Winclove publicaties

Onze publicaties

Onze onderzoekers bereiken regelmatig doorbraken op het gebied van microbiota-management, gepubliceerd in wetenschappelijke, peer-reviewed artikelen.

Publications in general

The Development of High-Quality Multispecies Probiotic Formulations: From Bench to Market

Auteurs: Lukas Grumet, Yorick Tromp, Verena Stiegelbauer

Jaar: 2020

Tijdschrift: Nutrients

Samenvatting:

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. To date, there is an increasing number of commercially available products containing probiotics on the market. Probiotics have been recommended by health care professionals for reasons ranging from their long-term immunomodulatory effects to proven benefits in the management of different health conditions. For probiotic products, there are several important aspects that determine the success rate of the development from bench to market. The aim of this review is to explore how the current knowledge on microbe–microbe and host–microbe interactions can be used to develop high-quality, evidence-based probiotic formulations, specifically probiotic dietary supplements, with a focus on the selection of safe strains with relevant functional properties. In addition, we will highlight aspects of the probiotic manufacturing process that need to be considered during the product development and the subsequent manufacturing process to guarantee consistent efficacy of a probiotic product. For each high-quality probiotic formulation, it is important to screen multiple strains, and select only those strains that show relevant functional properties and that can be considered safe for human consumption. In addition, it is imperative that attention is paid to the product development and manufacturing process, and that safety and quality properties are monitored. Importantly, the beneficial effects of probiotics should be evaluated in product efficacy studies and post-marketing surveys in order to demonstrate their clinical efficacy. All these aspects need to be evaluated and validated during the development of a successful high-quality and ready-to-market probiotic.

Next Generation Probiotics for Butyrate Production in the Gut

Auteurs: Eva M Gómez del Pulgar, Eleni Tsompanidou, Hermie JM Harmsen

Jaar: 2019

Tijdschrift: EC Nutrition

Samenvatting:

Health beneficial effects of Short Chain Fatty Acids (SCFAs) produced in the gut, especially butyrate, and their decreased abundance in several gut-related disorders makes them a potent approach for disease management and prevention. New insights into the microbiome have enlightened the path for new probiotic formulations based on the combined actions (cross feeding interactions) of different human gut commensals to increase SCFAs concentrations in the colon. In this line, the Novobiome consortium was created in order to overcome technical and regulatory challenges to bring these next-generation probiotics (NGPs) to the market to complete the suite of probiotic products for supporting a healthy gut microbiome.

Cross-feeding amongst probiotic bacterial strains on prebiotic inulin involving the extracellular exo-inulinase of Lactobacillus paracasei strain W20

Auteurs: Markus C.L. Boger, Alicia Lammerts van Bueren, Lubbert Dijkhuizen

Jaar: 2018

Tijdschrift: Applied and Environmental Microbioligy

Samenvatting:

Probiotic gut bacteria employ specific metabolic pathways to degrade dietary carbohydrates, beyond capabilities of their human host. Here we report how individual commercial probiotic strains degrade prebiotic (inulin type) fructans. First a structural analysis of the commercial fructose oligosaccharides/inulin samples used was performed.

These β(2-1) fructans differ in termination by either a glucose (GF) or a fructose residue (FF), with a broad variation in degree of polymerization (DP). Growth of individual probiotic bacteria on short-chain (sc)Inulin (Frutafit® CLR), a β(2-1) fructan (DP2-40), was studied. Lactobacillus salivarius W57 and other bacteria grew relatively poorly on scInulin with only fractions of DP3 and DP5 utilized, reflecting uptake via specific transport systems followed by intracellular metabolism.

Lactobacillus paracasei W20 completely used all scInulin components employing an extracellular exo-inulinase enzyme (glycoside hydrolase family GH32, LpGH32; also found in other strains of this species); the purified enzyme converted high DP compounds into fructose, sucrose, 1-kestose and F2 (inulobiose). Co-cultivation of L. salivarius W57 and L. paracasei W20 on scInulin resulted in cross-feeding of the former by the latter, supported by this extracellular exo-inulinase.

The extent of cross-feeding depended on the type of fructan, i.e. GF type (clearly stimulating) versus FF-type (relatively low stimulus), and on fructan chain-length, since relatively low DP β(2-1) fructans contain a relatively high content of GF-type molecules, thus resulting in higher concentrations of GF-type DP2-3 degradation products. The results provide an example of how in vivo cross-feeding on prebiotic β(2-1) fructans may occur amongst probiotic lactobacilli.

Microscopic colitis – microbiome, barrier function and associated diseases

Auteurs: Saskia van Hemert, Karolina Zydecha-Skonieczna, Igor Loniewski, Piotr Szredzki, Wojciech Marlicz

Jaar: 2017

Tijdschrift: Annuals of Translational Medicine

Samenvatting:

Microscopic colitis (MC) is a chronic inflammatory bowel disease (IBD) with little in terms of endoscopic abnormalities and is frequently associated with other autoimmune diseases. The peak incidence of the disease is in middle aged or older populations, mostly females. The pathogenesis of MC is complex, multifactorial and poorly understood. Current concepts revolve around innate immunity or microbiome alterations as well as gut barrier dysfunction, all of which lead to the development of subtle inflammatory lesions in gut mucosa. The results of numerous basic and clinical studies involving molecular techniques as well as advanced endoscopic imaging revealed the important role of both intrinsic (e.g., hormonal) as well as extrinsic (e.g., NSAIDs and PPIs) factors in the modulation of gastrointestinal microbiome and MC pathogenesis. Capsule endoscopy as well confocal endomicroscopy imaging, alongside standard endoscopic techniques offer new tools in the evaluation of MC patients and allow their better stratification for novel treatment protocols based on modulation of gut microbiome and barrier function.

How do probiotics and prebiotics function at distant sites?

Auteurs: G.Reid, T. Abrahamsson, M. Baily, L.B. Bindels, R. Bubnov, et al.

Jaar: 2017

Tijdschrift: Beneficial Microbes

Samenvatting:

The realisation that microbes regarded as beneficial to the host can impart effects at sites distant from their habitat, has raised many possibilities for treatment of diseases. The objective of a workshop hosted in Turku, Finland, by the International Scientific Association for Probiotics and Prebiotics, was to assess the evidence for these effects and the extent to which early life microbiome programming influences how the gut microbiota communicates with distant sites. In addition, we examined how probiotics and prebiotics might affect the skin, airways, heart, brain and metabolism. The growing levels of scientific and clinical evidence showing how microbes influence the physiology of many body sites, leads us to call for more funding to advance a potentially exciting avenue for novel therapies for many chronic diseases.

Women and Their Microbes: The Unexpected Friendship

Auteurs: J. Younes, E. Lievens, R. Hummelen, G. Reid, M.I. Petrova

Jaar: 2017

Tijdschrift: Trends in Microbiology

Samenvatting:

Communities of microbiota have been associated with numerous health outcomes, and while much emphasis has been placed on the gastrointestinal niche, there is growing interest in the microbiome specific for female reproductive health and the health of their offspring. The vaginal microbiome plays an essential role not only in health and dysbiosis, but also potentially in successful fertilization and healthy pregnancies. In addition, microbial communities have been isolated from formerly forbidden sterile niches such as the placenta, breast, uterus, and Fallopian tubes, strongly suggesting an additional microbial role in women’s health. A combination of maternally linked prenatal, birth, and postnatal factors, together with environmental and medical interventions, influence early and later life through the microbiome. Here, we review the role of microbes in female health focusing on the vaginal tract and discuss how male and female reproductive microbiomes are intertwined with conception and how mother–child microbial transfer is a key determinant in infant health, and thus the next generation.

D-tryptophan from probiotic bacteria influences the gut microbiome and allergic airway disease

Auteurs: Inge Kepert, Juliano FonsecaConstanze Muller, Katrin Milger, Kerstin Hochwind, Matea Kostric, Maria Fedoseeva, Caspar Ohnmacht, Stefan Dehmel, Petra Nathan, Sabine Bartel, Oliver Eick

Jaar: 2016

Tijdschrift: Journal of Allergy and Clinical Immunology

Samenvatting:

Background: Chronic immune diseases, such as asthma, are highly prevalent. Currently available pharmaceuticals improve symptoms but cannot cure the disease. This prompted demands for alternatives to pharmaceuticals, such as probiotics, for the prevention of allergic disease. However, clinical trials have produced inconsistent results. This is at least partly explained by the highly complex crosstalk among probiotic bacteria, the host’s microbiota, and immune cells. The identification of a bioactive substance from probiotic bacteria could circumvent this difficulty.

Objective: We sought to identify and characterize a bioactive probiotic metabolite for potential prevention of allergic airway disease.

Methods: Probiotic supernatants were screened for their ability to concordantly decrease the constitutive CCL17 secretion of a human Hodgkin lymphoma cell line and prevent upregulation of costimulatory molecules of LPS-stimulated human dendritic cells.

Results: Supernatants from 13 of 37 tested probiotic strains showed immunoactivity. Bioassay-guided chromatographic fractionation of 2 supernatants according to polarity, followed
by total ion chromatography and mass spectrometry, yielded C11H12N2O2 as the molecular formula of a bioactive substance. Proton nuclear magnetic resonance and enantiomeric
separation identified D-tryptophan. In contrast, L-tryptophan and 11 other D-amino acids were inactive. Feeding Dtryptophan to mice before experimental asthma induction increased numbers of lung and gut regulatory T cells, decreased lung TH2 responses, and ameliorated allergic airway inflammation and hyperresponsiveness. Allergic airway inflammation reduced gut microbial diversity, which was increased by D-tryptophan.

Conclusions: D-tryptophan is a newly identified product from probiotic bacteria. Our findings support the concept that defined bacterial products can be exploited in novel preventative
strategies for chronic immune diseases.

Intestinal microbiota in human health and disease: the impact of probiotics

Auteurs: Gerritsen, JSmidt, HRijkers, G.T, Vos, de W.M

Jaar: 2011

Tijdschrift: Genes & Nutrition

Samenvatting:

Abstract The complex communities of microorganisms that colonise the human gastrointestinal tract play an important role in human health. The development of culture- independent molecular techniques has provided new insights in the composition and diversity of the intestinal microbiota. Here, we summarise the present state of the art on the intestinal microbiota with specific attention for the application of high-throughput functional microbiomic
approaches to determine the contribution of the intestinal microbiota to human health. Moreover, we review the association between dysbiosis of the microbiota and both intestinal and extra-intestinal diseases. Finally, we discuss the potential of probiotic microorganism to modulate the intestinal microbiota and thereby contribute to health and well-being. The effects of probiotic consumption on the intestinal microbiota are addressed, as well as the development of tailor-made probiotics designed for specific aberrations that are associated with microbial dysbiosis

Monostrain, multistrain and multispecies probiotics —A comparison of functionality and efficacy

Auteurs: Timmerman, H.M, Koning, C.J.MMulder, L, Rombouts, F.M, Beynen, A.C

Jaar: 2004

Tijdschrift: International Journal of Food Microbiology

Samenvatting:

This literature review was carried out to make a comparison of functionality and efficacy between monostrain, multistrain and multispecies probiotics. A monostrain probiotic is defined as containing one strain of a certain species and consequently multistrain probiotics contain more than one strain of the same species or, at least of the same genus. Arbitrarily, the term
multispecies probiotics is used for preparations containing strains that belong to one or preferentially more genera. Multispecies probiotics were superior in treating antibiotic-associated diarrhea in children. Growth performance and particularly mortality in broilers could be improved with multistrain probiotics. Mice were better protected against S. Typhimurium infection with a multistrain probiotic. A multispecies probiotic provided the best clearance of E. coli O157:H7 from lambs. Rats challenged with S. Enteritidis showed best post-challenge weight gains when treated with a multispecies probiotic. Possible mechanisms underlying the enhanced effects of probiotic mixtures are discussed. It is also emphasized that strains used in multistrain and multispecies probiotics should be compatible or, preferably, synergistic. The design and use of multistrain and multispecies probiotics should be encouraged.

