The Impact of Probiotics, Prebiotics, and Synbiotics during Pregnancy or Lactation on the Intestinal Microbiota of Children Born by Cesarean Section: A Systematic Review

The gut microbiota is a key factor in the correct development of the gastrointestinal immune system. Studies have found differences between the gut microbiota of newborns delivered by cesarean section compared to those vaginally delivered. Our objective was to evaluate the effect of ingestion of probiotics, prebiotics, or synbiotics during pregnancy and/or lactation on the development of the gut microbiota of the C-section newborns. We selected experimental studies in online databases from their inception to October 2021. Of the 83 records screened, 12 met the inclusion criteria. The probiotics used belonged to the genera Lactobacillus, Bifidobacterium, Propionibacterium, and Streptococcus, or a combination of those, with dosages varying between 2 × 106 and 9 × 1011 CFU per day, and were consumed during pregnancy and/or lactation. Probiotic strains were combined with galacto-oligosaccharides, fructo-oligosaccharides, or bovine milk-derived oligosaccharides in the synbiotic formulas. Probiotic, prebiotic, and synbiotic interventions led to beneficial gut microbiota in cesarean-delivered newborns, closer to that in vaginally delivered newborns, especially regarding Bifidobacterium colonization. This effect was more evident in breastfed infants. The studies indicate that this beneficial effect is achieved when the interventions begin soon after birth, especially the restoration of bifidobacterial population. Changes in the infant microbial ecosystem due to the interventions seem to continue after the end of the intervention in most of the studies. More interventional studies are needed to elucidate the optimal synbiotic combinations and the most effective strains and doses for achieving the optimal gut microbiota colonization of C-section newborns.

Efficacy of Probiotics in Rheumatoid Arthritis and Spondyloarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: We aimed to provide a systematic review and meta-analysis of randomized controlled trials assessing the effect of probiotics supplementation on symptoms and disease activity in patients with chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondylarthritis (SpA), or psoriatic arthritis). Methods: A systematic literature review and meta-analysis from RA and SpA randomized controlled trials were conducted searching for articles in MEDLINE/PubMed and abstracts from recent international rheumatology meetings. The control group was a placebo or another dietary intervention. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration tool and the Jadad scale. Results: The initial search yielded 173 articles. Of these, 13 studies were included in the qualitative synthesis, 8 concerning a total of 344 RA patients and 2 concerning a total of 197 SpA patients. Three meta-analyses were also analyzed. Probiotic strains and quantities used were different among trials (5 studies using Lactobacillus sp., 1 trial Bacillus coagulans and the others a mix of different probiotic strains). Time to assess response ranged from 8 weeks to one year. Two studies associated probiotic supplementation with a dietary intervention. Meta-analysis showed a statistically significant decrease of C-reactive protein (CRP) concentration (mean difference (MD)) −3.04 (95% CI −4.47, −1.62) mg/L, p < 0.001; I2 = 20%, n patients = 209) with probiotics in RA. However, after excluding high-risk-of-bias trials of meta-analysis, there was no difference between probiotics and placebo on DAS28 (standard MD −0.54; 95% CI −1.94 to 0.85, p = 0.45, I2 93%, n patients = 143). The two studies on SpA patients showed no efficacy of probiotics. Conclusions: Probiotic supplementation might decrease RA activity with a moderate decrease effect on CRP, but lack of evidence and studies’ heterogeneity do not allow us to propose them to patients with inflammatory arthritis to control their disease. Further RCTs are required in the future to determinate the efficacy of probiotics and the optimal administration design.

