The Role of Probiotic Lactic Acid Bacteria and Bifidobacteria in the Prevention and Treatment of Inflammatory Bowel Disease and Other Related Diseases: A Systematic Review of Randomized Human Clinical Trials

Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammation of the small intestine and colon caused by a dysregulated immune response to host intestinal microbiota in genetically susceptible subjects. A number of fermented dairy products contain lactic acid bacteria (LAB) and bifidobacteria, some of which have been characterised as probiotics that can modify the gut microbiota and may be beneficial for the treatment and the prevention of IBD.

The objective of this review was to carry out a systematic search of LAB and bifidobacteria probiotics and IBD, using the PubMed and Scopus databases, defined by a specific equation using MeSH terms and limited to human clinical trials. The use of probiotics and/or synbiotics has positive effects in the treatment and maintenance of UC, whereas in CD clear effectiveness has only been shown for synbiotics.

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The Potential Role of Probiotics in the Management of Childhood Autism Spectrum Disorders

Autism spectrum disorders (ASD) are defined by impairments in verbal and non-verbal communication, social interactions, and repetitive and stereotyped behaviours. In addition to these core deficits, previous reports indicate that the prevalence of gastrointestinal (GI) symptoms ranges widely in individuals with ASD, from 9 to 91% in different study population.[1]

The role of probiotics in the management and treatment of these alterations has been explored in a recent free access paper, published in Gastroenterology Research and Practice Oct 2011.[2]

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Is this a Perfect Functional Meal for Mucosal Tolerance?

Stewed apples as medicine

 

Functional and pathological digestive tract conditions reflect a change in the relationship between the host microbiota and the mucosal immune and nervous system. These result in a wide range of distressing symptoms for which there are a variety of strategies, but no single intervention of consistent benefit. A component of patient care we sometimes overlook is that of the application of therapeutically relevant foods. For over 20 years I have been using a tried and tested formula that contemporary scientific research is now explaining why it has proven so effective for many patients.

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Vegas, Pregnancy, Immunity and Allergy Prevention!

The saying is ‘what happens in Vegas stays in Vegas’, or if you are English ‘what happens in Blackpool….’ but the same cannot be said about what happens in utero, as increasing evidence supports the understanding that the maternal nutritional environment and early feeding affects the health of the foetus beyond infancy and into adulthood.[1],[2] An article in Nature’s Mucosal Immunology this month explores some of the key events in foetal and neonatal immune management.[3] It stimulated a revisit to the area of what to consider for parents to be and mums of young children when they ask ‘is there anything I can do to prevent or reduce the risk of allergy or atopy in my child’.

The first moments, weeks and months of life can determine the health outcomes of an individual over the duration of their lifetime and this knowledge represents a significant choice for prospective parents. Fortunately the remarkable adaptability of the immune and central nervous system means that there are numerous opportunities in the early years of life to positively influence health outcomes even if the early stages were less than optimal.

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Is There A Rural/Urban Gradient In The Prevalence Of Eczema? A Systematic Review And What Can Be Done About It?

One in 10 schoolchildren in the western world suffers from eczema and even developing nations have also seen an increasing trend in the last few decades. There are many proposals to explain the increased incidence, one area of relevance is the environmental impact. Falling under the often misused ‘hygeine hypothesis’ title it has been proposed that there is a reflective difference in the gradient between rural and urban children. Implying the environmental impact on the developing immune system of children is different and therefore less protective in the urban setting.

This concept has now been studied in a recent article in the British Journal of Dermatology.[1] By conducting a Medline and Embase data base review studies that compared the incidence between the two environments were reviewed. Some 26 papers were assessed with 19 demonstrating a higher risk for eczema in an urbanised area, of these 11 were regarded as being statistically significant. A further 6 studies showed a lower risk of eczema in an urbanised area, of which just 1 was statistically significant.

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Fat – I’m Not To Blame Its My Bugs!

