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Science, Technology and Medicine open access publisher.Publish, read and share novel research. Lactic Acid Bacteria as Probiotics:Characteristics, Selection Criteria and Role in Immunomodulation of Human GI Muccosal BarrierDaoud Harzallah and Hani Belhadj[1] Laboratory of Applied Microbiology, Faculty of Natural and Life Sciences, University Ferhat Abbas, Setif, Algeria1. Probiotic organisms can provide a beneficial effect on intestinal epithelial cells in numerous ways.
It has been known for more than 30 years that children who continue at least partial breast feedings until age 3 have lower incidences of most all infectious diseases as well as asthma, allergies, and eczema.
As Europeans moved from hunting and gathering to farming and agriculture, these oral communities changed from healthy, diverse ones into those that we’d typically associate with disease. Our mouths are now a gentrified shadow of their former selves. And as Carl Zimmer described earlier this week, ecosystems with an impoverished web of species are more vulnerable to parasites.
Avoiding a serious case of influenza is not about vaccination but more about maintaining a healthy, well functioning immune system. Optimize Your Gut Flora. This may be the single most important strategy you can implement as the bacteria in your gut have enormous control of your immune response. Ideally, you’ll want to get all your vitamin D from sun exposure or a safe tanning bed, but as a last resort you can take an oral vitamin D3 supplement. Avoid Sugar and Processed Foods. Sugar impairs the quality of your immune response almost immediately, and as you likely know, a healthy immune system is one of the most important keys to fighting off viruses and other illness.
Have Effective Tools to Address Stress. We all face some stress every day, but if stress becomes overwhelming then your body will be less able to fight off the flu and other illness. Get Regular Exercise. When you exercise, you increase your circulation and your blood flow throughout your body. Take a High-Quality Source of Animal-Based Omega-3 Fats. Increase your intake of healthy and essential fats like the omega-3 found in krill oil, which is crucial for maintaining health. Wash Your Hands. Washing your hands will decrease your likelihood of spreading a virus to your nose, mouth or other people. Tried and True Hygiene Measures. In addition to washing your hands regularly, cover your mouth and nose when you cough or sneeze. In 2007, Parker and his colleagues suggested that the appendix has an immunological role, acting as a “safe house” for beneficial gut bacteria. The “safe house” idea makes sense, says Indi Trehan, a pediatrician at the Institute for Public Health at Washington University in St. The safe house hypothesis is reasonable, Nesse agrees, but he points out that just 50 of the 361 mammalian species included in the analysis have an appendix. The researchers found that infants born by cesarean delivery were lacking a specific group of bacteria found in infants delivered vaginally, even if they were breastfed. Beginning before birth, CHILD collects a range of information on environmental exposures such as pets, air pollution, household cleaning products, maternal and infant diet and more, and child health outcomes (including biological samples and clinical assessments). Known for causing digestive inconsistencies, legumes are storehouses of anti nutrients called lectins. While lectins are present in all plant and animal products, grains and legumes are a more concentrated source than others.
One of the more particular conditions associated with consuming lectins is known as leaky gut syndrome in which intestinal permeability is increased. Leaky gut syndrome can be a convenient precursor to food sensitivities, chronic inflammation, asthmaand even rheumatoid arthritis.
With all these tactics implemented though, some diseases or conditions related to the gut still persist and can prove to be a real challenge to deal with. Note that in case of a hard to treat condition, I would tackle the problem with a shotgun approach. All that I learnt from these people started me on the path of self-discovery in relation to my bowel health and my health overall.
I started to experiment with the various ideas and approaches I received from them and I was able to finally start joining the dots.
I started to look into health and nutrition from an evolutionary view-point which was another game-changer for me. If you are to have good Gut health – then you have to eat a diet that fits what your gut is evolved to eat. Lactobacillus bulgaricus is the only probiotic microorganism named after a certain territory and nation.
Lactobacillus bulgaricus was known to the Thracians the ancient population that lived in the present Bulgarian land more than 7 8 thousand years ago. In the beginning of 21st century, the father of probiotics, the Russian scientist and a Nobel prize winner Ilya Metchnikoff, in his work  Prolongation of life relates the long and healthy life of Bulgarians largely to the yoghurt consumption and in particular to the local bacterium in yoghurt – Lactobacillus bulgaricus. Complying with the Europeans standards of origin, BSS (Bulgarian State Standard) for yoghurt was established in Bulgaria.
In the 90s of the 21st century Lactobacillus bulgaricus was used in the production of probiotic functional food for astronauts that was tested during the flight of the second Bulgarian astronaut in space. Studies of many scientists from around the world prove the beneficial effects of Lactobacillus bulgaricus regarding regulation of functions and microbial flora of the gastrointestinal tract, including diarrhea and disbacteriosis, immune system stimulation, reduction of the risk of cancer, regulation of the cholesterol level, competitive inhibition of pathogenic strains, causing infections, relief of lactose intolerance, anti-mutagenic and anti-radiation effect. Lactobacillus bulgaricus causes homo-fermentative lactic acid fermentation in which it secretes only lactic acid and bacteriocins (beneficial substances), without alcohol and acetic acid production.
