The gut microbiota plays the important role to support the immunological tolerance. To study a metabolic activity of the intestinal microflora the 44 patients suffering from bronchial asthma and 17 healthy volunteers were tested. The short-chain fatty acids (SCFA) spectrum was determined using the method of gas-liquid chromatographic analysis. We have detected a significant decrease the total content of the fatty acids in the feces (P<0.001), the absolute concentrations of the individual acids (acetate, propionate, butyrate; P<0.001) and the total content of isoacids (P<0.001) for all of the patients with bronchial asthma in the study, regardless of the phenotype. The anaerobic type of the SCFA spectrum was detected for the majority (83%) of the patients tested. The aerobic type of the SCFA metabolic profile was detected for another part (17%) of the patients tested. Being detected the parameters change could play the principal role as for the bronchial asthma course as to support the organism sensibilisation.
We have reviewed the currently published results on a role of the gut microflora in a prevention of acute respiratory infections. The main biological properties of probiotic bacteria are presented in a context of their modulating activity on an inflammatory immune response. Available data on the reduction of a possible risk, duration, and severity of respiratory infection symptoms during a probiotic medication intake were analyzed. Potential antiviral probiotic mechanisms have been reviewed and discussed.
Aim. To provide practical recommendations on the use of probiotics for the treatment and prevention of gastroenterological diseases in adults.General provisions. Probiotics are living microorganisms that benefit the health of the host when administered in adequate amounts. The main functions of probiotics include the support for colonisation resistance, the metabolism of food substrates and utilisation of end metabolites, the production of substrates necessary for the macro-organism, as well as the regulation of local and adaptive immune responses. Probiotics can be registered in the Russian Federation as biologically active food additives (BAFA) or as pharmaceutical products (drugs) in accordance with the microbiological standards and legislative requirements of the Russian Federation. The probiotics registered in the Russian Federation as BAFA for adults include bacteria of the Lactobacillus, Bifidobacterium, Enterococcus, Pediococcus, Lactococcus, Streptococcus, Bacillus, and Escherichia genera, and fungi of the Saccharomyces genus; probiotics registered as drugs — bacteria of Lactobid, Lactobacid, Escherichia and Enterococcus genera and fungi of the Saccharomyces genus. Some probiotics registered in the Russian Federation include probiotic strains that have proved to be effective for the prevention and treatment of antibiotic-associated diarrhea, the prevention of C. difficile-associated disease, the eradication of H. pylori infection, as well as for the treatment of irritable bowel syndrome and functional constipation.Conclusions. The clinical efficacy of probiotics depends on the probiotic strains included in their composition and is confirmed by a comparative analysis of the results of appropriate clinical studies. Not all probiotics registered in the Russian Federation as BAFA or drugs contain bacterial or fungal strains; as a result, the expected clinical effect may not be achieved.
The efficacy of a gut microbiota control was investigated for patients with atopic asthma. 45 patients with atopic asthma were included in the study. The results of our clinical and lab tests, pulmonary function tests and the lactulose hydrogen breath tests have been presented to evaluate small intestine bacterial overgrowth (SIBO). Under the standard SIBO’s therapy (long-acting beta-agonists, inhaled glucocorticoids), the first group (15 patients) had being tested with Rifaximin for the SIBO therapy during 7 days. The second group (15 patients) had been tested with Rifaximin and with a succeeding probiotics therapy for three months (B. bifidum, B. longum, B. infantis, L. rhamnosus). SIBO was diagnosed for 30 (67%) patients. We have detected a higher IgE level (P<0.01), a higher eosinophils level (P<0.001) in sputum and more significant decrease of FEV1 (P<0.01) in SIBO(+). The IgE level in patients was decreased (P<0.01) after the complex SIBO therapy both for the Rifaximin therapy group (P<0.05) and for the Rifaximin + Probiotic therapy group (P<0.05). A dramatic decrease of the IgE level (P<0.05) had been induced by probiotics and it was confirmed by the control testing results with a high statistical accuracy for the observed groups of patients. We did not detect any changes for the patients without SIBO (P=0.46), those who had been treated with a standard therapy. A decrease in the number of patient hospitalization was defined by the treatment with probiotics after SIBO therapy (P<0.05). So, SIBO is a significant factor aggravating the atopic asthma in patients. The gut microflora correction with probiotics therapy has been accompanied by a statistical reliability improvement for the immune response and spirometry, as well as by a decrease in the number of hospitalizations for these patients during the year.
Aim. This work is aimed at studying the role of the small bowel bacterial overgrowth syndrome (SBBOS) in the pathogenesis of bronchial asthma (BA).Materials and methods. The study included 80 BA patients (45 and 35 patients allergic and non-allergic BA forms, respectively). Conventional laboratory and instrumental studies were conducted. SBBOS was confirmed by a hydrogen breath test with lactulose. Patients received conventional basal therapy with combined drugs (long-acting β2-adrenomimetics, and inhaled glucocorticoids). For SBBOS treatment, rifaximin (23 patients) or rifaximin followed by probiotic (B. bifidum, B. longum, B. infantis, L. rhamnosus) for 1 month (22 patients) was administered. Control studies were conducted on the 14th day and following 1 month of treatment.Results. A frequent combination of the small bowel bacterial overgrowth syndrome and bronchial asthma was revealed. 67 % and 43 % of the patients with the allergic form and non-allergic asthma form, respectively, are shown to suffer from SBBOS, p = 0.028. High levels of IgE (p < 0.01) and eosinophils in sputum (p < 0.001), combined with severe impairment of the function of external respiration (p < 0.01) in the case of SBBOS with allergic asthma reflect a more pronounced degree of sensitization of these patients. The correction of composition disorders of the intestinal microflora is accompanied by a statistically significant decrease in the immune response (p < 0.01) and improvement in the function of external respiration (p < 0.001).Conclusion. SBBOS is a significant factor, aggravating the course of bronchial asthma and playing an important role in the development and maintenance of sensitization of patients.
В обзоре даются определение и условия отнесения биопрепарата к пробиотикам, приводятся механизмы влияния пробиотиков и микробиоты на активность ЦНС, основные биологически активные амины, синтезируемые микробиотой. Рассматриваются нейроэндокринные эффекты пробиотиков и микробиоты и их роль в патогенезе ожирения и сахарного диабета. Обобщаются исследования, которые доказывают влияние микробиоты на обменные процессы через синтез витаминов В и D и связанные с этим перспективы их терапевтического применения.
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