Evaluation of physicochemical, sensory, and antimicrobial properties of small-scale produced fruit vinegars

Hungarian fruit vinegars were characterised in terms of physicochemical attributes (total polyphenol content, antioxidant characteristics/FRAP, CUPRAC, ABTS/, ascorbic acid content, pH, total soluble solids), sensory profiles, and antimicrobial properties. Both compositional and sensory profiles showed distinct patterns depending on the type of vinegar (Tokaj wine, balsamic or apple) and the additional fruit used. Balsamic vinegars maturated on rosehip, sea buckthorn, and raspberry showed outstanding antioxidant performances. Rosehip, raspberry, and quince vinegars, as well as vinegars produced from Tokaji aszú and balsamic apple obtained high scores for fruity and sweet notes. Antimicrobial activities were tested on Gram-negative and Gram-positive organisms, including probiotic bacteria. Generally, only weak activities were obtained, which was attributed to the natural sugar content of the samples, depending on the type of the vinegar and the fruit. Similar results, but more pronounced bacterial growth inhibitions were obtained for probiotic strains, however, some probiotic strains were resistant to at least two of the vinegars. Based on these, balsamic apple, raspberry, rosehip, quince, and sea buckthorn may qualify as potential functional components of probiotic preparations containing some of the strains tested.

Treatment of Hyperammonemia by Transplanting a Symbiotic Pair of Intestinal Microbes

Hyperammonemia is a deleterious and inevitable consequence of liver failure. However, no adequate therapeutic agent is available for hyperammonemia. Although recent studies showed that the pharmabiotic approach could be a therapeutic option for hyperammonemia, its development is clogged with poor identification of etiological microbes and low transplantation efficiency of candidate microbes. In this study, we developed a pharmabiotic treatment for hyperammonemia that employs a symbiotic pair of intestinal microbes that are both able to remove ammonia from the surrounding environment. By a radioactive tracing experiment in mice, we elucidated how the removal of ammonia by probiotics in the intestinal lumen leads to lower blood ammonia levels. After determination of the therapeutic mechanism, ammonia-removing probiotic strains were identified by high-throughput screening of gut microbes. The symbiotic partners of ammonia-removing probiotic strains were identified by screening intestinal microbes of a human gut, and the pairs were administrated to hyperammonemic mice to evaluate therapeutic efficacy. Blood ammonia was in a chemical equilibrium relationship with intestinal ammonia. Lactobacillus reuteri JBD400 removed intestinal ammonia to shift the chemical equilibrium to lower the blood ammonia level. L. reuteri JBD400 was successfully transplanted with a symbiotic partner, Streptococcus rubneri JBD420, improving transplantation efficiency 2.3×103 times more compared to the sole transplantation while lowering blood ammonia levels significantly. This work provides new pharmabiotics for the treatment of hyperammonemia as well as explains its therapeutic mechanism. Also, this approach provides a concept of symbiotic pairs approach in the emerging field of pharmabiotics.

Does Probiotic Consumption Enhance Wound Healing? A Systematic Review

The use of probiotics is one of the emerging lines of treatment for wound healing. This systematic review aimed to summarize currently available evidence on the effect of oral or enteral probiotic therapy on skin or oral mucosal wound healing in humans. To verify the developments in this field and the level of available scientific evidence, we applied a broad search strategy with no restrictions on wound type, target population, probiotic strain, or intervention protocol used. This review included seven studies involving 348 individuals. Four studies reported positive outcomes for healing improvement after probiotic therapy, and none of the studies reported adverse effects or a marked increase in wound healing time. The positive or neutral results observed do not generate strong evidence regarding the effectiveness of probiotics for wound healing. However, they suggest a promising field for future clinical research where the probiotic strains used, type of wounds, and target population are controlled for.

Incorporation of Sukkari Date in Probiotic-Enriched Fermented Camel Milk Improves the Nutritional, Physicochemical, and Organoleptical Characteristics

