Probiotics - Advanced Concepts, Uses and Benefits

A bug by any other name…. Why Use Probiotics?

Dr. Michael Wald - Integrated Medicine of Mount Kisco, P.C

914-242-8844 - www.intmedny.com

The use of probiotics as bio-therapeutic agents is commonplace in the US and around much of the world. Probiotics are typically delivered in relatively low-dose functional foods (primarily yogurts) providing a few billion colony forming units (CFU) or less; or in modest doses, in the form of dietary supplements of 5-25 billion CFU. It is simply not enough to take a “good thing” like probiotics if the dosages are useless!  Most of my patients seem completely unaware o the differences between one brand, type or strength of probiotic products.  In my clinical opinion and experience, I can tell you that the dosages that most people take are simply too low to make a real difference.  This is why I have produced Re-Inoculate (a term that means “putting it back) – a powered product that contains 240 billion organisms per dose…more than 10X more potent than any other product that I am aware of on the market.

Over the past several years, an emerging trend has witnessed much higher doses of probiotics being used in clinical practice and research.

The initial focus of the clinical research on high-dose probiotics has been primarily on functional GI disorders such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and antibiotic-associated diarrhea (AAD). These conditions represent extreme examples of dysbiosis and dysfunction within the mucosal immune system of the gut; a system which is integrally associated with the microflora of the gut lumen.

It is essential to keep in mind that probiotics are best used in combination with other supplements and certain foods that help maximize health benefits.

Probiotics have many other uses beyond helping gastrointestinal problems. Here is a partial list:

  • Lowers cholesterol
  • Offsets adverse side effects of antibiotics
  • Immunomodulation
  • Reduces inflammation
  • Helps diabetes
  • May reduce depression
  • Reduces colon cancer risk
  • Useful in a large number of cancers
  • Colitis
  • Procitis
  • Crohn’s Disease
  • Ulcerative Colitis
  • Reduces risk of acquired infection
  • Helps treat active infection
  • Helps prevent harmful bacteria translocation (traveling) form the colon to other parts of the body
  • Produces B-vitamins and vitamin K in the colon
  • And much more!

Research Findings

Strategies of mucosal immunotherapy for allergic diseases.

Ye YL, Chuang YH, Chiang BL.

Cell Mol Immunol. 2011 Jun 13. doi: 10.1038/cmi.2011.17. [Epub ahead of print]

 

Are bacteriocins underexploited? Novel applications for old antimicrobials.

Montalbán-López M, Sánchez-Hidalgo M, Valdivia E, Martínez-Bueno M, Maqueda M.

Curr Pharm Biotechnol. 2011 Aug;12(8):1205-20.

 

Nutrition considerations surrounding restorative proctocolectomy.

Buckman SA, Heise CP.

Nutr Clin Pract. 2010 Jun;25(3):250-6. Review.

 

Probiotic yeasts: anti-inflammatory potential of various non-pathogenic strains in experimental colitis in mice.

Foligné B, Dewulf J, Vandekerckove P, Pignède G, Pot B.

World J Gastroenterol. 2010 May 7;16(17):2134-45.

 

Probiotics: preventing antibiotic-associated diarrhea.

Jones K.

J Spec Pediatr Nurs. 2010 Apr;15(2):160-2.

 

Scuticociliatosis and its recent prophylactic measures in aquaculture with special reference to South Korea Taxonomy, diversity and diagnosis of scuticociliatosis: Part I Control strategies of scuticociliatosis: Part II.

Harikrishnan R, Balasundaram C, Heo MS.

Fish Shellfish Immunol. 2010 Jul;29(1):15-31. Epub 2010 Mar 6. Review.

 

Probiotics.

Williams NT.

Am J Health Syst Pharm. 2010 Mar 15;67(6):449-58. Review.

 

Use of oil bodies and oleosins in recombinant protein production and other biotechnological applications.

Bhatla SC, Kaushik V, Yadav MK.

Biotechnol Adv. 2010 May-Jun;28(3):293-300. Epub 2010 Jan 11. Review.

Inulin-type prebiotics--a review: part 1.

