INTRODUCTION
In the human intestinal flora there are more than 400 species of microorganisms that coexist in harmony synthesizing vitamins, beneficial substances, contributing to the absorption of nutrients, favoring the colonic metabolism of the fiber, improving the digestibility, neutralizing potentially pathogenic substances. The intestine offers substrates and the conditions for its development allowing the flora to promote a better intestinal function.
In the intrauterine life the intestinal tract is sterile, and it is after birth when the intestinal flora develops. During the first days of life the bifidobacteria colonize the intestine protecting the child from infections. The main functions of the intestinal flora are to limit the growth of potentially pathogenic microorganisms in the intestine and to interact with non-absorbed substrates of the diet. However, the intestinal flora is vulnerable to certain conditions. In adults it varies markedly as they depend on several factors such as diet, genes, the environment, antibiotic treatments, stress, medications, infections, age, weather, surgical interventions in stomach or intestine, liver diseases, kidney disease, cancer . Having a stable and well-balanced flora is a guarantee of good health since it prevents the colonization and development of pathogenic microorganisms through various mechanisms such as competition and the synthesis of bacteriocins, bacteriophages. The disequilibrium of the flora can be prevented with the administration of live microbial cultures, these crops are called Probiotics.
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ORIGIN OF THE PROBIOTICS
Hippocrates (460 BC-377 BC), the Greek doctor considered to be the creator of true Medicine, said: "Make your food your medicines and make your medicines your food"
Élie Metchnikoff (1845-1916) was a Russian zoologist and microbiologist who was awarded the Nobel Prize in Medicine and Physiology in 1908.
But Metchnikoff is as much or more known by others of his discoveries: he worked in the Bacteriological Institute of Odessa (1886-1887) and in the Pasteur Institute (1885-1916), of which he became its director, and the last decade of his Life fixed its attention on the fact that in Bulgaria there was an incredible number of centenarians, despite being one of the poorest European countries. The reason for that extraordinary longevity could not be the quality of their medical services either. But, what was evident was that the Bulgarians consumed large amounts of yogurt, which contains lactic fermenting bacteria. Metchnikoff managed to isolate the bacteria responsible for the production of yogurt and used it for his research. It was the official start of Probiotics.
Metchnikoff became a strong advocate of the concept that diet can protect the body from invading pathogens and consequently improve and prolong the quality of life. He was the first person to develop a therapeutic preparation using lactobacillus in the form of a capsule to ingest orally called Lactobacillin.
In 1965 Lilly and Stillwell used the term Probiotic for the first time, to name the products of gastric fermentation. This word is derived from two words, Latin -pro- meaning by or in favor of, and from Greek -bios- which means life.
This definition was modified and the term Probiotics was redefined as microorganisms and compounds that participate in the balance and intestinal microbial development. In 1989 R. Fuller defined the Probiotics as: "Those living microorganisms, mainly bacteria and yeast, which are added as a supplement in the diet and which beneficially affect the development of the microbial flora in the intestine"
And in 1998 the ILSI (International Life Science Institute, of the European Union) in Brussels defined Probiotics as live microorganisms, which when ingested in sufficient quantities, have beneficial effects on health, which goes beyond the nutritional effects conventional Affect beneficially to one or several functions of the organism. They provide a better state of health and well-being and / or reduce the risk of disease. They can be functional for the population in general or for particular groups of the same. It must be mentioned that, to be considered as Probiotic, a bacterium has to survive the strongly acid medium of the stomach and colonize the small and large intestine.
BACKGROUND
It was known, for example, that if it was administered to a newborn mouse, which still does not have microorganisms in its intestine, a culture with a habitual cause of acute diarrhea (E. coli) almost instantaneously died. If instead of giving it, was administered in conjunction with a natural inhabitant of the intestine, the mouse was still alive, because the second competed ecologically with the first and digested the dangerous toxins that segregated the latter.
Also known for some time, by the action of yogurt, the digestive and normalizing properties of lactic bacilli on intestinal function. Under these circumstances, it was entirely natural for children with diarrhea to be thought of in dealing with them. From there to the fermented milk there was only one step.
