Probiotice, prebiotice, simbiotice Prof. Dr. Doina Miere

Probiotice Nutriioniti germani terapia cu probiotice1907IstoricIlya Metchnikoff * (premiul Nobel) teoria longevitiiShirota, Kellogg teoria realitate comercialTissier - B. bifidusMoro B. acidophilus1900*The Prolongation of life. Optimistic Studies19301950

Definiie

microorganisme vii care, administrate n cantiti adecvate, confer gazdei efecte benefice pentru sntate, mbuntind balana intestinal

microorganismemicroorganisme sntoase prietenoase

Probiotice

Lactobacillus acidophilus,L. rhamnosus, L. lactusL plantarum L. brevis,L. bulgaricus, delbrueckiL. reuteri, L. fermentum, L. casei, L farciminisL. sporogenes, L crispatus

Lactococcus Enterococcus Streptococcus: lactis, cremoris, alivarius, intermedius, termophillusPropionibacterium etc. Sacharomyces cerevisiaeMicroorganisme probioticeAlte gen i speciiLactobacillusBifidobateriumBifidobacterium bifidumlonguminfantis breveadolescentistermophilumlactis, animalisLactobacillus acidophillusBifidobacterium BB-121. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment and management, A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728Bacterii, drojdii, mucegaiuri

Selecia probioticelorFAO/WHO - Guidelenes for the Evaluation of Probiotics in Food ex. patologic, genetic, imunologic, gastroenterologic microbiologicTehnici moleculare acceptate internaional fenotip, genotip, gen, specieE.M.M. Quigley, Prebiotic & probiotic, Pharmacological research 61, (2010), 213-218

Crieriul generalProprietateaCriteriul siguran / securitateOrigine, neinvazive, necarcinogeneSa nu prezinte patogenitate, infectivitateLipsa toxicitate, rezisten la antibiotice

Criterii tehnologiceTulpini stabile geneticViabilitate prelucrare, depozitare Proprieti senzoriale buneProducie la scar larg

Selecia probioticelorProbiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Crieriul generalProprietateaCriterii funcionaleRezisten la secreiile gastrice, biliare, motilitateAdeziune la mucoasa intestinal, formare de coloniiEfecte benefice dovedite asupra sntiiCriterii fiziologiceActivitate antagonic fa de agenii patogeni g-i multiplicare, produi antimicrobieni: acizi, H2O2, bacteriocineAciune imuno-modulatoareStimularea eliminrii toxinelorProprieti anti-mutagene, anti-carcinogene

dizaharidepolizaharideInulina

Amidon rezistent Fructo-oligozaharide

Oligozaharide din soia

Xilo-oligozaharide

Galacto-oligozaharideLactuloz

Lactitol Prebioticeoligozaharideingrediente alimentare nedigerabile, care acioneaz prin stimularea selectiv a unor bacterii din colonPrebioticeT Iannitti, B. Palmieri, Therapeutical use of probiotic...Clinical Nutrition xxx (2010), 1-25

PrebioticeCondiii:Rezistente la: activitatea gastric, hidroliza enzimatic, absorbia intestinal

S fie hidrolizate, fermentate de microflora din colon AGCS mresc osmolaritatea intestinal

S stimuleze selectiv dezvoltarea probioticelor din colon, s faciliteze adeziunea lor la epiteliul intestinalPrebiotice + probiotice simbioticeselecia optim pro/prebiotic eficacitatea simbioticJ.Grimoud et al.& Anaerobe XXX (2010) 1-8

Efecte ale probioticelor

Protejeaza organismul fata de aderenta, reproducerea si efectul daunator al bacteriilor enteropatogene asupra mucoasei, prin: formarea unui mediu ostil, reducand pH-ul intestinal, prin sinteza de acizi grasi cu catena scurta eliberarea de substante antibiotice bacteriocine epuizare nutrientilor si competitie pentru substrat inhibarea capacitatii de aderare a bacteriilor patogene pe situs-uri specifice

Imbunatatesc imunitatea specifica si nespecificainfluenteaza sistemul imun secretor (imunoglobuline)produsi de secretie ai probioticelor imunologic activi

Efect antiinflamator

etc.

Efecte benefice asupra sntii umane1. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment and management, A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte asupra sntiiMecanisme de aciuneEfecte terapeutice dovedite tiinific mbuntirea simptomelor de intoleran la lactozFurnizarea de lactaza / -galactozidaz n tractul gastro-intestinalPrevenirea i reducerea simptomelor diareei asociate cu: - rotavirus - antibioticeModificarea pH-ului intestinal Antagonizarea bacteriilor patogene - inhibarea aderenei i colonizrii bacteriilor patogeneEfect de translocare/bariermbuntirea rspunsului imun produciei de IgA antigen-specific, stimularea celulelor imunomodulatoareReducerea inflamaiei locale

