May 15;60 Suppl 2:S98-107. doi: 10.1093/cid/civ072.
(2) Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.
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Cochrane Database Syst Rev. 2017 Dec 19;12:CD006095. doi: 10.1002/14651858.CD006095.pub4.
Current status of probiotics usage for the prevention of a first episode of Clostridium difficile infection.
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Rev Med Suisse. 2018 Oct 17;14(623):1834-1837. French.
Oral probiotic combination of Lactobacillus and Bifidobacterium alters the gastrointestinal microbiota during antibiotic treatment for Clostridium difficile infection.
De Wolfe TJ, Eggers S, Barker AK, Kates AE, Dill-McFarland KA, Suen G, Safdar N.
PLoS One. 2018 Sep 28;13(9):e0204253. doi: 10.1371/journal.pone.0204253. eCollection 2018
(3) Probiotics for the Management of Infantile Colic.
Szajewska H, Dryl R.
J Pediatr Gastroenterol Nutr. 2016 Jul;63 Suppl 1:S22-4. doi: 10.1097/MPG.0000000000001220.
Guidance on the use of probiotics in clinical practice in children with selected clinical conditions and in specific vulnerable groups.
Hojsak I, Fabiano V, Pop TL, Goulet O, Zuccotti GV, Çokuğraş FC, Pettoello-Mantovani M, Kolaček S.
Acta Paediatr. 2018 Jun;107(6):927-937. doi: 10.1111/apa.14270. Epub 2018 Apr 16
Efficacy of Lactobacillus reuteri DSM 17938 for infantile colic: Systematic review with network meta-analysis.
Gutiérrez-Castrellón P, Indrio F, Bolio-Galvis A, Jiménez-Gutiérrez C, Jimenez-Escobar I, López-Velázquez G.
Medicine (Baltimore). 2017 Dec;96(51):e9375. doi: 10.1097/MD.0000000000009375.
(4) The long-term effects of probiotics in the therapy of ulcerative colitis: A clinical study.
Palumbo VD, Romeo M, Marino Gammazza A, Carini F, Damiani P, Damiano G, Buscemi S, Lo Monte AI, Gerges-Geagea A, Jurjus A, Tomasello G.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016 Sep;160(3):372-7. doi: 10.5507/bp.2016.044. Epub 2016 Sep 13.
Biological Activities of Lactose-Derived Prebiotics and Symbiotic with Probiotics on Gastrointestinal System.
Nath A, Haktanirlar G, Varga Á, Molnár MA, Albert K, Galambos I, Koris A, Vatai G.
Medicina (Kaunas). 2018 Apr 17;54(2). pii: E18. doi: 10.3390/medicina54020018.
Lactobacillus reuteri F-9-35 Prevents DSS-Induced Colitis by Inhibiting Proinflammatory Gene Expression and Restoring the Gut Microbiota in Mice.
Sun MC, Zhang FC, Yin X, Cheng BJ, Zhao CH, Wang YL, Zhang ZZ, Hao HW, Zhang TH, Ye HQ.
J Food Sci. 2018 Oct;83(10):2645-2652. doi: 10.1111/1750-3841.14326. Epub 2018 Sep 14.
(5) Probiotics for the prevention of pediatric antibiotic-associated diarrhea.
Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC.
Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827. doi: 10.1002/14651858.CD004827.pub4
A practical guide for probiotics applied to the case of antibiotic-associated diarrhea in The Netherlands.
Agamennone V, Krul CAM, Rijkers G, Kort R.
BMC Gastroenterol. 2018 Aug 6;18(1):103. doi: 10.1186/s12876-018-0831-x.
Effect of a multispecies probiotic on reducing the incidence of antibiotic-associated diarrhoea in children: a protocol for a randomised controlled trial.
Łukasik J, Szajewska H.
BMJ Open. 2018 Jun 4;8(5):e021214. doi: 10.1136/bmjopen-2017-021214.
(6) Probiotics for people with hepatic encephalopathy.
Dalal R, McGee RG, Riordan SM, Webster AC.
Cochrane Database Syst Rev. 2017 Feb 23;2:CD008716. doi: 10.1002/14651858.CD008716.pub3.
Role of probiotics in the treatment of minimal hepatic encephalopathy in patients with HBV-induced liver cirrhosis.
Xia X, Chen J, Xia J, Wang B, Liu H, Yang L, Wang Y, Ling Z.
J Int Med Res. 2018 Sep;46(9):3596-3604. doi: 10.1177/0300060518776064. Epub 2018 May 28.
The Effects of Probiotics and Symbiotics on Risk Factors for Hepatic Encephalopathy: A Systematic Review.
Viramontes Hörner D, Avery A, Stow R.