Ecologic ® BARRIER

Probiotics-induced changes in gut microbial composition and its effects on cognitive performance after stress: exploratory analyses

Auteurs: Mirjam Bloemendaal, Joanna Szopinska-Tokov, Clara Belzer, David Boverhoff, Silvia Papalini, Franziska Michels, Saskia van Hemert, Alejandro Arias Vasquez, Esther Aarts

Jaar: 2021

Tijdschrift: Translational Psychiatry

Samenvatting:

Stress negatively affects cognitive performance. Probiotics remediate somatic and behavioral stress responses, hypothetically by acting on the gut microbiota. Here, in exploratory analyses, we assessed gut microbial alterations after 28-days supplementation of multi-strain probiotics (EcologicBarrier consisting of Lactobacilli, Lactococci, and Bifidobacteria in healthy, female subjects (probiotics group n = 27, placebo group n = 29). In an identical pre-session and post-session, subjects performed a working memory task before and after an acute stress intervention. Global gut microbial beta diversity changed over time, but we were not able to detect differences between intervention groups. At the taxonomic level, Time by Intervention interactions were not significant after multiple comparison correction; the relative abundance of eight genera in the probiotics group was higher (uncorrected) relative to the placebo group: Butyricimonas, Parabacteroides, Alistipes, Christensenellaceae_R-7_group, Family_XIII_AD3011_group, Ruminococcaceae_UCG-003, Ruminococcaceae_UCG-005, and Ruminococcaceae_UCG-010. In a second analysis step, association analyses were done only within this selection of microbial genera, revealing the probiotics-induced change in genus Ruminococcaceae_UCG-003 was significantly associated with probiotics’ effect on stress-induced working memory changes (rspearman(27) = 0.565; pFDR = 0.014) in the probiotics group only and independent of potential confounders (i.e., age, BMI, and baseline dietary fiber intake). That is subjects with a higher increase in Ruminococcaceae_UCG-003 abundance after probiotics were also more protected from negative effects of stress on working memory after probiotic supplementation. The bacterial taxa showing an increase in relative abundance in the probiotics group are plant fiber degrading bacteria and produce short-chain fatty acids that are known for their beneficial effect on gut and brain health, e.g., maintaining intestinal-barrier and blood–brain-barrier integrity. This study shows that gut microbial alterations, modulated through probiotics use, are related to improved cognitive performance in acute stress circumstances.

Psychobiotics for Patients with Chronic Gastrointestinal Disorders Having Anxiety or Depression Symptoms

Auteurs: Viet Hang Dao, Long Bao Hoang, Thi Oanh Trinh, Thi Thu Trang Tran, Van Long Dao

Jaar: 2021

Tijdschrift: Journal of Multidisciplinary Healthcare

Samenvatting:

Using psychobiotics to modify the gut microbiome has been shown to improve the anxiety and depression situation of patients with chronic gastrointestinal (GI) symptoms. This study evaluated changes in depression, anxiety, GI symptomss and side effects when patients used a multispecies probiotics product.

Gut feelings: A randomised, triple-blind, placebo-controlled trial of probiotics for depressive symptoms

Auteurs: Chahwan, B, Kwan, S, Isik, A, Hemert van, S, Burke, C, Roberts, L

Jaar: 2019

Tijdschrift: Journal of Affective Disorders

Samenvatting:

Background: Depression is the leading cause of disability worldwide; with evidence suggesting that decreased gut barrier function and inflammation are correlated with depressive symptoms. We conducted a clinical trial to determine the effect of consumption of probiotic supplements (Winclove's Ecologic® Barrier) on depressive symptoms in a sample of participants with mild to severe depression.
Method: 71 participants were randomly allocated to either probiotic or placebo, which was, consumed daily over eight weeks. Pre- and post-intervention measures of symptoms and vulnerability markers of depression as well as gut microbiota composition were compared. Clinical trial participants were also compared on psychological variables and gut microbiota composition to a non-depressed group (n=20).
Results: All clinical trial participants demonstrated improvement in symptoms, suggesting non-specific therapeutic effects associated with weekly monitoring visits. Participants in the probiotic group demonstrated a significantly greater reduction in cognitive reactivity compared with the placebo group, particularly in the mild/ moderate subgroup. Probiotics did not significantly alter the microbiota of depressed individuals, however, a significant correlation was found between Ruminococcus gnavus and one depression metric.
Limitations: There was a high attrition rate, which may be attributed to weekly monitoring visits. Additionally, modulation of the gut microbiota may need more specific testing to distinguish subtle changes.
Conclusions: While microbiota composition was similar between all groups, probiotics did affect a psychological variable associated with susceptibility to depression. Further research is needed to investigate how probiotics can be utilised to modify mental wellbeing, and whether they can act as an adjunct to existing treatments.

The antidepressant-like effect of probiotics and their faecal abundance may be modulated by the cohabiting gut microbiota in rats

Auteurs: Abildgaard, A, Kern, T, Pedersen, O, Hansen, T, Wegener, G, Lund, S

Jaar: 2019

Tijdschrift: European Neuropsychopharmacology

Samenvatting:

Numerous studies have been published describing the effect of various probiotics (PRO) on behaviours related to psychiatric disease. We have previously shown a robust antidepressant- like effect of PRO in rats, but over time, the treatment effect seems to vary significantly between different sets of rats from the same commercial vendor. Therefore, we hypothesised that the antidepressant-like response may be modulated by the cohabiting gut microbiota. The aims of the present study were (1) to investigate any differences in the gut microbiota composition between responders (Resp) and non-responders (Non-resp) to PRO with regards to depressive-like behaviour, and (2) to evaluate the effects of PRO on the microbiota composi- tion. Two sets of 20 male Sprague-Dawley rats each were treated with multi-species PRO (nine Bi- fidobacterium, Lactococcus and Lactobacillus species) for eight weeks and subjected to a be- havioural assessment. Faecal samples were collected for 16 s rRNA (VR4) gene amplicon se- quencing (Illumina MiSeq).

Stress matters: Randomized controlled trial on the effect of probiotics on neurocognition

Auteurs: Papalini, S., Michels, F., Kohn, N., Wegman, J., van Hemert S., Roelofs, K, Arias-Vasquez A., Aarts, E.

Jaar: 2019

Tijdschrift: Neurobiology of Stress

Samenvatting:

Probiotics are microorganisms that provide health benefits when consumed. In animals, probiotics reverse gut microbiome-related alterations in depression-like symptoms, in cognition, and in hormonal stress response. However, in humans, a causal understanding of the gut-brain link in emotion and cognition is lacking. Additionally, whether the effects of probiotics on neurocognition are visible only in presence of stress, remains unclear. We investigated the effects of a multispecies probiotic (Ecologic®Barrier) on specific neurocognitive measures of emotion reactivity, emotion regulation, and cognitive control using fMRI. Critically, we also tested
whether probiotics can buffer against the detrimental effects of acute stress on working memory. In a double blind, randomized, placebo-controlled, between-subjects intervention study, 58 healthy participants were tested once before and once after a 28-day intervention.
Without stress induction, probiotics did not affect brain, behavioral, or related self-report measures. However, relative to placebo, the probiotics group did show a significant stress-related increase in working memory performance after supplementation. This change was associated with intervention-related neural changes in frontal cortex during cognitive control exclusively in the probiotics group. Overall, our results show neurocognitive effects of a multispecies probiotic in healthy women only under challenging situations, buffering against the detrimental effects of stress on cognition.

Influence of a multistrain probiotic on body composition and mood in female occupational shift workers

Auteurs: Smith-Ryan, A, Mock, M.G, Trexler, E.T, Hirsch, K.R, Blue, M.N.M

Jaar: 2018

Tijdschrift: Applied Physiology, Nutrition, and Metabolism

Samenvatting:

This study sought to investigate the effects of a multistrain probiotic on body composition, regional adiposity, and a series of associated metabolic health outcomes. Female health care workers employed on a rotating-shift schedule (n = 41) completed baseline anthropometric assessments; a fasted blood draw; questionnaires to assess anxiety, depression (Hospital Anxiety and Depression Scale), and fatigue (Chalder Fatigue Survey); and an exercise fatigue test. Identical post-tests occurred following 6 weeks of daily supplementation with placebo (PLA) or probiotics (2.5 × 109 CFU/g) containing 9 bacterial strains (PRO; Ecologic Barrier) combined with a prebiotic carrier matrix. PRO attenuated fat mass increases (change (), 0.14 kg; confidence
interval (CI) –0.46 to 0.75 kg) compared with PLA (, 0.79 kg; CI 0.03–1.54 kg), whereas modest reductions in visceral adiposity resulted for both PRO and PLA. Metabolic biomarkers (total cholesterol, high-density lipoprotein, glucose, adiponectin, C-reactive protein, interleukin-6, leptin) were not influenced by either treatment (p > 0.05). Nonsignificant, but potentially
clinically relevant, improvements in anxiety (, –2.3 ± 2.63) and fatigue (, –4.8 ± 5.5) were observed with PRO; exercise performance was unaffected. Results indicate a potential protective effect of probiotics against fat mass gain. Probiotics may alleviate anxiety and fatigue in shift-working females.

Probiotics reduce risk-taking behavior in the Elevated Plus Maze in the Flinders Sensitive Line rat model of depression

Auteurs: Sandra Tillmann, Gregers Wegener

Jaar: 2018

Tijdschrift: Behavioural Brain Research

Samenvatting:

Several studies have reported beneficial effects of probiotics on behavior and stress in humans and animals. The multi-strain probiotic product Ecologic® Barrier has shown antidepressant-like effects in rats when given in combination with high-fat diet. To circumvent the need for high-fat diet for future clinical use, the present study aimed to potentiate the behavioral effects of Ecologic® Barrier by developing a customized product that includes four additional bacterial species known to be associated with depression.

Flinders Sensitive Line (FSL) rats, an animal model of depression, were randomized to receive vehicle, Ecologic® Barrier, or the customized product Ecologic® Barrier + 4. The control strain, Flinders Resistant Line rats, received vehicle to ascertain the depressive-like phenotype of FSL rats. Behavior was tested in the Elevated Plus Maze, Y-Maze, Novel Object Recognition Test, Open Field, and Forced Swim Test; HPA-axis reactivity was assessed by the Dexamethasone Suppression Test. Our results indicate that both probiotic products reduced open arm exploration in the Elevated Plus Maze, suggesting a reduction in risk-taking behavior.

There were no intervention effects on cognition, locomotion, or depressive-like behavior. Moreover, all intervention groups had similar plasma corticosterone concentrations following the Dexamethasone Suppression Test. There was no difference between the two probiotic products, suggesting that the addition of four bacterial strains to Ecologic® Barrier did not potentiate its effect. Future studies should further investigate the effects of probiotics on risk-taking behavior and gain more mechanistic insights by studying individual strains and their cumulative contributions to the overall effect of a multi-strain product.

Probiotic treatment protects against the pro-depressant-like effect of high-fat diet in Flinders Sensitive Line rats

Auteurs: Anders Abildgaard, Betina Elfving, Marianne Hokland, Sten Lund, Gregers Wegener

Jaar: 2017

Tijdschrift: Brain, Behavior, and Immunity

Samenvatting:

Major depressive disorder (MDD) is highly associated with dysmetabolic conditions, such as obesity and diabetes mellitus type 2, and the gut microbiota may interact with both disease entities. We have previously shown that a high-fat diet (HFD) exacerbated depressive-like behaviour uniquely in Flinders Sensitive Line (FSL) rats that inherently present with an increased level of depressive-like behaviour compared with Flinders Resistant Line (FRL) rats.
We therefore investigated whether multispecies probiotics possessed anti-depressant-like effect in FSL rats or protected against the pro-depressant-like effect of HFD. We also examined blood and cerebral T cell subsets as well as plasma cytokines. Lastly, we investigated the effect of HFD in outbred Sprague- Dawley (SD) rats to substantiate the association between depressive-like behaviour and any immunological measures affected by HFD.
HFD exacerbated the depressive-like behaviour in FSL rats in the forced swim test, whereas SD rats remained unaffected. Probiotic treatment completely precluded the pro-depressant-like effect of HFD, but it did not affect FSL rats on control diet. Cerebral T lymphocyte CD4/8 ratios closely mirrored the behavioural changes, whereas the proportions of Treg and Th17 subsets were unaltered. No association between blood and brain CD4/8 ratios were evident; nor did plasma cytokine levels change as a consequence of HFD of probiotic treatment.
Our findings suggest that MDD may hold a dysmetabolic component that responds to probiotic treatment. This finding has wide implications owing to the high metabolic comorbidity in MDD. Furthermore, the close association between depressive-like behaviour and cerebral T cell populations demonstrate lymphocyte-brain interactions as a promising future research area in the field of psychoneuroimmunology.

Probiotic treatment reduces depressive-like behaviour in rats independently of diet

Auteurs: Abildgaard A., Elfving B., Hokland M., Wegener G., Lund S.

Jaar: 2017

Tijdschrift: Psychoneuroendocrinology

Samenvatting:

The gut microbiota has recently emerged as an important regulator of brain physiology and behaviourin animals, and ingestion of certain bacteria (probiotics) therefore appear to be a potential treatment formajor depressive disorder (MDD). However, some conceptual and mechanistical aspects need furtherelucidation.We therefore aimed at investigating whether the habitual diet may interact with the effect of pro-biotics on depression-related behaviour and further examined some potentially involved mechanismsunderlying the microbe-mediated behavioural effects.Forty male Sprague-Dawley rats were fed a control (CON) or high-fat diet (HFD) for ten weeks andtreated with either a multi-species probiotic formulation or vehicle for the last five weeks.Independently of diet, probiotic treatment markedly reduced depressive-like behaviour in the forcedswim test by 34% (95% CI: 22–44%). Furthermore, probiotic treatment skewed the cytokine production bystimulated blood mononuclear cells towards IFN, IL2 and IL4 at the expense of TNF and IL6. In addition,probiotics lowered hippocampal transcript levels of factors involved in HPA axis regulation (Crh-r1, Crh-r2 and Mr), whereas HFD increased these levels. A non-targeted plasma metabolomics analysis revealedthat probiotics raised the level of indole-3-propionic acid, a potential neuroprotective agent.Our findings clearly support probiotics as a potential treatment strategy in MDD. Importantly, theefficacy was not attenuated by intake of a “Western pattern” diet associated with MDD. Mechanistically,the HPA axis, immune system and microbial tryptophan metabolism could be important in this context.Importantly, our study lend inspiration to clinical trials on probiotics in depressed patients.