Spring in Stara planina mountain, Bulgaria, from which Lactobacillus bulgaricus is isolated. Using modern biotechnology, certain Bulgarian companies wrap strains of Lactobacillus bulgaricus and other probiotic microorganisms with a natural coating, consisting of components of the growing medium, during fermentation. Joint research of Lactobacillus bulgaricus, contained in the functional probiotic foods of Daflorn, by the scientists from the University of Food Technologies of Plovdiv and the University of California Davis will provide new fundamental knowledge for food technology. The benefits of probiotics have been widely discussed, particularly when it comes to their impact on digestive health.
Probiotics pertain to live microorganisms that provide health benefits to the host organism.
There are various microbes that can be used as probiotics, with bifidobacteria and lactic acid bacteria as the most common. Various studies have highlighted the potential beneficiary effects of probiotics, particularly on the digestive system. There are certain factors that can upset the balance of microbes in the gut, including taking certain medications like antibiotics and acquiring bad bacteria and parasites that cause diseases. Probiotics have been touted as effective when it comes to treating diarrhea and preventing urinary tract infections, particularly among female patients. The latter question arises because the ability of probiotics to survive when treated or after they have undergone manufacturing methods is still under debate. It is no secret that leading a healthy lifestyle and eating right are the most effective ways of battling diseases, including those related to the digestive system. All of us would want to keep our digestive system healthy, but keeping track of every food that we eat and every activity that we conduct is just not possible, sad as this may sound. Prebiotics, unlike probiotics, are heat-resistant, which means that even if they undergo processing or baking or any other procedure involved in creating food, their efficacy is not diminished, nor their make-up altered. Another benefit of prebiotics is their ability to stimulate metabolism, something that probiotics are not known for.
Simply put, we may not get the benefits of probiotics unless prebiotics are also present since the latter will make the former work more effectively.
What are Probiotics?Probiotics are live microorganisms thought to be healthy for the host organism.
IntroductionAs it was reported by Chow (2002), the notion that food could serve as medicine was first conceived thousands of years ago by the Greek philosopher and father of medicine, Hippocrates, who once wrote: 'Let food be thy medicine, and let medicine be thy food'. Epithelial cells lining the gastrointestinal tract are able to respond to infection by initiating either nonspecific or specific host-defence response (Kagnoff and Eckmann 1997, Strober 1998). As we say, optimal digestive health is the foundation upon which total body health is built. Since that is not likely to happen with the Western lifestyle, starting an infant on probiotics, fish oil, and vitamin D may help prevent this microbial shift, but I still think food and stress are primary shifters of the microbiome.
They’re just some of the trillions of microbes that share our body, and that are as much a part of us as our own flesh and blood. The advent of processed flour and sugar during the Industrial Revolution made things even worse. By following these simple guidelines, you can help keep your immune system in optimal working order so that you’re far less likely to acquire the infection to begin with or, if you do get sick with the flu, you are better prepared to move through it without complications and soon return to good health.
The best way to improve your beneficial bacteria ratio is avoid sugars as they will feed the pathogenic bacteria.
Be sure to check out my article Guide to a Good Night’s Sleep for some great tips to help you get quality rest. If you feel that stress is taking a toll on your health, consider using an energy psychology tool such as the Emotional Freedom Technique, which is remarkably effective in relieving stress associated with all kinds of events, from work to family to trauma.
The components of your immune system are also better circulated, which means your immune system has a better chance of finding an illness before it spreads.
It is also vitally important to avoid damaged omega-6 oils that are trans fats and in processed foods as it will seriously damage your immune response.
Be sure you don’t use antibacterial soap for this – antibacterial soaps are completely unnecessary, and they cause far more harm than good.
If possible, avoid close contact with those, who are sick and, if you are sick, avoid close contact with those who are well.
The best place to get plenty of rest and recover from illness that is not life-threatening is usually in the comfort of your own home. These bacteria help train the immune system and can prevent diseases by outcompeting dangerous pathogenic bacteria—but there are times when the dangerous microbes gain the upper hand and overrun the gut. Louis who recently studied the importance of maintaining gut bacteria when treating people with malnutrition.
Infants strictly formula-fed, compared with babies that were exclusively or partially breastfed, also had significant differences in their gut bacteria.
The researchers will use this information to study the development of the gut microbiome and its relationship to conditions such as wheeze and allergies in future studies. Rob Knight, a Howard Hughes Medical Institute Early Career Scientist and an Associate Professor with the BioFrontiers Institute and Departments of Chemistry and Biochemistry and Computer Science, University of Colorado, Boulder, Colorado, United States, in a related commentary. Modern cooking methods of soaking, fermenting and sprouting promise to neutralize these toxic substances but their consumption can still lead to direct gastric issues like flatulence, bloating, cramps and other non gastric aggravations like headaches, painful joints and fatigue.
The damage incurred by the lining of the intestines allows toxins and partially digested food particles to pass through its protective coating and enter the bloodstream. Granted, following a Paleo diet will often provide great relief and maybe even cure whatever ailment you’re dealing with.
This article will dig deeper into the subject and I will recommend a general strategy to cope with most gut and gut flora ailments. This basically means that I would eliminate any possible offending foods at the same time as I would try and maximize my immune system strength, gut healing and good flora rebuilding.