J Clin Gastroenterol. 2017 Apr;51(4):312-323. doi: 10.1097/MCG.0000000000000789
(7) Probiotics, Prebiotics, and Synbiotics for the Prevention of Necrotizing Enterocolitis.
Johnson-Henry KC, Abrahamsson TR, Wu RY, Sherman PM.
Adv Nutr. 2016 Sep 15;7(5):928-37. doi: 10.3945/an.116.012237. Print 2016 Sep.
Probiotics for prevention of necrotizing enterocolitis and sepsis in preterm infants.
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Curr Opin Infect Dis. 2016 Jun;29(3):256-61. doi: 10.1097/QCO.0000000000000269.
Probiotics and the prevention of necrotizing enterocolitis.
Underwood MA.
J Pediatr Surg. 2018 Sep 6. pii: S0022-3468(18)30563-3. doi: 10.1016/j.jpedsurg.2018.08.055
(8) Probiotics for the treatment of Helicobacter pylori infection in children.
Pacifico L, Osborn JF, Bonci E, Romaggioli S, Baldini R, Chiesa C.
World J Gastroenterol. 2014 Jan 21;20(3):673-83. doi: 10.3748/wjg.v20.i3.673.
Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis.
Feng JR, Wang F, Qiu X, McFarland LV, Chen PF, Zhou R, Liu J, Zhao Q, Li J.
Eur J Clin Pharmacol. 2017 Oct;73(10):1199-1208. doi: 10.1007/s00228-017-2291-6. Epub 2017 Jul 5.
Helicobacter pylori Infection and Gastric Dysbiosis: Can Probiotics Administration Be Useful to Treat This Condition?
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Can J Infect Dis Med Microbiol. 2018 Sep 10;2018:6237239. doi: 10.1155/2018/6237239. eCollection 2018
(9) Antimicrobial and anti-biofilm activities of Lactobacillus kefiranofaciens DD2 against oral pathogens.
Jeong D, Kim DH, Song KY, Seo KH.
J Oral Microbiol. 2018 May 28;10(1):1472985. doi: 10.1080/20002297.2018.1472985. eCollection 2018.
Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children.
Näse L, Hatakka K, Savilahti E, Saxelin M, Pönkä A, Poussa T. Caries Res. 2001;35:412–20
(10) A systematic review and meta-analysis of probiotics for the treatment of allergic rhinitis.
Zajac AE, Adams AS, Turner JH.
Int Forum Allergy Rhinol. 2015 Jun;5(6):524-32. doi: 10.1002/alr.21492. Epub 2015 Apr 20.
(11) Impact of Probiotics for Reducing Infections in Veterans (IMPROVE): Study protocol for a double-blind, randomized controlled trial to reduce carriage of Staphylococcus aureus.
Eggers S, Barker A, Valentine S, Hess T, Duster M, Safdar N.
Contemp Clin Trials. 2017 Jan;52:39-45. doi: 10.1016/j.cct.2016.11.004. Epub 2016 Nov 9.
Antimicrobial activity of Lactobacillus salivarius and Lactobacillus fermentum against Staphylococcus aureus.
Kang MS, Lim HS, Oh JS, Lim YJ, Wuertz-Kozak K, Harro JM, Shirtliff ME, Achermann Y.
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(12) New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond
Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis.
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(13) Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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Nutrients. 2016 Aug 6;8(8). pii: E483. doi: 10.3390/nu8080483.
(14) A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation
Valerio Mezzasalma, Enrico Manfrini, Emanuele Ferri, Anna Sandionigi, Barbara La Ferla, Irene Schiano, Angela Michelotti, Vincenzo Nobile, Massimo Labra, Patrizia Di Gennaro
Biomed Res Int. 2016; 2016: 4740907. Published online 2016 Aug 9. doi: 10.1155/2016/4740907
Systematic review of randomised controlled trials: probiotics for functional constipation.
Chmielewska A, Szajewska H.
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(15) Effect of Lactobacillus rhamnosus CGMCC1.3724 supplementation on weight loss and maintenance in obese men and women.
Sanchez M., Darimont C., Drapeau V., Emady-Azar S., Lepage M., Rezzonico E., Ngom-Bru C., Berger B., Philippe L., Ammon-Zuffrey C., et al.
Br. J. Nutr. 2014;111:1507–1519. doi: 10.1017/S0007114513003875
Effects of a Diet-Based Weight-Reducing Program with Probiotic Supplementation on Satiety Efficiency, Eating Behaviour Traits, and Psychosocial Behaviours in Obese Individuals.
Sanchez M, Darimont C, Panahi S, Drapeau V, Marette A, Taylor VH, Doré J, Tremblay A.
Nutrients. 2017 Mar 15;9(3). pii: E284. doi: 10.3390/nu9030284.
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