Camel milk and dates are well-known for their great nutritional and therapeutical benefits. Therefore, the study aimed to combine the benefits of fermented camel milk (FCM) and Sukkari date (SKD) in a naturally sweetened FCM. Six treatments of FCM using ABT-5 cultures with 0, 5, 7.5, 10, 12.5, and 15% SKD were carried out. Chemical, physicochemical, rheological properties were studied, while organoleptical attributes and probiotic strains viability were monitored during cold storage (4 °C) up to 15 days. Results showed that fortification with SKD increased total solids (TS), ash, dietary fiber, and carbohydrate content compared to plain FCM. Water holding capacity (WHC) values increased with low and medium SKD levels then decreased with high SKD levels. Minerals such as K, P, Mg, Zn, Fe, and Cu were significantly increased, while Na was significantly decreased. Increased SKD levels in FCM resulted in significant increases in total phenolic content (TPC), total flavonoids (TF), total flavonols (TFL), and antioxidant activity (AOA). Instrumental color analysis exhibited a significant change in L*, b*, BI, and ∆E due to adding SKD in a dose-dependent manner. The viability of Streptococcus thermophiles, Lactobacillus acidophilus, and Bifidobacterium bifidum was increased by adding low and medium SKD levels, resulting in a higher number than the accepted threshold for a probiotic effect. Adding 10 and 12.5% SKD recorded the best-balanced flavor score at the beginning and after up to 15 days of storage, respectively. Conclusively, the current study revealed that fortification with SKD at 7.5–12.5% improved the nutritional quality without adverse effects on the technological, organoleptic characteristics, and probiotics viability and provided acceptable, nutritious, and healthy benefits to FCM.

The Possible Link Between Manufacturing and Probiotic Efficacy; a Molecular Point of View on Bifidobacterium

Probiotics for food or supplement use have been studied in numerous clinical trials, addressing a broad variety of diseases, and conditions. However, discrepancies were observed in the clinical outcomes stemming from the use of lactobacillaceae and bifidobacteria strains. These differences are often attributed to variations in the clinical trial protocol like trial design, included target population, probiotic dosage, or outcome parameters measured. However, a contribution of the methods used to produce the live bioactive ingredients should not be neglected as a possible additional factor in the observed clinical outcome variations. It is well established that manufacturing conditions play a role in determining the survival and viability of probiotics, but much less is known about their influence on the probiotic molecular composition and functionality. In this review, we briefly summarize the evidence obtained for Lacticaseibacillus rhamnosus GG and Lactiplantibacillus plantarum WCFS1, highlighting that expression and presence of probiotic niche factor (NF) and/or effector molecules (EM) may be altered during production of those two well-characterized lactobacillaceae probiotic strains. Subsequently, we summarize in more depth what is the present state of knowledge about bifidobacterial probiotic NF and EM; how their expression may be modified by manufacturing related environmental factors and how that may affect their biological activity in the host. This review highlights the importance of gathering knowledge on probiotic NF and EM, to validate them as surrogate markers of probiotic functionality. We further propose that monitoring of validated NF and/or EM during production and/or in the final preparation could complement viable count assessments that are currently applied in industry. Overall, we suggest that implementation of molecular level quality controls (i.e., based on validated NF and EM), could provide mode of action based in vitro tests contributing to better control the health-promoting reliability of probiotic products.

Selective Fermentation of Lactobacillus and Streptococcus In Vitro: Effects of Chinese Fermented Glutinous Rice on the Growth Promotion of Potential Probiotics

A functional Chinese fermented glutinous rice has been developed with the supplementation of Fu brick tea (CRW-FBT). In this study, we aimed to evaluate its effect on the growth of potential probiotic strains in the Lactobacillus, Streptococcus, and Weissella genus, compared with traditional Chinese fermented glutinous rice (CRW). The growth profiles of lactic acid bacteria were analyzed based on fermentations in vitro, and the optical densities were recorded at 600 nm during the whole fermentation. Growth curve, maximum OD600 nm, and growth rate were measured and compared among samples with different ratios of CRW-FBT and CRW addition. Through the multiple analysis of growth parameters, we found that all the tested strains obtained better growth results when CRW-FBT was supplemented to the media, compared with the CRW and basic media. The bacterial growth was promoted by exhibiting the shortened lag time, prolonged logarithmic phase and stationary phase, and increased growth rate and cell density, as well as the better performance after 24 h and 48 h fermentation. Besides, short-chain fatty acids and organic acids in CRW-FBT were founded. Our work demonstrated the positive effect of Fu brick tea supplemented in the CRW and illustrated its beneficial role in the food fermentation industry for the purpose of microorganism enrichment and the improvement of microbial metabolism.