In this review new scientific technologies (genomics, proteomics, metabolomics, transcrip- tomics) were used to evaluate the prophylactic and therapeutic action of probiotics, which are a major component ofthe normal human microflora (microbiota). Modern terms, definitions, classification of probiotic preparations are provided in the paper, the list of the probiotics registered in the Russian Federation is also submitted. The review analyzes the majority of mechanisms of probiotics action on a human body. The problem of safe application of probiotics is considered along with the detailed characteristic of the most effective production probiotic strains. New scientific technology to assess the effects of probiotic bacteria on the various functions of the macroorganism are also examined. In the review the special attention is paid to discussion of effectiveness of the probiotics impact in chronic infectious and metabolic disease processes (atherosclerosis, lipid distress syndrome, type 2 diabetes, obesity, etc.), which are the most active during dysbacteriosis and the destruction of normal microflora. From data of this article clearly that new scientific technologies will allow us to establish the functions of proteins that regulate metabolic and signaling pathways and affect the expression of genes required for the adaptation of probiotic strains in contact with the human body. In this review it is shown that the successful solution of this problem is closely connected with application of new scientific technologies for studying the composition and functions of the human microbiota, methods of active influence on her, and also with development of more sophisticated and effective probiotic preparations.
BACKGROUND: Since probiotics are considered to exert beneficial health effects by enhancing the host's immune response, we investigated the benefits of a synbiotics treatment on the rate of infections, systemic inflammatory response syndrome (SIRS), severe sepsis, and mortality in critically ill, mechanically ventilated, multiple trauma patients. Length of stay in the intensive care unit (ICU) and number of days under mechanical ventilation were also evaluated. METHOD: Sixty-five patients were randomized to receive once daily for 15 days a synbiotic formula (Synbiotic 2000Forte, Medipharm, Sweden) or maltodextrin as placebo. The synbiotic preparation consisted of a combination of four probiotics (10(11) CFU each): Pediococcus pentosaceus 5-33:3, Leuconostoc mesenteroides 32-77:1, L. paracasei ssp. paracasei 19; and L. plantarum 2,362; and inulin, oat bran, pectin, and resistant starch as prebiotics. Infections, septic complications, mortality, days under ventilatory support, and days of stay in ICU were recorded. RESULTS: Synbiotic-treated patients exhibited a significantly reduced rate of infections (P = 0.01), SIRS, severe sepsis (P = 0.02), and mortality. Days of stay in the ICU (P = 0.01) and days under mechanical ventilation were also significantly reduced in relation to placebo (P = 0.001). CONCLUSION: The administration of this synbiotic formula in critically ill, mechanically ventilated, multiple trauma patients seems to exert beneficial effects in respect to infection and sepsis rates and to improve the patient's response, thus reducing the duration of ventilatory support and intensive care treatment.
To choose lactobacilli-contained probiotic for complex treatment of acute enteric infection caused by Klebsiella in infants.
On the basis of bacteriological analysis the group consisting of 40 infants with acute enteric infection caused by Klebsiella was formed. Efficacy of three probiotic preparations--lactobacterin, vitaflor, and biobacton--was assessed depending on biological features of causative agents and contents of lactobacilli and bifidobacteria in obligate gut microflora. Intraspecies antagonistic characteristics of manufacturing strains of lactobacilli against 9 clinical isolates of K. pneumoniae and 8 strains of indigenous lactoflora, as well as interspecies antagonism between Klebsiella and probiotic and indigenous strains of lactoflora were studied.
It was shown that complex therapy of Klebsiella infection in infants using vitaflor or biobacton promoted elimination of K. pneumoniae and restoration of indigenous microflora which became apparent in significant increase of titer of lactobacilli. In vitro maximal antagonism to K. pneumoniae was noted for vitaflor, lactobacterin and heteroenzyme autostrains of ill children's lactoflora. Contrantagonism to lactoflora was typical for slowly growing strains of Klebsiella.
It is therapeutically rational to use vitaflor, which promotes rapid elimination of infectious agent, in initial phase of acute infection caused by Klebsiella, and biobacton, which increases the titers of indigenous lactoflora, in phase of convalescence.
To review the evidence supporting selected complementary and alternative medicine approaches used in the treatment of irritable bowel syndrome (IBS).
MEDLINE (from January 1966), EMBASE (from January 1980), and the Cochrane Database of Systematic Reviews were searched until March 2008, combining the terms irritable bowel syndrome or irritable colon with complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, mind, relaxation, probiotic, hypnotherapy, psychotherapy, cognitive therapy, or behavior therapy. Results were screened to include only clinical trials, systematic reviews, and meta-analyses. Level I evidence was available for most interventions.