Efecte ale organismelor probiotice asupra sntii umane1. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment and management, A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte poteniale asupra sntiiMecanismReducerea susceptibilitii la alergii - alergii alimentare- dermatite atopice- astmModularea colonizriiEfect de barier al mucoasei intestinale: permeabilitii, a penetrrii sistemice a alergenilor Degradarea alergenilor, eliminare i reglareExcluziune imun produciei de IgA Reducerea riscului asociat cu mutagenitatea i carcinogenitateaLegarea oncogenilor Producerea de substante de detoxifierePrevenirea alterrii microecologiei intestinaleReglarea permeabilitii i motilitii intestinaleCreterea imunitii intestinale

Efecte ale organismelor probiotice asupra sntii umane1. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment and management, A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte poteniale asupra sntiiMecanismEfect hipocolesterolemiantDeconjugarea srurilor biliareInhibarea Helicobacter pylori i a patogenilor intestinaliProducerea de compui antimicrobieni H2O2, bacteriocine Excluziune competitiv cu H. pylori pt. aderare i colonizare, efect de barierStabilizarea mucoasei gastriceStimularea sistemului imunitarInducerea imunitii nnscute (rspuns imun local) i adaptative

Efecte ale organismelor probiotice asupra sntii umane1. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment and management, A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte poteniale asupra sntiiMecanismPrevenirea tulburrilor intestinale inflamatorii

(boala Crohn, colita ulcerativ, sindromul de colon iritabil)Inhibarea dezv. bacteriilor patogene - excludere competitiv, producere de acid lactic, acetic cu pH, secreie de peptide cu aciune bacteriostatic / bactericid - Modularea rspunsului imun- Descompunerea antigenelor patogene- mbuntirea funciei barierei intestinale producere de AGCS mbuntesc producia de mucus i permeabilitatea mucoasei intestinale

Efecte ale organismelor probiotice asupra sntii umaneR. Barrons et al., Use of Lactobacillus ...J.Clinical Therapeutics, 2008

Alte efecte poteniale asupra sntiiUrologie: prevenirea infeciilor urinarePrevenirea vaginozelor mbuntirea sntii ososase (prebiotice)

Efecte ale organismelor probiotice asupra sntii umane

Efecte asupra sntiiEfecte nutriionale dovedite tiinific (Lactobacili)

Producerea de vitamine B, vitamina K

mbuntirea digestibilitii alimentelorCreterea biodisponibilitii nutrienilor

Efectele probioticelordependente de:

caracteristicile organismului gazd forma de administraredoz - 107-1011 uniti formatoare de colonii (cfu)tulpinile administrate - specificitatea tulpinilor pentru anumite efecte clinice Indicaii clinice specifice ale probioticelor i prebioticelor n gastroenterologieWorld Gastroenterology Organisation practice guidelines:Probiotics and prebioticsArab J. of Gastroenterology 10 (2009) 3342

Utilizarea clinic / terapeutic a probioticelorWorld Gastroenterology Organisation practice guidelines:Probiotics and prebioticsArab J. of Gastroenterology 10 (2009) 3342

Boala Produsul probioticDoza recomandatTratamentul diareei infecioase acute la copiiL. rhamnosus GG1010-1011 cfu, 2x/ziL. reuteri ATTC 557301010-1011 cfu, 2x/ziL. acidophilus+B infantis109 fiecare, 3x/ziS cerevisiae (boulardii) liof.200 mg, 3x/ziTratamentul diareei infecioase acute la adultEnterococcus faecium LAB SF68108, 3x/ziPrevenirea diareei asociate cu antibiotice la copiiS cerevisiae (boulardii) liof.250mg, 2x/ziL. Rhamnosus GG1010cfu, 1-2x/ziB.lactis Bb12+S.thermophil107-106cfu/g formul

Utilizarea clinic / terapeutic a probioticelorWorld Gastroenterology Organisation practice guidelines:Probiotics and prebioticsArab J. Gastroenterology 10 (2009) 3342

Boala Produsul probioticDoza recomandatPrevenirea diareei asociate cu antibiotice la aduliEnterococ faecium LAB SF68108, 2x/ziS cerevisiae (boulardii) liof.1g sau 3x1010cfu/ziL. rhamnosus GG1010-1011 cfu, 2x/ziL casei DN-114 001 n lapte fermentat cu L.bulgaricus + S. thermophilus1010cfu, 2x/ziB. clausii 2x109 spori, 3x/ziL acidophilus CL1285 + L. casei Lbc80r5x1010+, 1 dat/ziPrevenirea diareei nosocomiale la copiiL. rhamnosus GG1010-1011 cfu, 2x/ziB lactis BB12 + S. thermophilus 108+107cfu/g formulB lactis BB12109cfu, 2x/ziL. reuteri ATTC 55730109cfu, 2x/zi

Utilizarea clinic / terapeutic a probioticelorWorld Gastroenterology Organisation practice guidelines:Probiotics and prebioticsArab J. Gastroenterology 10 (2009) 3342