The effects of the multispecies probiotic mixture Ecologic®Barrier on migraine: results of an open-label pilot study

Auteurs: N.M. de Roos1, C.G.T. Giezenaar, J.M.P. Rovers, B.J.M. Witteman, M.G. Smits and S. van Hemert

Jaar: 2015

Tijdschrift: Beneficial Microbes

Samenvatting:

Migraine prevalence is associated with gastrointestinal disorders. Possible underlying mechanisms could be increased gut permeability and inflammation. Probiotics may decrease intestinal permeability as well as inflammation, and therefore may reduce the frequency and/or intensity of migraine attacks. Therefore we assessed feasibility, possible clinical efficacy, and adverse reactions of probiotic treatment in migraine patients. 29 migraine patients took 2 g/d
of a probiotic food supplement (Ecologic®Barrier, 2.5×109 cfu/g) during 12 weeks. Participants recorded frequency and intensity of migraine in a headache diary and completed the Migraine Disability Assessment Scale (MIDAS) and Henry Ford Hospital Headache Disability Inventory (HDI) at baseline and after 12 weeks of treatment. Compliance was measured every 4 weeks by counting the remaining sachets with probiotics. The study was completed by 27/29 (93%) patients who took 95% of the supplements. Obstipation was reported by 4 patients during the first 2 weeks of treatment only. The mean±standard deviation (SD) number of migraine days/month decreased significantly from 6.7±2.4 at baseline to 5.1±2.2 (P=0.008) in week 5-8 and 5.2±2.4 in week 9-12 (P=0.001). The mean±SD intensity of migraine decreased significantly from 6.3±1.5 at baseline to 5.5±1.9 after treatment (P=0.005). The MIDAS score improved from 24.8±25.5 to 16.6±13.5 (P=0.031). However, the mean HDI did not change significantly. In conclusion, probiotics may decrease migraine supporting a possible role for the intestine in migraine management. Feasibility and lack of adverse reactions justify further placebo-controlled studies.

A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood

Auteurs: Laura Steenbergen, Roberta Sellaro, Saskia van Hemert, Jos A. Bosch, Lorenza S. Colzato

Jaar: 2015

Tijdschrift: Brain, Behavior, and Immunity

Samenvatting:

Background: Recent insights into the role of the human microbiota in cognitive and affective functioning have led to the hypothesis that probiotic supplementation may act as an adjuvant strategy to ameliorate or prevent depression.

Objective: Heightened cognitive reactivity to normal, transient changes in sad mood is an established marker of vulnerability to depression and is considered an important target for interventions. The present study aimed to test if a multispecies probiotic containing Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, and Lactococcus lactis (W19 and W58) may reduce cognitive reactivity in non-depressed individuals.

Design: In a triple-blind, placebo-controlled, randomized, pre and
post-intervention assessment design, 20 healthy participants without current mood disorder
received a 4-week probiotic food-supplement intervention with the multispecies probiotics, while 20 control participants received an inert placebo for the same period. In the pre- and post-intervention assessment, cognitive reactivity to sad mood was assessed using the revised Leiden index of depression sensitivity scale.

Results: Compared to participants who received the placebo intervention, participants who received the 4-week multispecies probiotics intervention showed a significantly reduced overall cognitive reactivity to sad mood, which was largely accounted for by reduced rumination and aggressive thoughts.

Conclusion: These results provide the first evidence that the intake of probiotics may help reduce negative thoughts associated with sad mood. Probiotics supplementation warrants further research as a potential preventive strategy for depression.

Ecologic ® BARRIER for Metabolic Health

Effects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double blind, placebo controlled pilot study

Auteurs: Angela Horvath, Bettina Leber, Nicole Feldbacher, Norbert Tripolt, Florian Rainer, Andreas Blesl, Markus Trieb, Gunther Marsche, Harald Sourij, Vanessa Stadlbauer

Jaar: 2020

Tijdschrift: European Journal of Nutrition

Samenvatting:

Purpose Diabesity, the combination of obesity and type 2 diabetes, is an ever-growing global health burden. Diabesityassociated dysbiosis of the intestinal microbiome has gained attention as a potential driver of disease and, therefore, a possible therapeutic target by means of pro- or prebiotic supplementation. This study tested the efects of a multispecies synbiotic (i.e. a combination of probiotics and prebiotics) on glucose metabolism, gut microbiota, gut permeability, neutrophil function and quality of life in treatment-experienced diabesity patients.

Methods A randomized, double-blind, placebo-controlled pilot study with 26 diabesity patients was conducted in which patients received a daily dose of a multispecies probiotic and a prebiotic (or a placebo) for 6 months.

Results There were no changes in glucose metabolism or mixed meal tolerance test responses throughout the study. The analysis of secondary outcomes revealed benefcial efects on hip circumference [−1 (95% CI −4; 3) vs +3 (−1; 8) cm, synbiotics vs. placebo, respectively, p=0.04], serum zonulin [−0.04 (−0.2; 0.1) vs +0.3 (−0.05; 0.6) ng/ml, p=0.004)] and the physical role item of the SF36 quality of life assessment [+5.4 (−1.7; 12.5) vs −5.0 (−10.1; 0.2) points, p=0.02] after 3 months of intervention, and lipoprotein (a) [−2.1 (−5.7; 1.6) vs +3.4 (−0.9; 7.9) mg/dl, p=0.02] after 6 months. There were no signifcant diferences in alpha or beta diversity of the microbiome between groups or time points. Conclusions Glucose metabolism as the primary outcome was unchanged during the intervention with a multispecies synbiotic in patients with diabesity. Nevertheless, synbiotics improved some symptoms and biomarkers of type 2 diabetes and aspects of quality of life suggesting a potential role as adjuvant tool in the management of diabesity.

The Multispecies Probiotic E ectively Reduces Homocysteine Concentration in Obese Women: A Randomized Double-Blind Placebo-Controlled Study

Auteurs: Karolina Majewska, Matylda Kregielska-Naro˙zna, Hieronim Jakubowski, Monika Szulinska, Pawel Bogdanski.

Jaar: 2020

Tijdschrift: Journal of clinical medicine

Samenvatting:

Dysregulated metabolism of homocysteine (Hcy) is associated with obesity.
Supplementation with probiotics can potentially be a natural therapeutic method for metabolic
disorders. The precise mechanism in which microbiota a ect Hcy metabolism in obese individuals is
still unknown. The aim of this study was to evaluate the e ects of a 12-week supplementation with a
multispecies probiotic on Hcy levels, oxidative stress, inflammation and lipid profile in obese patients.
This randomized double-blind placebo-controlled trial was performed on 50 obese women (aged
45–70 years). Subjects were randomly assigned to take either a multispecies probiotic supplement
(n = 25) or placebo (n = 25) for 12 weeks. The probiotic contained nine bacterial strains containing
2.5 109 CFU/g. Biochemical and anthropometric measurements were carried out at baseline and
after 12 weeks of intervention. At the end of the study, a significant decrease in Hcy, tumor necrosis
factor (TNF- ), total cholesterol (TC), low-density lipoprotein cholesterol (LDL) and triglyceride
(TG) levels were observed in the probiotic group. The amelioration of total antioxidant status (TAS)
was also observed. The 12-week supplementation of the multispecies probiotic (Ecologic® BARIER)
e ectively reduced Hcy concentration, oxidative stress and inflammation, and improved the lipid
profile. These multidirectional e ects can potentially reduce cardiometabolic risks.

Multispecies Probiotic Supplementation Favorably Affects Vascular Function and Reduces Arterial Stiffness in Obese Postmenopausal Women-A 12-Week Placebo-Controlled and Randomized Clinical Study

Auteurs: Monika Szulińska, Igor Łoniewski, Katarzyna Skrypnik, Magdalena Sobieska. Katarzyna Korybalska, Joanna Suliburska, Paweł Bogdański

Jaar: 2018

Tijdschrift: Nutrients

Samenvatting:

Obesity in the postmenopausal period is associated with an increased risk of cardiovascular diseases in women. One of the key drivers of cardiovascular risk is endothelial dysfunction; thus, this is also a crucial point for studies on new therapeutic methods of cardioprotective properties. The aim of the current study was to evaluate the effect of two doses of multispecies probiotic Ecologic® Barrier supplement on functional (primary endpoint) and biochemical parameters (secondary endpoint) of endothelial dysfunction in obese postmenopausal women in a 12-week randomized, placebo-controlled clinical trial. A total of 81 obese Caucasian women participated in the trial. The subjects were randomly assigned to three groups that received a placebo, a low dose (LD) (2.5 × 10⁸ colony forming units (CFU) per day), or a high dose (HD) (1 × 1010 CFU per day) of lyophilisate powder containing live multispecies probiotic bacteria. The probiotic supplement was administered each day for 12 weeks in two equal portions. A high dose probiotic supplementation for 12 weeks decreased systolic blood pressure, vascular endothelial growth factor, pulse wave analysis systolic pressure, pulse wave analysis pulse pressure, pulse wave analysis augmentation index, pulse wave velocity, interleukin-6, tumor necrosis factor alpha, and thrombomodulin. Low doses of probiotic supplementation decreased the systolic blood pressure and interleukin-6 levels. The mean changes in the estimated parameters, compared among the three groups, revealed significant differences in the vascular endothelial growth factor, the pulse wave analysis systolic pressure, the pulse wave analysis augmentation index, the pulse wave velocity, the tumor necrosis factor alpha, and thrombomodulin. The post hoc tests showed significant differences for all parameters between HD and the placebo group, and HD and LD (besides pulse wave analysis augmentation index). We show for the first time that supplementation with multispecies probiotic Ecologic® Barrier favorably modifies both functional and biochemical markers of vascular dysfunction in obese postmenopausal women.

Dose-Dependent Effects of Multispecies Probiotic Supplementation on the Lipopolysaccharide (LPS) Level and Cardiometabolic Profile in Obese Postmenopausal Women: A 12-Week Randomized Clinical Trial

Auteurs: Monika Szulińska, Igor Łoniewski. Saskia van Hemert, Magdalena Sobieska, Paweł Bogdánski

Jaar: 2018

Tijdschrift: Nutrients

Samenvatting:

During the postmenopausal period, the risk of cardiovascular diseases is increased in many obese women and is associated with a worse cardiometabolic profile and a sub-chronic low-grade systemic inflammation caused by a gut barrier permeability dysfunction. Here, we tested whether administration of two different dosages of the multispecies probiotic Ecologic® Barrier influenced the cardiometabolic biochemical parameters and lipopolysaccharide levels, the latter used as a marker of increased gut permeability in obese postmenopausal women. A total of 81 obese Caucasian postmenopausal women participated in the trial. The subjects were randomly assigned to three groups that received a placebo, a low dose (LD) (2.5 × 109 colony forming units (CFU) per day), or a high dose (HD) (1 × 1010 CFU per day) of lyophilisate powder containing live multispecies probiotic bacteria. The probiotic supplement was administered each day in two equal portions for 12 weeks. We found significant (p < 0.05) favorable changes (mostly large or medium effects) in the evaluated parameters in both the HD and LD groups but not in the placebo group. In the HD group, lipopolysaccharide, waist, fat mass, subcutaneous fat, uric acid, total cholesterol, triglycerides, low-density lipoprotein cholesterol, glucose, insulin, and insulin-resistant index (HOMA-IR) were improved. Similar changes were observed in the LD group, except for lipopolysaccharide, uric acid, triglycerides, and glucose levels. Additionally, significant differences were observed in both groups in terms of fat percentage and visceral fat. When the mean changes were compared between the three groups, statistically significant differences in lipopolysaccharide levels, uric acid, glucose, insulin, and HOMA-IR were found. Post hoc tests revealed significant differences in the mean changes (mostly medium effects) between the HD and LD groups for uric acid, glucose, insulin, and HOMA-IR. In the 12-week randomized, placebo-controlled, double-blind intervention, we observed that supplementation with the multispecies probiotic Ecologic® Barrier favorably affected the risk factors in a dose-dependent manner, showing beneficial effects on the cardiometabolic parameters and gut permeability of the patients. Our results suggest that this product can be effective in the prevention and treatment of cardiovascular diseases in obese postmenopausal women.

