Probiotic

from Wikipedia, the free encyclopedia

A probiotic (plural probiotics , hybrid word from Latin pro 'for' and ancient Greek bios 'life' ) is a preparation that contains living microorganisms . It is one of the functional food products. Ingested orally in sufficient quantities , probiotics can have a health-promoting influence on the host organismto have. The extent of this possible effect is in many cases controversial or not as stated. In comparison to "conventional" foods, an increased effect of probiotic foods has not been proven. The organisms that have long been used as probiotics are lactic acid bacteria , but yeast and other species are also in use.

Probiotics can be added to foods (including foods , food supplements or dietetic foods) or in the form of drugs . Probiotics are accrued by the prebiotics that has a positive effect (growth stimulation) on already in the intestine exploiting Dende microorganisms have, and synbiotics , a combination of both.

Probiotic foods

Foods designated as probiotic usually contain microorganisms (e.g. lactic acid bacteria of the type Lactobacillus casei ) which, if they can divide through the stomach passage to a significant extent , in the small intestine , sometimes also in the large intestine , through quantitative displacement and production of antibacterial substances ( Bacteriocins ) are intended to counteract incorrect colonization with intestinal germs. However, they may displace parts of the desired intestinal flora, which would severely disrupt the balance there. However, some probiotic bacteria (e.g. L. bulgaricus ) can only temporarily assert themselves within the intestinal flora and are almost completely displaced within a few weeks after the intake is stopped .

Probiotic yogurt

Probiotic yogurt can be made in a number of ways. With most probiotic products, yoghurt is first produced in the conventional way with the addition of the usual starter cultures and only afterwards the bacterial strain that is desirable for probiotics is added. Depending on the strain used, the fermentation of the milk can also be achieved by the probiotically desired bacterial strain itself; in this case the product contains only this bacterial strain.

More fermented foods

Other foods that are produced by fermentation , unless they are pasteurized or heated in any other way, contain live and probiotically desirable bacteria. These foods include, for example, sauerkraut , sauerkraut juice , bread drink and miso .

Probiotic foods

After originally only the corresponding yoghurt was offered, other foods, such as quark , cheese , sausage or ice cream , which contain probiotic bacteria , are increasingly appearing on the market.

An ice cream enriched with Lactobacillus acidophilus ( La ) and Bifidobacterium bifidum ( Bb ), slightly acidic for taste reasons with a pH value between 5.0 and 6.0, was stored at −29 ° C for 17 weeks. His live bacteria content decreased from an initial 1.5 × 10 8 cfu / ml ( La ) and 2.5 × 10 8 cfu / ml ( Bb ) to 4 × 10 6 cfu / ml ( La ) and 1 × 10 7 cfu / ml ( Bb ). This acceptable reduction showed that even longer frozen ice cream can be used as a probiotic food.

Additional probiotic preparations

Probiotic supplements (dietary supplements) must be clearly distinguished from foods. In contrast to food, these always contain several million to billions of viable bacteria in powder form. Most preparations contain bifidobacteria and lactobacteria with partially scientifically proven effects. The composition and the mixing ratio are selected by the manufacturer, and so the products have a different effect depending on the type and strain of bacteria. L. acidophilus is very popular, and there are many studies on its effectiveness. Most probiotic supplements are only available in pharmacies.

Properties and Criticism

The intensely advertised, supposedly health-promoting properties of various probiotic strains have only been scientifically proven to a very limited extent; there is still a great need for research in many areas. One of the many difficulties here is that the properties of probiotics are strain-specific. It should be noted, however, whether the studies examined probiotic foods or higher-dose probiotic food supplements, so that the statements cannot be generalized. Some strains of traditional lactic acid bacteria can have a similar positive effect in the intestine.

Studies on some probiotic bacterial strains (compared to placebo) brought partially positive results

However, positive effects of probiotics from previous studies could be called into question by false-positive results. Data from a study carried out in 2018 with pieces of the intestinal mucosa removed endoscopically indicate that the intestinal flora prevents probiotic strains from adhering - rather, the bacteria ingested pass through the intestine and are excreted again without integrating into the intestinal flora. The number of participants in the study was small with 15 people examined, in addition, only one probiotic was used, possible positive effects were not considered.

In addition, another study with a total of 21 participants showed that bacterial strains of the probiotics nestle quickly in intestinal flora artificially damaged by antibiotics. However, the regeneration of the intestinal flora was significantly delayed compared to the control group without taking probiotics. The consumption of probiotics in the case of diarrhea or gastrointestinal complaints during antibiotic therapy can even be counterproductive.

Examples of probiotic strains of bacteria in food

Examples of bacterial strains that clearly have no probiotic effect

"The following strains do not have a probiotic effect because they do not survive the extreme conditions in the stomach and through the bile and therefore do not arrive alive in the intestine:"

Health Claims

Since the beginning of 2007, unproven health-related statements ( health claims ) have been prohibited in the European Union ( Health Claims Regulation ). According to this, health-related statements on foods are only permissible if they are scientifically proven. There was a transition period until the end of 2009. Since then, a list has been drawn up for probiotics in which verifiable health-related statements are compiled. This is submitted to the European authority EFSA in order to scientifically test its traceability. In a number of articles, EFSA has already published positive notifications for most probiotic strains, but also several negative ones.