The more I experimented, the better I was able to figure out what was actually triggering my symptoms and, on the flip side, what was allowing my bowels to work how they should naturally. Richard Evershed from the Bristol University found over 2200 ceramic vessels dated back to 9000 years in the region around the Black sea (present boundary of Bulgaria). According to this standard the lactic acid fermentation must be made only with Lactobacillus bulgaricus and Streptococcus thermophilus. Lactobacillus bulgaricus is closest to derlein flora in the woman’s vagina and has a beneficial effect on the health of women and their newborns. During that fermentation Lactobacillus bulgaricus feeds on milk lactose, as the lactose remains in the lactic acid products in small quantities.
Bianchi show that as compared to the other lactic acid probiotic bacteria, Lactobacillus bulgaricus adheres best to the mucous membrane of the colon with subsequent rapid reproduction in the body. In a joint cultivation of Lactobacillus bulgaricus and Streptococcus thermophilus, there is a primary cooperation between them (associative link).
That and the isolation of new probiotic strains from spring water, which normally survive under the changing climatic conditions in nature, help the production of probiotic products in which the strains of Lactobacillus bulgaricus and other probiotic microorganisms retain their stability and vitality when passing through the gastrointestinal tract, as well as when stored in shops at a temperature up to 24?
In here, we are going to discuss what these benefits are and whether there are other things better than probiotics. They are also known as good bacteria, which share similar characteristics with the beneficial microorganisms that can be found inherently in the human stomach or the digestive system.
They are considered good bacteria and are therefore helpful in strengthening the body’s protection against bad bacteria that may cause certain diseases.
Probiotics are reportedly meant to inhibit the growth of these unfriendly microorganisms to keep the body, especially the gut, healthy and strong. Probiotics are also believed to have the ability to reduce the chances of a person of acquiring bladder cancer, of suffering from irritable bowel syndrome and are also believed to be effective in managing atopic dermatitis, especially in children.
There have been research studies asserting that, although probiotics do contribute to promoting a balanced digestive system, their impact is actually minimal. Some experts have claimed that any process undergone by probiotics actually alters their therapeutic impact.
However, most of us are not really in the habit of planning meals or following a strict healthy lifestyle program, mainly because of busy schedules. Prebiotics, as opposed to probiotics, are specific groups of food ingredients that are non-digestible but are absolutely healthy.
They can reach the intestines in their original form and continuously work on stimulating the activities of beneficial microorganisms that are already in our stomachs or are provided by probiotics.
If we are looking for an effective and efficient way to promote digestive health, foods and supplements with prebiotics should be our first choice.
Potential and established health benefits associated with the usage of probiotics (Leroy et al., 2008). However, during recent times, the concept of food having medicinal value has been reborn as 'functional foods'. Bacterial adhesion to the host cell or recognition by the host cell is often an essential first stage in the disease process.


If you eat a narrow highly processed food diet, it will be a bad one. We eat food that promotes bad bacteria and we use chemicals that kill any good bacteria. The narrow range of microbes in industrialised gobs are more vulnerable to invasions by species that cause disease, cavities, and other dental problems.  “As an ecosystem, it has lost resilience,” says Cooper. The future of Health Care will be not a fix after we are ill but taking care so that we have the best immune system possible. Additionally, processed foods and most grains should be limited and replacing with healthy fats like coconut oil, avocados, olives, olive oil, butter, eggs and nuts.
Be sure to take vitamin K2 if you are taking high dose oral vitamin D as it has a powerful synergy and will help prevent any D toxicity.
Be aware that sugar (typically in the form of high fructose corn syrup) is present in foods you may not suspect, like ketchup and fruit juice. The researchers reasoned that when this happens, the beneficial bacteria could retreat to the safety of the appendix, which remains unaffected. That suggests it is possible we still haven’t completely cracked the mystery of the appendix, he says. They are low grade toxins that when consumed by humans can cause many inflammatory and gastrointestinal complications.
Moreover, foods that do not agree with the digestive system compromise the body’s immune system as well. Also, other than being very strict with the diet, complete elimination of dairy, egg whites, nightshade vegetables, nuts and seeds and limiting fruit intake should be a priority, as discussed in my articles about dealing with autoimmune diseases and about the benefits of egg yolks. Note that each condition usually also requires a special approach, but the general ideas discussed here usually applies to all of them. Forgetting a step or doing things only partially often leads to poor results unfortunately.
This determines its more powerful curative and detoxic effect as compared to the other lactic acid probiotic bacteria.
It allows a fast  accumulation of biomass and bioactive substances and potentiates their beneficial effects. Some of the more common sources include yogurt, soy beverages, fermented and unfermented milk and some types of juices. Primarily, they are supposed to promote microbial balance in the intestines, a condition that is much needed if the body is to fight attacks from bad bacteria and toxins that can induce infections, diarrhea and atopic illnesses. Questions have also been raised on whether adding probiotic bacteria to food will diminish their efficacy. So, if probiotics can help us but are still not enough to give us the healthy gut that we need, where then should we turn? Their main function is stimulating the growth and activity of good bacteria that are already in our bodies. Lactic acid bacteria (LAB) and bifidobacteria are the most common types of microbes used as probiotics; but certain yeasts and bacilli may also be helpful. Key and desirable criteria for the selection of probiotics in commercial applications (Vasiljevic and Shah, 2008).
