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Prebiotics and Probiotics

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Rinisha Sinha
Rinisha Sinha

This document discusses prebiotics and probiotics. It defines prebiotics as non-digestible fibers that support beneficial gut bacteria, and probiotics as live microorganisms that provide health benefits. Some key points covered include: the health benefits of prebiotics like promoting probiotic growth and enhancing immune function; examples of probiotic foods like yogurt and fermented soy products; the criteria a microbe must meet to be considered a probiotic; and the mechanisms by which probiotics provide benefits like interacting with the immune system and competing with pathogens. The roles of prebiotics and probiotics in oral health are discussed, as well as their safety, dosages, and synergistic effects when combined as synbiotics.

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Prebiotics and Probiotics Dr. Rinisha Sinha MDS Part I
• Microbes and Human Beings • Rationale • What are Prebiotics !? • Sources of Prebiotics • Establishes Prebiotics • Health Benefits • Probiotics • Probiotic Rich Food • A Successful Probiotic must have… • Mechanism of Action • Probiotic Preparations • Systemic Health Benefits • Why Probiotics over Antibiotics • Role in Periodontology • Different means of Administration • Synbiotic • Pre v/s Pro • Safety and Adverse Effects • Dosage • References
MICROBES AND HUMAN BEINGS Microbes are best known for their role in causing disease in humans. In the 19th century, men lost their fear of Gods and instead acquired a fear of microbes. But Colonic Bacteria plays an important role in maintaining health and also in treatment of childhood diarrhea and post – antibiotic diarrhea.
WHY DO WE FEAR MICROBES !! TUBERCULOSIS AIDS SMALLPOX John Keats Alexander Graham Bell Srinivas Ramanujan Nelson Mandela Abraham Lincoln Isaac Asimov
RATIONALE INGESTION OF FERMENTATION BY PRODUCTION OF PREBIOTICS PROBIOTICS POSTBIOTIC S Specialized fiber that supports beneficial microbes present in the gut Live microorganisms that provide health benefits Products made by intestinal bacteria that affect a range of physiological processes
Prebiotics and Probiotics
• Gibson and Ruberoid, 1995 • “Non - digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon that can improve host health.”
PREBIOTICS • Non – digestible but fermentable food ingredients – Fructo-oligosaccharides (chicory, inulin) – Lactulose • Positively affect the endogenous flora by changing the composition and activity of the intestinal microbiota • Stimulate the growth of one or a limited number of bacterial species with prospect to promote the health of the host – FOS  Bifidobacterium – Lactulose  Lactobacilli
Prebiotics and Probiotics
Prebiotics and Probiotics
Health benefits of Prebiotics  promotion of growth of probiotics  increase of calcium absorption  direct effects on the host: • stimulation of IL-10 and interferon γ, • enhancement of IgA secretion, • modulation of inflammatory responses to pathogens  The oligosaccharide derivatives contain sugars that are specific epithelial cell receptors to which pathogens adhere and they, therefore, provide „decoy” adhesion sites and cause pathogens to adhere to luminal contents rather than to epithelial cells.
Prebiotics and Probiotics
1845 - 1916 First introduced Probiotics in the 20th Century He proposed consumption of fermenting food products positively influenced microflora of the colon He introduced Bulgarian Bacillus; later called as Lactobacillus delbrueckii subspecies ELIE METCHNIKOFF NOBEL PRIZEWINNING RUSSIAN BACTERIOLOGIST
Probiotics are defined as living micro-organisms, principally bacteria, that are safe for human consumption and, when ingested in sufficient quantities, have beneficial effects on human health, beyond basic nutrition. (World Health Organization / Food and Agriculture Organization of the United Nation) Probiotics : Greek meaning – “For Life” Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Gaurner et.al - 2005
Contains Live Bacteria Culture Unbaked Fermented Soya Milk Tofu Idli, dosa Uttapam, Dhokla
A Successful PROBIOTIC must… 1. It should capable of exerting a beneficial effect on the host animal, e.g. increased growth or resistance to disease. 2. It should be of human origin. 3. It should have high cell viability. 4. It should be non-pathogenic and non-toxic. 5. It should be able to interact or to send signals to immune cells. 6. It should have capacity to influence local metabolic activity. 7. It should be stable and capable of remaining viable for periods under storage.
MECHANISM OF ACTION 1. Direct interaction : Probiotics interact directly with the disease-causing microbes, making it harder for them to cause the disease. 2. Competitive exclusion : Beneficial microbes directly compete with the disease developing microbes for nutrition or enterocyte adhesion sites. 3. Modulation of host immune response : Probiotics interact with and strengthen the immune system and help prevent disease.
