Probiotic Bacteria and Enteric Infections (eBook)

Contents 5
Contributors 7
Part I Introduction and History of Probiotics 12
Chapter 1 13
Probiotics: From the Ancient Wisdom to the Actual Therapeutical and Nutraceutical Perspective 13
1.1 Probiotics 13
1.1.1 The Beginnings of Probiotics: The Fermented Milk 13
1.1.2 From the Intuition to the Yogurt 15
1.1.3 The term “Probiotic” and its Technical-Scientific Evolution 17
1.2 Prebiotics 19
1.3 Synbiotics 20
1.4 Various Genera of Probiotics 21
1.5 Probiotics as Therapy 23
1.5.1 Acute Infectious Diarrhea 23
1.5.2 Antibiotic Associated Diarrhea 25
1.5.3 Clostridium difficile Associated Diarrhea 26
1.5.4 Infection Caused by Helicobacter pylori 26
1.5.5 Traveller’s Diarrhea 28
1.5.6 Necrotizing Enterocolitis 28
1.5.7 Bacterial Vaginosis 29
1.5.8 Irritable Bowel Syndrome 30
1.5.9 Crohn’s Disease 30
1.5.10 Ulcerative Colitis 31
1.5.11 Atopic Dermatitis 32
1.5.12 Dental Caries 33
1.6 Advances Made from the Traditional Use to the Modern Application in Medical Field 35
1.7 Advances Made from the Traditional Use to the Modern Application in Food Industry 38
1.8 Final Considerations 41
References 41
Part II The Gut Microorganisms and Probiotics 48
Chapter 2 49
The Intestinal Microbiota and Probiotics 49
2.1 Introduction 49
2.2 Intestinal Microbiota in Newborns, Children, Adults and Elderly 49
2.3 Environment Factors 53
2.3.1 The Influence of Prebiotics on the Intestinal Microbiota 53
2.3.2 The Influence of Probiotics on the Intestinal Microbiota 55
2.3.3 The Influence of Medication on the Intestinal Microbiota 57
2.3.4 The Intestinal Microbiota and Stress 57
2.4 Selection of Probiotics for Gut Health 58
2.4.1 Viability During Storage in Probiotic Products 58
2.4.2 Resistance to Acid and Bile and Survival in the GI Tract 59
2.4.3 Adhesion to Host Tissues 59
2.4.4 Interactions with the Host Immune System 60
2.4.5 Interactions Among Gut Bacteria 61
2.4.6 Anti-carcinogenic and Anti-toxic Effects 61
2.4.7 Origin of the Probiotic Strains 62
2.4.8 Safety 62
2.4.9 Suitability for Commercial Production 63
2.5 Conclusions 63
References 64
Chapter 3 72
Ecology of Probiotics and Enteric Protection 72
3.1 Introduction 72
3.2 Probiotics from Taxonomy to Functionality 73
3.2.1 Origin and Taxonomy of Probiotics 74
3.2.2 Safety Assessment of Probiotics 76
3.2.3 Viability and Functionality of Probiotics 76
3.2.4 Probiotics and Technological Aspects 78
3.3 Interaction of Probiotics with Pathogens and Gut Microbiota 79
3.3.1 Dose-dependent Effects of Probiotics on Pathogens and Gut Microbiota 79
3.3.2 In vitro Assessment of Probiotic Functional Activity 80
3.3.3 In vivo Assessment of Probiotic Functional Activity 82
3.3.4 Human Studies—Ultimate Demonstration 82
3.4 Intestinal Cytoprotection of Probiotics in Prophylactic Uses 83
3.4.1 Protection via Secretion of Antimicrobial Substances and Acids 84
3.4.2 Competitive Exclusion and Improvement of Epithelial Barrier Function 85
3.4.3 Stimulation of Immunity 86
3.5 Intervention Designed for Specific Populations 87
3.6 Conclusion 87
References 88
Part III Pathophysiology of Enteric Disorders Due to Disturbed Microbiota 93
Chapter 4 94
