Probiotice, prebiotice, simbiotice

Prof. Dr. Doina

Miere

Probiotice
195
0

Istoric
190
0
Tissier
- B. bifidus
Moro
B.
acidophilus

193
0
Shirota,
Kellogg
teoria
realitate
Ilya Metchnikoff *
comercial
(premiul Nobel)
teoria longevitii
1907

Nutriioni
ti
germani
terapia
cu
probiotice

*The Prolongation of life. Optimistic

Studies

Probiotice
Definii
e

microorganisme vii care, administrate n cantiti adecv

confer gazdei efecte benefice pentru sntate,
mbuntind balana intestinal
microorganisme
sntoase

microorganisme
prietenoase

Microorganisme
probiotice
Bacterii, drojdii, mucegaiuri

Lactobacil
lus
acidophill
us

Bifidobacte
rium BB-12

Alte gen
Lacto
Bifido
i specii
bacillus
baterium
Lactobacillus
acidophilus,
Lactococcus
L. rhamnosus, L.
Enterococcus
lactus
Bifidobacterium
Streptococcus:
L plantarum L.
bifidum
lactis, cremoris,
brevis,
longum
alivarius,
L. bulgaricus,
infantis
intermedius,
delbruecki
breve
termophillus
L. reuteri, L.
adolescentis
Propionibacteriu
fermentum,
termophilum
m etc.
L. casei, L
lactis, animalis
Sacharomyces
farciminis
1. REVIEW, Role of Probiotics in health improvement,infection control and
disease treatment and m
cerevisiae
L.
sporogenes
,
L
A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)
2. Probiotics-From
Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728
crispatus

Selecia probioticelor
Crieriul general

Proprietatea
Origine, neinvazive, necarcinogene

Criteriul siguran Sa nu prezinte patogenitate,

/ securitate
infectivitate
Lipsa toxicitate, rezisten la
antibiotice
Tulpini stabile genetic
Viabilitate prelucrare, depozitare
Criterii
tehnologice

Proprieti senzoriale bune

la scaroflarg
FAO/WHO - GuidelenesProducie
for the Evaluation
Probiotics in Food
ex. patologic, genetic, imunologic, gastroenterologic
microbiologic
Tehnici moleculare acceptate internaional fenotip, genotip,
gen, specie
E.M.M. Quigley, Prebiotic & probiotic, Pharmacological research 61, (2010), 213-218

Selecia probioticelor
Crieriul
general

Proprietatea

Criterii
funcionale

Rezisten la secreiile gastrice, biliare,

motilitate
Adeziune la mucoasa intestinal, formare de
colonii
Efecte benefice dovedite asupra sntii

Criterii
fiziologice

Activitate antagonic fa de agenii

patogeni g-i multiplicare, produi
antimicrobieni: acizi, H2O2, bacteriocine
Aciune imuno-modulatoare
Stimularea eliminrii toxinelor
Proprieti anti-mutagene, anti-carcinogene
Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18,

Prebiotice
ingrediente alimentare nedigerabile, care
acioneaz prin stimularea selectiv a unor bacterii
din colon

Prebiotice

polizaharid
e
Inulina

oligozaharid
Fructo-e
oligozaharide

Amidon
rezistent

Oligozaharide din
soia

dizaharide
Lactuloz
Lactitol

Xilooligozaharide

T Iannitti, B. Palmieri,
Therapeutical use of probiotic...Clinical Nutrit
Galacto-

oligozaharide

Prebiotice
Rezistente la: activitatea gastric,
hidroliza enzimatic, absorbia
intestinal
Condiii:

S fie hidrolizate, fermentate de

microflora din colon AGCS mresc
osmolaritatea intestinal
S stimuleze selectiv dezvoltarea
probioticelor din colon, s faciliteze
adeziunea lor la epiteliul intestinal

Prebiotice + probiotice simbiotice

selecia optim pro/prebiotic eficacitatea
simbiotic
J.Grimoud et al.& Anaerobe XXX (2010) 1-8

Efecte ale probioticelor

Protejeaza organismul fata de aderenta, reproducerea si

efectul daunator al bacteriilor enteropatogene asupra mucoasei, prin:
formarea unui mediu ostil, reducand pH-ul intestinal, prin sinteza
de acizi grasi cu catena scurta
eliberarea de substante antibiotice bacteriocine
epuizare nutrientilor si competitie pentru substrat
inhibarea capacitatii de aderare a bacteriilor patogene pe situs-uri
specifice
Imbunatatesc imunitatea specifica si nespecifica
influenteaza sistemul imun secretor (imunoglobuline)
produsi de secretie ai probioticelor imunologic activi
Efect antiinflamator
etc.

