Symptomspesifikke probiotikum. Linda Mulder, MSc. Vårseminaret 2014

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1 Linda Mulder, MSc. Vårseminaret 2014

2 Content Background on probiotics Intestinal microbiota & health on 3 levels Indication-specific probiotics Strain-specific characteristics Monostrain vs. multispecies probiotics PAGE 2

3 What is a probiotic? No molecule No protein No medicine PAGE 3

4 What is a probiotic? Live micro-organisms Live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host PAGE 4

5 What kind of micro-organisms? Mostly bacteria; Bifidobacterium Lactobacillus Lactococcus Enterococcus E. coli Yeast: Saccharomyces boulardii Other PAGE 5

6 Nothing History new of probiotics Eli Metchnikov (Nobel prize 1908) PAGE 6

7 What do they look like? PAGE 7

8 Why eating bacteria? PAGE 8

9 Microbiota Stomach: bacteria/ml Increasing amount of bacteria Feces: bacteria/gram 10x more bacteria than host cells >1000 different species Unique personal microbiota PAGE 9

10 The intestine Skin 4 m 2 Lungs 40 m 2 Intestine 400 m 2 The largest surface with the outside world PAGE 10

11 PAGE 11

12 Disturbance Microbiota Disturbance via: nutrition antibiotics stress disease PAGE 12

13 Imbalance of the microbiota The Food and Agriculture Organization of the UN Directly linked with intestine: Diarrhoea - Antibiotic associated diarrhoea - Travelers diarrhoea - Infantile diarrhoea (Rotavirus) - Caused by food pathogens Constipation Inflammatory Bowel Disease (IBD) Irritable Bowel Syndrome (IBS) Helicobacter pylori infections World Health Organization Indirectly linked with intestine: Allergies Cancer Cardiovascular disease Urinary tract infections Bacterial vaginosis And more PAGE 13

14 Microbiota important for health Our microbiota is really important and we should keep it in balance in terms of numbers and diversity PAGE 14

15 To prevent imbalance of the microbiota Probiotics PAGE 15

16 Probiotics How to select the right probiotic? PAGE 16

17 Mechanisms of action Probiotics can have influence on human health on three levels 1. Microbe Microbe 2. Microbe Gut epithelium 3. Microbe Immune system PAGE 17

18 Level 1: Microbial environment Colonisation resistance Competition for nutrients Affecting metabolic activity Competition for adhesion sites Production of antimicrobial agents Stimulation of commensals PAGE 18

19 Level 2: Intestinal barrier Normal mucosa Damaged mucosa mucus layer tight junctions epithelial cells in good condition no mucus layer no tight junctions damaged epithelial cells Bacteria stay in the gut PAGE 19 Translocation of bacteria

20 Level 2: Intestinal barrier Mucosal barrier function Increase mucus production Enhancing intestinal integrity (TJs) Production of cytoprotective substances Regeneration epithelial cells PAGE 20

21 Level 3: Immune system Immunomodulation A healthy gut microbiota is able to modulate the immune system in a positive way PAGE 21

22 Level 3: Immune system Immunomodulation Possible outcomes: Antibody (IgA) production neutralization pathogens Cytokine production Induction/stimulation of regulatory T cells Result: stimulation of the immune reaction or dampening of inflammation PAGE 22

23 Indication-specific Disease-specific probiotics Not all diseases have the same background/mechanism Most disease are multifactorial Different diseases should be handled in different ways Indication-specific probiotics Probiotic strains specifically targeted against specific pathophysiological processes PAGE 23

24 No one size fits all Indication-specific probiotics need specifically selected strains Probiotics strains can be screened for their capacities Level 1; pathogen inhibition Level 2; increasing barrier function Level 3; immunomodulation PAGE 24

25 No one size fits all Examples Product for traveler s diarrhea -> select strains that inhibit ETEC (level 1) Product for migraine -> select strains that improve barrier function (level 2) Product for allergy -> select strains that modulate the immune system (level 3) PAGE 25

26 Selecting the right strains Different strains have different capacities even if they have the same name! PAGE 26

27 Bacteria names Cars Bacteria Genera: Opel Species: vectra Strain; station Genera: Lactobacillus Species: rhamnosus Strain: GG PAGE 27

28 Probiotic effects are strain-specific Sven Kramer Sven Kramer Lactobacillus acidophilus Lactobacillus acidophilus PAGE 28

29 controle stressor W64-Bac. coagulans W53-B. animalis W23-B. bifidum W28-B. bifidum W119-B. bifidum W25-B. breve W125-B. infantis W51-B. lactis W52-B. lactis W108-B. longum W54-E. faecium W74-L. acidophilus W22-L. acidophilus W37-L. acidophilus W55-L. acidophilus W70-L. acidophilus W63-L. brevis W78-L. brevis W20-L. casei W56-L. casei W79-L. casei W129-L. fermentum W21-L. plantarum W62-L. plantarum W71-L. rhamnosus W24-L. salivarius W57-L. salivarius W19-Lc. lactis W58-Lc. lactis W122-S. salivarius Strain specific properties Stressor + strain PAGE 29 % TEER

30 Multispecies probiotics Properties bacterium X properties bacterium Y Combination of different properties higher efficacy Multispecies probiotics more beneficial (action at three levels) Multispecies probiotics are more effective than single-strain probiotics PAGE 30

31 Different types of probiotics Monostrain probiotics: Contain 1 strain Example: Lactobacillus acidophilus Multistrain probiotics: contain >1 strain (from same genera) Example: Lactobacillus acidophilus Lactobacillus casei Multispecies probiotics: contain strains from different species/genera Example: Lactobacillus acidophilus Bifidobacterium bifidum Enterococcus faecium PAGE 31

32 16 However carefull selection of strains! Weight changes in rats (gr) (after salmonella challenge) Day 0-3 Day 0-7 Day The L. Plantarum showed antimicrobial capacities against other lactobacilli? 0-4 Killed Lb. Casei (control) Live Lb. Casei Lb. Casei Lb.Acidophilus Lb. Casei Lb.Acidophilus Lb.Salivarius Lb. Casei Lb.Acidophilus Lb. Salivarius St. Lactis Lb. Casei Lb.Acidophilus Lb. Salivarius St. Lactis Lb.Plantarum PAGE 32

33 In summary animatie_05 goed! - Snelkoppeling.lnk PAGE 33

34 Thank you for you attention!