Factors Causing Disturbances of the Gut Microbiota 94
4.1 Introduction 94
4.2 Types of Microbiotal Disruption 95
4.2.1 Putrefaction 95
4.2.2 Fermentation 96
4.2.3 Deficiency 96
4.2.4 Sensitization 96
4.3 Factors Disturbing the Intestinal Microbiota 96
4.3.1 Nutrition 96
4.3.1.1 Disturbances Leading to Colorectal Cancers 97
4.3.1.2 Nutritional Disturbances Due to Artificial 97
4.3.1.3 Nutritional Disturbances in Elderly 98
4.3.2 Antimicrobials 98
4.3.2.1 Antibiotics 99
4.3.2.2 Other Drugs 100
4.3.3 Alterations of Intestinal Motility 101
4.3.3.1 Decreased Intestinal Motility 101
4.3.3.2 Increased Intestinal Motility 101
4.3.3.3 Miscellaneous Causes of Intestinal Motility 102
4.3.4 Age 102
4.3.4.1 Factors Affecting the Microbiota of the Infant 103
4.3.4.2 Intestinal Microbiota in Adult Individuals 106
4.3.4.3 Intestinal Microbiota in Elderly Individuals 106
4.3.5 Perturbations of Behaviour 107
4.3.5.1 Mechanisms Behind Stress-Induced Microbiotal Disruption 108
4.3.6 Gut Inflammation 109
4.3.6.1 Food Hypothesis 109
4.3.6.2 Differential Killing Hypothesis 110
4.3.6.3 Commensal-Network-Disruption Hypothesis 111
4.3.6.4 Inflammatory Bowel Disease 111
4.4 Conclusion 111
References 112
Chapter 5 117
The Gut Microbiota, Probiotics and Infectious Disease 117
5.1 Introduction 117
5.2 Loss of Colonization Resistance in Germ-Free Mice 118
5.3 Antibiotic-Induced Changes to the Microbiota 119
5.4 Evidence of Colonization Resistance from Human Probiotic Intervention Studies 120
5.5 Mechanistic Basis of Colonization Resistance 122
5.5.1 Regulation of Inflammation 122
5.5.2 Production of Acid and Secretion of Inhibitory Substances 124
5.5.3 Inhibition of Virulence Factor Expression 126
5.5.4 Epithelial Barrier Function and Probiotic Signaling 126
5.5.5 Competition for Pathogen Binding Sites 128
5.6 Conclusions 129
References 129
Part IV Application of Molecular Biology and -omics of Probiotics in Enteric Protection 135
Chapter 6 136
Application of Molecular Biology and Genomics of Probiotics for Enteric Cytoprotection 136
6.1 Introduction 136
6.2 Functional Genomics 137
6.3 Genes and Molecules Involved in Adaptation of Probiotics to the Gut Niche 138
6.3.1 Genes and Molecules Involved in Stress Adaptation 138
6.3.2 Genes and Molecules Involved in Nutritional Adaptation 140
6.4 Genes and Molecules Involved in Interaction of Probiotics with Enteropathogens and Gut Microbial Symbionts 142
6.4.1 Genes and Molecules Involved in Nutrient-Based Interactions 142
6.4.2 Genes and Molecules Involved in Competitive Exclusion 143
6.4.3 Genes and Molecules Involved in Production of Antimicrobial Compounds 144
6.5 Genes and Molecules Involved in Interaction of Probiotics with Host 145
6.5.1 Genes and Molecules Involved in Metabolic Interactions 145
6.5.2 Genes and Molecules Involved in Modulation of Mucosal Barrier Function 146
6.5.3 Genes and Molecules Involved in Modulation of the Innate and Adaptive Immune System 148
6.6 Conclusion and Future Perspectives 149
References 150
Chapter 7 157
Application of Probiotic Proteomics in Enteric Cytoprotection 157
7.1 Introduction 157
7.2 State-of-the-Art Proteomics Technologies 158
7.3 Generic Proteomics Strategies 159