The list of health benefits accredited to functional food continues to increase, and the gut is an obvious target for the development of functional foods, because it acts as an interface between the diet and all other body functions.
A wide range of gastrointestinal cell surface constituents, such as several glygoconjucates, can serve as receptors for bacterial adherence (Servin and Coconnier 2003, Pretzer et al., 2005).
Once you change your diet than regular use of fermented foods can radically optimize the function of your immune response.
If you are healthy then sugar can be consumed but the LAST thing you should be eating when you are sick is sugar. However, it would be wise to radically reduce the intensity of your workouts while you are sick. Once the immune system has beaten the infection, the beneficial bacteria emerge from the appendix to quickly recolonize the gut.
I’ve been dealing with tough problems myself and it sometimes seems that even the stars have to be aligned to start seeing progress, so hang in there and make anything possible to regain health as soon as possible so you can laugh about it afterwards.
I was making so much progress quickly that I started to feel I was cracking the constipation code, so to speak. I started to get in touch with research by guys like Loren Cordain and Staffan Lindeberg that really opened my eyes and had me jumping down the rabbit hole so-to-speak.
Lactobacillus bulgaricus is a part of the Bulgarian traditional food, as Bulgarians put Lactobacillus bulgaricus both in home and industry production of traditional lactic acid products  yoghurt, white brine cheese, other types of cheese and cream, humanized baby food, probiotic functional foods and whole food supplements.
Code of Federal Laws, yoghurt is a fermented milk product that contains the typical bacterial cultures Lactobacillus bulgaricus and Streptococcus thermophilus. Lactobacillus acidofilus and Lactobacillus lactis produce alcohol, and the Bifidobacteria produce acetic acid and small amounts of the beneficial lactic acid. In Bulgaria there were carried out lots of scientific studies of yeasts, containing Lactobacillus bulgaricus and Streptococcus thermophilus, used in yoghurt production. Probiotics are commonly consumed as part of fermented foods with specially added active live cultures; such as in yogurt, soy yogurt, or as dietary supplements. One of the most promising areas for the development of functional food components lies in the use of probiotics and prebiotics which scientific researches have demonstrated therapeutic evidence. Furthermore, epithelial cells express constitutively host pattern recognition receptors (PRRS), such as Toll-like receptors (TLR).
Some of those in the mouth are involved in repairing damage to teeth and barring the way to more dangerous germs. The results show that these specific bacteria of yoghurt are stable and survive when they pass through the human gastrointestinal tract. Nowadays, consumers are aware of the link among lifestyle, diet and good health, which explains the emerging demand for products that are able to enhance health beyond providing basic nutrition.
But over time, we become dependent on these too and we lose the ability to have a natural poo. Petrova isolated strains of Lactobacillus bulgaricus and other lactic acid probiotic microorganisms from spring water in Bulgaria. Today, specific health effects are being investigated and documented including alleviation of chronic intestinal inflammatory diseases, prevention and treatment of pathogen-induced diarrhea, urogenital infections, and atopic diseases. Lactobacillus bulgaricus produces the antimicrobial substance Bulgarican, which is heat resistant and active against highly virulent (pathogenic) strains of microorganisms. TLRs are also found on innate immune cells, such as dendritic cells and macrophages (Vinderola et al., 2005). They can be found in fermented products as meat, milk products, vegetables, beverages and bakery products.
They are part of the microbiota on mucous membranes, such as the intestines, mouth, skin, urinary and genital organs of both humans and animals, and may have a beneficial influence on these ecosystems. Other known recognition receptors are nucleotide-binding oligomerization domain proteins, which recognize both gram-positive and gram-negative bacteria. LAB that grow as the adventitious microflora of foods or that are added to foods as cultures are generally considered to be harmless or even an advantage for human health.
However, tablets, capsules, powders and sachets containing the bacteria in freeze dried form are also available.
Since their discovery, LAB has been gained mush interest in various applications, as starter cultures in food and feed fermentations, pharmaceuticals, probiotics and as biological control agents.
Increased epithelial barrier permeability is frequently associated with gastrointestinal disorders contributing to both disease onset and persistence (Lu and Walker 2001, Berkes 2003). In food industry, LAB are widely used as starters to achieve favorable changes in texture, aroma, flavor and acidity (Leory and De Vuyst, 2004). The gatekeeper of the paracellular pathway is the tight junction, which is an apically located cell-cell junction between epithelial cells. Increases immune response to viral challenge.''Bifidobacterium LAFTIA® B94'' Bifidobacterium spLAFTI B94DSMProtects against Salmonella typhimurium in mice. The tight junction permits the passage of small molecules, such as ions, while restricting the movement of large molecules, such as antigens and microorganisms, which can cause inflammation.
Du to their antimicrobial and antioxidant activities some LAB strains are used in food biopreservation. Origine and safety of probiotics An old dogma of probiotic selection has been that the probiotic strains should be of “human origin”.
Many of the indications for probiotic activity have been obtained from effects observed in various clinical situations. One may argue that from evolutionary point of view, describing bacteria to be of human origin does not make much sense at all. The requirement for probiotics to be of human origin relates actually to the isolation of the strain rather than the “origin” itself.
