Probiotic, fructooligosaccharides (Oligofructose) Beneficial Bacteria For Normal Microflora

BENEFITS OF TAKING MEGAEL-DENA AS A SOURCE OF PROBIOTICS AND FRUCTOOLIGOSACCHARIDES

It is generally believed that taking supplements containing beneficial bacteria, compounds that stimulate their growth, or both (like MegaEl-Dena), is beneficial for health, especially for people with disturbances in the composition of endogenous microflora. It should be noted that clinical guidelines for the use of probiotics differ in different countries: in the US, they are considered as dietary supplements and thus cannot be formally considered to cure or treat any diseases (even if this is supported by clinical trials), whereas in European countries such claims are allowed and have to be substantiated by properly conducted human trials in the targeted population or in healthy volunteers [1].

Probiotics

One way to help normalize microbiota composition is to use supplements containing probiotics, defined as “microorganisms that have a favorable influence on the host by improving the indigenous microflora”[2]. The beneficial effects of Bifidobacterium and Lactobacillus bacteria have been reported at least since the late 1980s [3], and multiple clinical trials have been conducted to ascertain the usefulness of probiotics in patients with different conditions accompanied by disturbances in microbiota composition. Whereas species from several bacterial genera and at least one yeast species have been used as probiotics, Bifidobacterium and Lactobacillus remain the best studied (recently reviewed by McFarland [1]).

In this respect, MegaEl-Dena is largely a mainstream formulation because seven out of the eight species of viable beneficial bacteria that it contains belong to these genera: four species of Bifidobacterium (B. bifidum, B. breve, B. lactis, and B. longum), three species of Lactobacillus (L. acidophilus, L. casei, and L. rhamnosus), and Streptococcus thermophilus.

A recent analysis of the results of 63 trials conducted in different countries has found that 56%–83% of probiotic products helped improve the intestinal microbiota in patients with dysbiosis but almost 80% of such products had no effect on the microbiota in healthy individuals [1]. Thus, probiotic supplements would be most helpful after the events that disrupt the endogenous microbiota and until restoration of the normal microbiota, but would have little or no effect on the microbiota in healthy people. Below we mention specific use cases of the probiotic bacterial species included in MegaEl-Dena.

A large double-blind placebo-controlled study conducted in Cambridge (UK) involved 162 patients who had been treated with antibiotics for H. pylori infection [4]. This study found that supplementation with a combination of two strains of L. acidophilus and two strains of Bifidobacterium during and after antibiotic therapy helped to alleviate the antibiotic-induced disruption of the intestinal microbiota. Supplementation with probiotics was also found to be associated with a lower increase in the incidence of antibiotic resistance of enterococci after antibiotic therapy [4], although the probiotic strains used were antibiotic-sensitive.

A study conducted in Finland found that Lactobacillus rhamnosus ingestion for five days to four weeks was associated with alleviation of clinical symptoms of gastrointestinal inflammation and atopic dermatitis in children, possibly via enhanced production of the anti-inflammatory cytokine interleukin-10 [5].

Prebiotics

Improvement in the composition of gut microbiota may be transient if the conditions remain unfavorable for beneficial bacteria. Another concept, which is aimed at overcoming these problems, is that of prebiotics. This term was coined in 1995 to describe “a non-digestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon, and thus improves host health” [3]. Since beneficial bacteria are already present in the intestines (even if their numbers may be reduced), the concept of prebiotics postulates that taking these compounds would stimulate the growth of these bacteria and help normalize the microbiota.

The most widely known prebiotics are nondigestible oligosaccharides, in particular fructooligosaccharides (FOS) [3], also called oligofructose (which is included in the MegaEl-Dena formulation), as well as galactooligosaccharides and lactulose. Although FOS are non-digestible, bacteria in the colon metabolize them into short-chain fatty acids, which can be absorbed [6].

A specific case of the use of FOS was described by Whelan and colleagues [7]. Using healthy volunteers, they simulated enteral tube feeding, which is known to disturb the intestinal microbiota and increase the risk of Clostridium difficile colonization. The authors found that supplementation of the enteric formula with FOS/fiber was associated with increased bifidobacteria counts and reduced clostridia in comparison with the standard formula [7].