Soluble fibre improves constipation and global IBS symptoms. Peppermint oil alleviates IBS symptoms, including abdominal pain. Probiotic trials show overall benefit for IBS but there is little evidence supporting the use of any specific strain. Hypnotherapy and cognitive-behavioural therapy are also effective therapeutic options for appropriate patients. Certain herbal formulas are supported by limited evidence, but safety is a potential concern. All interventions are supported by systematic reviews or meta-analyses.
Several complementary and alternative therapies can be recommended as part of an evidence-based approach to the treatment of IBS; these might provide patients with satisfactory relief and improve the therapeutic alliance.
The use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries. There are no recent reports on CAM use among paediatric patients with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) in Europe. We hypothesized that CAM use associates with a more severe disease in paediatric IBD and JIA.
A cross-sectional questionnaire study among adolescent outpatients with IBD and JIA addressing the frequency and type of CAM use during the past year. The patients were recruited at the Children's Hospital, University of Helsinki, Finland.
Of the 147 respondents, 97 had IBD (Crohn's disease: n?=?46; median age 15.5, disease duration 3.4 years) and 50 had JIA (median age 13.8, disease duration 6.9 years). During the past 12 months, 48% regularly used CAM while 81% reported occasional CAM use. Compared to patients with JIA, the use of CAM in IBD patients tended to be more frequent. The most commonly used CAM included probiotics, multivitamins, and mineral and trace element supplements. Self-imposed dietary restrictions were common, involving 27.6% of the non-CAM users but 64.8% of all CAM users. Disease activity was associated with CAM use in JIA but not in IBD.
CAM use is frequent among adolescents with IBD and JIA and associates with self-imposed dietary restrictions. Reassuringly, adherence to disease modifying drugs is good in young CAM users. In JIA, patients with active disease used more frequently CAM than patients with inactive disease. As CAM use is frequent, physicians should familiarise themselves with the basic concepts of CAM. The potential pharmacological interaction or the toxicity of certain CAM products warrants awareness and hence physicians should actively ask their patients about CAM use.
The aim of this study was to measure patterns of complementary and alternative medicine (CAM) use among Finnish children and to explore whether CAM use among children is mainly complementary or alternative.
We carried out a cross-sectional population-based survey in spring 2007. The study population consisted of a representative sample (n?=?6,000) of Finnish children under 12 years of age. A questionnaire was sent to their parents, and 4,032 questionnaires were returned (response rate 67 %). Pearson's chi-square test and logistic regression analysis were conducted to measure factors associated with CAM use.
The prevalence of CAM use among children was 11 %. Fish oils and fatty acids (6 %) followed by probiotics (4 %) were the most commonly reported CAMs used. Being the first born, using vitamins and having at least one symptom predicted the use of CAMs. Parental use of vitamins and CAMs were also associated with CAM use among children. In the preceding 2 days, 3 % of children in the study had used only CAMs, and 7 % had used a CAM concomitantly with prescribed and/or over-the-counter medicines.
Our results indicate that the use of CAMs among Finnish children is mainly for improving health and alleviating symptoms, especially in families where at least one parent also uses these modalities. CAMs were mainly used as complementary rather than as an alternative to conventional care. Healthcare professionals should be aware of this complementary use of CAMs and medicines in patients to avoid risks of potential interactions.
Considering the enormity of the problem in terms of women infected per year, urogenital infections receive far too little attention from scientists, government funding agencies, and the pharmaceutical industry. A recent resurgence in interest among clinicians is a result of consumer demands for better therapies, problems resulting from drug resistance, and the prospect of new diagnostics and treatments on the horizon. It is now recognized that the intestinal and urogenital microflora are critical for the health and well-being of humans. The concept of replenishing these flora with probiotic organisms seems to be an option that has a growing scientific basis. Although few strains have been selected and targeted for urogenital applications, and none are currently available on the market, evidence shows that probiotic therapy has the potential to make an impact on women's health.
The increased prevalence of atopic diseases, atopic dermatitis, allergic rhinitis, and asthma has been described as an epidemic. New approaches in the fight against allergic diseases are called for, the target being the persistence of the atopic T helper 2-skewed immune responder pattern beyond infancy. Atopic dermatitis, the earliest of these conditions, might act as a portal for the development of IgE-mediated atopic manifestations. Abundant evidence implies that specific strains selected from the healthy gut microbiota exhibit powerful antipathogenic and anti-inflammatory capabilities, and several targets for the probiotic approach have emerged in atopic dermatitis: degradation/structural modification of enteral antigens, normalization of the properties of aberrant indigenous microbiota and of gut barrier functions, regulation of the secretion of inflammatory mediators, and promotion of the development of the immune system. Better understanding of the effects of different probiotic strains and deeper insight into the mechanisms of the heterogeneous manifestations of atopic disease are needed for the validation of specific strains carrying anti-allergic potential.