Efecte benefice asupra sntii umane

Efecte asupra sntii

Mecanisme de aciune

Efecte terapeutice dovedite tiinific

mbuntirea
simptomelor de
intoleran la lactoz

Furnizarea de lactaza / galactozidaz n tractul gastrointestinal

Prevenirea i reducerea
simptomelor diareei
asociate cu:
- rotavirus
- antibiotice

Modificarea pH-ului intestinal

Antagonizarea bacteriilor patogene inhibarea aderenei i colonizrii
bacteriilor patogene
Efect de translocare/barier

mbuntirea rspunsului imun

produciei de IgA antigen-specific,
stimularea celulelor
imunomodulatoare
inflamaiei
1. REVIEW, Role of Probiotics in healthReducerea
improvement,infection
control locale
and disease treatment an
A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)
2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte ale organismelor probiotice asupra

sntii umane
Efecte poteniale
asupra sntii

Mecanism

Reducerea
susceptibilitii la
alergii
- alergii alimentare
- dermatite atopice
- astm

Modularea colonizrii
Efect de barier al mucoasei intestinale:
permeabilitii, a penetrrii sistemice a
alergenilor
Degradarea alergenilor, eliminare i
reglare
Excluziune imun produciei de IgA

Reducerea riscului
asociat cu
mutagenitatea i
carcinogenitatea

Legarea oncogenilor
Producerea de substante de detoxifiere
Prevenirea alterrii microecologiei
intestinale
permeabilitii
i motilitii
1. REVIEW, Role of Probiotics in Reglarea
health improvement,infection
control
and disease treatment an
A.A. Amara, A. Shibl, Saudi Pharmaceutical
Journal (2013)
intestinale
2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728
Creterea imunitii intestinale

Efecte ale organismelor probiotice asupra

sntii umane
Efecte poteniale
asupra sntii

Mecanism

Efect
Deconjugarea srurilor biliare
hipocolesterolemia
nt
Inhibarea
Helicobacter pylori
i a patogenilor
intestinali

Producerea de compui antimicrobieni

H2O2, bacteriocine
Excluziune competitiv cu H. pylori pt.
aderare i colonizare, efect de barier
Stabilizarea mucoasei gastrice

Stimularea
Inducerea imunitii nnscute (rspuns
sistemului
imun local) i adaptative
imunitar
1. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment an
A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)
2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte ale organismelor probiotice asupra

sntii umane
Efecte
poteniale
asupra sntii

Mecanism

Prevenirea
tulburrilor
intestinale
inflamatorii

-Inhibarea dezv. bacteriilor patogene excludere competitiv, producere de acid

lactic, acetic cu pH, secreie de peptide cu
aciune bacteriostatic / bactericid
- Modularea rspunsului imun
(boala Crohn,
- Descompunerea antigenelor patogene
colita ulcerativ, - mbuntirea funciei barierei intestinale
sindromul de
producere de AGCS mbuntesc
colon iritabil)
producia de mucus i permeabilitatea
mucoasei intestinale

1. REVIEW, Role of Probiotics in health improvement,infection control and disease treatment an

A.A. Amara, A. Shibl, Saudi Pharmaceutical Journal (2013)
2. Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 714-728

Efecte ale organismelor probiotice asupra

sntii umane
Alte efecte poteniale asupra sntii
Urologie: prevenirea infeciilor urinare
Prevenirea vaginozelor
mbuntirea sntii ososase (prebiotice)