Synbiotics

The two approaches, probiotics and prebiotics, are not mutually exclusive; moreover, they can be used as complementary, leading to the concept of synbiotics, i.e. supplements containing both probiotics and prebiotics that are assumed to have synergistic effects on the growth of beneficial bacteria, both endogenous and those introduced with the supplement [3,8]. Since MegaEl-Dena combines 8 species of viable beneficial bacteria and FOS, it is a synbiotic.

Finally, it should be noted that some studies have addressed the safety of the use of probiotics. For example, a study conducted in Finland [9] examined a hypothesis that a wide use of probiotics might increase the probability of bacteremia, i.e. the presence of bacteria in the blood that may cause sepsis. However, this study failed to find any link between bacteremia and the use of L. rhamnosus (one of the species used in MegaEl-Dena), thus confirming the safety of the probiotic use. Another species used in MegaEl-Dena, S. thermophilus, is related to such human pathogens as Streptococcus pyogenes (which causes a range of localized or systemic infections) and Streptococcus pneumoniae (the causative agent of pneumonia as its Latin name indicates). However, S. thermophilus is generally recognized as safe, which has been recently explained by a comparative study of its genome and genomes of pathogenic streptococci, which found that S. thermophilus has lost all genes necessary for virulence in related species; this confirms that “massive consumption of this bacterium by humans likely entails no health risk” [10]. Moreover, the use of S. thermophilus as a probiotic is well documented. For example, supplementation with a mixture of S. thermophilusand Bifidobacterium was found to be effective in prevention of rotavirus-induced diarrhea [11] and antibiotic-associated diarrhea [12] and in reducing severity of acute diarrhea in infants [13].

Another beneficial effect of S. thermophilus is that it stimulates the growth of lactobacilli by providing them with specific nutrients, such as formic acid, folic acid, and fatty acids [14]. Thus, the inclusion of S. thermophilus in a probiotic formulation can be expected to have an effect similar to that of the inclusion of prebiotics.

References

  1. McFarland, L.V. Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events: a systematic review. BMJ Open 4, e005047 (2014).
  2. Erickson, K.L. & Hubbard, N.E. Probiotic immunomodulation in health and disease. J Nutr 130, 403S-409S (2000).
  3. Gibson, G.R. & Roberfroid, M.B. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr 125, 1401-1412 (1995).
  4. Plummer, S.F. et al. Effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy. Int J Antimicrob Agents 26, 69-74 (2005).
  5. Pessi, T., Sutas, Y., Hurme, M. & Isolauri, E. Interleukin-10 generation in atopic children following oral Lactobacillus rhamnosus GG. Clin Exp Allergy 30, 1804-1808 (2000).
  6. Tokunaga, T. Novel physiological function of fructooligosaccharides. Biofactors 21, 89-94 (2004).
  7. Whelan, K. et al. Fructooligosaccharides and fiber partially prevent the alterations in fecal microbiota and short-chain fatty acid concentrations caused by standard enteral formula in healthy humans. J Nutr 135, 1896-1902 (2005).
  8. Roberfroid, M.B. Prebiotics and synbiotics: concepts and nutritional properties. Br J Nutr 80, S197-202 (1998).
  9. Salminen, M.K. et al. Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland. Clin Infect Dis 35, 1155-1160 (2002).
  10. Bolotin, A. et al. Complete sequence and comparative genome analysis of the dairy bacterium Streptococcus thermophilus. Nat Biotechnol 22, 1554-1558 (2004).
  11. Saavedra, J.M., Bauman, N.A., Oung, I., Perman, J.A. & Yolken, R.H. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 344, 1046-1049 (1994).
  12. Corrêa, N.B., Péret Filho, L.A., Penna, F.J., Lima, F.M. & Nicoli, J.R. A randomized formula controlled trial of Bifidobacterium lactis and Streptococcus thermophilus for prevention of antibiotic-associated diarrhea in infants. J Clin Gastroenterol 39, 385-389 (2005).
  13. Thibault, H., Aubert-Jacquin, C. & Goulet, O. Effects of long-term consumption of a fermented infant formula (with Bifidobacterium breve c50 and Streptococcus thermophilus 065) on acute diarrhea in healthy infants. J Pediatr Gastroenterol Nutr 39, 147-152 (2004).
  14. Sieuwerts, S. et al. Mixed-culture transcriptome analysis reveals the molecular basis of mixed-culture growth in Streptococcus thermophilus and Lactobacillus bulgaricus. Appl Environ Microbiol 76, 7775-7784 (2010).