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Potential benefits
Experiments into the benefits of probiotic therapies suggest a range of potentially beneficial medicinal uses for probiotics. For many of the potential benefits, research is limited and only preliminary results are available. It should be noted that the effects described are not general effects of probiotics. Recent research on the molecular biology and genomics of Lactobacillus has focused on the interaction with the immune system, anti-cancer potential, and potential as a biotherapeutic agent in cases of antibiotic-associated diarrhoea, travellers' diarrhoea, pediatric diarrhoea, inflammatory bowel disease and irritable bowel syndrome.[21]
All effects can only be attributed to the individual strain(s) tested. Testing of a supplement does not indicate benefit from any other strain of the same species, and testing does not indicate benefit from the whole group of LAB (or other probiotics).[22]
[edit] Managing lactose intolerance
As lactic acid bacteria actively convert lactose into lactic acid, ingestion of certain active strains may help lactose intolerant individuals tolerate more lactose than what they would have otherwise.[23] In practice probiotics are not specifically targeted for this purpose, as most are relatively low in lactase activity as compared to the normal yogurt bacteria.
[edit] Prevention of colon cancer
In laboratory investigations, some strains of LAB (Lactobacillus bulgaricus) have demonstrated anti-mutagenic effects thought to be due to their ability to bind with heterocyclic amines, which are carcinogenic substances formed in cooked meat.[24] Animal studies have demonstrated that some LAB can protect against colon cancer in rodents, though human data is limited and conflicting.[25] Most human trials have found that the strains tested may exert anti-carcinogenic effects by decreasing the activity of an enzyme called β-glucuronidase[25] (which can generate carcinogens in the digestive system). Lower rates of colon cancer among higher consumers of fermented dairy products have been observed in some population studies.[23]
[edit] Lowering cholesterol
Animal studies have demonstrated the efficacy of a range of LAB to be able to lower serum cholesterol levels, presumably by breaking down bile in the gut, thus inhibiting its reabsorption (which enters the blood as cholesterol). Some, but not all human trials have shown that dairy foods fermented with specific LAB can produce modest reductions in total and LDL cholesterol levels in those with normal levels to begin with, however trials in hyperlipidemic subjects are needed.[23]
[edit] Lowering blood pressure
Several small clinical trials have shown that consumption of milk fermented with various strains of LAB can result in modest reductions in blood pressure. It is thought that this is due to the ACE inhibitor-like peptides produced during fermentation.[23]
[edit] Improving immune function and preventing infections
LAB are thought to have several presumably beneficial effects on immune function. They may protect against pathogens by means of competitive inhibition (i.e., by competing for growth) and there is evidence to suggest that they may improve immune function by increasing the number of IgA-producing plasma cells, increasing or improving phagocytosis as well as increasing the proportion of T lymphocytes and Natural Killer cells.[26][27] Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory tract infections[28] and dental caries in children.[29] LAB foods and supplements have been shown to be aid in the treatment and prevention of acute diarrhea, and in decreasing the severity and duration of rotavirus infections in children and travelers' diarrhea in adults.[26][27]
[edit] Helicobacter pylori
LAB are also thought to aid in the treatment of Helicobacter pylori infections (which cause peptic ulcers) in adults when used in combination with standard medical treatments. However more studies are required into this area.[30]
[edit] Antibiotic-associated diarrhea
Antibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy. Microbiota alteration changes carbohydrate metabolism with decreased short-chain fatty acid absorption and an osmotic diarrhea as a result. Another consequence of antibiotic therapy leading to diarrhea is overgrowth of potentially pathogenic organisms such as Clostridium difficile.
Probiotic treatment can reduce the incidence and severity of AAD as indicated in several meta-analyses.[31][32][33][34][35][34] However, further documentation of these findings through randomized, double blind, placebo-controlled trials are warranted. Efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage.[36][37] Up to a 50% reduction of AAD occurrence has been found.[35] No side-effects have been reported in any of these studies. Caution should, however, be exercised when administering probiotics to immunocompromised individuals or patients who have a compromised intestinal barrier.
[edit] Reducing inflammation
LAB foods and supplements have been found to modulate inflammatory and hypersensitivity responses, an observation thought to be at least in part due to the regulation of cytokine function.[26] Clinical studies suggest that they can prevent reoccurrences of inflammatory bowel disease in adults,[26] as well as improve milk allergies.[38] They are not effective for treating eczema, a persistent skin inflammation.[39]. How probiotics counteract immune system overactivity remains unclear, but a potential mechanism is desensitization of so-called T lymphocytes, an important compenent of the immune system, towards pro-inflammatory stimuli [40].
[edit] Improving mineral absorption
It is hypothesized that probiotic lactobacilli may help correct malabsorption of trace minerals, found particularly in those with diets high in phytate content from whole grains, nuts, and legumes.[41]
[edit] Preventing harmful bacterial growth under stress
In a study done to see the effects of stress on intestinal flora, rats that were fed probiotics had little occurrence of harmful bacteria latched onto their intestines compared to rats that were fed sterile water.[42]
[edit] Irritable bowel syndrome and colitis
B. infantis 35624, sold as Align, was found to improve some symptoms of irritable bowel syndrome in women in a recent study.[43] Another probiotic bacterium, Lactobacillus plantarum 299v, was also found to be effective in reducing IBS symptoms.[44] Additionally, a probiotic formulation, VSL#3, was found to be safe in treating ulcerative colitis, though efficacy in the study was uncertain.[45] Bifidobacterium animalis DN-173 010 may help.[46]
[edit] Managing urogenital health
Several in vitro studies have revealed probiotics' potential in relieving urinary tract infections[47] and bacterial vaginosis.[48] Results have been varied on these studies, and in vivo studies are still required in this area to determine efficacy. |
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