Prebiotics and Probiotics

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Intestinal
Microecology

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PREBIOTICS
 Prebiotics are non-digestible food ingredients that benefit the host

by selectively stimulating the growth or activity of one or a limited

number of intestinal bacteria.

 Not absorbed or degraded.

 Bananas, garlic, barley, onion,

Jerusalem, artichoke tuber, wheat,

asparagus, rye, and chicory root.

 In fact, they are the food for the friendly bacteria.

 They may be added to the diet to provide the situation for

effective bacteria to grow and survive in the digestive mechanism.
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Prebiotics –Mechanism of action

 Changes in composition and functionality of the microflora

 Selective stimulation of beneficial bacteria

 Facilitating competitive exclusion of pathogens

 Immunomodulation and enhancing host defence

 Increases the amount of lactic acid producing bacteria

 Increases the amount of Short Chain Fatty Acids (SCFAs)

 Activates carbohydrate receptor immune cells

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PREBIOTICS : – Examples

 Fructo-oligosaccharides

 Inulin

 Galacto-, galactosyllactose-, xylo-, isomalto – and soya

oligosaccharides

 Pyrodextrins (glucose oligosaccharides)

 Lactulose

 Breast milk oligosaccharides

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Oligosaccharides

 Usual pleasant slight sweet taste

 Add texture to foods

 Naturally occurs in artichoke, onion, garlic, chicory, leek,

and to a lesser degree in cereals

 Raffinose and stachynose are major CHO of beans and

peas

 Commercially produced Fructo oligosaccharide (FOS)

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Benefits of Oligosaccharides

 Promote the growth of bifido-and lactobacilli

 Lower colon pH

 Discourage growth of Clostridia

 Prevent constipation and diarrhea

 Have low glycemic index

 Water-soluble and of low viscosity

 Do not bind minerals

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Inulin

 Naturally occurs in fruits and vegetables

 Longer chain length than FOS

 Provides a fat mimicking texture when added to food

 Now available in a supplement

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Pathological Gut Disorders

 Acute inflammation

 Pseudomembranous colitis

 Inflammatory bowel disease

 Pneumatosis (PCI)

 Bowel cancer

 IBS

 Systemic

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Potential Benefits of Prebiotics

Improve bowel function

Increase stool frequency

Increase stool weight

Increase production of short-chain fatty acids

Promote the growth of the health promoting bacteria Lactobacilli

and Bifidobacteria

Restore gut flora during or after antibiotic therapy

Inulin can reduce insulin concentrations and lowered triglyceride

levels
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Potential Adverse Effects of Prebiotics

 GI Disturbances:

 Constipation

 Abdominal pain

 Flatulence (the accumulation of gas in the

alimentary canal)

 Bloating (swollen stomach)

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Probiotics microorganisms

Probiotics consist specific microbial cultures and/ or

ingredients that stimulate gut micro flora capable of

modifying the gastrointestinal environment which keeps

the host healthy

• Lactic acid producing bacteria

 Lactobacilli and Bifidobacterium

• Yeast

• Others
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Probiotics

 Lactobacillus Rhamnosus  Enterococci (Enterococcus

 L. Reuteri, Faecium SF68)

 Certain strains of L. Casei,  Probiotic yeast

Saccharomyces Boulardii
 L. acidophilus,

 Aspergillus
 Escherichia coli strain Nissle

 Bacillus
1917,

 certain Bifidobacteria

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Bifidobacteria

 At least 4g/day of FOS are needed to increase counts

 Effect increases with increased doses

 Ferment oligosaccharides to SCFA (short-chain fatty

acids)

 Produce B vitamins and some amino acids

 Restore flora after antibiotics

 Inhibit the growth of pathogenic bacteria

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Potential mechanisms of Probiotics for
prevention or treatment of diarrhea

 Protection of intestinal epithelial barrier function

 Regulation of intestinal epithelial homeostasis

 Regulation of intestinal microbial environment

 Modifications to commensal and probiotic bacteria to

enhance diarrhea prevention

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Protection of intestinal epithelial
barrier function

 integrity of the gastrointestinal epithelium

 L. acidophilus; S. thermophilus, prevent enteroinvasive E.

coli disruption of intestinal epithelial barrier function

 L. acidophilus－ p38 mitogen activated protein kinase

and Akt signal transduction pathways prevent cytokine-

induced increases in intestinal epithelial paracellular

permeability

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Regulation of intestinal epithelial
homeostasis

 Inflammatory cytokines and chemokines

－intestinal epithelial cell injury.

