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Probiotics

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About Probiotics

The scientific definition of Probiotic is: Live Microorganisms which when administered in adequate amounts confer a Health Benefit on the host. [1]

Previous definitions for Probiotics have included the mechanism of Health Benefit, such as boosting Immune System Function or affecting Intestinal Microbial Balance, has been removed in order that Microbes with an unknown or different Health Benefit may be included.

There is no legal definition for Probiotics which allows for marketing of misleading information on products that do not fit the scientific definition for Probiotic but are labeled as such.[1]

There are many different strains of microbes and different strains can have different effects on health.

Probiotics in Crohn's Disease and Ulcerative Colitis

A recent study showed marked differences in Microbe-Induced GI Tract gene expression between Controls (Healthy) and patients with Inflammatory Bowel Disease (IBD). Biopsies were taken from Control and IBD GI and co-cultured with DNA from Bacteria representing "Pathogenic" (Salmonella dublin) or "Probiotic" (Lactobacillus plantarum) types.[2]

Probiotics in the Healthy GI Tract
There have been multiple studies on Health Benefits of Probiotics on the Gastrointestinal (GI) tract of Healthy individuals. When GI Mucosa is co-cultured with Lactobacillus plantarum DNA, STAT3 and STAT6 cellular pathways are involved, and IL10 is upregulated.[2]

In contrast, when DNA from a "Pathogenic" bacteria (Salmonella dublin) is introduced, cellular responses include NFkB and STAT6 pathways.[2]

Probiotics in Ulcerative Colitis
Patients with Ulcerative Colitis (UC) often have an increase in gene expression involved in Inflammation, decreased expression of Apoptosis-Related genes, and Microbial Dysbiosis of the GI Tract.

When GI Mucosa was co-cultured with DNA from "Pathogenic" bacteria, cellular responses approximated those seen in Healthy GI Patients. However, when "Probiotic" bacterial DNA was introduced, cell pathways appeared to be largely Anti-Inflammatory. These data suggest that the "Probiotic" bacteria, Lactobacillus plantarum may have an Anti-Inflammatory effect in Ulcerative Colitis Patients.[2]

Probiotics in Crohn's Disease
In the GI Tract of patients with Crohn's Disease (CD), there is often an increase in Pro-Inflammatory gene expression and decreased Apoptosis-related gene expression. Microbial Dysbiosis is also common in Crohn's Disease.

The most striking effect of bacterial DNA co-culture with GI Tract Mucosa was seen in Crohn's Disease Patients. The "Pathogenic" bacterial DNA (Salmonella dublin) increased Pro-Inflammatory pathways. However, in contrast to the Anti-Inflammatory Pathways stimulated in the Control (Healthy) and Ulcerative Colitis groups, the Crohn's Disease patients did not upregulate Anti-Inflammatory pathways and actually Increased expression of Pro-Inflammatory genes.[2]

Although further study on the relationship between Probiotics and Crohn's Disease needs to be done, it indicates that Probiotics (especially Lactobacillus plantarum) may actually make symptoms of Crohn's Disease worse.

Control (Healthy)Crohn's Disease (CD)Ulcerative Colitis (UC)
BaselineIFNG, IL12RA, IL1A, IL1B, IL4, IL6, IL8, IL17, CSF3, TNF, CXCL10, CXCL11, CCR4, CCL19, NOS2A, REN, ICAM1, SELE, SELP AGTR1, FASLG, CCL5, IL13IL1A, IL1B, IL4, IL6, IL8, IL17, CXCL11, CCL19, NOS2A, SELE, SELP IL13, CSF1, SMAD7, FASLG
Salmonella dublin (Pathogen)IL5, CCR2, CCR7, CD19 IL13IL1A, IL1B, IL8, CCL3, CXCL11, IL17, REN , C3, CCL19, CD19, HLADRB1, IL13, TNFRSF18AGTR1, CCL19, CXCL10, CXCL11, IL1A, CD3E, IL5
Lactobacillus plantarum (Probiotic)CCR2, CD19, IL10 IL4IL17, REN , C3, HLADRB1, IFN1, IL6, IL13, TNFRSF18AGTR1, CXCR3, IL1A, TBX21, REN, CCR2, FASLG, IL5, IL12B, TFRC
Bold = Gene Expression Up
Ital = Gene Expression Down

How do I obtain Probiotics?

They are commonly found in yogurts such as Actimel and Yakult and other fermented foods. These tend to be lactobacilli (which feed off lactose). The benefits of these for treating IBD is unclear, but they may help to alleviate symptoms of lactose intolerance, as the bacteria predigest the lactose.

Probiotics can also be taken in pill form. The most effective pills need refrigeration- this keeps the bacteria alive but functioning very slowly. Once they warm up in the body they become active.

Probiotics can be useful in repopulating the body's natural bacteria during or after treatment with Antibiotics. However you should leave a gap between taking probiotics and antibiotics, otherwise they will interact with each other.

You can also get prebiotics, which claim to feed the probiotic bacteria, however there is no evidence that prebiotics are beneficial in treating IBD.

References

1. Sanders ME. Probiotics: Definition, Sources, Selection, and Uses. Clin Infect Dis. 2008; 46(Supplement 2): S58-S61. http://cid.oxfordjournals.org/conten....full.pdf+html

2. Hotte NSC, Salim SY, Tso RH, Albert EJ, Bach P, et al. Patients with Inflammatory Bowel Disease Exhibit Dysregulated Responses to Microbial DNA. PLoS ONE 2012; 7(5): e37932. doi:10.1371/journal.pone.0037932. http://www.plosone.org/article/fetch...esentation=PDF

3. Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N, Knight R. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. PNAS. 2010; 107(26): 11971-11975. http://www.pnas.org/content/107/26/11971.full.pdf+html

4. Usha Vyas and Natarajan Ranganathan, “Probiotics, Prebiotics, and Synbiotics: Gut and Beyond,” Gastroenterology Research and Practice, vol. 2012, Article ID 872716, 16 pages, 2012. doi:10.1155/2012/872716. http://www.hindawi.com/journals/grp/2012/872716

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