7.4 Quantitative Proteomics 159
7.5 Proteomics Methods Applied in Probiotics 161
7.6 The Outer Surface Proteome of Probiotic Bacteria 165
7.7 Clinical Applications of Probiotics 167
7.8 Conclusions 167
References 168
Chapter 8 171
Promoting Gut Health with Probiotic Metabolomics 171
8.1 Introduction 171
8.2 The Role of Gut Microbes in Determining Gastrointestinal Functional Ecology and Influencing Mammalian Metabolic Phenotypes 172
8.3 Metabolomics: A Unique Non-invasive Tool to Measure the Contribution of Gut Microbial Metabolism to Gut Disorders 175
8.4 Metabolomics: New Research Venues to Decipher Probiotics’ Effects on the Mammalian Gut Microbial Metabolic Cross Talk 176
8.5 Probiotic Action and Therapeutic Surveillance with Metabonomics 179
8.6 Conclusion 182
References 183
Part V Probiotics, Gut Immunology and Enteric Protection 188
Chapter 9 189
Microbiota, Probiotics and Natural Immunity of the Gut 189
9.1 The Intestinal Immune Organ 189
9.2 Pattern Recognition Receptors in the Innate Immune Response 190
9.3 The Role of Innate Immunity in Gut Homeostasis 191
9.3.1 Maintaining Immune Cell Homeostasis to Avoid Inflammation and Modulation of the Adaptive Immune Response 194
9.4 Innate and Adaptive Immune Response, Functional Continuity and Common Functional Characteristics 194
9.5 Impaired Innate Immunity in the Gut as a Pathogenic Factor 196
9.5.1 Chronic Disease 196
9.5.2 Acute Disease 197
9.6 Modulation of the Microbiota to Improve Gut Defences, Modulate Innate Reactivity and Deliver Health Benefits 197
9.6.1 Gut Microbiota and Probiotics to Enhance Innate Immune Defences 197
9.6.2 Gut Microbiota and Probiotics to Promote Immune Intestinal Homeostasis 199
9.7 Conclusion 201
References 201
Chapter 10 206
Interaction of Probiotics with the Acquired Immune System in the Gut 206
10.1 Introduction 206
10.2 GALT Components Involved in Adaptive Immunity 207
10.3 Regulatory Elements of Immune Tolerance in GALT 208
10.4 Probiotics and Induction of Tolerance 209
10.5 Probiotics and Enhancement of Adaptive Immunity in the GALT 211
10.6 New Applications of Probiotics for GALT Immunomodulation 213
10.7 Concluding Remarks 214
References 215
Chapter 11 219
The Protective Role of Probiotics in Disturbed Enteric Microbiota 219
11.1 Introduction 219
11.2 The Enteric Microbiota 220
11.3 The Probiotic Effect 221
11.3.1 Pharmacokinetic Considerations 222
11.3.1.1 Probiotic Survival 225
11.3.1.2 Persistence 226
11.3.1.3 Stabilisation 229
11.4 Disturbance of the Enteric Microbiota 230
11.4.1 Antibiotic Treatment 231
11.4.2 Irritable Bowel Syndrome 233
11.5 Immunomodulation 234
11.5.1 Innate Immune System and Interaction with Probiotics 235
11.5.2 The Mucosal Immune System and Interaction with Probiotics 235
11.5.3 Adaptive Immune System and Interaction with Probiotics 238
11.5.4 Stimulation of IgA Production by Probiotics 239
11.5.5 Stimulation of Dendritic Cells by Probiotics 239
11.5.6 Th1/Th2 Balance and Probiotics 241
11.6 Conclusion 249
References 249
Chapter 12 260
Modulation of Immune System by Probiotics to Protect Against Enteric Disorders 260
12.1 Introduction 260
12.2 Disruption of Intestinal Immunity 261