Boala Produsul probioticDoza recomandatPrevenirea diareei Clostridium difficile la aduliL casei DN-114 001 n lapte fermentat cu L.bulgaricus + S. thermophilus1010cfu, 2x/ziL acidophilus + B bifidum2x 1010cfu fiecare 1 dat / ziS cerevisiae (boulardii) liof. 2 x 1010cfu/ ziOligofructoz 4g de 3x / ziTerapie adjuvant n eradicarea Helicobacter pyloriL. rhamnosus GG6 x 109 cfu, 2x/ziB. clausii2 x 109 spori, 3x/ziIaurt cu lactobacili i bifidobacterii nespecifice5 x 109 bacterii viabile, 2x/ziS cerevisiae (boulardii) liof. 1g sau 5x109 cfu/zi L casei DN-114 001 n lapte fermentat cu L.bulgaricus + S. thermophilus1010cfu, 2x/zi

Utilizarea clinic / terapeutic a probioticelorWorld Gastroenterology Organisation practice guidelines:Probiotics and prebioticsArab J. Gastroenterology 10 (2009) 3342

Boala Produsul probioticDoza recomandatReducerea simptomelor asociate cu intolerana la lactozIaurt normal cu L. bulgaricus + S. thermophilusIaurtul netratat termic conine culturi adecvate pt. a mbunti digestia lactozei din iaurtReducerea simptomelor asociate cu sindromul de colon iritabilB infantis 35624108 cfu, 1 dat/ziL rhamnosus GG6 x 109 cfu, 2x/ziL rhamnosus GG, L rhamnosus LC705, B breve Bb99 i Propionibacterium freudenreichii ssp shermanii1010 cfu 1/ziB animalis DN-173 010 n lapte fermentat cu L. Bulgaricus + S thermophilus1010, 2x/zi

Utilizarea clinic / terapeutic a pro- si pre-bioticelorWorld Gastroenterology Organisation practice guidelines: Probiotics and prebioticsArab Journal of Gastroenterology 10 (2009) 3342

Boala Produsul probioticDoza recomandatControlul remisiei n colita ulcerativE coli Nissle 19175 x 1010 bacterii viabile, de 2x/ziTratamentul constipaieiLactuloz20 40 g / ziOligofructoz > 20 g / ziPrevenirea enterocolitei necrozante la copii prematuriB infantis, S thermophilus i B bifidum0,35 x 109 chu fiecare tulpin, 1 dat/ziL acidophilus + B infantis109 chu fiecare tulpin, 2x/ziPrevenirea infecii post-operativeSinbiotic 2000: 4 tulpini bacteriene + fibre cu inulin 1010 cfu + 10 g fibre, 2x/ziTratamentul encefalopatiei hepaticeLactuloz 45 - 90 g / zi

Utilizarea probioticelor/prebioticelor Optimizarea simbiozei flora intestinal / organism gazd intervenia farmacologic, nutriional utiliznd probiotice i prebioticeImportance of food in probiotics efficacy, Ranadheera & col, Food Res. Int, 43, 2010Alimentele - transportori ideali ai probioticelor:protecie - tract gastro-intestinalreglarea colonizarii interaciunea componeni bioactivi probiotice funcionalitatea, eficacitatea

Alimente funcionale cu probiotice/prebioticeTradiional: iaurt, kefir

Probiotice - extensiv exploatate de industria lactat produse funcionale noi:

Brnz, ngheat, deserturi lactateFormule de lapte praf, produse de diversificare

Ranadheera & col, Importance of food in probiotics efficacy, Food Res. Int, 43, 2010

Alimente funcionale cu probiotice/prebioticeAlte alimente transportori pt. probiotice microncapsulate i prebiotice:

Maioneza, produse comestibile tartinabileProduse din carneaButuri, suc de fructeProduse pe baz de cereale - ovz etcCiocolat, alimente pentru copii

Z Wang, Prebiotic: Present and future...Food Research International 42 (2009), 8-12

Probiotice prezente n produse alimentareCulturile utilizate de productori - tulpini de Lactobacillus spp. i Bifidobacterium spp.:

Lactobacilus acidophilus LA1/LA5 CHR Hansen L. delbrueckii ssp. Bulgaricus Lb12L. paracasei CRL431Bifibobacterium animalis ssp. Lactis Bb12L casei immunitasDanone (Activia)B animalis DN173010 (Bioactiva) Danone (Activia)L casei DN-114 001Danone (Actimel)L. acidophilus NMCFDaniscoL. acidophilus La, etcProbiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Suplimente alimentare cu probioticeForme farmaceutice cu probioticeTablete - efectele formulrii, parametrilor de procesare, a condiiilor de pstrare asupra viabilitii bacteriene

Capsule

Pulberi (plicuri)

Soluii buvabile

S. Klayraung et al., Development o tablets containing probiotics: Effects of formulation and processing parameters on bacterial viability, Int.J.Pharm 370 (2009) 54-60

L/O/G/O

V mulumesc!