PROBIOTIC PREPARATIONS L.casei L.salivarius L.fermentumL.brevis L.acidophilus S.salivarius S.lactis E.faecalisBifidobacterium
SYSTEMIC HEALTH BENEFITS Elimination of lactose intolerance Anti-diarrheal Immunomodulator y Anticarcinogenic Hypo- cholesterolemic Antihypertensive
Probiotics Normal Intestine Immunomodulation Metabolic Effects Control of IBD Intestinal mucosal integrity Regulation of bowel movement Suppression of PPMs Alleviate food allergy symptoms Strengthens Immunity Lowers cholesterol Lactose tolerance Production of Vitamins; Improved Digestion
WHY PROBIOTICS OVER ANTIBIOTICS ANTIBIOTICS PROBIOTICS  Damage the normal flora,  Predisposes additional infections  Emergence of resistant strains ANTIBIOTICS PROBIOTICS  Prevent colonization, overgrowth and translocation  Reduce incidence of future infections
ROLE OF PROBIOTICS IN PERIODONTICS ROLE OUTCOME STRAINS REFERENCE PLAQUE CONTROL AND GINGIVAL INFLAMMATION Reduction in plaque accumulation and gingivitis . Nisin, bacteriocin extracted from L.lactis K.Noordin and S.Kamin PERIODONTITIS IN SMOKERS Improvement of plaque index and probing pocket depth from baseline within 8 weeks L.salivarius WB21 H.Shimauchi et al 2008 REDUCTION OF MALODOR In-vivo and in-vitro study showed a definite inhibitory effect on production of Volatile Sulphur Compounds W.cibaria Kang et al 2006
ROLE OF PROBIOTICS IN PERIODONTICS ROLE OUTCOME STRAINS REFERENCE ATTACHMENT, ADHESION AND ORAL COLONIZATION Co-aggregated with F.nucleatum thereby forming a barrier that prevents colonization of pathogenic bacteria indicating that probiotics affect formation of oral biofilms and modify resident microflora W.Cibaria Kang et al, 2005 PERIODONTAL DISEASES Diminish the number of periodontal pathogens like Bacteroides sp, Actinomyces sp, and C. albicans Lactobacillus species Volozin et al 2004 PERIODONTAL DISEASES Inhibits the growth of P.gingivalis and P.intermedia Resident lactobacilli flora Koll-klais et al 2006 YEAST INFECTIONS Rapid decline in C.albicans in mice L.acidophilus and L.fermentum. Elahi et al 2005
DIFFERENT MEANS OF PROBIOTIC ADMINISTRATION FOR ORAL HEALTH PURPOSES • Most common : Dairy products and probiotic – fortified foods • Formulations :  Drops  Chewable tablets  Lozenges  Capsules  Straws  Powder blends  Bacteria in freeze dried form
RESTORE THE MICROFLORA BALANCE PROBIOTICS + PREBIOTICS = SYNBIOTICS Potential Synergy between pre and pro-biotics Eg : Bifidobacterium and fructo-oligosaccharides
PROBIOTICS V/S PREBIOTICS
SAFETY AND ADVERSE EFFECTS • Mild side effects, if occur. • Digestive – bloating and flatulence • Infections in Immunocompromised patients and Not recommended in critically ill person • Diabetic patient to be cautious because of high level of sugar in probiotic drinks • Constipation and Increased Thirst – associated with S. boulardii • Consumption of a mixture of six probiotic bacteria increased the death rate of patients with predicted severe acute pancreatitis. • Prebiotic – Oligosaccharide  Abdominal Discomfort and Distension + significant levels of flatulence
DOSAGE • Minimum Consumption = 100 g of a probiotic food of 107 cfu/gram • Over the counter dose = 1-10 billion cfu/dose • Recommended dosage = 5 grams a day • The Nutrition Information center of South Africa’s University of Stellenbosch recommended that daily consumption of prebiotics be held below 20 grams.
