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Lactobacillus caseistrain GG in the treatment of infants with acute watery diarrhea: A randomized, double-blind, placebo controlled clinical trial [ISRCTN67363048]
Specific Lactobacillus cultures for specific conditions
Gerardo Nava, UNAM-Mexico
5 September 2004
The intestinal tract is colonized for several Lactobacillus and Bifidobacterium species (1). Each bacterial community has a specific function into the ecosystem. Metchnikoff in 1908 recognized the importance of lactobacilli on human health and longevity (2). Through a process of colonization and fermentation, the metabolites of these intestinal microbiota have varying consequences on the intestinal physiology of the host. In some extend, the health of the intestinal mucosa depends on the establishment of complex and dynamic bacterial communities (3).
There is no doubt about the importance of these microbial ecosystems for the protection of the intestinal mucosa and the advantage as a therapeutic alternative. However, basic concepts, principles, and methodology for manipulating and restoring these ecosystems have not been well understood yet.
Recently, lactobacilli cultures have been associated with a decrease in the prevalence of intestinal infections. Several probiotic products have been extensively evaluated as potential alternatives for the prevention and treatment of infections. This tendency and the economical impact of this phenomenon have generated several sources and brands of probiotic supplements without governmental regulation. Consequently, it is difficult to make an adequate recommendation regarding appropriate product choice (4).
In the selection of Lactobacillus biotic products, physicians may consider:
· Prophylactic or therapeutic probiotic administration.
· Detailed analysis of the medical conditions of the patient basing its recommendation on clinic and physical evaluations.
· Patient condition (e.g. antibiotic medications, age of the patient, pathological process, local alteration of the mucosal environment, pathogenic bacteria involved in the infectious process, local inflammatory response, local medications, etc.)
· Lactobacilli strains (e.g. endemic isolates, predominant communities, number of active cells, probiotic competitiveness, compatibility, and synergies; probiotic mucosal colonization, probiotic persistence on the mucosal epithelium, etc.).
Recently, it has been reported that host-specific and competitive probiotic culture could be an effective alternative for therapeutic treatment against salmonellosis in animal models (5).
Lately, some studies have shown discouraging results with the use of probiotic therapies for controlling intestinal diseases. However, none of the have consider selecting probiotic therapies based on clinical exams. Like in the antibiotic therapy, specific products should be prescribed for specific conditions.
References
1. Ouwehand AC, Salminen S, Arvola T, Ruuska T, Isolauri E. Microbiota Composition of the Intestinal Mucosa: Association with Fecal Microbiota? Microbil Immuno 2004;48:497-500.
2. Metchnikoff E. (1910). The Prolongation of Life. London UK: G.P. Putnam's sons, 1910:109-16.
3. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: Introducing the concept of prebiotics. J Nutr 1995;125(6), 1401–12.
4. Jeavons HS. Prevention and treatment of vulvovaginal candidiasis using exogenous Lactobacillus. JOGNN 2003;32:287-96.
5. Nava GM, Pixley C, Jarquin RL, Sartor CD, Vicente JL, Tellez G, Donoghue AM, Hargis BM, Reduction of Salmonella enteritidis infection by therapeutic administration of Lactobacillus probiotic culture. Poult Sci 2004;83(Suppl. 1):108.
Specific Lactobacillus cultures for specific conditions
5 September 2004
The intestinal tract is colonized for several Lactobacillus and Bifidobacterium species (1). Each bacterial community has a specific function into the ecosystem. Metchnikoff in 1908 recognized the importance of lactobacilli on human health and longevity (2). Through a process of colonization and fermentation, the metabolites of these intestinal microbiota have varying consequences on the intestinal physiology of the host. In some extend, the health of the intestinal mucosa depends on the establishment of complex and dynamic bacterial communities (3).
There is no doubt about the importance of these microbial ecosystems for the protection of the intestinal mucosa and the advantage as a therapeutic alternative. However, basic concepts, principles, and methodology for manipulating and restoring these ecosystems have not been well understood yet.
Recently, lactobacilli cultures have been associated with a decrease in the prevalence of intestinal infections. Several probiotic products have been extensively evaluated as potential alternatives for the prevention and treatment of infections. This tendency and the economical impact of this phenomenon have generated several sources and brands of probiotic supplements without governmental regulation. Consequently, it is difficult to make an adequate recommendation regarding appropriate product choice (4).
In the selection of Lactobacillus biotic products, physicians may consider:
· Prophylactic or therapeutic probiotic administration.
· Detailed analysis of the medical conditions of the patient basing its recommendation on clinic and physical evaluations.
· Patient condition (e.g. antibiotic medications, age of the patient, pathological process, local alteration of the mucosal environment, pathogenic bacteria involved in the infectious process, local inflammatory response, local medications, etc.)
· Lactobacilli strains (e.g. endemic isolates, predominant communities, number of active cells, probiotic competitiveness, compatibility, and synergies; probiotic mucosal colonization, probiotic persistence on the mucosal epithelium, etc.).
Recently, it has been reported that host-specific and competitive probiotic culture could be an effective alternative for therapeutic treatment against salmonellosis in animal models (5).
Lately, some studies have shown discouraging results with the use of probiotic therapies for controlling intestinal diseases. However, none of the have consider selecting probiotic therapies based on clinical exams. Like in the antibiotic therapy, specific products should be prescribed for specific conditions.
References
1. Ouwehand AC, Salminen S, Arvola T, Ruuska T, Isolauri E. Microbiota Composition of the Intestinal Mucosa: Association with Fecal Microbiota? Microbil Immuno 2004;48:497-500.
2. Metchnikoff E. (1910). The Prolongation of Life. London UK: G.P. Putnam's sons, 1910:109-16.
3. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: Introducing the concept of prebiotics. J Nutr 1995;125(6), 1401–12.
4. Jeavons HS. Prevention and treatment of vulvovaginal candidiasis using exogenous Lactobacillus. JOGNN 2003;32:287-96.
5. Nava GM, Pixley C, Jarquin RL, Sartor CD, Vicente JL, Tellez G, Donoghue AM, Hargis BM, Reduction of Salmonella enteritidis infection by therapeutic administration of Lactobacillus probiotic culture. Poult Sci 2004;83(Suppl. 1):108.
Competing interests
The autor has not competing interests