Michael Ash: Probiotics – Sorting the ‘Wheat from the Chaff’

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Michael Ash

Michael Ash BSc (Hons) DO, ND, F.Dip ION has spent over 20 years of his clinical practice exploring the role of the mucosal tissues in health and disease. This includes the use of probiotics and other natural agents to modify the local tissues, to impart benefit locally and systemically through the propagation and management of mucosal tolerance.

He has lectured all over the world on mucosal immunity and is regarded as an authority on the clinical use of probiotics.

He will explain how the role of probiotics is evolving from the traditional ‘ecological approach’ to one that is more condition specific, and will explore the changing comprehension of the immune system and how as nutritionists you are in a position to convert this into effective clinical strategies.

During this evening’s presentation he will look at the progressive science in the use of probiotics, which species and strains have been shown to have benefits in humans and present case histories to highlight potential clinical interventions.

Probiotics are defined as:  “Live microorganisms which when administered in adequate amounts confer a health benefit on the host”.

Michael Ash presented a fascinating, informed and clinically relevant presentation at The Institute of Physics on 22nd September 2009. This presentation was recorded.

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Probiotics: The Microbial Health Factor

A panoply of functions have been attributed to probiotic bacteria, including: competitive inhibition of the growth of pathogenic bacteria in the gut, stimulation of antimicrobial peptides, improvement of digestive enzyme production, management of bio-films, repair of gastrointestinal barrier integrity, creation of substances that help fuel and reinforce the barrier defense of the gastrointestinal (GI) tract, assisting in the generation and absorption of certain vitamins, influencing the maturation and maintenance of the immune system, production of anti-inflammatory compounds, and antioxidant and cellular protection.

Topics covered will include:

  1. What is mucosal immunity?
  2. How do the mucosal tissues communicate with the rest of the body?
  3. What a probiotic does and does not do – Evidence based review
  4. What is the current understanding of our microbial biome?
  5. How to select the best strain based on published data
  6. Why does, timing, duration and strain selected determine the difference between success and failure?
  7. How Nutritional Therapists are ideally placed to use these products.

Conditions looked at will include:

CPD Approval Credits/hours
British Association for Applied Nutrition and Nutritional Therapy
British Association for Applied Nutrition and Nutritional Therapy
3

Traditional Ecological View

When probiotics latch on to and temporarily colonise the intestinal mucosa, they help prevent attachment of pathogenic bacteria. This ability of colonic microflora to help resist colonisation of pathogenic bacteria is now well established. Given the complexity of the intestinal ecosystem, the exact mechanisms have yet to be fully elucidated; however, several mechanisms appear to be involved and to act separately, sequentially, or together, and include:

Modern Condition Specific View

The increased understanding of the relationship between bacteria deemed to be non pathogenic and us is growing at a tremendous rate. Many times the purported benefits of a probiotic exceed the evidence base. However, in this instance Michael will explain how science is both catching up on clinical experience and helping to shape a future where the humble ‘gram positive’ and ‘gram negative’ bacteria may become a clinically sophisticated ally. Michael will teach you to read through marketing hype and make judgements based on scientific evidence and patient needs.

You will never look at a probiotic in the same way again – we guarantee it!

How does gut health relate to immune health?

The gastrointestinal tract is the body’s primary immune organ with some 70-80 per cent of the body’s immune cells being localised in the gastrointestinal tract, its glands, mucosa and mucosa-associated lymphoid system. A substantial amount of research and significant scientific agreement in the literature supports the ability of various probiotic species to help support immunity.

Researchers have documented interactions between probiotics and the gut-associated lymphatic or immune tissue. For instance, experiments that compared specific germ-free and normal mice and rats have shown the strong influence of the presence of intestinal flora on the maturation and development of local and systemic immunity and on the regulation of immune functions. In humans, probiotics administered to critically ill patients have shown significant improvements in systemic immunoglobulin (ie, IgA and IgG) concentrations with a corresponding reduction in intestinal permeability.

L acidophilus and B bifidum appear to enhance nonspecific immune activity. They seem to do this by stimulating lymphocyte and macrophage activity and modulating cytokine production by mononuclear cells. They also appear to enhance synthesis of antibodies in response to microbial pathogens, particularly secretory IgA. Various other species, including L plantarum, L rhamnosus, L casei, L bulgaricus, B lactis, and L paracasei, have demonstrated a variety of immuno-regulatory effects that could help bolster an individual’s immune protection. For instance, clinical research suggests that L rhamnosus and L casei can enhance natural killer-cell activity.

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