Effects of a 6-month multi-strain probiotics supplementation in endotoxemic, inflammatory and cardiometabolic status of T2DM patients: A randomized, double-blind, placebo-controlled trial

Auteurs: Shaun Sabico, Ayah Al-Mashharawi, Nasser M Al-Daghri, Kaiser Wani, Osama E. Amer, Danish S. Hussain, Mohammed Ghouse Ahmed Ansari, Mohammad S. Masoud, Majed S. Alokail, Philip G. McTernan

Jaar: 2018

Tijdschrift: Clinical Nutrition

Samenvatting:

Objective: The aim of this trial was to characterize the beneficial effects of probiotics on decreasing

endotoxin levels and other cardiometabolic parameters in Arab patients with type 2 diabetes mellitus (T2DM).

Methods: Saudi adults with naïve T2DM (n ¼ 30; 12 males and 18 females) were randomly allocated to receive twice daily placebo or 2.5 109 cfu/g of Ecologic®Barrier (multi-strain probiotics; n ¼ 31; 14

males and 17 females) in a double-blind manner over a 6 month period, respectively. Anthropometrics were measured and fasting blood samples were collected to analyze endotoxin, glycemic parameters [glucose, insulin, c-peptide and homeostasis model assessment for insulin resistance (HOMA-IR)], lipids [triglycerides, total cholesterol, low and high-density lipoprotein (LDL and HDL, respectively) cholesterol and total/HDL-cholesterol ratio], inflammatory markers [tumor-necrosis factor-alpha (TNF-a), interleukin-6 (IL-6) and C-reactive protein (CRP)] and adipocytokines [leptin, adiponectin and resistin] at baseline and after 3 and 6 months of intervention.

Results: Multi-strain probiotics supplementation for 6 months caused a significant decrease in circulating levels of endotoxin by almost 70% over 6 months, as well as glucose (38%), insulin (38%), HOMA-IR (64%), triglycerides (48%), total cholesterol (19%), total/HDL-cholesterol ratio (19%), TNF-a (67%), IL-6 (77%), CRP (53%), resistin (53%), and a significant increase in adiponectin (72%) as compared with baseline. Only HOMA-IR had a clinically significant reduction (3.4, 64.2%) in the probiotics group as compared to placebo group at all time points. No other clinically significant changes were observed between the probiotic or placebo group at 3 and 6 months in other markers.

Conclusion: Multi-strain probiotic supplementation over 6 months as a monotherapy significantly

decreased HOMA-IR in T2DM patients, with the probiotic treatment group highlighting reduced

inflammation and improved cardiometabolic profile. As such, multi-strain probiotics is a promising

adjuvant anti-diabetes therapy.

Influence of a multistrain probiotic on body composition and mood in female occupational shift workers

Auteurs: Smith-Ryan, A Mock, M.G Trexler, E.T Hirsch, K.R Blue, M.N.M

Jaar: 2018

Tijdschrift: Applied Physiology, Nutrition, and Metabolism

Samenvatting:

This study sought to investigate the effects of a multistrain probiotic on body composition, regional adiposity, and a series of associated metabolic health outcomes. Female health care workers employed on a rotating-shift schedule (n = 41) completed baseline anthropometric assessments; a fasted blood draw; questionnaires to assess anxiety, depression (Hospital Anxiety and Depression Scale), and fatigue (Chalder Fatigue Survey); and an exercise fatigue test. Identical post-tests occurred following 6 weeks of daily supplementation with placebo (PLA) or probiotics (2.5 × 109 CFU/g) containing 9 bacterial strains (PRO; Ecologic Barrier) combined with a prebiotic carrier matrix. PRO attenuated fat mass increases (change (), 0.14 kg; confidence
interval (CI) –0.46 to 0.75 kg) compared with PLA (, 0.79 kg; CI 0.03–1.54 kg), whereas modest reductions in visceral adiposity resulted for both PRO and PLA. Metabolic biomarkers (total cholesterol, high-density lipoprotein, glucose, adiponectin, C-reactive protein, interleukin-6, leptin) were not influenced by either treatment (p > 0.05). Nonsignificant, but potentially
clinically relevant, improvements in anxiety (, –2.3 ± 2.63) and fatigue (, –4.8 ± 5.5) were observed with PRO; exercise performance was unaffected. Results indicate a potential protective effect of probiotics against fat mass gain. Probiotics may alleviate anxiety and fatigue in shift-working females.

Effects of a multi-strain probiotic supplement for 12 weeks in circulating endotoxin levels and cardiometabolic profiles of medication naïve T2DM patients: a randomized clinical trial

Auteurs: Shaun Sabico, Ayah Al-Mashharawi, Nasser M Al-Daghri, Sobhy Yakout, Abdullah M Alnaami, Majed S Alokail, Philip G McTernan

Jaar: 2017

Tijdschrift: Journal of Translational Medicine

Samenvatting:

Background: The present randomized clinical trial characterized the beneficial effects of a multi-strain probiotics supplementation on improving circulating endotoxin levels (primary endpoint) and other cardiometabolic biomarkers (secondary endpoint) in patients with T2DM.

Methods: A total of 78 adult Saudi T2DM patients (naïve and without co-morbidities) participated in this clinical trial and were randomized to receive twice daily placebo or probiotics [(2.5 × 109 cfu/g) containing the following bacterial strains: Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19 and Lactococcus lactis W58 (Ecologic®Barrier)] in a double-blind manner for 12 weeks. Anthropometrics and cardiometabolic profiles were obtained at baseline and after 12/13 weeks of treatment.

Results: After 12/13 weeks of intervention and using intention-to-treat analysis, no difference was noted in endotoxin levels between groups [Placebo – 9.5% vs. Probiotics – 52.2%; (CI – 0.05 to 0.36; p = 0.15)]. Compared with the placebo group however, participants in the probiotics groups had a significant but modest improvement in WHR [Placebo 0.0% vs. Probiotics 1.11%; (CI – 0.12 to – 0.01; p = 0.02)] as well as a clinically significant improvement in HOMA-IR [Placebo – 12.2% vs. Probiotics – 60.4%; (CI – 0.34 to – 0.01; p = 0.04)].

Conclusion: Using a multi-strain probiotic supplement daily for 12/13 weeks significantly improved HOMA-IR and modestly reduced abdominal adiposity among medication naïve T2DM patients.

Influence of the Multispecies Probiotic Ecologic® BARRIER on Parameters of Intestinal Barrier Function

Auteurs: Saskia van Hemert, Geline Ormel

Jaar: 2014

Tijdschrift: Food and Nutrition Sciences

Samenvatting:

The intestinal epithelium is a single cell layer that forms the largest and most important barrier against the external environment. A proper functioning of the intestinal barrier is essential for maintaining optimal health. A disrupted intestinal barrier function has been associated with the development of autoimmune and inflammatory diseases. Probiotics are live microorganisms that confer a health benefit to the host and have been associated with prevention of diseases such as antibiotic-associated diarrhea, irritable bowel syndrome and inflammatory bowel disease. Probiotics can improve and restore the intestinal barrier function in diverse ways and effects are thought to be species- and even strain-specific. With this research the influence of probiotic bacteria in Ecologic® BARRIER on parameters of intestinal barrier function was investigated. The results show that each bacterial strain in Ecologic® BARRIER is in vitro capable to improve the epithelial barrier in diverse ways.

Ecologic ® AAD

Multispecies probiotics promote perceived human health and wellbeing: insights into the value of retrospective studies on user experiences

Auteurs: A.M. van der Geest, I. Besseling-van der Vaart, E.M. Schellinger-de Goede, M.B. van der Waal, E. Claassen, J. Flach, L.H.M. van de Burgwal

Jaar: 2021

Tijdschrift: Beneficial Microbes

Samenvatting:

When taking a broader perspective on the societal impact of probiotics, engagement of end-users is important to discover unmet needs, define relevant health benefits and identify key considerations for successful implementation in daily practice. This study therefore takes a retrospective approach and analyses a database of user experiences to review the effects of four multispecies probiotic formulations. The user experiences were analysed in a dependent sample manner (without control group) and complement previous randomised controlled trials that have been performed with the formulations. The database consisted of 584 evaluable user experiences regarding the impact of probiotic supplementation on perceived quality of life (QoL), gastrointestinal (GIT) symptoms and reported stool consistency after two weeks of consumption. Two different scales were used (n=344 in a 5-point scale; n=240 in a 10-point scale), which are presented as separate analyses. In the combined population of the 5-point-scale questionnaire, a significant increase in perceived QoL and a significant reduction in perceived GIT symptoms was observed. Descriptive summaries also indicate that diarrhoea- and constipation-like stool patterns are reduced following supplementation. Moreover, half of participants indicated that probiotic supplementation had a positive effect on their unmet medical need, and 64% of users were likely to continue using the product. Similar results were observed in the 10-point scale questionnaire. Considering the clinical relevance of probiotic supplementation in specific target groups, subgroup analyses were performed on participants who consumed the products for diarrhoea, constipation, Inflammatory Bowel Disease, Irritable Bowel Syndrome, and antibiotic usage. Overall, findings support the potential of probiotics to advance perceived human health and support the daily wellbeing of users. This systematic analysis of user experiences thereby contributes to the external validity of studies evaluating clinical effects of probiotics and increases knowledge on their societal impact.

Use of a multi-species probiotic * For the prevention of antibiotic associated diarrhea

Auteurs: Lang F.C.

Jaar: 2020

Tijdschrift: Nutrafoods

Samenvatting:

Previous experience in our hospital and in the literature indicate an incidence of diarrhea between 5% and 50% after antibiotic treatment (depending on the antibiotic used). In the present study, a total of 199 patients receiving antibiotic treatment after surgical intervention received additionally to their antibiotic treatment daily two sachets of the multispecies probiotic MSP. The application of MSP reduced the incidence of diarrhea to 0.5% (1 patient out of the199 probands). The probiotic administration was forgotten in two subjects, both generated AAD (with evidence of Clostridium difficile in one subject). In conclusion, the use of the multispecies probiotic for primary prevention of AAD was found to be successful. Prevention of AAD in this manner promises to result in a reduction of overall costs for health care.

Probiotics use for antibiotic-associated diarrhea: a pragmatic participatory evaluation in nursing homes

Auteurs: Herman A. van Wietmarschen, Martine Busch, Annemiek van Oostveen, Gerda Pot, Miek C. Jong

Jaar: 2020

Tijdschrift: BMC Gastroenterology

Samenvatting:

Background
Antibiotic-associated diarrhea (AAD) occurs in 2–25% of nursing home residents, which may lead to dehydration, malnutrition, severe complications and hospitalizations. Research shows that probiotics can be effective and safe in reducing AAD. However, probiotics are not routinely used in Dutch nursing homes. The objectives of this evaluation were to develop a procedure for the implementation of probiotics to prevent AAD in nursing homes, to evaluate effects on AAD occurrence, and to evaluate the implementation process of probiotics in daily care.

Methods
A pragmatic participatory evaluation (PPE) design was chosen, as it seemed a suitable approach for implementation of probiotics, as well as for evaluation of its effectiveness in daily nursing home practice. Probiotics administration was implemented in three nursing homes of the Rivas Zorggroep for residents with somatic and/or psychogeriatric conditions. Ninety-three residents provided data on 167 episodes of antibiotics use, of which 84 episodes that included supplementation with probiotics and 83 episodes with no probiotics supplementation. A
multispecies probiotics was administered twice daily upon start of antibiotic treatment, up to 1 week after completing the antibiotics course. The occurrence of AAD was monitored and a process evaluation was conducted to assess facilitators and barriers of probiotics implementation.

Results
The number of episodes with AAD when using probiotics was significantly lower than when no probiotics was used (20% vs 36%; p = 0,022, Chi-square). No significant differences in the occurrence of AAD were found between the residents taking amoxicillin/clavulanic acid or ciprofloxacin. Reported facilitators for implementation were perceived benefits of probiotics and prescription by medical staff. Reported challenges were probiotics intake by residents and individual decision-making as to which resident would benefit from it.

Conclusion
Successful implementation of probiotics demonstrated the prevention of AAD in nursing home
residents.

Effect of a multispecies probiotic on reducing the incidence of antibiotic-associated diarrhoea in children: a protocol for a randomised controlled trial

Auteurs: Jan Łukasik, Hania Szajewska

Jaar: 2018

Tijdschrift: BMJ Open

Samenvatting:

Introduction: Certain individual probiotic strains have been proven to be effective in reducing the risk of antibiotic-associated diarrhoea (AAD). However, the effects of using multispecies probiotics (MPs) remain unclear. We aim to assess the effectiveness of a specific MP preparation (Winclove 612) in reducing the incidence of AAD in children.