The central idea of Dr. Oliver, extremely simple but revolutionary, was to propose the ecological normalization of intestinal flora, altered in children with diarrhea, by the implantation of lactic bacilli in his intestine.
The lactic bacilli that were selected for the treatment were not the Bulgarian strains of the common yogurt. It was thought of Lactobacillus casei, which - unlike the bacilli of yogurt - are part of the normal intestinal flora. For this reason, while the Bulgarian Lactobacilli are only transit through the intestine, disappearing when their intake is suspended, the strain chosen tends to remain and reproduce in it, that is, to be implanted, colonizing permanently once administered.
The CERELA researchers prepared a concentrated culture of Lactobacilli casei that they sent to the hospital's lactate to be incorporated into the pasteurized milk that the small patients took, in the dose of one teaspoon per bottle. It was called CERELA, as was the Center.
We have also known for a long time, by the action of yogurt, the digestive and normalizing properties of lactic bacilli on intestinal function. In these circumstances, it is natural to think about treating children with diarrhea with Lactobacilli.
PROBIOTIC MICROORGANISMS
- Lactobacillus acidophilus
- Lactobacillus casei var. Shirota
- Lactobacillus fermentum
- Lactobacillus casei
- Lactobacillus crispatus
- Lactobacillus reuteri
- Lactobacillus rhamnosus
- Lactobacillus plantarum
- Lactobacillus bulgaricus
- Lactobacillus cellobiosus
- Lactobacillus curvatus
- Lactobacillus lactis cremoris
- Lactobacillus GG
- Bifidobacteria
- Bifidobacterium longum
- Bifidobacteria adolescentis
- Bifidobacteria animalis
- Bifidobacteria infantis
- Bifidobacteria bifidum
- Streptococcus salivaris
- Streptococcus faecium
- Streptococcus diacetylactis
- Streptococcus intermedius
- Saccharomyces boulardii
EFFECTS OF PROBIOTICS IN VARIOUS PATHOLOGIES
The effects of the Probiotics are several including the modification of the flora avoiding the pathogenic colonization, the prevention of the imbalance of the intestinal flora, the reduction of the incidence and duration of diarrhea, the maintenance of the integrity of the mucous membranes, the modulation of the immunity by avoiding bacterial translocation, the production of vitamins such as B2, B6 and biotin, the assimilation of trace elements and the antitumor activity.
NUTRITIONAL EFFECTS
A. LACTOSE INTOLERANCE
About 70% of the world population, presents intolerance to lactose, related to the decrease of the activity of lactase in the intestinal mucosa, genetically determined. The undigested Lactose is fermented by the intestinal flora, with production of water, fatty acids and gas, which cause symptoms such as abdominal pain, flatulence and diarrhea.
The Probiotics contribute to improve the digestion of lactose and reduce the symptoms due to malabsorption, thanks to the Lactobacillus possess an enzymatic activity (lactase) that continues to function in the intestine and allows the digestion of sugar, which allows people with Lactose intolerance can consume milk, a source rich in proteins, vitamins and calcium; avoiding eventual symptoms such as diarrhea, abdominal pain, flatulence, etc.
The probiotics that act in the fermentation of yogurt such as Lactobacillus bulgaricus and S. thermophilus possess the enzyme. Lactobacillus and bifidobacteria have a favorable effect on the digestion of Lactose
B. REDUCTION OF CHOLESTEROL LEVELS
Some probiotics can exert hypocholesterolemic effects, that is, they contribute to the reduction of blood cholesterol in three different ways:
- Using cholesterol in the intestine and thus reducing its absorption
- Increasing the excretion of bile salts
- Producing volatile fatty acids in the colon that can be absorbed and interfere with the metabolism of lipids in the liver.
PROTECTIVE EFFECTS
Probiotics are microorganisms that stimulate the protective functions of the digestive tract, are also known as bioterapeutics, bioprotectors or bioprophylactic, are used to prevent enteric and gastrointestinal infections. In order for a microorganism to fulfill this protection function, it must possess characteristics such as: Being a normal inhabitant of the intestine, having a short time of reproduction, being able to produce antimicrobial compounds and being stable during the production, marketing and distribution process for that can be alive in the intestine.
