SUMMARYHelicobacter pylori is a highly prevalent pathogen considered as an aetiological factor for gastroduodenal ulcers, and a risk factor for gastric adenocarcinoma and lymphoma in humans. Most subjects colonized by this micro-organism are asymptomatic and remain untreated. In symptomatic patients, the antibiotic treatment has a high cost and is not 100% effective because of resistance to antibiotics and to moderate patient compliance. This review discusses the role of probiotics as alternative solutions to assist in the control of H. pylori colonization in atrisk populations.The evidence that some strains of Lactobacillus and Bifidobacterium are able to inhibit H. pylori growth through the release of bacteriocins or organic acids, and may also decrease its adhesion to epithelial cells, is reviewed. In addition, probiotics have a possible role in the stabilization of the gastric barrier function and the decrease of mucosal inflammation. Other aspects that are considered are the contribution of probiotics to the healing of the gastric mucosa linked to their antioxidant and anti-inflammatory properties.Clinical trials in colonized adults and children are reviewed, and suggest that probiotics do not eradicate H. pylori but maintain lower levels of this pathogen in the stomach; in combination with antibiotics, probiotics may increase eradication rate and/or decrease adverse effects. Papers suggesting similar effects on H. pylori by foodstuffs such as berry juice and some milk proteins are quoted. Regular intake of these and other dietary products might constitute a low-cost, large-scale alternative solution applicable for populations at-risk for H. pylori colonization.
Recognizing the possible beneficial effect of prebiotics in food, the Food and Agriculture Organization of the United Nations (FAO) convened a Technical meeting to start work on the evaluation of the functional and health properties of prebiotics. A group of international experts agreed on guidelines, recommended criteria, and methodology for conducting a systematic approach for the evaluation of prebiotics leading to its safe use in food. It was recommended that a full expert consultation be convened under the auspices of FAO. This work provides governments, industry, and consumers with scientific advice in relation to functional and health aspects of prebiotics and general guidance for the assessment of prebiotics in relation to their nutritional properties or safety. These guidelines may also be used by Member Countries and Codex Alimentarius to identify and define what data need to be available to accurately substantiate health and nutrition claims.
Antibiotics exert deleterious effects on the intestinal microbiota, favoring the emergence of opportunistic bacteria and diarrhea. Prebiotics are nondigestible food components that stimulate the growth of bifidobacteria. Our aim was to evaluate the effects on the intestinal microbiota of a prebiotic-supplemented milk formula after an antibiotic treatment. A randomized, double-blind, controlled clinical trial was carried out in 140 infants 1-2 y of age distributed into two groups after a 1-wk amoxicillin treatment (50 mg/kg/d) for acute bronchitis. The children received for 3 wk >500 mL/d of a formula with prebiotics (4.5 g/L) or a control without prebiotics. Fecal samples were obtained on d -7 (at the beginning of the antibiotic treatment), on d 0 (end of the treatment and before formula administration), and on d 7 and 21 (during formula administration). Counts of Bifidobacterium, Lactobacillus-Enterococcus, Clostridium lituseburiense cluster, Clostridium histolyticum cluster, Escherichia coli, and Bacteroides-Prevotella were evaluated by fluorescent in situ hybridization (FISH) and flow cytometry. Tolerance and gastrointestinal symptoms were recorded daily. Amoxicillin decreased total fecal bacteria and increased E. coli. The prebiotic significantly increased bifidobacteria from 8.17 +/- 1.46 on d 0 to 8.54 +/- 1.20 on d 7 compared with the control 8.22 +/- 1.24 on d 0 versus 7.95 +/- 1.54 on d 7. The Lactobacillus population showed a similar tendency while the other bacteria were unaffected. No gastrointestinal symptoms were detected during the prebiotic administration. Prebiotics in a milk formula increase fecal bifidobacteria early after amoxicillin treatment without inducing gastrointestinal symptoms.
SUMMARY BackgroundObesity is associated with low-grade inflammation contributing to insulinresistance. Gut barrier alterations, described in animal models of obesity, probably favour inflammation. This has not been hitherto described in obese humans.
The effects of a nucleotide-supplemented formula on diarrhoeal disease was studied in 141 infants (group 1) who belonged to the low socioeconomic stratum; 148 controls (group 2) received the same formula but unsupplemented. Group 1 experienced less episodes of diarrhoea (109 versus 140), including less first episodes (74 versus 102; chi-square = 8.19, p < 0.004; odds ratio 2.01) and for a lesser number of days (807 versus 996 days); 45.0% and 31.1% of infants in groups 1 and 2, respectively, never developed episodes of diarrhoea. There were no differences in the clinical characteristics of the episodes or in the enteropathogens isolated from symptomatic or asymptomatic infants. The mechanisms through which nucleotides decrease the incidence of diarrhoeal disease in infants remain unclear.
Microminerals including copper and iron are essential to immunity and health in human beings. The development of powerful tools in analytical cell biology and molecular genetics has facilitated efforts to identify specific cellular and molecular functions of trace elements in the maturation, activation and functions of host defence mechanisms. Selected recent reports about the role of copper and iron nutrition on immune functions are critically analysed here. Effects of trace element supplementation on infectious morbidity are also reviewed. While micromineral deficiencies, in general, may have widespread effects on nearly all components of immune response, these effects can be reversed by supplementation. However, the conflicting effects of iron deficiency and iron supplementationin vitroon the defensive systems reveals the urgent need for further additional information on thein vivosituation. In the elderly, vaccination against respiratory infections is likely to protect only 30–70 % of the population. However, it may be possible to modulate immune function and ultimately reduce the severity of infections through micronutrient supplementation. Thus, microminerals contribute to the maintenance of the balance between immunity and health in humans.
S. boulardii seems promising as an agent that interferes with Hp in colonized individuals. More studies are needed to confirm these results and to elucidate the mechanisms by which Sb inhibits Hp.
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