Methods and analysis: A total of 350 children aged 6 months to 18 years, undergoing antibiotic treatment, will be randomly allocated to receive either a MP consisting of two strains of Bifidobacterium (B. bifidum W23 and B. lactis W51) and six strains of Lactobacillus (L. acidophilus W37, L. acidophilus W55, L. paracasei W20, L. plantarum W62, L. rhamnosus W71 and L. salivarius W24) at a total dose of 1010 colony-forming units daily, or a placebo, from the first day of antibiotic treatment until 7 days after antibiotic cessation, up to a maximum of 17 days. The primary outcome will be the incidence of AAD, defined as ≥3 loose or watery stools (a score of A on the Amsterdam Infant Stool Scale or a score of 5–7 on the Bristol Stool Form scale) in 24 hours, caused either by Clostridium difficile or of otherwise unexplained aetiology, occurring during the intervention period. The secondary outcomes will include the incidence of AAD according to alternative definitions; the incidence of any kind of diarrhoea; the duration of diarrhoea; the need for hospitalisation; intravenous rehydration or discontinuation of antibiotic treatment due to diarrhoea; adverse events; and the intestinal microbiota composition.

Ethics and dissemination: The study protocol is approved by the Ethics Committee of the Medical University of Warsaw. The findings will be published in a peer-reviewed journal and submitted to relevant conferences.

Date and protocol version identifier: 14/10/2017.

Trial registration number: NCT03334604; Pre-results.

Probiotics in Clostridium difficile infection: reviewing the need for a multistrain probiotic

Auteurs: Hell M., Bernhofer C. et al

Jaar: 2013

Tijdschrift: Beneficial Microbes

Samenvatting:

In the past two years an enormous amount of molecular, genetic, metabolomic and mechanistic data on the host-bacterium interaction, a healthy gut microbiota and a possible role for probiotics in Clostridium difficile infection (CDI) has been accumulated. Also, new hypervirulent strains of C. difficile have emerged. Yet, clinical trials in CDI have been less promising than in antibiotic associated diarrhoea in general, with more meta-analysis than primary papers on CDI-clinical-trials. The fact that C. difficile is a spore former, producing at least three different toxins has not yet been incorporated in the rational design of probiotics for (recurrent) CDI. Here we postulate that the plethora of effects of C. difficile and the vast amount of data on the role of commensal gut residents and probiotics point towards a multistrain mixture of probiotics to reduce CDI, but also to limit (nosocomial) transmission and/or endogenous reinfection. On the basis of a retrospective chart review of a series of ten CDI patients where recurrence was expected, all patients on adjunctive probiotic therapy with multistrain cocktail (Ecologic®AAD/OMNiBiOTiC® 10) showed complete clinical resolution. This result, and recent success in faecal transplants in CDI treatment, are supportive for the rational design of multistrain probiotics for CDI.

Probiotics during and after antibiotics use

Auteurs: Koning C.J.K.

Jaar: 2011

Tijdschrift: Nutracos

Samenvatting:

Each individual has a unique, relatively stable, intestinal microbiota which plays an important role in human health. One of the side effects of antibiotic intake is a disturbance of this microbiota which can result in antibiotic-associated diarrhoea (AAD). It was widely assumed that these disturbances were short-term but recently medium and long-term disturbances have been described. The exact clinical consequences of these microbiota disturbances are not yet clear but they are associated with a multitude of disorders such as IBS and allergy. Knowledge of the effect of antibiotics on the intestinal microbiota and ways of restoring their unique composition are therefore of clinical importance. A RTC performed by the Maastricht University Medical Centre showed that the probiotic Ecologic® AAD was not only able to reduce AAD but also to restore the intestinal microbiota towards the pre-antibiotic state.

The Effect of a Multispecies Probiotic on the Intestinal Microbiota and Bowel Movements in Healthy Volunteers Taking the Antibiotic Amoxycillin

Auteurs: Koning, C.J.M., Jonkers, D.M.,A.E. et al.

Jaar: 2007

Tijdschrift: American Journal of Gasterology

Samenvatting:

One of the side effects of antimicrobial therapy is a disturbance of the intestinal microbiota potentially resulting in antibiotic-associated diarrhea (AAD). In this placebo-controlled double-blind study, the effect of a multispecies probiotic on the composition and metabolic activity of the intestinal microbiota and bowel habits was studied in healthy volunteers taking amoxycillin. Forty-one healthy volunteers were given 500 mg amoxycillin twice daily for 7 days and were randomized to either 5 g of a multispecies probiotic, Ecologic AAD (109cfu/g), or placebo, twice daily for 14 days. Feces and questionnaires were collected on day 0, 7, 14, and 63. Feces was analyzed as to the composition of the intestinal microbiota, and β-glucosidase activity, endotoxin concentration, Clostridium difficile toxin A, short chain fatty acids (SCFAs), and pH were determined. Bowel movements were scored according to the Bristol stool form scale. Mean number of enterococci increased significantly from log 4.1 at day 0 to log 5.8 (day 7) and log 6.9 (day 14) cfu/g feces (P<0.05) during probiotic intake. Although no other significant differences were observed between both intervention groups, within each group significant changes were found over time in both microbial composition and metabolic activity. Moreover, bowel movements with a frequency ≥3 per day for at least 2 days and/or a consistency ≥5 for at least 2 days were reported less frequently in the probiotic compared to the placebo group (48% vs 79% P<0.05). Apart from an increase in enterococci no significant differences in microbial composition and metabolic activity were observed in the probiotic compared with the placebo group. However, changes over time were present in both groups, which differed significantly between the probiotic and the placebo arm, suggesting that the amoxycillin effect was modulated by probiotic intake. Moreover, the intake of a multispecies probiotic significantly reduced diarrhea-like bowel movements in healthy volunteers receiving amoxycillin.

Ecologic ® PANDA

Probiotics for indigestion in pregnancy and infant colic

Auteurs: Hannes Hofmann

Jaar: 2015

Tijdschrift: Gynaecology

Samenvatting:

• Benefit for pregnant women: Probiotics significantly reduce frequency of flatulence and
constipation in the last months of pregnancy.
• Benefit for newborns and infants: Specific intestinal synbiotics for the preventive treatment of 3
month colic.
• Probiotic bacteria significantly reduce diseases of the allergic spectrum – confirmed multiple times in clinical studies.

Long Term Development of Gut Microbiota Composition in Atopic Children: Impact of Probiotics

Auteurs: N. B. M. M. Rutten, D. M.W. Gorissen, A. Eck, L. E. M. Niers, A. M. Vlieger, I. Besseling-van der Vaart, A. E. Budding, P. H. M. Savelkoul, C. K. van der Ent, G. T. Rijkers

Jaar: 2015

Tijdschrift: PLoSONE

Samenvatting:

Introduction. Imbalance of the human gut microbiota in early childhood is suggested as a risk factor for immune-mediated disorders such as allergies. With the objective to modulate the intestinal microbiota, probiotic supplementation during infancy has been used for prevention of allergic diseases in infants, with variable success. However, not much is known about the long-term consequences of neonatal use of probiotics on the microbiota composition. The aim of this study was to assess the composition and microbial diversity in stool samples of infants at high-risk for atopic disease, from birth onwards to six years of age, who were treated with probiotics or placebo during the first year of life.

Methods. In a double-blind, randomized, placebo-controlled trial, a probiotic mixture consisting of B. bifidum W23, B. lactis W52 and Lc. Lactis W58 (Ecologic® Panda) was administered to pregnant women during the last 6 weeks of pregnancy and to their offspring during the first year of life. During follow-up, faecal samples were collected from 99 children over a 6-year period with the following time points: first week, second week, first month, three months, first year, eighteen months, two years and six years. Bacterial profiling was performed by IS-pro. Differences in bacterial abundance and diversity were assessed by conventional statistics.

Results. The presence of the supplemented probiotic strains in faecal samples was confirmed, and the probiotic strains had a higher abundance and prevalence in the probiotic group during supplementation. Only minor and short term differences in composition of microbiota were found between the probiotic and placebo group and between children with or without atopy. The diversity of Bacteroidetes was significantly higher after two weeks in the placebo group, and at the age of two years atopic children had a significantly higher Proteobacteria diversity (p < 0.05). Gut microbiota development continued between two and six years, whereby microbiota composition at phylum level evolved more and more towards an adult-like configuration.

Conclusion. Perinatal supplementation with Ecologic® Panda, to children at high-risk for atopic disease, had minor effects on gut microbiota composition during the supplementation period. No long lasting differences were identified. Regardless of intervention or atopic disease status, children had a shared microbiota development over time determined by age that continued to develop between two and six years

Probiotic supplementation influences faecal short chain fatty acids in infants at high risk for eczema

Auteurs: H.K. Kim, N.B.M.M. Rutten, I. Besseling-van der Vaart, L.E.M. Niers, Y.H. Choi, G.T. Rijkers and S. van Hemert

Jaar: 2015

Tijdschrift: Beneficial Microbes

Samenvatting:

The composition of the gut microbiota plays a role in the development of allergies. Based on the immunomodulating capacities of bacteria, various studies have investigated the potential role for probiotics in the prevention of childhood eczema. In a previous study we have shown that significantly less children developed eczema after probiotic supplementation Bifidobacterium bifidum W23, Bifidobacterium animalis subsp. lactis W52 and Lactococcus
lactis W58, Ecologic®Panda) at three months of age as compared to controls. Here, metabolites in faecal samples of these 3-month old children were measured by 1H-nuclear magnetic resonance to investigate possible gut metabolic alterations. Lower amounts of short-chain fatty acids (SCFAs), succinate, phenylalanine and alanine were found in faecal samples of children later developing eczema, whereas the amounts of glucose, galactose, lactate and lactose
were higher compared to the children not developing eczema. Although these differences were already present at the age of 3 months, eczema did not develop in the majority of children before the age of 1 year. Supplementation of multispecies probiotics seems to induce higher levels of lactate and SCFAs, and lower levels of lactose and succinate when compared with the placebo group. This might explain the temporary preventive effect of probiotics
on the development of eczema. These results highlight the role bacterial metabolites may play in development of the immune system, even before clinical manifestations of allergic disease arise.

Preventive effects of selected probiotic strains on the development of asthma and allergic rhinitis in childhood. The Panda study

Auteurs: D. M. W. Gorissen, N. B. M. M. Rutten, C. M. J. Oostermeijer, L. E. M. Niers, M. O. Hoekstra, G. T. Rijkers and C. K. van der Ent

Jaar: 2014

Tijdschrift: Clinical & Experimental Allergy

Samenvatting:

Evidence is mounting that progressive westernization and allergic disease are associated with disturbance of the intestinal microbial balance. This includes altered early colonization patterns and reduced bacterial diversity. In 2009, we reported results of early and long-term administration of selected probiotics to high-risk infants. All participating children had a positive family history of allergic disease, such as atopic eczema, food allergy, asthma or allergic rhinitis in either the mother or the father plus an older sibling. In these children, administration of a probiotic mixture consisting of Bifidobacterium bifidum, Bifidobacterium lactis and Lactococcus
lactis (EcologicPanda, Winclove Probiotics B.V., Amsterdam, the Netherlands) during pregnancy
and during the first year of life was compared with placebo in a randomized controlled trial. Treatment with this combination of probiotics resulted in a preventive effect on the incidence of eczema, but not atopic eczema (eczema and IgE sensitization) [1]. This preventive effect was established within the first 3 months of life, together with significant changes in the intestinal
microbiota and decreased IL-5 production. No differences were observed in respiratory symptoms indicative for asthma or allergic rhinitis at the age of 2 years. In this study, we hypothesise a possible beneficial effect of long-term perinatal administration of selected probiotic strains on the prevalence of asthma, allergic rhinitis and eczema in these high-risk children at the age of 6 years.

The effects of selected probiotic strains on the development of eczema (the PandA study)

Auteurs: L. Niers, R. Martin, G. Rijkers, F. Sengers, H. Timmerman, N. van Uden, H. Smidt, J. Kimpen, M. Hoekstra

Jaar: 2009

Tijdschrift: Allergy

Samenvatting:

Background: Modification of the intestinal microbiota by administration of probiotic bacteria may be a potential approach to prevent allergic disease. We aimed to study primary prevention of allergic disease in high-risk children by pre- and postnatal supplementation of selected probiotic bacteria.

Methods: In a double-blind, randomized, placebo-controlled trial, a mixture of probiotic bacteria selected by in-vitro experiments (Bifidobacterium bifidum, Bifidobacterium lactis, and Lactococcus lactis; Ecologic Panda) was prenatally administered to mothers of high-risk children (i.e. positive family history of allergic disease) and to their offspring for the first 12 months of life.

Results: Parental-reported eczema during the first 3 months of life was significantly lower in the intervention group compared with placebo, 6/50 vs 15/52 (P = 0.035). After 3 months, the incidence of eczema was similar in both groups. Cumulative incidence of parental-reported eczema at 1 and 2 years was 23/50 (intervention) vs 31/48 (placebo) and 27 (intervention) vs 34 (placebo), respectively. The number needed to treat was 5.9 at age 3 and 12 months and 6.7 at age 2 years. The intervention group was significantly more frequently colonized with higher numbers of Lc. lactis. Furthermore, at age 3 months, in vitro production of IL-5 (146 pg/ml vs 72 pg/ml; P = 0.04) was decreased in the probiotic-group compared with the placebo-group.