R. Barrons et al., Use of Lactobacillus ...J.Clinical Therap

Efecte ale organismelor probiotice asupra

sntii umane
Efecte asupra sntii
Efecte nutriionale dovedite tiinific (Lactobacili)
Producerea de vitamine B, vitamina K
mbuntirea digestibilitii alimentelor
Creterea biodisponibilitii nutrienilor

Indicaii clinice specifice ale probioticelor i

prebioticelor n gastroenterologie

tele
oticelor
ente de:

tulpinile administrate - specificitatea tulpinilo

pentru anumite efecte clinice

doz - 107-1011 uniti formatoare de colon

forma de administrare

caracteristicile organismului gazd

World Gastroenterology Organisation practice
guidelines:Probiotics and prebiotics

Utilizarea clinic / terapeutic a

probioticelor
Boala

Produsul probiotic

Doza recomandat

Tratamentul diareei
infecioase acute la
copii

L. rhamnosus GG

1010-1011 cfu, 2x/zi

L. reuteri ATTC 55730

1010-1011 cfu, 2x/zi

L. acidophilus+B
infantis

109 fiecare, 3x/zi

S cerevisiae (boulardii)
liof.

200 mg, 3x/zi

Tratamentul diareei
infecioase acute la
adult

Enterococcus faecium
LAB SF68

108, 3x/zi

Prevenirea diareei
asociate cu
antibiotice la copii

S cerevisiae (boulardii)
liof.

250mg, 2x/zi

L. Rhamnosus GG

1010cfu, 1-2x/zi

World Gastroenterology Organisation practice 7

6
B.lactis
10
-10
cfu/g
guidelines:Probiotics and prebiotics
Bb12+S.thermophil
Arab J. of Gastroenterology
10 (2009) 3342formul

Utilizarea clinic / terapeutic a

probioticelor
Boala

Produsul probiotic

Doza recomandat

Prevenire
a diareei
asociate
cu
antibiotic
e la aduli

Enterococ faecium LAB SF68

108, 2x/zi

S cerevisiae (boulardii) liof.

1g sau
3x1010cfu/zi

L. rhamnosus GG

1010-1011 cfu, 2x/zi

L casei DN-114 001 n lapte

fermentat cu L.bulgaricus + S.
thermophilus

1010cfu, 2x/zi

B. clausii

2x109 spori, 3x/zi

L acidophilus CL1285 + L. casei

Lbc80r

5x1010+, 1 dat/zi

L. rhamnosus GG

1010-1011 cfu, 2x/zi

B lactis BB12 + S. thermophilus

108+107cfu/g
formul

B lactis BB12

109cfu, 2x/zi

Prevenire
a diareei
nosocomi
ale la
copii

World Gastroenterology Organisation practice

9
L.
reuteri
ATTC
55730
10
cfu, 2x/zi
guidelines:Probiotics and prebiotics

Utilizarea clinic / terapeutic a

probioticelor

Boala

Produsul probiotic

Doza
recomandat

Prevenirea
diareei
Clostridium
difficile la
aduli

L casei DN-114 001 n lapte

fermentat cu L.bulgaricus + S.
thermophilus

1010cfu, 2x/zi

L acidophilus + B bifidum

2x 1010cfu fiecare
1 dat / zi

S cerevisiae (boulardii) liof.

2 x 1010cfu/ zi

Oligofructoz

4g de 3x / zi

L. rhamnosus GG

6 x 109 cfu, 2x/zi

B. clausii

2 x 109 spori,
3x/zi

Iaurt cu lactobacili i
bifidobacterii nespecifice

5 x 109 bacterii
viabile, 2x/zi

S cerevisiae (boulardii) liof.

1g sau 5x109
cfu/zi

Terapie
adjuvant
n
eradicarea
Helicobact
er pylori

World Gastroenterology Organisation practice10

L casei DN-114 001 n lapte
10 cfu, 2x/zi
guidelines:Probiotics and prebiotics

fermentat cu L.bulgaricus + S.

