Пробиотики для повседневного приема: польза и обдуманное применение
https://doi.org/10.21518/2079-701X-2021-15-136-143
Аннотация
В настоящем обзоре охарактеризовано действие пробиотиков и возможное влияние отдельных штаммов на общее состояние здоровья при ежедневном приеме.
Содержание и активность бактерий в пищевых продуктах должны регулироваться специальными предписаниями. При сбалансированном питании человек получает полезные для здоровья штаммы естественным путем. Повседневное потребление в составе функциональных продуктов питания определенных штаммов перспективно для профилактики ожирения, сахарного диабета 2-го типа, неалкогольной жировой болезни печени, функциональных кишечных расстройств, рака толстой кишки, сердечно-сосудистых заболеваний и депрессии. Специального изучения требуют вопросы безопасности пробиотических штаммов, вновь внедряемых в клиническую практику. Синбиотики могут включать пробиотические штаммы бактерий, например Lactobacillus acidophilus La-14, Lactobacillus rhamnosus Lr-32, Bifidobacterium lactis Bl-04, обладающих кислото-, пепсинои желчеустойчивостью, а также пребиотики (как правило, инулин) и витамины группы В (В1, В2, В6 и В12), способствующие выживанию полезных бактерий. L. аcidophilus широко распространен в естественной среде и продуктах питания, не установлено случаев антибиотикорезистентности этого вида. Штаммы Lactobacillus acidophilus La-14, Lactobacillus rhamnosus Lr-32, Bifidobacterium lactis Bl-04 обладают высокой способностью к адгезии, выраженным ингибирующим влиянием на кишечные патогены, включая грибки, противовоспалительным эффектом, способствуют выведению оксалатов. Таким образом, применение пробиотиков и синбиотиков – одно из самых перспективных профилактических направлений медицины.
Об авторах
Ю. О. ШульпековаРоссия
к.м.н., доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии
119991, Москва, ул. Погодинская, д. 1, стр. 1
В. Ю. Русяев
Россия
клинический ординатор
107076, Москва, Потешная ул., д. 3
Список литературы
1. Haak B.W., Prescott H.C., Wiersinga W.J. Therapeutic Potential of the Gut Microbiota in the Prevention and Treatment of Sepsis. Front Immunol. 2018;9:2042. https://doi.org/10.3389/fimmu.2018.02042.
2. Мечников И.И. Записки старого биолога. О том, как нужно жить и когда умирать. М.: Родина; 2020. Режим доступа: https://iknigi.net/avtor-ilyamechnikov/184683-zapiski-starogo-biologa-o-tom-kak-nuzhno-zhit-ikogda-umirat-ilya-mechnikov/read/page-1.html.
3. Scaldaferri F., Gerardi V., Mangiola F., Lopetuso L.R., Pizzoferrato M., Petito V. et al. Role and mechanisms of action of Escherichia coli Nissle 1917 in the maintenance of remission in ulcerative colitis patients: An update. World J Gastroenterol. 2016;22(24):5505–5511. https://doi.org/10.3748/wjg. v22.i24.5505.
4. Fuller R. Probiotics in man and animals. J Appl Bacteriol. 1989;66(5):365–378. Available at: https://pubmed.ncbi.nlm.nih.gov/2666378.
5. Hill C., Guarner F., Reid G., Gibson G., Merenstein D., Pot B. et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11:506–514. https://doi. org/10.1038/nrgastro.2014.66.
6. Hogan D.E., Ivanina E.A., Robbins D.H. Probiotics: a review for clinical use. Gastroenterology & Endoscopy News. 2018:1–7. Available at: https://www. gastroendonews.com/Review-Articles/Article/05-21/Probiotics-forClinical-Use/63435.
7. Laulund S., Wind A., Derkx P.M.F., Zuliani V. Regulatory and Safety Requirements for Food Cultures. Microorganisms. 2017;5(2):28. https://doi. org/10.3390/microorganisms5020028.
8. Bernardeau M., Guguen M., Vernoux J.P. Beneficial lactobacilli in food and feed: long-term use, biodiversity and proposals for specific and realistic safety assessments. FEMS Microbiology Reviews. 2006;30(4):487–513. https://doi.org/10.1111/j.1574-6976.2006.00020.x
9. Angelescu I., Zamfir M., Stancu M. et al. Identification and probiotic properties of lactobacilli isolated from two different fermented beverages. Ann Microbiol. 2019;69:1557–1565. https://doi.org/10.1007/s13213-019-01540-0.
10. Gultekin F., Oner M.E., Savas H.B., Dogan B. Food additives and microbiota. North Clin Istanb. 2020;7(2):192–200. https://doi.org/10.14744/ nci.2019.92499.