Usually, the strains claimed to be “of human origin” have been isolated from faecal samples of healthy human subjects, and have therefore been considered to be “part of normal healthy human gut microbiota”. Overview of probioticsThe most tried and tested manner in which the gut microbiota composition may be influenced is through the use of live microbial dietary additions, as probiotics. In reality the recovery of a strain from a faecal sample does not necessarily mean that this strain is part of the normal microbiota of this individual, since microbes passing the GI tract transiently can also be recovered from the faecal samples (Forssten et al., 2011). Utilises prebiotics for improved colonisation Reduces inflammation in an IBDReduces allergic responses in an allergy Reduces the severity of H.pylori infection of the stomachmucosaInhibits pathogenic bacteria (H.
In practice it is impossible to know the actual origin of the probiotic strains, regardless of whether they have been isolated from faecal samples, fermented dairy products or any other source for that matter.
Isolation of a strain from faeces of a healthy individual is also not a guarantee of the safety of the strain—such a sample will also always contain commensal microbes which can act as opportunistic pathogens, or even low levels of true pathogens, which are present in the individual at sub-clinical levels.
However, at the beginning of this century probiotics were first put onto a scientific basis by the work of Metchnikoff (1908).
He hypothesised that the normal gut microflora could exert adverse effects on the host and that consumption of ‘soured milks’ reversed this effect. However, many species of the genera Lactobacillus, Leuconostoc, Pediococcus, Enterococcus, and Bifidobacterium were isolated frequently from various types of infective lesions. The origin of the first use can be traced back to Kollath (1953), who used it to describe the restoration of the health of malnourished patients by different organic and inorganic supplements. Later, Vergin (1954) proposed that the microbial imbalance in the body caused by antibiotic treatment could have been restored by a probiotic rich diet; a suggestion cited by many as the first reference to probiotics as they are defined nowadays. Similarly, Kolb recognized detrimental effects of antibiotic therapy and proposed the prevention by probiotics (Vasiljevic and Shah, 2008) Later on, Lilly and Stillwell (1965) defined probiotics as “…microorganisms promoting the growth of other microorganisms”. The idea of health-promoting effects of LAB is by no means new, as Metchnikoff proposed that lactobacilli may fight against intestinal putrefaction and contribute to long life.
A study in 2004 testing the immune system of students given either milk or Actimel over a 6 week exam period (3 weeks of studying, 3 weeks of exams) tested 19 different biomarkers. Of these 19 biomarkers only 2 were shown to be different between the two groups, increased production of lymphocytes and increased production of CD56 cells.
Although minor side effects of the use of probiotics have been reported, infections with probiotic bacteria occur and invariably only in immunocompromised patients or those with intestinal bleeding (Leroy et al., 2008). Other definitions advanced through the years have been restrictive by specification of mechanisms, site of action, delivery format, method, or host. An issue of concern regarding the use of probiotics is the presence of chromosomal, transposon, or plasmid-located antibiotic resistance genes amongst the probiotic microorganisms. At this moment, insufficient information is available on situations in which these genetic elements could be mobilised, and it is not known if situations could arise where this would become a clinical problem (Leroy et al., 2008). The mechanism of action of probiotics (e.g, having an impact on the intestinal microbiota or enhancing immune function) was dropped from the definition to encompass health effects due to novel mechanisms and to allow application of the term before the mechanism is confirmed. Furthermore, certain mechanisms of action (such as delivery of certain enzymes to the intestine) may not require live cells. In vitro safety screenings of probiotics may include, among others, antibiotic resistance assays, screenings for virulence factors, resistance to host defence mechanisms and induction of haemolysis. For many of the potential benefits, research is limited and only preliminary results are available. In relation to food, probiotics are considered as “viable preparations in foods or dietary supplements to improve the health of humans and animals”. According to these definitions, an impressive number of microbial species are considered as probiotics. Recent research on the molecular biology and genomics of ''Lactobacillus'' has focused on the interaction with the immune system, anti-cancer potential, and potential as a biotherapeutic agent in cases of antibiotic-associated diarrhoea, travellers' diarrhoea, pediatric diarrhoea, inflammatory bowel disease and irritable bowel syndrome. ConclusionThe individual diversity of the intestinal microflora underscores the difficulty of identifying the entire human microbiota and poses barriers to this ?eld of research. Selection of probioticsMany in vitro tests are performed when screening for potential probiotic strains.
Animal studies have demonstrated that some LAB can protect against colon cancer in rodents, though human data is limited and conflicting. The first step in the selection of a probiotic LAB strain is the determination of its taxonomic classification, which may give an indication of the origin, habitat and physiology of the strain. It is also apparent that even a single strain of probiotic may exert its actions via multiple, concomitant pathways.
Most human trials have found that the strains tested may exert anti-carcinogenic effects by decreasing the activity of an enzyme called I?-glucuronidase Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory tract infections and dental caries in children. All these characteristics have important consequences on the selection of the novel strains (Morelli, 2007).
Probiotics have long been used as an alternative to traditional medicine with the goal of maintaining enteric homeostasis and preventing disease.