Utilizarea clinic / terapeutic a

probioticelor

Boala

Produsul probiotic

Doza recomandat

Reducerea
simptomelo
r asociate
cu
intolerana
la lactoz

Iaurt normal cu L. bulgaricus

+ S. thermophilus

Iaurtul netratat
termic conine
culturi adecvate pt.
a mbunti
digestia lactozei din
iaurt

Reducerea
simptomelo
r asociate
cu
sindromul
de colon
iritabil

B infantis 35624

108 cfu, 1 dat/zi

L rhamnosus GG

6 x 109 cfu, 2x/zi

L rhamnosus GG, L
rhamnosus LC705, B breve
Bb99 i Propionibacterium
freudenreichii ssp shermanii

1010 cfu 1/zi

B animalis DN-173 010 n

lapte fermentat cu L.
Bulgaricus + S thermophilus

1010, 2x/zi

World Gastroenterology Organisation practice

guidelines:Probiotics and prebiotics

Utilizarea clinic / terapeutic a

pro- si pre-bioticelor

Boala

Produsul probiotic

Doza recomandat

Controlul
E coli Nissle 1917
remisiei n
colita ulcerativ

5 x 1010 bacterii
viabile, de 2x/zi

Tratamentul
constipaiei

Lactuloz

20 40 g / zi

Oligofructoz

> 20 g / zi

Prevenirea
enterocolitei
necrozante la
copii prematuri

B infantis, S thermophilus 0,35 x 109 chu

i B bifidum
fiecare tulpin, 1
dat/zi
L acidophilus + B infantis

109 chu fiecare

tulpin, 2x/zi

Prevenirea
infecii postoperative

Sinbiotic 2000: 4 tulpini

bacteriene + fibre cu
inulin

1010 cfu + 10 g
fibre, 2x/zi

Tratamentul
Lactuloz
45 - 90 g / zi
encefalopatiei
World Gastroenterology Organisation practice guidelines: Probiotics and prebiotics
hepatice
Arab Journal of Gastroenterology 10 (2009) 3342

Utilizarea
probioticelor/prebioticelor

Optimizarea simbiozei flora intestinal /

organism gazd

intervenia farmacologic, nutriional

utiliznd
probiotice i prebiotice

Alimentele - transportori ideali ai probioticelor:

protecie - tract gastro-intestinal
reglarea colonizarii
interaciunea componeni bioactivi
probiotice funcionalitatea, eficacitatea

Importance of food in probiotics efficacy, Ranadheera & col, Food

Alimente funcionale cu
probiotice/prebiotice
Tradiional:
iaurt, kefir

Probiotice - extensiv exploatate de industria lactat

produse funcionale noi:
Brnz, ngheat, deserturi lactate
Formule de lapte praf, produse de diversificare

Ranadheera & col, Importance of food in probiotics efficacy, Food Res

Alimente funcionale cu
probiotice/prebiotice
Alte alimente transportori pt. probiotice microncapsulate i
prebiotice:

Maioneza, produse comestibile tartinabile

Produse din carnea
Buturi, suc de fructe
Produse pe baz de cereale - ovz etc
Ciocolat, alimente pentru copii

Z Wang, Prebiotic: Present and future...Food Research International 42

Probiotice prezente n produse

alimentare
Culturile utilizate de productori - tulpini de Lactobacillus
spp. i Bifidobacterium spp.:

Lactobacilus acidophilus LA1/LA5

CHR Hansen
L. delbrueckii ssp. Bulgaricus Lb12
L. paracasei CRL431
Bifibobacterium animalis ssp. Lactis Bb12
L casei immunitas
Danone (Activia)
B animalis DN173010 (Bioactiva)
Danone (Activia)
L casei DN-114 001
Danone (Actimel)
L. acidophilus NMCF Danisco
L. acidophilus La, etc

Probiotics-From Metchnikoff to bioactives, Int. Dairy J., 18, 2008, 71

Suplimente alimentare cu probiotice

Forme farmaceutice cu probiotice
Tablete
- efectele formulrii, parametrilor de procesare, a
condiiilor de pstrare asupra viabilitii bacteriene
Capsule
Pulberi (plicuri)
Soluii buvabile

S. Klayraung et al., Development o tablets containing probiotics: Effects

of formulation and processing parameters on bacterial viability,
Int.J.Pharm 370 (2009) 54-60

V mulumesc!
L/O/G/O