Conclusions: This particular combination of probiotic bacteria shows a preventive effect on the incidence of eczema in high-risk children, which seems to be sustained during the first 2 years of life. In addition to previous studies, the preventive effect appears to be established within the first 3 months of life.

Selection of probiotic bacteria for prevention of allergic diseases: immunomodulation of neonatal dendritic cells

Auteurs: L. E. M. Niers, M. O. Hoekstra, H. M. Timmerman, N. O. van Uden, P.MA. de Graaf, H. H. Smits, J. L. L. Kimpen and G. T. Rijkers

Jaar: 2007

Tijdschrift: Clinical & Experimental Allergy

Samenvatting:

Modification of intestinal microbiota early in life by administration of probiotic bacteria may be a potential approach to prevent allergic disease. To select probiotic bacteria for in vivo purposes, we investigated the capacity of probiotic bacteria to interact with neonatal dendritic cells (DC) and studied the ensuing T cell polarizing effect. Immature DC were generated from cord blood-derived monocytes and maturation was induced by maturation factors (MF), lipopolysaccharide (LPS) plus MF and Bifidobacterium bifidum, B. infantis, Lactobacillus salivarius, Lactococcus lactis alone or combined with MF. After 12 days of co-culture with DC and Staphylococcus aureus enterotoxin B (SEB) as antigenic stimulus, cytokine production by autologous T cells was determined by intracellular cytokine staining. Additionally, cells were stimulated with CD3 and CD28 monoclonal antibodies and cytokines were measured in supernatants by multiplex assay. The probiotic strains induced partial maturation of DC. Full maturation of DC was induced for all strains tested when MF was added. The percentage of interleukin (IL)-4 producing T cells was lower in T cell cultures stimulated with B. bifidum matured DC compared to MF and LPS matured DC, which coincided with a higher percentage of interferon (IFN)-g-producing T cells. Furthermore, T cells stimulated by B. bifidum matured DC produced significantly more IL-10 compared to MF matured DC. Selected species of the Bifidobacterium genus prime in vitro cultured neonatal DC to polarize T cell responses and may therefore be candidates to use in primary prevention of allergic diseases.

Identification of strong interleukin-10 inducing lactic acid bacteria which down-regulate T helper type 2 cytokines

Auteurs: L. E. M. Niers, H. M. Timmerman, G. T. Rijkers, G. M. van Bleek, N. O. P. van Uden, E. F. Knol, M. L. Kapsenberg, J. L. L. Kimpen and M. O. Hoekstra

Jaar: 2005

Tijdschrift: Clinical & Experimental Allergy

Samenvatting:

Background. Decreased exposure to microbial stimuli has been proposed to be involved in the
increased prevalence of atopic disease. Such a relationship was indicated by enhanced presence of typical probiotic bacteria in the intestinal flora correlating with reduced prevalence of atopic disease. Recent clinical trials suggested that probiotic bacteria may decrease and prevent allergic symptoms, but which (different) species or strains may contribute is poorly understood.

Objective. We sought to select probiotic bacteria by their ability to modulate in vitro production of cytokines by peripheral blood mononuclear cells (PBMCs), to make a rational choice from available strains.

Methods. PBMCs, purified monocytes, and lymphocytes from healthy donors were co-cultured with 13 different strains of probiotic bacteria. The effect of lactic acid bacteria (LAB) on different cell populations and effects on cytokine production induced by the polyclonal T cell stimulator
phytohaemagglutinin (PHA) was evaluated by measuring T helper type 1, T helper type 2 (Th2), and regulatory cell cytokines in culture supernatants by multiplex assay.
Results. PBMCs cultured with different strains produced large amounts of IL-10 and low levels of
IL-12p70, IL-5, and IL-13. In PHA-stimulated PBMC cultures, the tested strains decreased the
production of Th2 cytokines. Neutralizing IL-10 production resulted in partial to full restoration of
Th2 cytokine production and concurred with an increase in pro-inflammatory cytokines such as IL-12p70 and TNF-a. Within the PBMCs, the CD141 cell fraction was the main source of IL-10
production upon interaction with LAB.
Conclusion. Our results indicate that certain strains of lactobacilli and bifidobacteria modulate the production of cytokines by monocytes and lymphocytes, and may divert the immune system in a regulatory or tolerant mode. These specific strains may be favorable to use in prevention or treatment of atopic disease.

Ecologic ® Allergycare

A Specifically Designed Multispecies Probiotic Supplement Relieves Seasonal Allergic Rhinitis Symptoms

Auteurs: Annamelle M. Watts, Amanda J. Cox, Peter K. Smith, Isolde Besseling-van der Vaart, Allan W. Cripps, Nicholas P. West

Jaar: 2018

Tijdschrift: The journal of alternative and complementary medicine

Samenvatting:

Background:
Probiotics are purported to reduce symptoms of allergic rhinitis. This study sought to determine
the proportion of participants with an improvement in the mini Rhinoconjunctivitis Quality of Life Questionnaire (mRQLQ) in response to a multispecies probiotic supplement with a Simon Two-Stage design.

Methods:
his studywas based on a Simon Two-StageDesign for p1-p0 = 0.18 to account for seasonal variation in symptoms. Under this design, ‡10 patients are required to exhibit an improvement in quality-of-life scores to determine that there was sufficient activity for the supplement to be considered effective. Participants consumed a probiotic supplement (Ecologic® AllergyCare) twice daily for 8 weeks. The primary outcome measure was based on a change in mRQLQ scores following supplementation. Secondary outcomes include assessment of change in symptoms andmedication usage with a twice-weekly symptom andmedication diary, nasal congestion by rhinomanometry, and total serum Immunoglobulin E (IgE) and specific IgE for Bermuda grass.

Results:
A total of 40 participants completed the study. A total of 25 participants (63%, 49–76%, p < 0.001; mean, 95% confidence interval, p-value) out of 40 participants had a clinically meaningful response to treatment based on assessment of mRQLQ. On average, mRQLQ scores changed from 2.83 – 1.51 at baseline to 1.66 – 1.36 at week 4 and 1. 38 – 1.13 at week 8 ( p < 0.01) (mean – SD, p-value). Sum of individual symptom scores and overall symptom scores over the course of treatment was significantly reduced ( p = 0.036 and p = 0.039, respectively). A moderate reduction in frequency of allergy-related medication use in the final 4 weeks of supplementation period was observed (52.5% weeks 0–4 to 41.4% weeks 4–8; average proportion of total diary responses, p = 0.085). The supplement was largely well tolerated by participants at the dose provided.

Conclusions:
The proportion of participants exhibiting improvement in quality-of-life metrics warrants continued investigation in the form of a phase III placebo-controlled trial.

Probiotics and Allergic Rhinitis: A Simon Two-Stage Design to Determine Effectiveness

Auteurs: Watts A.M., West N.P, et al

Jaar: 2016

Tijdschrift: Journal of alternative and complementary medicine

Samenvatting:

Allergic rhinitis (AR) is a chronic upper respiratory disease affecting 10-30% of the population worldwide. It associated with significant economic and medical burden. Probiotics have received attention in recent years as a novel strategy to treat infectious/immune conditions, including AR. However, substantiation of these health claims by regulatory bodies has been rejected due, in part, to inadequate clinical trial design. While randomized controlled trials are considered the gold standard for assessing clinical efficacy, such trials require a priori preclinical data on effect size, which may be a reason for the conflicting results in the probiotic and AR literature. Progressive clinical trial designs, such as the Simon Two-Stage Design, are showing promise within the area of integrative and alternative medicine, particularly in relation to probiotic supplementation, to obtain empirical data for the design of clinical trials that meet regulatory requirements. This Phase II study uses a Simon Two-Stage Design to determine the response rate of patients with AR to a probiotic supplement. Patients will consume a multispecies probiotic twice daily for 8 weeks, and will attend an allergy clinic at the beginning and end of the intervention period for assessment. Symptom improvement following probiotic supplementation will be measured by the mini-Rhinoconjunctivitis Quality of Life Questionnaire. Secondary outcomes include twice-weekly symptom and medication diaries, objective determination of nasal congestion via Nasal Rhinomanometry, and change in frequency of medication usage. This study provides an exemplar of the value of using a progressive study design in the complementary and alternative medicine setting. A Simon Two-Stage Design was adopted to investigate whether a multispecies probiotic supplement, not yet trialed in the context of AR, has promise as a therapeutic intervention and warrants the design of larger placebo-controlled studies.

Effect of probiotics on the treatment of children with atopic dermatitis

Auteurs: Yesilova Y.Calka 0. et al

Jaar: 2012

Tijdschrift: Annals of Dermatology

Samenvatting:

Atopic dermatitis, a chronic recurrent disease, is frequently encountered in clinical practice. In the last 30 years, the prevalence of atopic dermatitis has rapidly increased due to industrialization. Therefore, there have been attempts in recent years to find new ways of treating and preventing atopic dermatitis.In this double-blind, randomized, placebo-controlled study, a combination of Bifidobacterium bifidum, Lactobacillus acidophilus, Lactobacillus casei, and Lactobacillus salivarius strains were evaluated in the treatment of atopic dermatitis in pediatric patients. Forty pediatric patients (23 males and 17 females) aged 1~13 years were enrolled. One eligible individual who was approached declined to participate. The probiotic group was administered a probiotic complex containing B. bifidum, L. acidophilus, L. casei, and L. salivarius for 8 weeks. The placebo group, on the other hand, was administered skim milk powder and dextrose. All of the parameters including serum cytokines, eosinophil cationic protein), SCORing Atopic Dermatitis (SCORAD) index, and total serum immunoglobulin E (IgE) were measured in both the probiotic group and the placebo group at the end of 8 weeks. Probiotic intervention in pediatric atopic dermatitis patients effectively reduced the SCORAD index and serum cytokines interleukin (IL)-5, IL-6, interferon (IFN)-γ, and total serum IgE levels, but did not reduce levels of serum cytokines IL-2, IL-4, IL-10, ECP, or tumor necrosis factor-α (TNF-α) compared to the placebo group. Our study found probiotics to be effective in reducing atopic dermatitis patients' SCORAD index, serum IL-5, IL-6, IFN-γ, and total serum IgE levels but not effective in reducing serum IL-2, IL-4, IL-10, ECP, or TNF-α levels

Ecologic ® RELIEF

Multispecies probiotics promote perceived human health and wellbeing: insights into the value of retrospective studies on user experiences

Auteurs: A.M. van der Geest, I. Besseling-van der Vaart, E.M. Schellinger-de Goede, M.B. van der Waal, E. Claassen, J. Flach, L.H.M. van de Burgwal

Jaar: 2021

Tijdschrift: Beneficial Microbes

Samenvatting:

When taking a broader perspective on the societal impact of probiotics, engagement of end-users is important to discover unmet needs, define relevant health benefits and identify key considerations for successful implementation in daily practice. This study therefore takes a retrospective approach and analyses a database of user experiences to review the effects of four multispecies probiotic formulations. The user experiences were analysed in a dependent sample manner (without control group) and complement previous randomised controlled trials that have been performed with the formulations. The database consisted of 584 evaluable user experiences regarding the impact of probiotic supplementation on perceived quality of life (QoL), gastrointestinal (GIT) symptoms and reported stool consistency after two weeks of consumption. Two different scales were used (n=344 in a 5-point scale; n=240 in a 10-point scale), which are presented as separate analyses. In the combined population of the 5-point-scale questionnaire, a significant increase in perceived QoL and a significant reduction in perceived GIT symptoms was observed. Descriptive summaries also indicate that diarrhoea- and constipation-like stool patterns are reduced following supplementation. Moreover, half of participants indicated that probiotic supplementation had a positive effect on their unmet medical need, and 64% of users were likely to continue using the product. Similar results were observed in the 10-point scale questionnaire. Considering the clinical relevance of probiotic supplementation in specific target groups, subgroup analyses were performed on participants who consumed the products for diarrhoea, constipation, Inflammatory Bowel Disease, Irritable Bowel Syndrome, and antibiotic usage. Overall, findings support the potential of probiotics to advance perceived human health and support the daily wellbeing of users. This systematic analysis of user experiences thereby contributes to the external validity of studies evaluating clinical effects of probiotics and increases knowledge on their societal impact.

Is a multispecies probiotic mixture effective in constipation during pregnancy? 'A pilot study

Auteurs: de Milliano I., Tabbers M.M., et al.