The protection of these microorganisms is carried out through two mechanisms: The antagonism that prevents the multiplication of pathogens and the production of toxins that impede their pathogenic action. This antagonism is given by competition for nutrients or adhesion sites. Through immunomodulation they protect the host from infections by inducing an increase in the production of immunoglobulins, increased activation of mononuclear cells and lymphocytes.
The lactic acid bacteria can transiently colonize the intestine and survive during intestinal transit. Moreover, due to their adhesion to the epithelium, they modify the local immune response of the host.
Certain Probiotics can stimulate the immunity of the individual both at the intestinal level and at a general level, which translates into a higher production of antibodies and a better defense. Several studies suggest that the consumption of Probiotics could help to regulate the alterations of the immune system that are observed in cases of allergy and, therefore, to reduce the symptoms associated with this pathology.
Certain lactic bacteria protect the intestine against pathogens in different ways:
- Competing for physical space and nutrients
- Producing antibiotic substances active against these pathogens
- Stimulating the immune system of the intestine
- Contributing to the acidification of the colon content, which is unfavorable for the growth of pathogens
- Inactivation of certain toxins released by pathogens.
3. ANTICARCINOGENETIC EFFECTS
Probiotics seem to have anticarcinogenic activity through the production of certain substances during their growth, which would act by reducing procarcinogenic substances by direct action on them. A known example is the passage of nitrites in foods to nitrosamines, carcinogenic substances. Lactobacteria are able to act both chemically and enzymatically on nitrites, and bifidobacteria are able to unfold nitrosamines. Therefore, these Probiotic microorganisms decrease the carcinogenic substances.
Also secondary bile salts from the degradation of bile have been linked as colon cancer initiating substances. In this sense, it is considered that a high number of lactobacilli in the intestine can reduce the biotransformation of bile salts and therefore decrease the risk of suffering from this type of cancer.
Probiotics can act on procarcinogenic substances indirectly through the enzymatic system that transforms procarcinogenéticos into carcinogenéticos. It has been seen that the consumption of probiotics causes a decrease in the enzymes that make the transition from procarcinogenic to carcinogenic, resulting in a decrease in carcinogenic substances.
4. PROBIOTICS ALSO INHIBIT THE PROLIFERATION OF TUMOR CELLS
The Probiotics do not only have an anticarcinogenic action, but also show an antagonistic action on the proliferation of tumor cells, perhaps due to stimulation of the immune system both locally (intestine), as systemic or general level. In this regard, experiments with animals fed yogurt have resulted in an increase in the percentage and antibacterial activity of B lymphocytes.
The results of several studies carried out by Ian Rowland and collaborators (1998), of the School of Biomedical Sciences of the University of Ulster, in Northern Ireland, confirm how Probiotic principles can positively influence the reduction of tumor incidence. humans. In their experiments with rats they have observed that the joint administration of lactobacilli or bifidobacteria and azoxymethane, a colon carcinogenic agent, reduces the incidence of cancer foci in these. Even the combination of bifidobacteria and inulin, substrate for the growth of bifidobacteria, has been shown to be more effective than either treatment alone. In these studies, dietary treatments were provided after exposure to carcinogens, from which the suggestion is derived that during the activation phase of the carcinogenic process a protective effect was being exerted.
5. EFFECTS OF PROBIOTICS IN GASTROINTESTINAL PATHOLOGIES
A. ACUTE DIARRHEA
Diarrhea modifies the normal function of the gastrointestinal tract such as: Digestion, absorption and immunomodulation, to combat diarrhea, strategies such as antibiotics are used, implying the risk of developing resistance and reducing the non-pathogenic flora. The use of Probiotics represents a promising alternative in the prevention and treatment of diarrhea
Effect of the probiotic on acute diarrhea
- Production of Antibacterial Substances: Bacteriocins, Lactocins, Helveticins, Bifidines
- Production of fatty acids that acidify the intestinal lumen, inhibiting bacteria and maintaining the proper functioning of the intestinal mucosa.
- Decreased Intestinal Permeability
- Competitive Action
- Immunomodulation Increase in Ig A, Regulation of Cytokines and the immune response.