Kelly G.

Altern Med Rev. 2008 Dec;13(4):315-29. Review.

 

Lactobacillus crispatus M247-derived H2O2 acts as a signal transducing molecule activating peroxisome proliferator activated receptor-gamma in the intestinal mucosa.

Voltan S, Martines D, Elli M, Brun P, Longo S, Porzionato A, Macchi V, D'Incà R, Scarpa M, Palù G, Sturniolo GC, Morelli L, Castagliuolo I.

Gastroenterology. 2008 Oct;135(4):1216-27. Epub 2008 Jul 9.

 

Probiotics: from functional foods to pharmaceutical products.

Bansal T, Garg S.

Curr Pharm Biotechnol. 2008 Aug;9(4):267-87.

 

Interactions between Staphylococcus aureus and lactic acid bacteria: an old story with new perspectives.

Charlier C, Cretenet M, Even S, Le Loir Y.

Int J Food Microbiol. 2009 Apr 30;131(1):30-9. Epub 2008 Jul 4. Review.

 

Pharmacologic treatment of constipation: what is new?

Pohl D, Tutuian R, Fried M.

Curr Opin Pharmacol. 2008 Dec;8(6):724-8. Epub 2008 Aug 20. Review.

 

Probiotics: overview of microbiological and immunological characteristics.

Blandino G, Fazio D, Di Marco R.

Expert Rev Anti Infect Ther. 2008 Aug;6(4):497-508.

 

Effects of orally administered probiotic Pediococcus acidilactici on the small and large intestine of weaning piglets. A qualitative and quantitative micro-anatomical study.

Di Giancamillo A, Vitari F, Savoini G, Bontempo V, Bersani C, Dell'Orto V, Domeneghini C.

Histol Histopathol. 2008 Jun;23(6):651-64.

 

Probiotics as drugs against human gastrointestinal infections.

Sanz Y, Nadal I, Sánchez E.

Recent Pat Antiinfect Drug Discov. 2007 Jun;2(2):148-56. Review.

 

Additional Evidence of Efficacy

Lactobacillus acidophilus (La-14): 1

• In vitro studies show L. acidophilus La-14 is very resistant to low pH conditions and survives the presence of bile at

concentrations present in the duodenum.

• L. acidophilus La-14 has demonstrated excellent adhesion to human epithelial cell lines applied in in vitro studies, an indicator

of its potential to attach to the intestinal mucosa.

• In vitro studies show that L. acidophilus La-14 inhibited S. typhimurium, S. aureus, E. coli, and L. monocytogenes.

• In humans, an accumulation of oxalic acid can result in a number of conditions including hyperoxaluria, kidney stones and

renal failure. The oxalate-degrading activity of L. acidophilus La-14 was found to be 100%, which was as high as the control

Oxalobacter formigenes DSM, a well known probiotic with oxalate-degrading activity.

• In mice with antibiotic associated diarrhea, L. acidophilus La-14 was able to increase Lactobacillus and Bifidobacterium and

decrease the amount of E. coli and Enterococcus.

• An in vitro study showed L. acidophilus La-14 was able to induce IL-12.

• In humans, L. acidophilus La-14 was shown to induce specific IgA and IgG faster and higher than in the control group of those

who had received an oral vaccination.

• L.acidophilus La-14 is resistant to many common antibiotics.

Bifi dobacterium bifi dum (Bb-02): 2

• In vitro studies show B. bifidum Bb-02 is very resistant to low pH conditions and survives the presence of bile at concentrations

present in the duodenum.

• B. bifidum Bb-02 has demonstrated excellent adhesion to human epithelial cell lines applied in in vitro studies, an indicator of

its potential to attach to the intestinal mucosa.

• In vitro studies show that B. bifidum Bb-02 inhibited S. typhimurium, S. aureus, E. coli, and L. monocytogenes.

• B. bifidum Bb-02 is resistant to many common antibiotics.

Bifi dobacterium lactis (BI-04): 3

• In vitro studies show B. lactis BI-04 is extremely resistant to low pH conditions and survives the presence of bile at the

concentrations present in the duodenum.