12.2.1 Impaired Intestinal Permeability 261
12.2.2 Causes of Impaired Permeability 262
12.2.2.1 Disorders of Digestion 262
12.3 Disruption of Tight Junctions 262
12.4 Disruption of the Microbiota 263
12.4.1 The Hygiene Hypothesis 263
12.5 Disorders of the Immune System 264
12.5.1 Allergy 264
12.5.1.1 Microbiota and Allergy 264
12.5.1.2 Mechanisms of Allergy 266
12.5.1.3 The Role of Probiotics in Allergic Reactions 267
12.5.1.4 Maintenance of Barrier Integrity 267
12.5.1.5 Degradation/Structural Modification of Enteral Antigens 267
12.5.1.6 Modulation of IgE Production 268
12.5.2 Autoimmune Diseases 268
12.5.2.1 Celiac Disease 269
12.5.2.2 Type 1 Diabetes 269
12.5.2.3 Inflammatory Bowel Disease 270
12.5.2.4 Irritable Bowel Syndrome 271
12.5.2.5 Autism 271
12.6 Modulation of Immune System by Probiotic Bacteria 272
12.6.1 Cell Regulation 273
12.6.2 Cytokine Regulation 274
12.6.3 Influence on Toll Like Receptors 275
12.7 Conclusion 277
References 277
Part VI Probiotics for Enteric Therapy 284
Chapter 13 285
Probiotic-Pathogen Interactions and Enteric Cytoprotection 285
13.1 Introduction 285
13.2 Barriers for Pathogens to Cross 286
13.2.1 Gastric Acidity 286
13.2.2 The Mucous Layer 286
13.2.3 Intestinal Motility 287
13.2.4 Competition of the Microbiota 287
13.2.5 Phagocytosis by Cells of the Immune System 287
13.3 Mechanisms of Enteric Diseases by Bacteria 288
13.3.1 Enterotoxigenic Organisms 288
13.3.2 Enteropathogenic Organisms 289
13.3.3 Entero-invasive Organisms 290
13.4 Mechanisms of Enteric Diseases by Viruses 291
13.5 Parasites 291
13.6 Probiotic-Pathogenic Bacteria Interaction 292
13.6.1 Competitive Exclusion 293
13.6.2 Stabilization of the Cellular Cytoskeleton 294
13.6.3 Stabilization of the Barrier Integrity 295
13.6.4 Impairment of Flagella Motility 296
13.6.5 Production of Antimicrobial Compounds 296
13.6.5.1 Compounds Inhibiting Pathogen Adhesion 296
13.6.5.2 Bacteriocins 297
13.6.5.3 Bacteriocin-Like Compounds 298
13.6.5.4 Siderophores 298
13.6.6 Production of Organic Acids 299
13.6.7 Co-aggregating 300
13.6.8 Modulation of the Immune System 300
13.6.9 Improvement of the Enteric Mucosal Anti-oxidative Status 300
13.7 Conclusion 301
References 301
Chapter 14 308
Bacteriocins of Probiotics and Enteric Cytoprotection 308
14.1 Introduction 308
14.2 Classification of Bacteriocins 309
14.2.1 Bacteriocins of LAB (Gram-Positive Bacteria) 309
14.2.1.1 Lantibiotics 310
14.2.1.2 Class II LAB (or Gram-Positive) Bacteriocins 311
14.2.1.3 Circular Bacteriocins 312
14.2.2 Bacteriocins of E. coli 313
14.2.3 Bacteriocins of Probiotic Bacteria 313
14.3 Regulation of Bacteriocin Production by Quorum Sensing 322
14.4 Bacteriocin Detection in Intestinal and Faecal Samples 323
14.5 Direct Effects of Antibacterial Peptides Including Bacteriocins on the Host 324
14.6 Effects of Bacteriocinogenic Probiotic Bacteria on GI Microbiota and on Pathogenic Bacteria 326
14.6.1 Effects on GI Microbiota 326
14.6.2 Clostridium difficile 328
14.6.3 Staphylococcus 328
14.6.4 Helicobacter pylori 329
14.6.5 Enterococcus 330
14.6.6 Campylobacter 331
14.6.7 Salmonella 331
14.6.8 Escherichia coli 332
14.6.9 Listeria monocytogenes 332