11. Zmora N., Zilberman-Schapira G., Suez J., Mor U., Dori-Bachash M., Bashiardes S. et al. Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features. Cell. 2018;174(6):1388–1405.e21. https://doi.org/10.1016/j. cell.2018.08.041.
12. Hills R.D., Pontefract B.A., Mishcon H.R., Black C.A., Sutton S.C., Theberge C.R. Gut Microbiome: Profound Implications for Diet and Disease. Nutrients. 2019;11(7):1613. https://doi.org/10.3390/nu11071613.
13. Marchesi J.R., Adams D.H., Fava F., Hermes G.D.A., Hirschfield G.M., Hold G. et al. The gut microbiota and host health: a new clinical frontier. Gut. 2016;65(2):330–339. https://doi.org/10.1136/gutjnl-2015-309990.
14. Fontané L., Benaiges D., Goday A., Llauradó G., Pedro-Botet J. Influence of the microbiota and probiotics in obesity. Influencia de la microbiota y de los probióticos en la obesidad. Clin Investig Arterioscler. 2018;30(6):271–279. https://doi.org/10.1016/j.arteri.2018.03.004.
15. Forssten S.D., Ouwehand A.C. Simulating colonic survival of probiotics in single-strain products compared to multi-strain products. Microb Ecol Health Dis. 2017;28(1):1378061. https://doi.org/10.1080/16512235.2017.1378061.
16. Lammers K.M., Brigidi P., Vitali B., Gionchetti P., Rizzello F., Caramelli E. et al. Immunomodulatory effects of probiotic bacteria DNA: IL-1 and IL-10 response in human peripheral blood mononuclear cells. FEMS Immunol Med Microbiol. 2003;38(2):165–172. https://doi.org/10.1016/ S0928-8244(03)00144-5.
17. Milajerdi A., Mousavi S.M., Sadeghi A., Salari-Moghaddam A., Parohan M., Larijani B., Esmaillzadeh A. The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials. Eur J Nutr. 2020;59(2):633–649. https://doi.org/10.1007/s00394-019-01931-8.
18. Gionchetti P., Rizzello F., Helwig U., Venturi A., Lammers K., Brigidi P. et al. Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology. 2003;124(5):1202–1209. https://doi.org/10.1016/s0016-5085(03)00171-9.
19. Strandwitz P. Neurotransmitter modulation by the gut microbiota. Brain Res. 2018;1693(Pt B):128–133. https://doi.org/10.1016/j.brainres.2018.03.015.
20. Sudo N. Biogenic Amines: Signals Between Commensal Microbiota and Gut Physiology. Front Endocrinol. 2019;10:504. https://doi.org/10.3389/ fendo.2019.00504.
21. Zhang Y., Guo X., Guo J., He Q., Li H., Song Y., Zhang H. Lactobacillus casei reduces susceptibility to type 2 diabetes via microbiota-mediated body chloride ion influx. Sci Rep. 2014;4:5654. https://doi.org/10.1038/srep05654.
22. Parekh P.J., Nayi V.R., Johnson D.A., Vinik A.I. The Role of Gut Microflora and the Cholinergic Anti-inflammatory Neuroendocrine System in Diabetes Mellitus. Front Endocrinol (Lausanne). 2016;7:55. https://doi.org/10.3389/ fendo.2016.00055.
23. Gurung M., Li Z., You H., Rodrigues R., Jump D.B., Morgun A., Shulzhenko N. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine. 2020;51:102590. https://doi.org/10.1016/j.ebiom.2019.11.051.
24. Crovesy L., Ostrowski M., Ferreira D.M.T.P., Rosado E.L., Soares-Mota M. Effect of Lactobacillus on body weight and body fat in overweight subjects: a systematic review of randomized controlled clinical trials. Int J Obes (Lond). 2017;41(11):1607–1614. https://doi.org/10.1038/ijo.2017.161.
25. Borgeraas H., Johnson L.K., Skattebu J., Hertel J.K., Hjelmesaeth J. Effects of probiotics on body weight, body mass index, fat mass and fat percentage in subjects with overweight or obesity: a systematic review and metaanalysis of randomized controlled trials. Obes Rev. 2018;19(2):219–232. https://doi.org/10.1111/obr.12626.
26. Suzumura E.A., Bersch-Ferreira Â.C., Torreglosa C.R., da Silva J., Coqueiro A., Kuntz M. et al. Effects of oral supplementation with probiotics or synbiotics in overweight and obese adults: a systematic review and meta-analyses of randomized trials. Nutr Rev. 2019;77(6):430–450. https://doi. org/10.1093/nutrit/nuz001.