Bioterapeutic Probiotic Microorganism
Lactobacillus casei, Lactobacillus rhamnosus LGG, Bifidobacterium, S. thermophilus, Lactobacillus reuteri, Lactobacillus delbruckii
B. DIARRHEA ASSOCIATED WITH ANTIBIOTICS
The use of antibiotics can cause diarrhea, by altering the balance of the intestinal flora with decrease in Lactobacillus and Bifidobacteria, which are responsible for the resistance to colonization by pathogens, producing infections by opportunistic microorganisms such as:
- Clostridium difficile
- Klepsiella oxytoca
- perfringens
- S. aureus
- Candida sp.
- Salmonella sp.
- The Probiotics studied in the prevention of these diarrheas are Lactobacillus and Saccharomyces boulardii
C. TRAVELER'S DIARRHEA
Many travelers may develop acute diarrhea when visiting high risk areas, most cases is not severe, however prophylaxis is effective according to studies, by administration of Lactobacillus rhamnosus and Saccharomyces boulardii
D. INTESTINAL INFLAMMATORY DISEASE
Genetic predisposition, immunological alterations and pathogenic bacteria interact as triggering and perpetuating agents of inflammatory bowel disease.
The administration of Probiotics used as a therapy of bacterial antagonism, is able to displace the bacteria with pathogenic potential, with the subsequent increase of bifidobacteria, favorably modifying the exaggerated inflammatory response, improving the intestinal epithelium and decreasing its symptoms.
Probiotics with biotherapeutic effect:
Lactobacillus reuteri, Lactobacillus plantarum, Lactobacillus brevis, Bifidobacterium adolecentis, Saccharomyces boulardii
E. INFECTION BY Helicobacter Pylori
Gram-negative pathogen responsible for gastritis, peptic ulcer and gastric cancer. In vitro and human studies have shown that Probiotics have an antagonistic effect against H. pylori, inhibiting their gastric colonization and preventing the development of the related pathology, they inhibit the activity of the enzyme urease, necessary for the pathogen to remain in the environment stomach acid
Probiotic antagonists: Lactobacillus salivarius and Lactobacillus johnsonii
BIOTERAPEUTIC PROPERTIES
- Prevention and treatment of infectious diseases
- Decrease in cholesterol levels.
- Decreased diarrhea, either by viruses, bacteria or parasites.
- Treatment of lactose intolerance, acts in the digestion of lactose
- Stimulation of the immune system.
- Exclusion or reduction of pathogenic adhesion
- Persistence and multiplicity.
- Production of acids, hydrogen peroxide and bacteriocins antagonists to pathogenic growth.
- Formation of a balanced intestinal flora.
- Prevention of certain allergic manifestations
- Prevention of colon cancer
- Treatment against tumors
- They have antimicrobial effects.
- They have the ability to stick to cells
WHO CAN USE PROBIOTICS?
The use of Probiotics is recommended to anyone who wants to favor the balance of the intestinal flora. In people with antibiotic treatment, in the elderly, in pregnancy, in intestinal disturbances, to improve the intolerance to the latose. It is also used to reduce the effects of diarrhea and constipation, in inflammatory bowel diseases since modulating the intestinal flora increases the production of immunoglobulin A and these patients have decreased lactobacilli.
DOSE
Functional foods prepared with Probiotics must contain at least 10 million viable cells per 100 ml, ideal dose to achieve the desired effects and increase natural defenses, however the dose will depend on the microorganism used, the way of consumption and the desired effect.
One of the studies carried out in the University Corporation of Santander UDES Cúcuta in Colombia for the program of Bacteriology with children of 1-5 years of the I.C.B.F. It resulted that the dose of 1.4 * 1010 cell / ml of Lactobacillus casei was the ideal concentration to reduce the cases of diarrhea in 81% caused by intestinal pathogenic parasites (Giardia lamblia)
As Elie Metchnikoff said: "If the expected and intended effects do not appear, at least the consumer will be satisfied by the good taste of the product." Health!
