Phosphate binders and dialysis can have harmful side-effects during the treatments of hyperphosphatemia. Therefore, we evaluated the capability of intestinal bacteria (lactic acid bacteria and bifidobacteria) as phosphate-accumulating organisms (PAOs) for phosphate accumulation, with the aim of determining whether PAO-formulated food can prevent hyperphosphatemia in the early stages. However, methods for estimating microbial phosphate-accumulation capacities require significant improvements regarding specificity, cost, and simplicity. The presented method analyzed cell-free broth to assess the phosphate accumulation capability of cells. Active cells and the constructed phosphate-deficient cells were incubated in assay salt media. After incubation, phosphate-deficient cell-free broth was taken as sample and the blank was the active cell-free broth. Therefore, effects of interfering agents and other metabolites were avoided and enhanced the specificity remarkably. Phosphate contents were assessed by reactions with toluidine blue O. In contrast to the case in previous studies, the shift in the first absorbance peak was found to be inversely proportional to the phosphate concentration. The minimum detectable phosphate concentrations for the 11th isolate of Lactobacillus casei JCM 1134 and 8th isolate of Bifidobacterium adolescentis JCM 1275 were determined to be 1.24 and 0.4 mg/L, respectively. Further, the validation results were found to be significant (p-value < 0.05).
Hyperphosphatemia is a secondary health issue that arises during chronic kidney disorder (CKD). Phosphate binders and dialysis are prescribed in later stages of CKD, although they may lead to harmful side-effects and worsen quality of life. Therefore, we examined the potential of intestinal bacteria (lactic acid bacteria and bifidobacteria) as phosphate-accumulating organisms (PAOs), whether PAO-formulated food can prevent CKD at earlier stages. Among the experimental organisms, Bifidobacterium adolescentis JCM1275 was the most effective. The effects of prebiotic and soy peptides were also evaluated where fructooligosaccharide was found to further enhance phosphate accumulation by B. adolescentis JCM1275, resulting in the best phosphate accumulation activity, identified in the study. Therefore, certain bifidobacteria and lactic acid bacteria strains have the potential to act as biological phosphate accumulators and contribute to the prevention of CKD pathology and improve patient outcome by care (not cure by medicines).
Hyperphosphatemia is a secondary issue associated with chronic kidney disorder. Use of phosphate binders and dialysis are the treatments for hyperphosphatemia, albeit with harmful side effects and high cost, respectively. A safer and healthier approach is attempted to administer phosphate-accumulating organisms (PAOs) from probiotics to prevent hyperphosphatemia. However, screening and isolation of PAOs are limited by inefficient enrichment of relevant metabolism and contamination. Therefore, we devised a novel strategy to isolate elite PAOs from Lactobacillus casei JCM 1134 and Bifidobacterium adolescentis JCM 1275 (previously reported PAOs). PAOs were first enriched for phosphate uptake and incubated in low-pH phosphate-free media to dormant non-PAOs, and then purified using Percoll density gradient centrifugation. Subsequently, elite PAOs were isolated from centrifuged pellet on a toluidine blue O-supplemented agar-based media. Using this technique, elite PAOs could not only be isolated, but also semi-quantitatively scored for their phosphate accumulation capabilities. Additionally, these scores correlated well with their accumulated phosphate values. The elite PAOs isolated from L. casei and B. adolescentis showed 0.81 and 0.70 [mg-phosphate/mg-dry cell], respectively (23- and 4.34-fold increase, respectively). Thus, our method can be used to successfully isolate elite PAOs, which might be of use to prevent hyperphosphatemia at early stages.
Hyperphosphataemia is treated with phosphate binders, which can cause adverse effects. Spray-dried synbiotic powder (SP) composed of Lactobacillus casei JCM1134 (a phosphate-accumulating organism; PAO) and Aloe vera is potentially a safer alternative for efficient phosphate removal. In this study, a novel strategy was developed; lysine-derivatized deacetylated A. vera (DAVK) was synthesised and fabricated on phosphate-deficient PAO (PDP) for efficient phosphate transfer and then spray-dried with the supernatant of DAV centrifugation to form a sacrificial layer on PDP for SP integrity during gastric passage. In vitro experiments revealed that PAO removed only 1.6% of the phosphate from synthetic media, whereas SP removed 89%, 87%, and 67% (w/v) of the phosphate from milk, soft drink, and synthetic media, respectively, confirming the protective role of A. vera and efficient phosphate transport. Compared with commercial binders, SP effectively removed phosphate from synthetic media, whereas SP and CaCO3 exhibited comparative results for milk and soft drink. Importantly, CaCO3 caused hypercalcaemia. Thus, the described SP presents a promising tool to prevent hyperphosphataemia. This study also revealed a novel factor: diets of patients with chronic kidney disease should be monitored to determine the optimal phosphate binders, as phosphate removal performance depends on the accessible phosphate forms.
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