A trial to see if the ingestion of a probiotic bacterium enriched drink might have a beneficial impact on central obesity was funded by Snow Brand Milk Products company in Japan and the results were published in the European Journal of Clinical Nutrition this June 2010. [i]

Whilst it may seem a stretch that bacteria can influence our body mass, (I have written a previous review) it is an area of growing interest and investigation as bacteria have previously been implicated in the metabolic storage of fat. Studies in mice have shown up to 30% greater fat storage in mice with gastrointestinal colonies of commensals rather than their skinnier counterparts operating with sterile guts.

One proposal for this is that certain bacteria (Bacteroides Thetaiotaomicron is one likely contender) are able to manipulate energy to be stored in adipocytes through a pathway that involves microbial regulation of the intestinal epithelial expression of fasting-induced adipocyte protein (Fiaf), a circulating inhibitor of lipoprotein lipase (LPL).[ii]

The microbiota can then, based on this and other studies be viewed as a metabolic “organ” exquisitely tuned to our physiology and performing functions that we have not had to evolve on our own.

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A Bacteria Triggers Arthritis.

The gut microbiomes of humans and mice are broadly similar which is helpful as this paper has used the mouse model to explain how a resident bacteria in the gut can induce arthritis. In both hosts human and mouse upwards of ∼1000 different microbial species from ∼10 different divisions colonise the gastrointestinal tract, but just two bacterial divisions—the Bacteroidetes and Firmicutes—and one member of the Archaea appear to dominate, together accounting for ∼98% of the 16S rRNA sequences obtained from this site.[1] 16SrRNA is a laboratory method for analysing bacterial and provides species-specific signature sequences useful for bacterial identification but is not routinely used in diagnostic settings yet.

Their analysis revealed that despite the enormous species variation in the gut a single species of bacteria that lives here is able to trigger a cascade of immune responses that can ultimately result in the development of arthritis.[2] Gut-residing bacteria can also play a role in disorders of the immune system, especially autoimmune disorders in which the body attacks its own cells. The gut microbiota is now known to shape intestinal immune responses during health and disease with systemic effects.

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What Do Bacteria Do To Our Immune System?

The germ theory that has so modernised medicine and driven us, the western world living human to regard all bugs as bad has been undergoing a dramatic rethink over the last few years. Firstly the recognition that your body is teeming with bacteria, providing a warm residence to approximately 10 times as many bacterial cells as human cells. Our mutual inhabitants live on skin, in the respiratory tract and throughout the digestive tract. Your digestive tract alone is home to between 1,000 and 40,000 bacterial species depending on your choice of journal.

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Butyrate Improves Bowel Transit

Problems such as poor transit or constipation are common, and can produce significant misery for the individual compromised in this manner. Butyrate is a short chain fatty acid, manufactured in the gut by the anaerobic fermentation of dietary fibres by resident microbiota. It is proposed that apart from its already well understood properties that it has another remarkable effect – the ability to increase the neuronal concentration of the Enteric Nervous System.[1]

Butyrate-generating foods and supplements might become an effective and simple option to prevent or treat functional gut disorders via modulation of enteric neuroplasticity.

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Can Bacteria Make You Smarter?

The potential cognitive gains linked to the role of gastrointestinal bacteria continues to attract international interest. The scientific community are becoming entranced with the notion that our bacterial exposure affects not only the local tissues, but also others including the brain.

Exposure to specific bacteria in the environment, already believed to have antidepressant qualities, could increase learning behaviour.  Mice fed live cultures of Mycobacterium vaccae were able to learn and complete a maze twice as fast as control mice were the key comments delivered at the 110th General Meeting of the American Society for Microbiology last week.

Mycobacterium vaccae is a natural soil bacterium which people likely ingest or breath in when they spend time in nature,” says Dorothy Matthews of The Sage Colleges in Troy, New York, who conducted the research with her colleague Susan Jenks.

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