LAB foods and supplements have been shown to be aid in the treatment and prevention of acute diarrhea, and in decreasing the severity and duration of rotavirus infections in children and travelers' diarrhea in adults.Helicobacter pyloriLAB are also thought to aid in the treatment of ''Helicobacter pylori'' infections (which cause peptic ulcers) in adults when used in combination with standard medical treatments. However more studies are required into this area.Antibiotic-associated diarrheaAntibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy. This conclusion was brought forward due to uncertainty of the origin of the human intestinal microflora since the infants are borne with virtually sterile intestine. Clinical trials have shown that probiotic treatment can reduce the risk of some diseases, especially antibiotic-associated diarrhea, but conclusive evidence is impeded owing to the wide range of doses and strains of bacteria used.


Microbiota alteration changes carbohydrate metabolism with decreased short-chain fatty acid absorption and an osmotic diarrhea as a result. However, the panel also underlined a need for improvement of in vitro tests to predict the performance of probiotics in humans. Another consequence of antibiotic therapy leading to diarrhea is overgrowth of potentially pathogenic organisms such as ''Clostridium difficile''.Probiotic treatment can reduce the incidence and severity of AAD as indicated in several meta-analyses. While many probiotics meet criteria such as acid and bile resistance and survival during gastrointestinal transit, an ideal probiotic strain remains to be identified for any given indication. Many studies, as discussed above, have shown that probiotics increase barrier function in terms of increased mucus, antimicrobial peptides, and sIgA production, competitive adherence for pathogens, and increased TJ integrity of epithelial cells. However, further documentation of these findings through randomized, double blind, placebo-controlled trials are warranted.Efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage.
Furthermore, it seems unlikely that a single probiotic will be equally suited to all indications; selection of strains for disease-specific indications will be required (Shanahan, 2003). Current investigation into the mechanism of action of speci?c probiotics has focused on probiotic-induced changes in the innate immune functions involvingTLRs and its downstream systems Like NF-?B, and other pathways (Yoon and Sun, 2011).
Although the immunomodulatory effects of probiotics have been demonstrated in experimental animal models of allergy, autoimmunity, and IBD, information from clinical trials in humans is scarce.
The ability to adhere to the intestinal mucosa is one of the more important selection criteria for probiotics because adhesion to the intestinal mucosa is considered to be a prerequisite for colonization (Tuomola et al., 2001). The table below (Table 2) indicates key creteria for sellecting probiotic candidat for commercial application, and figure 1 presents major and cardinal steps for sellecting probiotic candidats.It is of high importance that the probiotic strain can survive the location where it is presumed to be active. Therefore, more research, especially in the form of well-designed clinical trials, is needed to evaluate the ef?cacy and safety of probiotics (Ezendam and Van Loveren, 2008). For a longer and perhaps higher activity, it is necessary that the strain can proliferate and colonise at this specific location. Probably only host-specific microbial strains are able to compete with the indigenous microflora and to colonise the niches. Results have been varied on these studies, and in vivo studies are still required in this area to determine efficacy.
Besides, the probiotic strain must be tolerated by the immune system and not provoke the formation of antibodies against the probiotic strain. On the other hand, the probiotic strain can act as an adjuvant and stimulate the immune system against pathogenic microorganisms.
Basic initial characterization of strain identity and taxonomy should be conducted, followed by evaluation with validated assays both in studies of animal models and in controlled studies in the target host.
In vitro assays are frequently conducted that have not been proved to be predictive of in vivo function. Those given the good bacteria were ''more'' likely to develop a sensitivity to allergens.Some hospitals have reported treating lactobacillus septicaemia which is a potentially fatal disease caused by the consumption of probiotics by people with lowered immune systems or who are already very ill.
Technological robustness must also be determined, such as the strain’s ability to be grown to high numbers, concentrated, stabilized, and incorporated into a ?nal product with good sensory properties, if applicable, and to be stable, both physiologically and genetically, through the end of the shelf life of the product and at the active site in the host.
Assessment of stability can also be a challenge, since factors such as chain length and injury may challenge the typical assessment of colony-forming units, as well as in vivo function (Sanders, 2008). Dose levels of probiotics should be based on levels found to be ef?cacious in human studies. Furthermore, the impact of product format on Figure 1.Scheme of the Guidelines for the Evaluation of Probiotics for Food Use. The common quality-control parameter of colony-forming units per gram may not be the only parameter indicative of the ef?cacy of the ?nal product. Other factors, such as probiotic growth during product manufacture, coating, preservation technology, metabolic state of the probiotic, and the presence of other functional ingredients in the ?nal product, may play a role in the effectiveness of a product. Potential mechanisms of action of probioticsA wide variety of potential beneficial health effects have been attributed to probiotics (Table 3). Claimed effects range from the alleviation of constipation to the prevention of major life-threatening diseases such as inflammatory bowel disease, cancer, and cardiovascular incidents.
Some of these claims, such as the effects of probiotics on the shortening of intestinal transit time or the relief from lactose maldigestion, are considered well-established, while others, such as cancer prevention or the effect on blood cholesterol levels, need further scientific backup (Leroy et al., 2008). The mechanisms of action may vary from one probiotic strain to another and are, in most cases, probably a combination of activities, thus making the investigation of the responsible mechanisms a very difficult and complex task. In general, three levels of action can be distinguished: probiotics can influence human Probiotic organisms can provide a beneficial effect on intestinal epithelial cells in numerous ways.
