Lactic acid bacteria and health: are probiotics safe for human?

COMMENTARY ON THE LAW

Lactic acid bacteria and health: are probiotics safe for human?

Izabela Kubiszewska 1 , Milena Januszewska 1 , Joanna Rybka 2 , Lidia Gackowska 1

1. Katedra Immunologii, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy UMK w Toruniu
2. Katedra i Zakład Biochemii, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy UMK w Toruniu

Published: 2014-11-17
DOI: 10.5604/17322693.1129120
GICID: 01.3001.0003.1371
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2014; 68 : 1325-1334

 

Abstract

The effect of Lactobacillus and Bifidobacterium on human health has been examined for many years. Numerous in vivo and in vitro studies have confirmed the beneficial activity of some exogenous lactic acid bacteria in the treatment and prevention of rotaviral infection, antibiotic-associated diarrhea, inflammatory bowel disease and other gastrointestinal disorders. Probiotics support the action of the intestinal microflora and exhibit a favorable modulatory effect on the host’s immune system. However, it should be remembered that relatively harmless lactobacilli can occasionally induce opportunistic infections. Due to reaching almost 20 x 1012 probiotic doses per year which contain live cultures of bacteria, it is essential to monitor the safety aspect of their administration. In recent years, infections caused by Lactobacillus and Bifidobacterium made up 0.05% to 0.4% of cases of endocarditis and bacteremia. In most cases, the infections were caused by endogenous microflora of the host or bacterial strains colonizing the host’s oral cavity. According to a review of cases of infections caused by bacteria of the genus Lactobacillus from 2005 (collected by J.P. Cannot’a), 1.7% of infections have been linked directly with intensive dairy probiotic consumption by patients. Additionally, due to the lack of a precise description of most individuals’ eating habits, the possible effect of probiotics on infection development definitively should not be ruled out. The present paper describes cases of diseases caused by lactic acid bacteria, a potential mechanism for the adverse action of bacteria, and the possible hazard connected with probiotic supplementation for seriously ill and hospitalized patients.