Prebiotics and Probiotics
• Dr. D. Chatterjee . Probiotics in periodontal health and disease. JISP 2011 ; vol 15 ; issue 1 • Person RG . Immune responses and vaccination against periodontal infections. J Clin Periodontol 2005: 32;39-53 • Caglar E, Kargul B, Tanboga I. Bacteriotherapy and probiotics role on oral health. Oral Diseases 2005:11;131- 37 • JH Meurman, I.Stamatova- Probiotics- Contributions to oral health. Oral Diseases 2007:13;443-45. • K.Noordin, S.Kamin. The effect of probiotic mouthwash on plaque and gingival inflammation.Annal Dental university Malaysia 2007:14;19-25 • J.Burton. The rationale and potential for reduction of oral malodor using Streptococcus salivarius probiotics. Oral diseases 2005:11;29-31 • Wim Tuegels et.al. Probiotics and oral health care. Periodontology 2000:48;111-147 • Gupta g Probiotics and periodontal health j of medicine and life 2011 vol 4 issue 4

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Prebiotics and Probiotics

  • 1. Prebiotics and Probiotics Dr. Rinisha Sinha MDS Part I
  • 2. • Microbes and Human Beings • Rationale • What are Prebiotics !? • Sources of Prebiotics • Establishes Prebiotics • Health Benefits • Probiotics • Probiotic Rich Food • A Successful Probiotic must have… • Mechanism of Action • Probiotic Preparations • Systemic Health Benefits • Why Probiotics over Antibiotics • Role in Periodontology • Different means of Administration • Synbiotic • Pre v/s Pro • Safety and Adverse Effects • Dosage • References
  • 3. MICROBES AND HUMAN BEINGS Microbes are best known for their role in causing disease in humans. In the 19th century, men lost their fear of Gods and instead acquired a fear of microbes. But Colonic Bacteria plays an important role in maintaining health and also in treatment of childhood diarrhea and post – antibiotic diarrhea.
  • 4. WHY DO WE FEAR MICROBES !! TUBERCULOSIS AIDS SMALLPOX John Keats Alexander Graham Bell Srinivas Ramanujan Nelson Mandela Abraham Lincoln Isaac Asimov
  • 5. RATIONALE INGESTION OF FERMENTATION BY PRODUCTION OF PREBIOTICS PROBIOTICS POSTBIOTIC S Specialized fiber that supports beneficial microbes present in the gut Live microorganisms that provide health benefits Products made by intestinal bacteria that affect a range of physiological processes
  • 7. • Gibson and Ruberoid, 1995 • “Non - digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon that can improve host health.”
  • 8. PREBIOTICS • Non – digestible but fermentable food ingredients – Fructo-oligosaccharides (chicory, inulin) – Lactulose • Positively affect the endogenous flora by changing the composition and activity of the intestinal microbiota • Stimulate the growth of one or a limited number of bacterial species with prospect to promote the health of the host – FOS  Bifidobacterium – Lactulose  Lactobacilli
  • 11. Health benefits of Prebiotics  promotion of growth of probiotics  increase of calcium absorption  direct effects on the host: • stimulation of IL-10 and interferon γ, • enhancement of IgA secretion, • modulation of inflammatory responses to pathogens  The oligosaccharide derivatives contain sugars that are specific epithelial cell receptors to which pathogens adhere and they, therefore, provide „decoy” adhesion sites and cause pathogens to adhere to luminal contents rather than to epithelial cells.
  • 13. 1845 - 1916 First introduced Probiotics in the 20th Century He proposed consumption of fermenting food products positively influenced microflora of the colon He introduced Bulgarian Bacillus; later called as Lactobacillus delbrueckii subspecies ELIE METCHNIKOFF NOBEL PRIZEWINNING RUSSIAN BACTERIOLOGIST
  • 14. Probiotics are defined as living micro-organisms, principally bacteria, that are safe for human consumption and, when ingested in sufficient quantities, have beneficial effects on human health, beyond basic nutrition. (World Health Organization / Food and Agriculture Organization of the United Nation) Probiotics : Greek meaning – “For Life” Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Gaurner et.al - 2005
  • 15. Contains Live Bacteria Culture Unbaked Fermented Soya Milk Tofu Idli, dosa Uttapam, Dhokla
  • 16. A Successful PROBIOTIC must… 1. It should capable of exerting a beneficial effect on the host animal, e.g. increased growth or resistance to disease. 2. It should be of human origin. 3. It should have high cell viability. 4. It should be non-pathogenic and non-toxic. 5. It should be able to interact or to send signals to immune cells. 6. It should have capacity to influence local metabolic activity. 7. It should be stable and capable of remaining viable for periods under storage.
  • 17. MECHANISM OF ACTION 1. Direct interaction : Probiotics interact directly with the disease-causing microbes, making it harder for them to cause the disease. 2. Competitive exclusion : Beneficial microbes directly compete with the disease developing microbes for nutrition or enterocyte adhesion sites. 3. Modulation of host immune response : Probiotics interact with and strengthen the immune system and help prevent disease.