 L. casei －downregulates Shigella flexneri

by inhibition of NFκB-dependent transcription

 LGG － prevents cytokine-induced intestinal

epithelial injury

1.by preventing apoptosis and promoting cell growth

2.cytoprotective shock proteins

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Regulation of intestinal microbial
environment

 Disturbing the balance between the host and commensal

bacterial flora in GI tract is associated with antibiotic-

associated diarrhea

 fungal infections

L. acidophilus and Bifidobacterium spp.

1. prevent antibiotic treatment-induced

increases in facultative anaerobic bacteria

2. decrease antibiotic-resistant enterococci.

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Probiotics in prevention and treatment of
diarrhea

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Clinical applications of Probiotics for diarrhea

 Antibiotic-associated diarrhea (AAD) and Clostridium difficile

infection major pathological bacteria

 Lactobacillus GG (LGG)

 Saccharomyces boulardii

1.significantly reduced the incidence of antibiotic-

associated diarrhea from 18.9% (placebo) to 5.7% (P < 0.05)

2.combination with susceptible antibiotics decreases

recurrence of C. difficile infection

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 Administration of LGG, Saccharomyces boulardii, before

and during antibiotic treatment reduced the frequency

and/or duration of episodes and the severity of

symptoms in many cases but was not always effective

 Eradication Helicobacter pylori using clarithromycin,

amoxicillin, and omeprazol leads to diarrheas

Coadministration of S. boulardii during H. pylori

eradication did reduce AAD from 11.5 to 6.9%

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Acute infectious diarrhea and
rotavirus infection

 S. boulardii shortening the duration of acute diarrhea in

children and in adults

 majority of successful treatments － young children. Many

of them suffered from nosocomial rotavirus infections.

 meta-analysis of 23 randomized controlled studies in adults

and children with a total of 1917 subjects probiotics reduce

the mean duration of diarrheal episodes by 30.5 h.

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 severe infectious diarrhea？

1) moderate,

2) strain- (LGG, L. reuteri, B. lactis Bb12)

3) dose-dependent,

4) more evident when probiotics are applied early in the

episode,

5) significant only in watery diarrhea viral gastroenteritis

but not in invasive bacterial diarrhea

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Traveler’s diarrhea

 either LGG or Bifidobacterium animalis MB5 inhibited

both neutrophil transmigration and cytokine

induction by enterotoxic E. coli

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Irritable bowel syndrome
 functional GI disorder diarrhea, constipation, abdominal pain,

flatulence

and bloating

 fecal samples － significantly lower Lactobacillus strains and mild

reduction of

Bifidobacterium strains

 B. infantis reducing the symptom scores for abdominal pain, bloating

normalized IL-10/IL-12 ratio, which suggests inhibition of a

proinflammatory state

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Diarrhea in immunocompromised
subjects

 Chemo- and radiotherapy

－ diarrhea

－ increased Candida albicans in the GI tract

 Side effects were ameliorated by the administration

of probiotic bacteria

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Small bowel bacterial overgrowth

1.insufficient production of gastric acid

2.extented gastrointestinal transit time

3.terminal renal failure excessive growth of single

bacterial strains

 decreased frequency of diarrheas following

administration of L. acidophilus and L. casei

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Regulation of Prebiotics/Probiotics

 Intended use of product determines how the product is

regulated.

 Biological product – a virus, bacteria, or fungi that is

used for the prevention, treatment, or cure of a

disease/condition of human beings.

 Dietary supplement – a product taken by mouth

that contains a dietary ingredient intended to supplement

the diet.

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 Biological products require pre-market review and approval by

the FDA; however, dietary supplements do not.

 The safety, purity, and potency, as well as efficacy, of a biological

product must be demonstrated for approval.

 Dietary supplements are not required to demonstrate any of

these properties to be marketed.

 The FDA’s Center for Food Safety and Applied Nutrtion

(CFSAN) regulates probiotics and prebiotics marketed as dietary

supplements or food ingredients.

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 The FDA’s Center for Biologics Evaluation and Research

(CBER) regulates probiotic products when they are used for

clinical indications.

 CBER’s Office of Vaccines Research and Review has regulatory

jurisdiction over most probiotic products for clinical use.

 A probiotic product marketed or promoted as a treatment,

prevention, or cure for a specific disease or condition without

an approved indication for such a claim is considered

unapproved and an illegal drug.

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References

 www.http//EzineArticle.com/3259508

 Central Food Technology Research Institute, Mysore

 Institute of microbial technology, Chandigarh.

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