References

  • 1. Ahrné S., Nobaek S., Jeppsson B., Adlerberth I., Wold A.E., MolinG.: The normal Lactobacillus flora of healthy human rectal and oralmucosa. J. Appl. Microbiol., 1998; 85: 88-94
    Google Scholar
  • 2. Besselink M.G., van Santvoort H.C., Buskens E., Boermeester M.A.,van Goor H., Timmerman H.M., Nieuwenhuijs V.B., Bollen T.L., vanRamshorst B., Witteman B.J., Rosman C., Ploeg R.J., Brink M.A., SchaapherderA.F., Dejong C.H. i wsp.: Probiotic prophylaxis in predictedsevere acute pancreatitis: a randomised, double-blind, placebo-controlledtrial. Lancet, 2008; 371: 651-659
    Google Scholar
  • 3. Boehm G., Fanaro S., Jelinek J., Stahl B., Marini A.: Prebiotic conceptfor infant nutrition. Acta Paediatr., 2003; 92 (Suppl. s441): 64-67
    Google Scholar
  • 4. Borriello S.P., Hammes W.P., Holzapfel W., Marteau P., SchrezenmeirJ., Vaara M., Valtonen V.: Safety of probiotics that contain lactobacillior bifidobacteria. Clin. Infect. Dis., 2003; 36: 775-780
    Google Scholar
  • 5. Brandtzaeg P., Kiyono H., Pabst R., Russell M.W.: Terminology:nomenclature of mucosa-associated lymphoid tissue. Mucosal. Immunol.,2008; 1: 31-37
    Google Scholar
  • 6. Cannon J.P., Lee T.A., Bolanos J.T., Danziger L.H.: Pathogenic relevanceof Lactobacillus: a retrospective review of over 200 cases. Eur.J. Clin. Microbiol. Infect. Dis., 2005; 24: 31-40
    Google Scholar
  • 7. Cesta M.F.: Normal structure, function, and histology of mucosaassociatedlymphoid tissue. Toxicol. Pathol., 2006; 34: 599-608
    Google Scholar
  • 8. Cukovic-Cavka S., Likic R., Francetic I., Rustemovic N., Opacic M.,Vucelic B.: Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn’s disease. Digestion, 2006; 73: 107-110
    Google Scholar
  • 9. de Vrese M., Schrezenmeir J.: Probiotics and non-intestinal infectiousconditions. Br. J. Nutr., 2002; 88 (Suppl. 1): S59-S66
    Google Scholar
  • 10. Didierlaurent A., Sirard J.C., Kraehenbuhl J.P., Neutra M.R.: Howthe gut senses its content. Cell. Microbiol., 2002; 4: 61-72
    Google Scholar
  • 11. Działo J., Niedźwiedzka-Rystwej P., Mękal A., Deptuła W.: Charakterystykatkanki limfatycznej błon śluzowych przewodu pokarmowegoi układu oddechowego. Alergia Astma Immunol., 2010; 15: 197-202
    Google Scholar
  • 12. Fanaro S., Chierici R., Guerrini P., Vigi V.: Intestinal microflora inearly infancy: composition and development. Acta Paediatr. Suppl.,2003; 91: 48-55
    Google Scholar
  • 13. Fanning S., Hall L.J., Cronin M., Zomer A., MacSharry J., GouldingD., Motherway M.O., Shanahan F., Nally K., Dougan G., van SinderenD.: Bifidobacterial surface-exopolysaccharide facilitates commensalhostinteraction through immune modulation and pathogen protection.Proc. Natl. Acad. Sci. USA, 2012; 109: 2108-2113
    Google Scholar
  • 14. Feehley T., Stefka A., Tripathi P., McCoy K., Mazmanian S., SeoG.Y., Theriault B., Antonopoulos D., Chang E., Nagler C.: Commensalbacteria induce a barrier protective response to prevent sensitizationto food allergens. J. Immunol., 2013; 190: 120.19
    Google Scholar
  • 15. Fooks L.J., Gibson G.R.: Probiotics as modulators of the gut flora.Brit. J. Nutr., 2002; 88 (Suppl. 1): S39-S49
    Google Scholar
  • 16. Forchielli M.L., Walker W.A.: The role of gut-associated lymphoidtissues and mucosal defence. Brit. J. Nutr., 2005; 93 (Suppl. 1): S41-S48
    Google Scholar
  • 17. Górska S., Jarząb A., Gamian A.: Bakterie probiotyczne w  przewodziepokarmowym człowieka jako czynnik stymulujący układodpornościowy. Postępy Hig. Med. Dośw., 2009; 63: 653-667
    Google Scholar
  • 18. Guidelines for the Evaluation of Probiotics in Food. Raport ofa Joint FAO/WHO Working Group, London, Ontario, Canada, 2002: 1-11
    Google Scholar
  • 19. Hamilton-Miller J.M.: The role of probiotics in the treatmentand prevention of Helicobacter pylori infection. Int. J. Antimicrob.Agents, 2003; 22: 360-366
    Google Scholar
  • 20. Hao W.L., Lee Y.K.: Microflora of the gastrointestinal tract: a review.Methods Mol. Biol., 2004; 268: 491-502
    Google Scholar