14.7 Effects of Purified Bacteriocins on GI Microbiota 333
14.8 Applications of Bacteriocins as Gastrointestinal Antibiotics 336
14.9 Inhibition of Adhesion of Pathogens to the Intestinal Enterocytes 337
14.10 Conclusions 338
References 339
Chapter 15 350
Probiotics in Clinical Practice as Therapeutics Against Enteric Disorders 350
15.1 Introduction 350
15.2 Probiotics in Acute Diarrhoea 351
15.3 Antibiotic-Associated Diarrhoea 354
15.4 Probiotics in Constipation and Bloating 354
15.5 Probiotics in Colonic Diverticular Disease 355
15.6 Probiotics in Irritable Bowel Syndrome 356
15.7 Probiotics in Inflammatory Bowel Disease 358
15.8 Probiotics in Ulcerative Colitis 359
15.9 Probiotics in Pouchitis 360
15.10 Probiotics in the Maintenance of Remission of Chronic Pouchitis 361
15.11 Probiotics in Preventing the Onset of Pouchitis 361
15.12 Probiotics in Crohn’s Disease 362
15.13 Conclusions and Perspectives 363
References 365
Chapter 16 369
Potential Mechanisms of Enteric Cytoprotection by Probiotics: Lessons from Cultured Human Intestinal Cells 369
16.1 Introduction 369
16.2 The Mucosal Barrier 370
16.2.1 Extracellular Components of the Barrier 371
16.2.2 Cellular Components of the Mucosal Barrier 372
16.3 Enteric Cytoprotective Effects of Probiotics 374
16.3.1 Preservation of the Barrier Function 375
16.3.2 Preservation of Intestinal Cell Functions 377
16.3.3 Regulation of Pro-inflammatory Immune Responses 379
16.4 Closing Remarks 383
References 384
Chapter 17 392
Probiotics and Enteric Cancers 392
17.1 Introduction 393
17.2 Effects of Probiotics on Carcinogens 394
17.2.1 Clinical Evidences 394
17.2.2 Mechanisms 395
17.3 Effects of Probiotics on Mutagens 397
17.3.1 In-vitro and In-vivo Evidences 397
17.3.2 Mechanisms 399
17.4 Probiotics and Neoplasm 402
17.4.1 Anti-neoplastic Activities of Probiotics 402
17.4.2 In-vitro and In-vivo Evidences 405
17.5 Probiotics and Deoxyribonucleic Acid (DNA) 406
17.5.1 DNA-Induced Colonic Damage 406
17.5.2 In-vitro and In-vivo Evidences 407
17.6 Probiotics and Gut Lesions 409
17.6.1 Carcinogen-Induced Lesions 410
17.6.2 Enzyme-Induced Lesions 411
17.6.3 Pathogen-Induced Lesions 413
17.7 Conclusions 414
References 415
Chapter 18 421
Designer Probiotics and Enteric Cytoprotection 421
18.1 Introduction 421
18.2 “Designer” Probiotics that Target Bacterial Toxin-Receptor Interactions 423
18.2.1 STEC Disease 425
18.2.2 ETEC Disease 427
18.2.3 Cholera 428
18.3 Safety and Regulatory Issues 429
18.4 Future Prospects 431
References 432
Part VII The Future of Probiotics 420
Chapter 19 436
Future Prospects of Probiotics as Therapeutics Against Enteric Disorders 436
19.1 Introduction 436
19.1.1 Diarrheal Disease 436
19.1.1.1 Necrotizing Enterocolitits (NEC) 437
19.2 Selection Criteria and Characteristics of Probiotics 439
19.2.1 In vivo Survival 439
19.3 A Need for Alternative Strategies/Future Prospects of Bioengineered Probiotics 440
19.3.1 Designer Probiotics 441
19.3.1.1 Patho-Biotechnology 443
19.4 Metagenomics 447
19.4.1 The Human Gut Metagenome and Meta-biotechnology 447
19.5 Biological Containment 448
19.6 Conclusions and Future Outlook 449
References 450
Index 456