Gut microbiotaThe human gastrointestinal tract is inhabited by a complex and dynamic population of around 500-1000 of different microbial species which remain in a complex equilibrium. It has been estimated that bacteria account for 35–50% of the volume content of the human colon.
These include Bacteroides, Lactobacillus, Clostridium, Fusobacterium, Bifidobacterium, Eubacterium, Peptococcus, Peptostreptococcus, Escherichia and Veillonella.
The bacterial strains with identified beneficial properties include mainly Bifidobacterium and Lactobacillus species. The dominant microbial composition of the intestine have been shown to be stable over time during adulthood, and the microbial patterns are unique for each individual. However, there are numerous external factors that have potential to influence the microbial composition in the gut as host genetics, birth delivery mode, diet, age, antibiotic treatments and also, other microorganisms as probiotics. The intestine is one of the main surfaces of contact with exogenous agents (viruses, bacteria, allergens) in the human body. It has a primary role in the host defense against external aggressions by means of the intestinal mucosa, the local immune system, and the interactions with the intestinal microbiota (resident and in transitbacteria).
Gut microbiota influences human health through an impact on the gut defense barrier, immune function, nutrient utilization and potentially by direct signaling with the gastrointestinal epithelium (Collado et al., 2009). In healthy adults, 80% of phylotypes belong to four major phylogenetic groups, which are the Clostiridium leptum, Clostridium coccoides, Bacteroides and Bifidobacteria groups. Also, studies have found that mucosal microbiota is stable along the distal gastrointestinal tract from ileum to rectum, but mucosa-associated microbiota is different from fecal microbiota. The number of bacterial cells present in the mammalian gut shows a continuum that goes from 101 to 103 bacteria per gram of contents in the stomach and duodenum, progressing to 104 to 107 bacteria per gram in the jejunum and ileum and culminating in 1011 to 1012 cells per gram in the colon (Figure 3a). In addition to the longitudinal heterogeneity displayed by the intestinal microbiota, there is also a great deal of latitudinal variation in the microbiota composition (Figure 3b). The intestinal epithelium is separated from the lumen by a thick and physicochemically complex mucus layer. The microbiota present in the intestinal lumen differs significantly from the microbiota attached and embedded in this mucus layer as well as the microbiota present in the immediate a: variations in microbial numbers and composition across the length of the gastrointestinal tract. For instance, Bacteroides, Bifidobacterium, Streptococcus, members of Enterobacteriacea, Enterococcus, Clostridium, Lactobacillus, and Ruminococcus were all found in feces, whereas only Clostridium, Lactobacillus, and Enterococcus were detected in the mucus layer and epithelial crypts of the small intestine (Sekirov et al., 2010). Upon passage through the birth canal, infants are exposed to a complex microbial population. After the initial establishment of the intestinal microbiota and during the first year of life, the microbial composition of the mammalian intestine is relatively simple and varies widely between different individuals and also with time. Survival and antagonism effects of probiotics in the gutThe intestinal epithelium is the largest mucosal surface in the human body, provides an interface between the external environment and the host.
The gut epithelium is constantly exposed to foreign microbes and antigens derived from digested foods. Thus, the gut epithelium acts as a physical barrier against microbial invaders and is equipped with various elements of the innate defense system.
In the gut, two key elements govern the interplay between environmental triggers and the host: intestinal permeability and intestinal mucosal defense. Resident bacteria can interact with pathogenic microorganisms and external antigens to protect the gut using various strategies.According to the generally accepted de?nition of a probiotic, the probiotic microorganism should be viable at the time of ingestion to confer a health bene?t. Although not explicitly stated, this de?nition implies that a probiotic should survive GI tract passage and, colonize the host epithelium.
A variety of traits are believed to be relevant for surviving GI tract passage, the most important of which is tolerance both to the highly acidic conditions present in the stomach and to concentrations of bile salts found in the small intestine. These properties have consequently become important selection criteria for new probiotic functionality. One of the mechanisms by which the gut ?ora resists colonization by pathogenic bacteria is by the production of a physiologically restrictive environment, with respect to pH, redox potential, and hydrogen sul?de production. Probiotic bacteria decrease the luminal pH, as has been demonstrated in patients with ulcerative colitis (UC) following ingestion of the probiotic preparation VSL#3. Several bacteriocins produced by different species from the genus Lactobacillus have been described.
The inhibitory activity of these bacteriocins varies; some inhibit taxonomically related Gram-positive bacteria, and some are active against a much wider range of Gram-positive and Gram-negative bacteria as well as yeasts and molds.
Lacticin 3147, a broad-spectrum bacteriocin produced by Lactococcus lactis, inhibits a range of genetically distinct Clostridium dif?cile isolates from healthy subjects and patients with IBD.
A further example is the antimicrobial effect of Lactobacillus species on Helicobacter pylori infection of gastric mucosa, achieved by the release of bacteriocins and the ability to decrease adherence of this pathogen to epithelial cells (Gotteland et al., 2006).
The pretreatment of intestinal (T84) cells with lactic acid-producing bacteria reduced the ability of pathogenic E.
Adhesion and invasion of an intestinal epithelial cell line (Intestine 407) by adherent invasive E.