  • 21. Health and Nutritional Properties of Probiotics in Food includingPowder Milk with Live Lactic Acid Bacteria. Raport of a Joint FAO/WHO Expert Consultation, Córdoba, Argentina 2001; 1-34
    Google Scholar
  • 22. Husni R.N., Gordon S.M., Washington J.A., Longworth D.L.: Lactobacillusbacteremia and endocarditis: review of 45 cases. Clin. Infect.Dis., 1997; 25: 1048-1055
    Google Scholar
  • 23. Immunity and probiotics Nutrition And Health Collection, JohnLibbey Eurotext, Ed. Danone and Research Centers, Paris 1999
    Google Scholar
  • 24. Kraehenbuhl J.P., Neutra M.R.: Epithelial M cells: differentiationand function. Annu. Rev. Cell Dev. Biol., 2000; 16: 301-332
    Google Scholar
  • 25. Land M.H., Rouster-Stevens K., Woods C.R., Cannon M.L., CnotaJ., Shetty A.K.: Lactobacillus sepsis associated with probiotic therapy.Pediatrics, 2005; 115: 178-181
    Google Scholar
  • 26. Ledoux D., LaBombardi V.J., Karter D.: Lactobacillus acidophilusbacteraemia after use of a probiotic in a patient with AIDS and Hodgkin’sdisease. Int. J. STD AIDS, 2006; 17: 280-282
    Google Scholar
  • 27. Macpherson A.J., Gatto D., Sainsbury E., Harriman G.R., HengartnerH., Zinkernagel R.M.: A primitive T cell-independent mechanismof intestinal mucosal IgA responses to commensal bacteria. Science,2000; 288: 2222-2226
    Google Scholar
  • 28. Marteau P.: Safety aspects of probiotic products. Scand. J. Nutr.,2001; 45: 22-24
    Google Scholar
  • 29. Marteau P.R.: Probiotics in clinical conditions. Clin. Rev. AllergyImmunol., 2002; 22: 255-273
    Google Scholar
  • 30. Muszyński Z., Mirska I., Matuska K.: Pałeczki z rodzaju Lactobacillus– czynnik zakażeń oportunistycznych u dzieci. Przegl. Epidemiol.,2007; 61: 79-84
    Google Scholar
  • 31. Olano A., Chua J., Schroeder S., Minari A., La Salvia M., Hall G.:Weissella confusa (basonym: Lactobacillus confusus) bacteremia: a casereport. J. Clin. Microbiol., 2001; 39: 1604-1607
    Google Scholar
  • 32. Rautio M., Jousimies-Somer H., Kauma H., Pietarinen I., SaxelinM., Tynkkynen S., Koskela M.: Liver abscess due to a Lactobacillusrhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin.Infect. Dis., 1999; 28: 1159-1160
    Google Scholar
  • 33. Reid G., Hammond J.A.: Probiotics. Some evidence of their effectiveness.Can. Fam. Physician, 2005; 51: 1487-1493
    Google Scholar
  • 34. Rolfe R.D.: The role of probiotic cultures in the control of gastrointestinalhealth. J. Nutr., 2000; 130 (Suppl. 2S): 396S-402S
    Google Scholar
  • 35. Saarela M., Mättö J., Mattila-Sandholm T.: Safety aspects ofLactobacillus and Bifidobacterium species originating from humanoro-gastrointestinal tract or from probiotic products. Microb. Ecol.Health D, 2002; 14: 233-240
    Google Scholar
  • 36. Salminen M.K., Tynkkynen S., Rautelin H., Saxelin M., Vaara M.,Ruutu P., Sarna S., Valtonen V., Järvinen A.: Lactobacillus bacteremiaduring a rapid increase in probiotic use of Lactobacillus rhamnosusGG in Finland. Clin. Infect. Dis., 2002; 35: 1155-1160
    Google Scholar
  • 37. Sanders M.E.: Considerations for use of probiotic bacteria tomodulate human health. J. Nutr., 2000; 130 (Suppl. 2S): 384S-390S
    Google Scholar
  • 38. Schrezenmeir J., de Vrese M.: Probiotics, prebiotics, and synbiotics– approaching a definition. Am. J. Clin. Nutr., 2001; 73 (Suppl.2): 361S-364S
    Google Scholar
  • 39. Servin A.L.: Antagonistic activities of lactobacilli and bifidobacteriaagainst microbial pathogens. FEMS Microbiol. Rev., 2004;28: 405-440
    Google Scholar
  • 40. Stiles M.E., Holzapfel W.H.: Lactic acid bacteria of foods and theircurrent taxonomy. Int. J. Food Microbiol., 1997; 36: 1-29
    Google Scholar
  • 41. Tomasik P.J., Tomasik P.: Probiotics and prebiotics. Cereal Chem.,2003; 80: 113-117
    Google Scholar
  • 42. The use of probiotics for patients in hospitals. A benefit and riskassessment. Opin. Steering Committee Norwegian Sci. CommitteeFood Safety, 2009; 1-29
    Google Scholar
  • 43. Weiner H.L., van Rees E.P.: Mucosal tolerance. Immunol. Lett.,1999; 69: 3-4
    Google Scholar

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