Jaar: 2016

Tijdschrift: Nutrition Journal

Samenvatting:

Constipation during pregnancy is a common problem. Nowadays only few effective interventions are published preventing or treating constipation during pregnancy. However, their use is limited due to side-effects. This uncontrolled intervention study was performed to determine if a mixture of probiotics in the treatment of constipation during pregnancy is effective. Women aged ≥ 18 years with functional constipation were included at the Obstetrical outpatient clinic and midwife practices. Patients received during four weeks a daily dose of Ecologic®Relief (Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Bifidobacterium longum W108, Lactobacillus casei W79, Lactobacillus plantarum W62 and Lactobacillus rhamnosus W71 (total 4*10⁹ CFU)). For all analyses, the non-parametric paired Wilcoxon test was used. Primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency, sensation of incomplete evacuation, sensation of anorectal obstruction, manual manoeuvres to facilitate defecation, abdominal pain, adverse effects, presence of reflux episodes and intake of Bisacodyl. 20 women were included. Defecation frequency significantly increased from 3.1 at baseline to 6.7 in week four (p < 0.01). Compared to baseline, a significant decrease in 1) sensation of anorectal obstruction from 90.0% to 45.0% (p < 0.01), 2) sensation of incomplete evacuation from 90.0% to 40.0% (p < 0.01), 3) straining during defecation from 100% to 65% (p = 0.01), 4) episodes of abdominal pain from 60% to 20% (p = 0.01) and 5) the presence of reflux episodes from 60% to 20% in week four (p = 0.01) was found. Other secondary outcomes did not decrease significantly. No side effects were reported. Ecologic®Relief is effective in the treatment of constipation during pregnancy. A randomised placebo controlled trial is required to confirm these data.

The role of a probiotics mixture in the treatment of childhood constipation: a pilot study

Auteurs: Bekkali N.L, Bongers M.E., et al.

Jaar: 2007

Tijdschrift: Nutrition journal

Samenvatting:

Inconsistent data exist about the efficacy of probiotics in the treatment of constipation. Several studies in adults with constipation showed positive effects of probiotics on constipation. Inconsistent data exist regarding the effect of a single probiotic strain in constipated children. The aim of this pilot study was to determine the effect of a mixture of probiotics containing bifidobacteria and lactobacilli in the treatment of childhood constipation. Children aged 4-16 years with constipation as defined by the Rome III criteria were eligible for the study. During a 4 week period, children received a daily mix of 4 x 109 colony forming units of a probiotic mixture (Ecologic(R)Relief) containing Bifidobacteria (B.) bifidum, B. infantis, B. longum, Lactobacilli (L.) casei, L. plantarum and L. rhamnosus. Primary outcome measures were frequency of bowel movements (BMs) per week and stool consistency. Secondary outcome measures were number of faecal incontinence episodes per week, abdominal pain and side effects.Twenty children, 50% male, median age 8 (range 4-16) were included. The frequency of BMs per week increased from 2.0 (1.0-5.0) to 4.2 (0.0-16.0) in week 2 (p = 0.10) and 3.8 (2.1-7.0) in week 4 (p = 0.13). In 12 children presenting with <3 BMs/week, BMs per week increased significantly from 1.0 (0.0-2.0) to 3.0 (0.0-7.0) in week 2 (p = 0.01) and 3.0 (0.0-10.0) in week 4 (p = 0.01). The stool consistency was reported as hard in 7 children at baseline, in 4 children at week 2 (p = 0.23) and in 6 children after 4 weeks of treatment (p = 1.00). A significant decrease in number of faecal incontinence episodes per week was found in the entire group: 4.0 (0.0-35.0) to 1.5 (0.0-14.0) in week 2 (p = 0.01) and 0.3 (0.0-7.0) in week 4 (p = 0.001). The presence of abdominal pain decreased significantly from 45% to 25% in week 2 (p = 0.04) and 20% at week 4 (p = 0.006). No side effects were reported. This pilot study shows that a mixture of probiotics, has positive effects on symptoms of constipation. To confirm these findings, a large randomised placebo controlled trial is required.

Ecologic ® PERFORMANCE

Probiotic Supplements Beneficially Affect Tryptophan–Kynurenine Metabolism and Reduce the Incidence of Upper Respiratory Tract Infections in Trained Athletes: A Randomized, Double-Blinded, Placebo-Controlled Trial

Auteurs: Barbara Strasser, Daniela Geiger, Markus Schauer, Johanna M. Gostner, Hannes Gatterer, Martin Burtscher and Dietmar Fuchs

Jaar: 2016

Tijdschrift: Nutrients

Samenvatting:

Abstract: Background: Prolonged intense exercise has been associated with transient suppression of immune function and an increased risk of infections. In this context, the catabolism of amino acid tryptophan via kynurenine may play an important role. The present study examined the effect of a probiotic supplement on the incidence of upper respiratory tract infections (URTI) and themetabolism of aromatic amino acids after exhaustive aerobic exercise in trained athletes during three months of winter training.

Methods: Thirty-three highly trained individuals were randomly assigned to probiotic
(PRO, n = 17) or placebo (PLA, n = 16) groups using double blind procedures, receiving either
1  1010 colony forming units (CFU) of a multi-species probiotic (Bifidobacterium bifidum W23,
Bifidobacterium lactisW51, Enterococcus faeciumW54, Lactobacillus acidophilusW22, Lactobacillus brevis W63, and Lactococcus lactis W58) or placebo once per day for 12 weeks. The serum concentrations of tryptophan, phenylalanine and their primary catabolites kynurenine and tyrosine, as well as the concentration of the immune activation marker neopterin were determined at baseline and after 12 weeks, both at rest and immediately after exercise. Participants completed a daily diary to identify any infectious symptoms.

Results: After 12 weeks of treatment, post-exercise tryptophan levels were lowered by 11% (a significant change) in the PLA group compared to the concentrations measured before the intervention (p = 0.02), but remained unchanged in the PRO group. The ratio of subjects taking the placebo who experienced one or more URTI symptoms was increased 2.2-fold compared to those on probiotics (PLA 0.79, PRO 0.35; p = 0.02).

Conclusion: Data indicate reduced exercise-induced tryptophan degradation rates in the PRO group. Daily supplementation with probiotics limited exercise-induced drops in tryptophan levels and reduced the incidence of URTI, however, did not benefit athletic performance.

Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial

Auteurs: Lamprecht M., Bogner S., et al.

Jaar: 2012

Tijdschrift: Journal of the international society of sports nutrition

Samenvatting:

Probiotics are an upcoming group of nutraceuticals claiming positive effects on athlete's gut health, redox biology and immunity but there is lack of evidence to support these statements. We conducted a randomized, double-blinded, placebo controlled trial to observe effects of probiotic supplementation on markers of intestinal barrier, oxidation and inflammation, at rest and after intense exercise. 23 trained men received multi-species probiotics (1010 CFU/day, Ecologic®Performance or OMNi-BiOTiC®POWER, n = 11) or placebo (n = 12) for 14 weeks and performed an intense cycle ergometry over 90 minutes at baseline and after 14 weeks. Zonulin and α1-antitrypsin were measured from feces to estimate gut leakage at baseline and at the end of treatment. Venous blood was collected at baseline and after 14 weeks, before and immediately post exercise, to determine carbonyl proteins (CP), malondialdehyde (MDA), total oxidation status of lipids (TOS), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Statistical analysis used multifactorial analysis of variance (ANOVA). Level of significance was set at p < 0.05, a trend at p < 0.1. Zonulin decreased with supplementation from values slightly above normal into normal ranges (<30 ng/ml) and was significantly lower after 14 weeks with probiotics compared to placebo (p = 0.019). We observed no influence on α1-antitrypsin (p > 0.1). CP increased significantly from pre to post exercise in both groups at baseline and in the placebo group after 14 weeks of treatment (p = 0.006). After 14 weeks, CP concentrations were tendentially lower with probiotics (p = 0.061). TOS was slightly increased above normal in both groups, at baseline and after 14 weeks of treatment. There was no effect of supplementation or exercise on TOS. At baseline, both groups showed considerably higher TNF-α concentrations than normal. After 14 weeks TNF-α was tendentially lower in the supplemented group (p = 0.054). IL-6 increased significantly from pre to post exercise in both groups (p = 0.001), but supplementation had no effect. MDA was not influenced, neither by upplementation nor by exercise.The probiotic treatment decreased Zonulin in feces, a marker indicating enhanced gut permeability. Moreover, probiotic supplementation beneficially affected TNF-α and exercise induced protein oxidation. These results demonstrate promising benefits for probiotic use in trained men.

Ecologic ® 825

Multispecies probiotics promote perceived human health and wellbeing: insights into the value of retrospective studies on user experiences

Auteurs: A.M. van der Geest, I. Besseling-van der Vaart, E.M. Schellinger-de Goede, M.B. van der Waal, E. Claassen, J. Flach, L.H.M. van de Burgwal

Jaar: 2021

Tijdschrift: Beneficial Microbes

Samenvatting:

When taking a broader perspective on the societal impact of probiotics, engagement of end-users is important to discover unmet needs, define relevant health benefits and identify key considerations for successful implementation in daily practice. This study therefore takes a retrospective approach and analyses a database of user experiences to review the effects of four multispecies probiotic formulations. The user experiences were analysed in a dependent sample manner (without control group) and complement previous randomised controlled trials that have been performed with the formulations. The database consisted of 584 evaluable user experiences regarding the impact of probiotic supplementation on perceived quality of life (QoL), gastrointestinal (GIT) symptoms and reported stool consistency after two weeks of consumption. Two different scales were used (n=344 in a 5-point scale; n=240 in a 10-point scale), which are presented as separate analyses. In the combined population of the 5-point-scale questionnaire, a significant increase in perceived QoL and a significant reduction in perceived GIT symptoms was observed. Descriptive summaries also indicate that diarrhoea- and constipation-like stool patterns are reduced following supplementation. Moreover, half of participants indicated that probiotic supplementation had a positive effect on their unmet medical need, and 64% of users were likely to continue using the product. Similar results were observed in the 10-point scale questionnaire. Considering the clinical relevance of probiotic supplementation in specific target groups, subgroup analyses were performed on participants who consumed the products for diarrhoea, constipation, Inflammatory Bowel Disease, Irritable Bowel Syndrome, and antibiotic usage. Overall, findings support the potential of probiotics to advance perceived human health and support the daily wellbeing of users. This systematic analysis of user experiences thereby contributes to the external validity of studies evaluating clinical effects of probiotics and increases knowledge on their societal impact.

Probiotics for improving quality of life in ulcerative colitis: Exploring the patient perspective

Auteurs: van der Waal, M.B. Flach, J. Browne, P. D. Besseling- van der Vaart, I. Claassen, E. van de Burgal, L.H.M.

Jaar: 2019

Tijdschrift: PharmaNutrition

Samenvatting:

Ulcerative colitis (UC) is known to burden patients in ways that are not always clinically apparent and therefore easily overlooked in conventional treatment regimens. The medical needs of UC patients thus may be unmet, calling for novel patient-centered approaches to alleviate disease impact and improve quality of life (QoL). Probiotics are suggested as a safe and effective addition to current regimens, but the clinical evidence base appears insufficient to support efficacy verdicts. This study therefore qualitatively explored UC’s impact on QoL from a patient perspective, and evaluated the potential of a multispecies probiotic for impact alleviation. Semistructured interviews were held with 23 UC patients, who had either opted for a trial period with the multispecies probiotic Ecologic® 825 (n=14) or had not (n=9). The thematic analysis elucidates the broad nature of UC’s impact, identifying 5 core impact domains and effects throughout. Furthermore, as patients’ attitudes towards probiotics were predominantly positive, 57% of users reported positive impact of consumption, and the vast majority of these deemed this as (highly) relevant for improving QoL, the findings favor probiotic supplementation and warrant further clinical evaluation. In this regard, defecation frequency and stool texture seem
promising outcome parameters for being most often reported.

 

Read the scientific article

Effects of an oral synbiotic on the gastrointestinal immune system and microbiota in patients with diarrhea-predominant irritable bowel syndrome

Auteurs: Moser, A. Spindelboeck, W. Halwachs, B. Strohmaier, H. Kump, P. Gorkiewicz, G. Hogenauer, C.

Jaar: 2018

Tijdschrift: European Journal of Nutrition

Samenvatting:

Purpose
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a common functional gastrointestinal disorder. Probiotics and synbiotics have been shown to improve symptoms of IBS, although mechanisms of action are currently not understood.

Methods
We investigated the effects of a 4-week oral synbiotic treatment (OMNi-BiOTiC® Stress Repair) in ten IBS-D patients on gastrointestinal mucosal and fecal microbiota, mucosa-associated immune cells, and fecal short-chain fatty acids. The upper and lower gastrointestinal tracts were compared before and after a 4-week synbiotic treatment using endoscopic evaluation to collect mucosal specimens for FACS analysis and mucosal 16S rRNA gene analysis. In stool samples, analysis for fecal SCFAs using GC–MS, fecal zonulin using ELISA, and fecal 16S rRNA gene analysis was performed.