THE IDEAL PROBIOTICS
For a probiotic to be ideal it must survive the gastrointestinal tract. Arriving intact to the intestine is lodged there for what needs to have the property of adherence to the epithelium to be able to colonize and thus increase the acidity, which prevents the development of bacteria that cause disease and above all things, must be innocuous. In the majority, the Probiotics are lactic acid bacteria, which constitute an important percentage of the native flora of the human intestine. Lactobacillus casei acts at the level of the small intestine and Bifidobacterium at the level of the colon.
To properly select the Probiotic supplement, it must be in refrigeration (liquid or capsules), the "freeze drying" preparations are more stable and maintain their properties for longer. It is advisable to check the expiration date, because if they have been stored for a long time, they may lose their beneficial effects.
The Most Employed Probiotic
Lactobacillus acidophilus is one of the most popular Probiotics and besides its benefits to the intestinal tract, it is noted:
Production of vitamin B complex (B6, B12, folic acid, riboflavin, Niacin, Biotin and pantothenic acid, improves calcium absorption, produces enzymes such as lactase, which helps the digestion of milk protein (lactose) and improve the symptoms of Irritable Bowel Syndrome, produces natural antibiotics that help in the control of intestinal pathogenic bacteria, helps in the digestion of food and control of intestinal candidiasis.
The Acidófilus can be consumed in the form of dairy products such as yogurt, cottage cheese and is also on sale in stores of natural products in the form of liquid or capsules, which provide a higher concentration of bacteria than milk, yogurt with Acidophilus or other cultured dairy products.
In addition to Lactobacillus acidophylus yogurt contains two other classes of beneficial bacteria that are: Lactobacillus bulgaricus and Streptococcus thermophilus, which help in the digestion of milk carbohydrates, property desired for those who suffer from protein intolerance of the milk (lactose) Look on the label of yogurt for the words: "live cultures" (active cultures) or "active cultures" (active cultures) and avoid products that have been heated during processing, since heat destroys beneficial bacteria.
Many people take Acidofilus when they travel to other countries, as a prevention for intestinal infections and as an aid for the recovery of the digestive tract, after a treatment with antibiotics, especially broad-spectrum antibiotics. It is also recommended to women with vaginal infections.
DEVELOPMENT OF FERMENTED MILK WITH PROBIOTICS
These probiotic bacteria develop very well in a milk medium. The first of these special milks is the maternal one: studies carried out on infants fed with breast milk, showed that in the intestine of these children there are bacteria (such as bifidobacteria) that made them less susceptible to infections than to children fed other milk . Therefore, another of the probiotic options found in the gondolas are fermented milks, added with bacteria. One of them, the biotic milk, has Argentine citizenship, more precisely from Tucumán and was developed by Dr. Guillermo Oliver, a researcher at CERELA (Center of reference for lactobacilli) dependent on Conicet, and his team, which investigated the issue to alleviate some of the child malnutrition and the terrible diarrheas that are experienced in the Argentine Northwest, but unfortunately are a universal heritage. For this last reason, in parallel, other similar milks, such as those that emerged in 1995, were added to GG in other parts of the world. All these milks defeat the pathogenic microorganisms, regulate the intestinal balance, facilitate the digestibility of food, increase the tolerance to lactose, improve the immunity of the digestive and respiratory systems and favor the absorption of calcium. In short, benefits that far exceed the nutritional values of conventional milks.
ADVERSE EFFECTS
It must be taken into account that they are living organisms and theoretically may be responsible for adverse effects, such as infections and metabolic disorders. There have been isolated cases of septicemia due to S. boulardii and Lactobacillus.
PRODUCTION AND SCALING OF PROBIOTIC MICROORGANISMS
- Selection and / or isolation of the Strain
- Activation
- Cell Count
- Propagation
- Scaling
- Drying
- Lyophilization
- Feasibility tests, purity, pathogenicity
- Control of process variables
PROSPECTS AND INVESTIGATIONS
- Establishment of a maximum, safe and permissible intake
- Study of the transitory and permanent effects of the Probiotics.
- Establishment of the safety and security of long-term probiotic foods
- Investigation of new strains of Probiotics
- Specific studies of risk reduction of diseases sufficiently reliable and sensitive.
- Study of functional foods and their regulations or legislation for commercialization.