Medical applications

In addition to the controversial addition of probiotic bacteria to conventional foods, probiotics are used therapeutically as probiotic drugs for a variety of diseases . Some possible applications are not secured according to scientific criteria. In contrast, z. B. the use of E. coli strain Alfred Nissle 1917 (manufacturer Ardeypharm; trade name Mutaflor) for the prevention of recurrence of ulcerative colitis or for the treatment of diarrhea in infants, toddlers and children and meets the requirements of evidence-based medicine . To put it more critically, the double-blind studies carried out suggest a positive effect in acute diarrheal diseases in children, the prevention of antibiotic-induced diarrhea and ulcerative colitis .

Species used

Probiotic drugs can consist of either a single strain of a species or mixtures of several strains or species.

Mechanisms of Action

The exact mechanism of action of the bacteria used is not always known. However, it is known that they partially stimulate or modulate the mucosal immune system, which is also known as MALT ( mucosa associated lymphatic tissue ). As a result, the production of secretory immunoglobulins A, which z. B. be deposited in the intestinal lumen or are located on all mucous membranes, stimulates, which benefits the immune system. There is also a so-called colonization resistance, which means that probiotic bacteria u. a. produce bacteriocins themselves (in coli bacteria it is colicins , in lactococci e.g. nisin ), which inhibit the growth of other competing bacteria.

Indications

Probiotics have been used for a variety of diseases, but scientific proof of their positive effectiveness is often pending. The effectiveness of probiotics has been relatively well researched for the following diseases :

Contraindication

Although not proven, probiotic products are believed to aggravate the inflammatory phases of some autoimmune diseases such as ankylosing spondylitis . Isolated cases of probiotic bacteremia and fungemia in immunocompromised patients and in the chronically ill have been reported. There are no known cases of blood poisoning in healthy people who took probiotics. In severe, acute pancreatitis , taking probiotics significantly increases mortality (Propatria study). The use of probiotics should be avoided in critically ill patients.

Antibiotic resistance

Often, probiotic bacteria contain various genes that code for antibiotic resistance . These can belong to the natural makeup of the bacterium or have been acquired. It is currently unknown to what extent those resistance genes that can be mobilized and passed on to other bacterial species contribute to the development of resistance in pathogenic species.

research

Research on the diversity of bacteria in the intestine and their interaction with the human organism has so far raised more questions than it has found answers. Should the suspicion of the connection between disturbed intestinal flora and individual diseases be confirmed, new forms of therapy could develop from this.

literature

Web links

Individual evidence

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  2. ^ Pschyrembel, Clinical Dictionary, Verlag de Gruyter, 2002
  3. ↑ Hahn, Andreas (Ed.): Dietary supplements and supplementary balanced diets , Wissenschaftl. Verlagsges., Stuttgart 2006
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  6. ↑ For the di- , oligo- and polysaccharides inulin , lactulose , lactitol , raffinose , stachyose as well as other fructans and oligofructose , prebiotic properties were investigated and proven.
    Entry on prebiotics. In: Römpp Online . Georg Thieme Verlag, accessed on February 23, 2012.
  7. ↑ Sharareh Hekmat, Donald J. McMahon: Survival of Lactobacillus acidophilus and Bifidobacterium bifidum in ice cream for use as a probiotic food. In: Journal of Dairy Science , Vol. 75, No. 6, 1992, pp. 1415-1422. doi : 10.3168 / jds.S0022-0302 (92) 77895-3 .
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  11. ↑ J. Bienenstock, G. Gibson, TR Klaenhammer, WA Walker, AS Neish: New insights into probiotic mechanisms: a harvest from functional and metagenomic studies. In: Gut microbes. Volume 4, Number 2, 2013 Mar-Apr, pp. 94-100. doi : 10.4161 / gmic.23283 . PMID 23249742 . PMC 3595083 (free full text).
  12. ^ LE Miller, AC Ouwehand: Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials. In: World journal of gastroenterology: WJG. Volume 19, Number 29, August 2013, pp. 4718-4725. doi : 10.3748 / wjg.v19.i29.4718 . PMID 23922468 . PMC 3732843 (free full text).
  13. ↑ Eating probiotics regularly may improve your blood pressure. ( Memento of the original from July 26, 2014 in the Internet Archive ) Info: The @1@ 2Template: Webachiv / IABot / newsroom.heart.org archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. American Heart Association Rapid Access Journal Report, July 21, 2014.
  14. ↑ Eran Elinav et al .: Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features . In: Cell . tape 174 , no. 6 , September 6, 2018, p. 1388-1405.e21 , doi : 10.1016 / j.cell.2018.08.041 , PMID 30193112 .
  15. ↑ Eran Elinav et al .: Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT . In: Cell . tape 174 , no. 6 , September 6, 2018, p. 1406-1423.e16 , doi : 10.1016 / j.cell.2018.08.047 , PMID 30193113 .
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  17. ↑ List: As of September 2018 , EFSA Journal 2019, vol. 17, 1, adopted in December 2018 doi : 10.2903 / j.efsa.2019.5555 (engl.) The list is updated regularly.
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  23. ↑ Probiotics increase mortality in acute pancreatitis . In: Medicinal Telegram . tape 39 , no. 3 , p. 44 ( arznei-telegramm.de - 03/2008; preliminary version in Blitz at of February 14, 2008).
  24. ↑ Miguel Gueimonde, Borja Sánchez u. a .: Antibiotic resistance in probiotic bacteria . In: Frontiers in Microbiology . tape 4 , 2013, ISSN  1664-302X , p. 202 , doi : 10.3389 / fmicb.2013.00202 (review).
  25. ↑ Hellmuth Nordwig: Healthy thanks to the diversity of microbes - Bacteria flat share in the intestine , SWR2 - Knowledge from December 6, 2017 (manuscript)