27. Kumar M., Babaei P., Ji B., Nielsen J. Human gut microbiota and healthy aging: Recent developments and future prospective. Nutr Healthy Aging. 2016;4(1):3–16. https://doi.org/10.3233/NHA-150002.
28. Landete J.M., Gaya P., Rodríguez E., Langa S., Peirotén Á., Medina M., Arqués J.L. Probiotic Bacteria for Healthier Aging: Immunomodulation and Metabolism of Phytoestrogens. Biomed Res Int. 2017;2017:5939818. https://doi. org/10.1155/2017/5939818.
29. Malaguarnera L., Cristaldi E., Malaguarnera M. The role of immunity in elderly cancer. Crit Rev Oncol Hematol. 2010;74(1):40–60. https://doi. org/10.1016/j.critrevonc.2009.06.002.
30. Borchers A.T., Selmi C., Meyers F.J., Keen C.L., Gershwin M.E. Probiotics and immunity. J Gastroenterol. 2009;44(1):26–46. https://doi.org/10.1007/ s00535-008-2296-0.
31. Gill H.S., Rutherfurd K.J., Cross M.L. Dietary probiotic supplementation enhances natural killer cell activity in the elderly: An investigation of age-related immunological changes. J Clin Immun. 2001;21(4):264–271. https://doi.org/10.1023/a:1010979225018.
32. Sultana R., McBain A.J., O’Neill C.A. Strain-dependent augmentation of tight-junction barrier function in human primary epidermal keratinocytes by lactobacillus and bifidobacterium lysates. Applied and Environmental Microbiology. 2013;79(16):4887–4894. https://doi. org/10.1128/AEM.00982-13.
33. Sharma R., Kapila R., Dass G., Kapila S. Improvement in Th1/Th2 immune homeostasis, antioxidative status and resistance to pathogenic E. coli on consumption of probiotic Lactobacillus rhamnosus fermented milk in aging mice. Age. 2014;36:9686–9703. https://doi.org/10.1007/s11357- 014-9686-4.
34. Yang H.Y., Liu S.L., Ibrahim S.A., Zhao L., Jiang J.L., Sun W.F., Ren F.Z. Oral administration of live Bifidobacterium substrains isolated from healthy centenarians enhanced immune function in BALB/c mice. Nutr Res. 2009;29(4):281–289. https://doi.org/10.1016/j.nutres.2009.03.010 .
35. Vidal K., Benyacoub J., Moser M., Sanchez-Garcia J., Serrant P., SeguraRoggero I. et al. Effect of Lactobacillus paracasei NCC2461 on antigenspecific T-cell mediated immune responses in aged mice. Rejuvenation Res. 2008;11(5):957–964. https://doi.org/10.1089/rej.2008.0780.
36. Molina V., Médici M., Villena J., Font G., Taranto M.P. Dietary Supplementation with Probiotic Strain Improves Immune-Health in Aged Mice. Open J Immunol. 2016;6(3):73–78. https://doi.org/10.4236/oji.2016.63008.
37. van Beek A.A., Sovran B., Hugenholtz F., Meijer B., Hoogerland J.A., Mihailova V. et al. Supplementation with Lactobacillus plantarum WCFS1 Prevents Decline of Mucus Barrier in Colon of Accelerated Aging Ercc1-/Δ7 Mice. Front Immunol. 2016;7:408. https://doi.org/10.3389/ fimmu.2016.00408.
38. Neunez M., Goldman M., Ghezzi P. Online Information on Probiotics: Does It Match Scientific Evidence? Front Med (Lausanne). 2020;6:296. https://doi. org/10.3389/fmed.2019.00296.
39. Davison J.M., Wischmeyer P.E. Probiotic and synbiotic therapy in the critically ill: State of the art. Nutrition. 2019;59:29–36. https://doi. org/10.1016/j.nut.2018.07.017.
40. Van den Nieuwboer M., Brummer R.J., Guarner F., Morelli L., Cabana M., Claassen E. The administration of probiotics and synbiotics in immune compromised adults: Is it safe? Benef Microbes. 2015;6(1):3–17. https://doi. org/10.3920/BM2014.0079.
41. Doron S., Snydman D.R. Risk and safety of probiotics. Clin Infect Dis. 2015;60(2 Suppl.):129–134. https://doi.org/10.1093/cid/civ085.
42. Salminen M., Tynkkynen S., Rautelin H., Saxelin M., Vaara M., Ruutu P. et al. Lactobacillus Bacteremia during a Rapid Increase in Probiotic Use of Lactobacillus rhamnosus GG in Finland. Clin Infect Dis. 2002;35(10):1155–1160. https://doi.org/10.1086/342912.
