Probiotics, D–Lactic acidosis, oxidative stress and strain specificity

Abstract

The existence of an implicit living microscopic world, composed primarily of bacteria, has been known for centuries. The exact mechanisms that govern the contribution of bacteria to human health and disease have only recently become the subject of intense research efforts. Within this very evident shift in paradigms, the rational design of probiotic formulations has led to the creation of an industry that seeks to progress the engineering of probiotic bacteria that produce metabolites that may enhance human host health and prevent disease. The promotion of probiotics is often made in the absence of quality scientific and clinically plausible data. The latest incursions into the probiotic market of claims have posited the amelioration of oxidative stress via potent antioxidant attributes or limiting the administration of probiotics to those species that do not produce D-Lactic acid (i.e., claims that D-Lactic acid acidosis is linked to chronic health conditions) or are strain-specific (shaping an industry point of difference) for appraising a therapeutic effect. Evidence-based research should guide clinical practice, as there is no place in science and medicine that supports unsubstantiated claims. Extravagant industry based notions continue to fuel the imprimatur of distrust and skepticism that is leveled by scientists and clinicians at an industry that is already rife with scientific and medical distrust and questionable views on probiotics. Ignoring scientifically discordant data, when sorting through research innovations and false leads relevant to the actions of probiotics, drives researcher discomfit and keeps the bar low, impeding the progress of knowledge. Biologically plausible posits are obligatory in any research effort; companies formulating probiotics often exhibit a lack of analytical understanding that then fuels questionable investigations failing to build on research capacity.

Understanding oxidants and antioxidants: Classical team with new players

“…The gut microbes are directly involved in conferring protection against pathogen colonization by inducing direct killing, competing with nutrients, and enhancing the response of gut‐associated immune system. Damage to the microbiome (dysbiosis) is linked with several life‐threatening pathophysiological conditions, that is, inflammatory bowel disease, cancer, obesity, allergy, and auto‐immunity (Sokol et al, ; Viennois et al, ; Vitetta, Coulson, Thomsen, Nguyen, & Hall, ). Therefore, the manipulation of human gut microbiota is a potential target for therapeutic intervention in several human diseases (Mamantopoulos et al, ; Mamantopoulos, Ronchi, McCoy, & Wullaert, ; Mukherjee, Joardar, Sengupta, & Sinha Babu, ; Richard & Sokol, ).…”

Bacteria, Bones, and Stones: Managing Complications of Short Bowel Syndrome

“…Among clinicians, there is a common practice to avoid Lactobacillus strains of probiotics in SBS with a colon in continuity because of the belief that there is a risk of developing DLA. However, these claims are made in the absence of quality scientific data …”

“…With all that potential comes the need for well‐designed, randomized controlled trials testing for strain‐specific effects that may support specific claims. In addition to finding an effective therapeutic agent, it is also important to determine the duration and frequency of treatment administration …”

“…However, these claims are made in the absence of quality scientific data. 22 One of the goals of treating SIBO is to reduce the risk of an overproduction of D-lactic acid, which in turn would reduce the risk of developing an episode of DLA. This is done by attempting to reduce the number of pathogenic bacteria present and to reduce the count of D-lactic acid producers.…”

“…In addition to finding an effective therapeutic agent, it is also important to determine the duration and frequency of treatment administration. 22 Surgical options. Among patients with SBS, medical and antibiotic therapies may fail, indicating the need for surgical strategies.…”