Results
Synbiotics led to an increased microbial diversity in gastric (p = 0.008) and duodenal (p = 0.025) mucosal specimens. FACS analysis of mucosal immune cells showed a treatment-induced reduction of CD4+T cells (60 vs. 55%, p = 0.042) in the ascending colon. Short-chain fatty acids (acetate 101 vs. 202 μmol/g; p = 0.007) and butyrate (27 vs. 40 μmol/g; p = 0.037) were elevated in fecal samples after treatment. Furthermore, treatment was accompanied by a reduction of fecal zonulin concentration (67 vs. 36 ng/ml; p = 0.035) and disease severity measured by IBS-SSS (237 vs. 54; p = 0.002).

Conclusions
Our findings indicate that a short-course oral synbiotic may influence the human gastrointestinal tract in IBS-D patients on different levels which are region specific.

 

Scientific Publication: 

Effects of Supplementation of the Synbiotic Ecologic ® 825/FOS P6 on Intestinal Barrier Function in Healthy Humans: A Randomized Controlled Trial

Auteurs: E. Wilms, J. Gerritsen, H. Smidt, I. Besseling-van der Vaart, G. T. Rijkers, A. R. Garcia Fuentes, A. A. M. Masclee, F. J. Troost

Jaar: 2016

Tijdschrift: PLoSONE

Samenvatting:

Background and Aims. Probiotics, prebiotics and synbiotics have been suggested as dietary strategies to improve intestinal barrier function. This study aimed to assess the effect of two weeks synbiotic supplementation on intestinal permeability under basal and stressed conditions. Secondary aims were the assessment of two weeks synbiotic supplementation on systemic immune function and gastrointestinal symptoms including defecation pattern.

Design. Twenty healthy adults completed a double-blind, controlled, randomized, parallel design study.

Intervention. Groups either received synbiotic (1.5 × 1010 CFU Ecologic® 825 + 10 g fructo-oligosaccharides (FOS P6) per day) or control supplements for two weeks.

Outcomes. Intestinal segment specific permeability was assessed non-invasively by oral administration of multiple sugar probes and, subsequently, assessing the excretion of these probes in urine. This test was conducted at baseline and at the end of intervention, in the absence and in the presence of an indomethacin challenge. Indomethacin was applied to induce a compromised gut state. Plasma zonulin, cytokines and chemokines were measured at baseline and at the end of intervention. Gastrointestinal symptoms and stool frequency were recorded at baseline and daily during intervention.

Results. Significantly more male subjects were in the synbiotic group compared to the control group (P = 0.025). Indomethacin significantly increased urinary lactulose/rhamnose ratio versus without indomethacin, both in the control group (P = 0.005) and in the synbiotic group (P = 0.017). Urinary sugar recoveries and ratios, plasma levels of zonulin, cytokines and chemokines, and gastrointestinal symptom scores were not significantly different after control or synbiotic intervention. Stool frequency within the synbiotic group was significantly increased during synbiotic intervention compared to baseline (P = 0.039) and higher compared to control intervention (P = 0.045).

Conclusion. Two weeks Ecologic® 825/FOS P6 supplementation increased stool frequency, but did not affect intestinal permeability neither under basal nor under indomethacin-induced stressed conditions, immune function or gastrointestinal

Clinical Studies Evaluating Effects of Probiotics on Parameters of Intestinal Barrier Function

Auteurs: Saskia van Hemert, Jurre Verwer, Burkhard Schütz

Jaar: 2013

Tijdschrift: Advances in Microbiology

Samenvatting:

The intestinal barrier is important in preventing translocation of bacteria, toxins and antigens from the lumen of the gut into the body. Enhanced permeability, or gut leakiness, has been associated with different diseases. Probiotics can, strain-specifically, improve the epithelial barrier function. However, so far most researches have used cell lines or ani-mal models due to the difficulty of measuring the effects of products on the epithelial barrier function in vivo in humans. Here a systematic literature search was performed to find articles addressing the effects of probiotics on the barrier function in human trials. The Pubmed database was searched (January 2013) to identify human in vivo studies with pro-biotic products in which parameters for epithelial barrier function were measured. In total 29 studies were identified, but patients, bacterial characteristics and methods to measure intestinal barrier function caused large heterogeneity among these studies. About half of the studies showed positive results of probiotics on the epithelial barrier function, indicating a clear potential of probiotics in this field. In a case series of 14 patients using Ecologic825, a probiotic food supple- ment with known effect on epithelial barrier function, different markers of intestinal integrity improved significantly. Further studies in this field should consider strain(s), dose and duration of the probiotic supplementation as well as the markers used to measure epithelial barrier function. Besides the lactulose/mannitol test, zonulin and α1-antitrypsin might be valuable markers to measure epithelial barrier function in future experiments.

The effects of probiotics on barrier function and mucosal pouch microbiota during maintenance treatment for severe pouchitis in patients with ulcerative colitis

Auteurs: M. Persborn, J. Gerritsen, C. Wallon, A. Carlsson, L. M. A. Akkermans & J. D. Söderholm

Jaar: 2013

Tijdschrift: Alimentary Pharmacology and Therapeutic

Samenvatting:

ckground: A total of 10–15% of patients with an ileoanal pouch develop severe pouchitis necessitating long-term use of antibiotics or pouch excision. Probiotics reduce the risk of recurrence of pouchitis, but mechanisms behind these effects are not fully understood.

Aim: To examine mucosal barrier function in pouchitis, before and after probiotic supplementation and to assess composition of mucosal pouch microbiota.

Methods: Sixteen patients with severe pouchitis underwent endoscopy with biopsies of the pouch on three occasions: during active pouchitis; clinical remission by 4 weeks of antibiotics; after 8 weeks of subsequent probiotic supplementation (Ecologic 825, Winclove, Amsterdam, the Netherlands). Thirteen individuals with a healthy ileoanal pouch were sampled once as controls. Ussing chambers were used to assess transmucosal passage of Escherichia coli K12, permeability to horseradish peroxidase (HRP) and 51Cr-EDTA. Composition and diversity of the microbiota was analysed using Human Intestinal Tract Chip.

Results: Pouchitis Disease Activity Index (PDAI) was significantly improved after antibiotic and probiotic supplementation. Escherichia coli K12 passage during active pouchitis [3.7 (3.4–8.5); median (IQR)] was significantly higher than in controls [1.7 (1.0–2.4); P < 0.01], did not change after antibiotic treatment [5.0 (3.3–7.1); P = ns], but was significantly reduced after subsequent probiotic supplementation [2.2 (1.7–3.3); P < 0.05]. No significant effects of antibiotics or probiotics were observed on composition of mucosal pouch microbiota; however, E. coli passage correlated with bacterial diversity (r = 0.40; P = 0.018). Microbial groups belonging to Bacteroidetes and Clostridium clusters IX, XI and XIVa were associated with healthy pouches.

Conclusions: Probiotics restored the mucosal barrier to E. coli and HRP in patients with pouchitis, a feasible factor in prevention of recurrence during maintenance treatment. Restored barrier function did not translate into significant changes in mucosal microbiota composition, but bacterial diversity correlated with barrier function.

A multispecies probiotic food supplement (Ecologic 825) for IBD.

Auteurs: Mulder L. A

Jaar: 2008

Tijdschrift: NUTRAfoods

Winclove TRAVEL

Strain-specific probiotic properties of lactic acid bacteria and their interference with human intestinal pathogens invasion

Auteurs: Raffaella Campana, Saskia van Hemert, Wally Baffone

Jaar: 2017

Tijdschrift: Gut Pathogens

Samenvatting:

Background
One of the working mechanisms of probiotic bacteria is their ability to compete with pathogens. To define the probiotic properties of seven Lactic Acid Bacteria (LAB) strains, we tested them for survival in simulated gastro-intestinal conditions, antimicrobial activities, co-aggregative abilities, and interferences studies against five human intestinal pathogens (Salmonella enteritidis ATCC 13076, Listeria monocytogenes ATCC 7644, Escherichia coli O157: H7 ATCC 35150, Cronobacter sakazakii ATCC 29544 and Campylobacter jejuni ATCC 33291).

Results
The LAB strains were able to survive the stomach simulated conditions, and varied in their abilities to survive the small intestinal-simulated conditions. The strains showed antibiotic susceptibility profiles with values equal or below the breakpoints set by the European Food and Safety Authority. The LAB cell-free cultures supernatants showed antimicrobial activities, with inhibition zones ranging from 10.0 to 17.2 mm. All the LAB strains showed moderate auto-aggregation abilities while the greatest co-aggregation abilities were observed for Bifidobacterium bifidum W23, Lactobacillus plantarum W21 and Lactobacillus rhamnosus W71. The individual LAB strains showed strain-specific abilities to reduce the invasion of intestinal pathogens in an interference model with Caco-2 cells. Increased invasion inhibition was found when different combinations of LAB strains were used in the interference tests.

Conclusion
The LAB strains examined in this study may protect the intestinal epithelium through a series of barriers (antimicrobial activity, co-aggregation with pathogens, adherence) and interference mechanisms. Consequently, these LAB strains may be considered candidates for prophylactic use to prevent intestinal infections

Winclove ADULT

Multispecies probiotics promote perceived human health and wellbeing: insights into the value of retrospective studies on user experiences

Auteurs: A.M. van der Geest, I. Besseling-van der Vaart, E.M. Schellinger-de Goede, M.B. van der Waal, E. Claassen, J. Flach, L.H.M. van de Burgwal

Jaar: 2021

Tijdschrift: Beneficial Microbes

Samenvatting:

When taking a broader perspective on the societal impact of probiotics, engagement of end-users is important to discover unmet needs, define relevant health benefits and identify key considerations for successful implementation in daily practice. This study therefore takes a retrospective approach and analyses a database of user experiences to review the effects of four multispecies probiotic formulations. The user experiences were analysed in a dependent sample manner (without control group) and complement previous randomised controlled trials that have been performed with the formulations. The database consisted of 584 evaluable user experiences regarding the impact of probiotic supplementation on perceived quality of life (QoL), gastrointestinal (GIT) symptoms and reported stool consistency after two weeks of consumption. Two different scales were used (n=344 in a 5-point scale; n=240 in a 10-point scale), which are presented as separate analyses. In the combined population of the 5-point-scale questionnaire, a significant increase in perceived QoL and a significant reduction in perceived GIT symptoms was observed. Descriptive summaries also indicate that diarrhoea- and constipation-like stool patterns are reduced following supplementation. Moreover, half of participants indicated that probiotic supplementation had a positive effect on their unmet medical need, and 64% of users were likely to continue using the product. Similar results were observed in the 10-point scale questionnaire. Considering the clinical relevance of probiotic supplementation in specific target groups, subgroup analyses were performed on participants who consumed the products for diarrhoea, constipation, Inflammatory Bowel Disease, Irritable Bowel Syndrome, and antibiotic usage. Overall, findings support the potential of probiotics to advance perceived human health and support the daily wellbeing of users. This systematic analysis of user experiences thereby contributes to the external validity of studies evaluating clinical effects of probiotics and increases knowledge on their societal impact.

Use of the multispecies probiotic Winclove 500/Bactosan pro FOS leads to less gastrointestinal complaints in adults – an observational in vivo pilot study

Auteurs: F. Grossenbacher, A. Gashi, I. Besseling-van der Vaart

Jaar: 2016

Tijdschrift: Advances in Microbiology

Samenvatting:

The potential benefit of probiotics on the gut microbiota and on various gastrointestinal disorders is well documented. It has become clear that these probiotic effects are
strain-specific, underlying the necessity for a well-founded strain selection for research
and clinical practice. Whether probiotics also have a positive effect on parameters of
gastrointestinal function in a healthy population is less investigated.
The objective of this in vivo observational study was to investigate the effect of a
6-week intervention with a multispecies probiotic product on gut health and quality of
life (QoL) in a population of otherwise healthy adults and to evaluate the feasibility of
conducting a controlled trial on probiotic effects in this population. A total of 40 participants
from 3 different health centres were included in the study. After a 1-week
inclusion phase, participants were supplemented for a 6-week period with Winclove
500/BactoSan pro FOS. During the run-in phase and each week during the observational
period, gastrointestinal functional parameters were documented by an adapted
version of the Eypasch questionnaire. Data on QoL was collected at baseline and at the
end of the intervention period. The total gastrointestinal (GI) symptom score was reduced
from 10 (4-21) at baseline to 6 (0-15) (p<0,05) after 6 weeks intervention. More
specifically, after the probiotic intervention the percentage of participants which were
fully resolved of a particular symptom significantly increased to 27.5% (p<0.02) for
gastrointestinal pain, to 25% (p<0.03) for epigastric fullness/bloating and to 20%
(p<0.02) for flatulence, compared to baseline. The treatment was well-tolerated. This
observational study provides important information on the ability to investigate potential
effects of a probiotic product in otherwise healthy adults. The promising results
Winclove 500/BactoSan pro FOS showed on gut health and QoL in this target group
should be further investigated in a randomized, placebo-controlled study.

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