• B. lactis BI-04 has demonstrated excellent adhesion to human epithelial cell lines applied in in vitro studies, an indicator of its

potential to attach to the intestinal mucosa.

• In vitro studies show B. lactis BI-04 is able to induce IL-10 and IL-12, indicating a strong anti-inflammatory property.

• In a mouse model of colitis, B. lactis BI-04 was able to provide anti-inflammatory benefits, confirming its ability to contribute to

a balanced immune system.

• In humans, B. lactis BI-04 was shown to induce specific IgG faster and higher than in the control group of those who had

received an oral vaccination.

• B. lactis BI-04 is resistant to many common antibiotics.

Lactobacillus plantarum (Lp-115): 4

• L. plantarum is found naturally in most latic acid fermented plant based foods including brined olives, sauerkraut and kimchi.

• In vitro studies show L. plantarum Lp-115 is extremely resistant to low pH conditions and survives the presence of bile at

concentrations present in the duodenum.

• L. plantarum Lp-115 has demonstrated excellent adhesion to human epithelial cell lines applied in in vitro studies, an indicator

of its potential to attach to the intestinal mucosa.

• In vitro studies show that L. plantarum Lp-115 inhibited S. typhimurium, S. aureus, E. coli, and L. monocytogenes.

• In humans, an accumulation of oxalic acid can result in a number of conditions including hyperoxaluria, kidney stones and

renal failure. The oxalate-degrading activity of L. plantarum Lp-115 was found to be 40%.

• In vitro studies show L. plantarum Lp-115 is able to induce moderate amounts of IL-10 and significant amounts of IL-12,

indicating a strong anti-inflammatory property.

• In an animal model of intestinal inflammation, L. plantarum Lp-115 reduced inflammation, displaying a capacity to interact with

the mucosal immune response.

• In humans, L. plantarum Lp-115 was shown to induce IgG faster than in the control group of those who had received an oral

vaccination.

• L. plantarum Lp-115 is resistant to many common antibiotics.

Lactobacillus salivarius (Ls-33): 5

• In vitro studies show L. salivarius Ls-33 is very resistant to low pH conditions and survives the presence of bile at concentrations

present in the duodenum.

• L. salivarius Ls-33 has demonstrated excellent adhesion to human epithelial cell lines applied in in vitro studies, an indicator of

its potential to attach to the intestinal mucosa.

• In vitro studies show that L. salivarisu Ls-33 inhibited S. typhimurium, S. aureus, E. coli, and L. monocytogenes.

• In vitro studies show L. salivarius Ls-33 is able to induce IL-10 and IL-12, indicating a strong anti-inflammatory property.

• In mice L. salivarius Ls-33 led to significant reductions in colitis symptoms and exerted significant protection against intestinal

inflammation, demonstrating its ability to interact with and balance the intestinal mucosal immune response.

• L. salivarius Ls-33 is resistant to many common antibiotics.

Lactobacillus casei (Lc-11): 6

• L. casei is found naturally in fermented vegetables, milk and meat. This strain is commonly used as a starter strain in many

fermented food products.

• In vitro studies show L. casei Lc-11 is very resistant to low pH conditions and survives the presence of bile at the concentrations

present in the duodenum.

• L. casei Lc-11 has demonstrated excellent adhesion to human epithelial cell lines applied in in vitro studies, an indicator of its

potential to attach to the intestinal mucosa.

• In vitro studies show that L. casei Lc-11 inhibited S. typhimurium, S. aureus, E. coli, and L. monocytogenes.

• L. casei Lc-11 is resistant to many common antibiotics.

 

Contraindications, Adverse or Other reactions:

Probiotics are considered very safe with no known adverse affects. Some changes in the stool may be noted and occasionally some people notice a temporary increase in digestive gas.  However, probiotics produce vitamin K in the colon; if an individual is on Coumadin or warfarin then I would not have them suddenly add a large amount (or any probiotics) necessarily. If the individual has already been taking probiotics prior to beginning the anticoagulants above then this is considered ok.