Application of probiotics in gastroenterology
Abstract
The aim of review. To present the definition of probiotics, to indicate principle of their action and international requirements to probiotic products, to review clinical studies of probiotic application in gastroenterology.
Original positions. Original studies assume a set of positive properties of probiotics. Most frequently strains of lactobacilli and bifidobacteria are used as probiotics, brewing yeast and some Escherichia coli strains also serve for this role can. Specific influence on health of the person can be attributed only to particular researched strain or strains, but not to species and not to the whole group of lactic acid bacteria or other probiotics as a whole. Probiotics are designed to aid a human body which has intestinal flora by virtue of evolutionary development. Some of them are used for prophylaxis of diarrhea caused by application of antibiotics, or as a part of complex treatment of antibiotic-associated colitis. Various effects of probiotics are known at numerous diseases, including inflammatory bowel disease, irritable bowel syndrome, vaginal infections and disorders of immunodefence. Properties of some probiotics have also been studied in atopic eczema, rheumatoid arthritis and liver cirrhosis. There is clinical evidence of a role of probiotics in decrease of level of cholesterol, but results of various studies are equivocal. Recent investigations showed efficacy of Lactobacillus casei DN-114 001 Actimel, DanActive (Danone/ Dannon) in prophylaxis of antibiotic-associated diarrhea and diarrhea caused by C. difficile. There is an opinion, that some strains of probiotics and prebiotic oligofructose are effective for stimulation of immune response. Indirect proof of this is obtained in studies directed on prophylaxis of acute infections (e.g., winter epidemy of flu). Study of H. Duez et al. serves as evidence, that probiotics remain alive during small-intestinal transit, which proved presence of Bifidobacterium animalis DN-173 010 strain in human excrements samples by immunoblotting method.
Conclusion. The further study of probiotics efficacy in treatment of patients with inflammatory bowel diseases, cardio-vascular diseases and many other morbid conditions is required. High-quality clinical investigations with good design are essential for this. Results of these studies should provide demonstrative base and yield clear references concerning a dose, mode and duration of intake of probiotics, prebiotics and synbiotics.
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Review
For citations:
Mayevskaya M.V. Application of probiotics in gastroenterology. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(6):65-72. (In Russ.)
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