Probiotics and the mucous layerMost mucosal surfaces are covered by a hydrated gel formed by mucins. Mucins are secreted by specialized epithelial cells, such as gastric foveolar mucous cells and intestinal goblet cells, Goblet cells are found along the entire length of the intestinal tract, as well as other mucosal surfaces. Of the 18 mucin-type glycoproteins expressed by humans, MUC2 is the predominant glycoprotein found in the small and large bowel mucus. The NH2- and COOH-termini are not glycosylated to the same extent, but are rich in cysteine residues that form intra- and inter-molecular disul?de bonds. These glycan groups confer proteolytic resistance and hydrophilicity to the mucins, whereas the disul?de linkages form a matrix of glycoproteins that is the backbone of the mucous layer (Ohland and MacNaughton, 2010). Although small molecules pass through the heavily glycosylated mucus layer with relative ease, bulk fluid flow is limited and thereby contributes to the development of an unstirred layer of fluid at the epithelial cell surface.
As the unstirred layer is protected from convective mixing forces, the diffusion of ions and small solutes is slowed (Turner, 2009). This gel layer provides protection by shielding the epithelium from potentially harmful antigens and molecules including bacteria from directly contacting the epithelial cell layer, while acting as a lubricant for intestinal motility.
Mucins can also bind the epithelial cell surface carbohydrates and form the bottom layer, which is ?rmly attached to the mucosa, whereas the upper layer is loosely adherent. The mucus is the ?rst barrier that intestinal bacteria meet, and pathogens must penetrate it to reach the epithelial cells during infection (Ohland and MacNaughton, 2010).Probiotics may promote mucus secretion as one mechanism to improve barrier function and exclusion of pathogens.
In support of this concept, probiotics have been shown to increase mucin expression in vitro, contributing to barrier function and exclusion of pathogens.
Several studies showed that increased mucin expression in the human intestinal cell lines Caco-2 (MUC2) and HT29 (MUC2 and 3), thus blocking pathogenic E. However, healthy rats did not display increased colonic TFF3 expression after stimulation by VSL#3 probiotics (Caballero-Franco et al., 2007). Furthermore, mice treated with 1% dextran sodium sulfate (DSS) to induce chronic colitis did not exhibit increased TFF3 expression or wound healing when subsequently treated with VSL#3. This observation indicates that probiotics do not enhance barrier function by up-regulation of TFF3, nor are they effective at healing established in?ammation. Therefore, use of current probiotics is likely to be effective only in preventing in?ammation as shown by studies in animal models (Ohland and MacNaughton, 2010).5.
Interaction of probiotic bacteria with gut epitheliumThe composition of the commensal gut microbiota is probably influenced by the combination of food practices and other factors like the geographical localization, various levels of hygiene or various climates.
The establishment of a normal microbiota provides the most substantial antigenic challenge to the immune system, thus helping the gut associated lymphoid tissus (GALT) maturation.
The intestinal microbiota contributes to the anti-inflammatory character of the intestinal immune system. Several immunoregulatory mechanisms, including regulatory cells, cytokines, apoptosis among others, participate in the control of immune responses by preventing the pathological processes associated with excessive reactivity. An interesting premise for probiotic physiological action is their capacity to modulate the immune system.
Consequently, many studies have focused on the effects of probiotics on diverse aspects of the immune response. Following consumption of probiotic products, the interaction of these bacteria with intestinal enterocytes initiates a host response, since intestinal cells produce various immunomodulatory molecules when stimulated by bacteria (Delcenseri et al., 2009). Furthermore, The indigenous microbiota is a natural resistance factor against potential pathogenic microorganisms and provides colonization resistance, also known as gut barrier, by controlling the growth of opportunistic microorganisms. It has been suggested that commensal bacteria protect their host against microbial pathogens by interfering with their adhesion and toxic effects (Myllyluoma, 2007).A fraction of ingested probiotics are able to interact with intestinal epithelial cells (IECs) and dendritic cells (DCs), depending on the presence of a dynamic mucus layer. Probiotics can occasionally encounter DCs through two routes: DCs residing in the lamina propria sample luminal bacterial antigens by passing their dendrites between IECs into the gut lumen, and DCs can also interact directly with bacteria that have gained access to the dome region of the gut-associated lymphoid tissue (GALT) through specialized epithelial cells, termed microfold or M cells. The interaction of the host cells with microorganism-associated molecular patterns (MAMPs) that are present on the surface macromolecules of probiotic bacteria will induce a certain molecular response. The host pattern recognition receptors (PRRs) that can perceive probiotic signals include Toll-like receptors (TLRs) and the C type lectin DC-specific intercellular adhesion molecule 3-grabbing non-integrin (DC-SIGN). Some molecular responses of IECs depend on the subtype of cell, for example, Paneth cells produce defensins and goblet cells produce mucus. Important responses of DCs against probiotics include the production of cytokines, major histocompatibility complex molecules for antigen presentation, and co-stimulatory molecules that polarize T cells into T helper or CD4+CD25+ regulatory T cells in the mesenteric lymph nodes (MLNs) or subepithelial dome of the GALT. Host interactions of probiotic bacterial surface molecules: comparison with commensals and pathogens.



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