  • 19. SYSTEMIC HEALTH BENEFITS Elimination of lactose intolerance Anti-diarrheal Immunomodulator y Anticarcinogenic Hypo- cholesterolemic Antihypertensive
  • 20. Probiotics Normal Intestine Immunomodulation Metabolic Effects Control of IBD Intestinal mucosal integrity Regulation of bowel movement Suppression of PPMs Alleviate food allergy symptoms Strengthens Immunity Lowers cholesterol Lactose tolerance Production of Vitamins; Improved Digestion
  • 21. WHY PROBIOTICS OVER ANTIBIOTICS ANTIBIOTICS PROBIOTICS  Damage the normal flora,  Predisposes additional infections  Emergence of resistant strains ANTIBIOTICS PROBIOTICS  Prevent colonization, overgrowth and translocation  Reduce incidence of future infections
  • 22. ROLE OF PROBIOTICS IN PERIODONTICS ROLE OUTCOME STRAINS REFERENCE PLAQUE CONTROL AND GINGIVAL INFLAMMATION Reduction in plaque accumulation and gingivitis . Nisin, bacteriocin extracted from L.lactis K.Noordin and S.Kamin PERIODONTITIS IN SMOKERS Improvement of plaque index and probing pocket depth from baseline within 8 weeks L.salivarius WB21 H.Shimauchi et al 2008 REDUCTION OF MALODOR In-vivo and in-vitro study showed a definite inhibitory effect on production of Volatile Sulphur Compounds W.cibaria Kang et al 2006
  • 23. ROLE OF PROBIOTICS IN PERIODONTICS ROLE OUTCOME STRAINS REFERENCE ATTACHMENT, ADHESION AND ORAL COLONIZATION Co-aggregated with F.nucleatum thereby forming a barrier that prevents colonization of pathogenic bacteria indicating that probiotics affect formation of oral biofilms and modify resident microflora W.Cibaria Kang et al, 2005 PERIODONTAL DISEASES Diminish the number of periodontal pathogens like Bacteroides sp, Actinomyces sp, and C. albicans Lactobacillus species Volozin et al 2004 PERIODONTAL DISEASES Inhibits the growth of P.gingivalis and P.intermedia Resident lactobacilli flora Koll-klais et al 2006 YEAST INFECTIONS Rapid decline in C.albicans in mice L.acidophilus and L.fermentum. Elahi et al 2005
  • 24. DIFFERENT MEANS OF PROBIOTIC ADMINISTRATION FOR ORAL HEALTH PURPOSES • Most common : Dairy products and probiotic – fortified foods • Formulations :  Drops  Chewable tablets  Lozenges  Capsules  Straws  Powder blends  Bacteria in freeze dried form
  • 25. RESTORE THE MICROFLORA BALANCE PROBIOTICS + PREBIOTICS = SYNBIOTICS Potential Synergy between pre and pro-biotics Eg : Bifidobacterium and fructo-oligosaccharides
  • 27. SAFETY AND ADVERSE EFFECTS • Mild side effects, if occur. • Digestive – bloating and flatulence • Infections in Immunocompromised patients and Not recommended in critically ill person • Diabetic patient to be cautious because of high level of sugar in probiotic drinks • Constipation and Increased Thirst – associated with S. boulardii • Consumption of a mixture of six probiotic bacteria increased the death rate of patients with predicted severe acute pancreatitis. • Prebiotic – Oligosaccharide  Abdominal Discomfort and Distension + significant levels of flatulence
  • 28. DOSAGE • Minimum Consumption = 100 g of a probiotic food of 107 cfu/gram • Over the counter dose = 1-10 billion cfu/dose • Recommended dosage = 5 grams a day • The Nutrition Information center of South Africa’s University of Stellenbosch recommended that daily consumption of prebiotics be held below 20 grams.
  • 30. • Dr. D. Chatterjee . Probiotics in periodontal health and disease. JISP 2011 ; vol 15 ; issue 1 • Person RG . Immune responses and vaccination against periodontal infections. J Clin Periodontol 2005: 32;39-53 • Caglar E, Kargul B, Tanboga I. Bacteriotherapy and probiotics role on oral health. Oral Diseases 2005:11;131- 37 • JH Meurman, I.Stamatova- Probiotics- Contributions to oral health. Oral Diseases 2007:13;443-45. • K.Noordin, S.Kamin. The effect of probiotic mouthwash on plaque and gingival inflammation.Annal Dental university Malaysia 2007:14;19-25 • J.Burton. The rationale and potential for reduction of oral malodor using Streptococcus salivarius probiotics. Oral diseases 2005:11;29-31 • Wim Tuegels et.al. Probiotics and oral health care. Periodontology 2000:48;111-147 • Gupta g Probiotics and periodontal health j of medicine and life 2011 vol 4 issue 4