PROBIOTICS
Dr K Preethi
Final yr pg
Dept of pharmacology
Contents
Definition History Mechanism of action Probiotic strains Foods containing probiotics Clinical implications of probiotics Preparations Prebiotics Symbiotics
Definition
According to WHO, 2001 “probiotics are live microorganisms which, when administered in adequate amounts confer a health benefit on the host”.
Pro – promoting Biotic - life
History In 1907 , Russian Noble prize winner, ELIE
METCHINKOFF first conceptualised probiotics
In 1930s in Japan, MINORU SHIROTA developed YAKULT
Probiotic term coined by LILLY & STILLWELL in 1965
Mechanism of action
Probiotics produce acidic, lactic & propionic acid lowers the intestinal pH & inhibit the growth of certain pathogenic bacteria like E.coli
Prevent adhesion and colonization of pathogenic organisms
Produce immunologic response – increase IgA production, cytokine modulation
Helps absorption of minerals Produce wide range of antimicrobial
substances like acidophilin, bacteriocin Enhance the intestinal barrier function
Probiotic strains
Lactobacillus species
L. acidophillus
L. plantarum
L. casei rhamnosus
L. brevis
L. bulgaricus
Bifidobacterium species
B. adolescentis
B. bifidum
B. infantis
B. breve
Others Streptococcus thermophilus Enteterococcus faecium Lactococcus lactis Yeast – Saccharomyces boulardii
Foods containing probiotics Yakult dairy drink Milk – soya milk, Tofu Milk products – sour cream, butter milk,
yogurt Fermented Indian foods like – idly, dosa,
kadhi, dhoklas
Clinical implications 1) Diarrhoea:
A) Treatment & prevention of acute diarrhoea:
- L. reuteri, L. rhamnosus, L. casei
Saccharomyces boulardii
B) Antibiotic associated diarrhoea
- Saccharomyces boulardii,
L. rhamnosus
- L. casei DN – 114001 – effective in
hospitalized adult patients
2) Inflammatory bowel disease:
- pouchitis, ulcerative colitis
3) Irritable bowel syndrome
- reduction in abdominal bloating and flatulence
- L. reuteri may improve colicky symptoms
4) Colon cancer
5) Lactose malabsorption
- Streptococcus thermophillus and L. delbrueckii
- prodution of β- D galactosidase enzymes that breakdown lactose
6) Eradication of H. pylori
7) Allergy
- decreases serum IgE levels
- reduction of Th2 cytokine response
8) Lowering cholesterol
9) Bp reduction: related to the ACE inhibitor like peptides produced during fermentation
10) Necrotising enterocolitis in preterm infants if given in early life decreases the severity and incidence
11) Hypo response to food allergens 12) Bacterial vaginosis 13) Decreases atopic dermatitis in
neonates if given in pregnancy and early life of neonate
Prepartions
Tablets , capsules, powders Sporlac - 60 million spores of lactic acid
bacillus Econorm - Saccharomyces boulardii 250
mg per sachet Bifilac – lactobacillus 50 million spores
sterptococcus faecalis 30 million
clostridium butyricum 2 million
bacillus mesenteric 1 million per
sachets/capule
Bifilin : lactobacillus species 1 billion
bifidobacterium bifidum 1 billion
streptococcus thermophillus 0.25B
saccharomyces boulardii 0.25 billion Actigut: lactobacillus species
bifidobacterium species Enterogermina: Bacillus clausii 2 billion
spores 5ml oral ampule
Prebiotcs
Nondigestable dietary substances Increases the no. of beneficial anaerobic
bacteria and decreases the pathogenic microorganisms
Metabolic effects - Produce short chain fatty acids, absorption of ions( Ca, Fe, Mg)
Enhances host immunity ( IgA production, cytokine modulation)
Commonly known prebiotics are
oligofructose – wheat, onions, bananas, garlic
inulin
lactulose
breastmilk oligosaccharides
galacto oligosaccharides
Lactulose – a synthetic disaccharide used as a drug for the treatment of hepatic encephalopathy and constipation
Symbiotics
probiotic + prebiotioc
References
Probiotics and prebiotics, World Gastroenterology Organisation Practise Guidelines, May,2008.
The pharmacological basics for therapeutics, Goodman & Gillman, 12th edition
Essentials of medical pharmacology – K. D. Tripathi, 7th edition
Pharmacology & pharmacotherapeutics – R. D. Satoskar, 23rd edition
THANK YOU
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