43. Сухорукова М.В., Тимохова А.В., Эйдельштейн М.В., Козлов Р.С. Чувствительность к антибиотикам штаммов бактерий, входящих в состав пробиотика Линекс. Клиническая микробиология и антимикробная химиотерапия. 2012;14(3):245–251. Режим доступа: https://cmac-journal.ru/publication/2012/3/cmac-2012-t14-n3-p245.
44. Захарова Н.В., Симаненков В.И. Эффективность и безопасность пробиотической терапии. Врач. 2014;(1):8–12. Режим доступа: http://elib.fesmu.ru/elib/Article.aspx?id=292182.
45. Delcour J., Ferain T., Deghorain M., Palumbo E., Hols P. The biosynthesis and functionality of the cell-wall of lactic acid bacteria. Antonie Van Leeuwenhoek. 1999;76(1–4):159–184. Available at: https://pubmed.ncbi.nlm.nih.gov/10532377.
46. McGuinness W.A., Malachowa N., DeLeo F.R. Vancomycin Resistance in Staphylococcus aureus. Yale J Biol Med. 2017;90(2):269–281. Режим доступа: https://pubmed.ncbi.nlm.nih.gov/28656013.
47. Gigante A., Sardo L., Gasperini M.L., Molinaro A., Riggio O., Laviano A., Amoroso A. D-Lactic acidosis 25 years after bariatric surgery due to Salmonella enteritidis. Nutrition. 2012;28(1):108–111. https://doi. org/10.1016/j.nut.2011.07.005.
48. Rao S.S.C., Rehman A., Yu S., Andino N.M. Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis. Clin Transl Gastroenterol. 2018;9(6):162. https://doi.org/10.1038/s41424-018-0030-7.
49. Jacobs C., Coss Adame E., Attaluri A., Valestin J., Rao S.S. Dysmotility and proton pump inhibitor use are independent risk factors for small intestinal bacterial and/or fungal overgrowth. Aliment Pharmacol Ther. 2013;37(11):1103–1111. https://doi.org/10.1111/apt.12304.
50. De Angelis M., Gobbetti M. Lactobacillus SPP.: General Characteristics. In: Reference Module in Food Science. 2016. https://doi.org/10.1016/B978- 0-08-100596-5.00851-9.
51. Kaplan H., Hutkins R.W. Fermentation of fructooligosaccharides by lactic acid bacteria and bifidobacteria. Appl Environ Microbiol. 2000;66(6):2682– 2684. https://doi.org/10.1128/aem.66.6.2682-2684.2000.
52. Emanuel V., Adrian V., Diana P. Microbial Biofilm Formation under the Influence of Various Physical-Chemical Factors. Biotech & Biotech Equip. 2010;24(3):1993–1996. https://doi.org/10.2478/V10133-010-0056-9.
53. Bendazzoli C., Turroni S., Gotti R., Olmo S., Brigidi P., Cavrini V. Determination of oxalyl-coenzyme A decarboxylase activity in Oxalobacter formigenes and Lactobacillus acidophilus by capillary electrophoresis. J Chromatogr B. 2007;854(1–2):350–356. https://doi. org/10.1016/j.jchromb.2007.04.027.
54. Giardina S., Scilironi C., Michelotti A., Samuele A., Borella F., Daglia M., Marzatico F. In vitro anti-inflammatory activity of selected oxalatedegrading probiotic bacteria: potential applications in the prevention and treatment of hyperoxaluria. J Food Sci. 2014;79(3):384–390. https://doi. org/10.1111/1750-3841.12344.
55. Toh M., Liu S.Q. Impact of coculturing Bifidobacterium animalis subsp. lactis HN019 with yeasts on microbial viability and metabolite formation. J Appl Microbiol. 2017;123(4):956–968. https://doi.org/10.1111/jam.13571.
56. Morovic W., Roper J.M., Smith A.B., Mukerji P., Stahl B., Rae J.C., Ouwehand A.C. Safety evaluation of HOWARU® Restore (Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, Bifidobacterium animalis subsp. lactis Bl-04 and B. lactis Bi-07) for antibiotic resistance, genomic risk factors and acute toxicity. Food Chem Toxicol. 2017;110:316–324. https://doi. org/10.1016/j.fct.2017.10.037.
Рецензия
Для цитирования:
Шульпекова ЮО, Русяев ВЮ. Пробиотики для повседневного приема: польза и обдуманное применение. Медицинский Совет. 2021;(15):136-143. https://doi.org/10.21518/2079-701X-2021-15-136-143
For citation:
Shulpekova YO, Rusyaev VY. Daily probiotics: benefits and reasonable application. Meditsinskiy sovet = Medical Council. 2021;(15):136-143. (In Russ.) https://doi.org/10.21518/2079-701X-2021-15-136-143