Probiotics Use in pharmaceuticals

 

Probiotics Use in pharmaceuticals

Probiotic drugs are used therapeutically for certain clinical pictures. These effects must be scientifically proven. Areas of application include chronic inflammatory bowel diseases, antibiotic-induced diarrheal diseases, or allergies. The number of studies continues to grow, but strong evidence has been difficult to derive due to strain specificity and highly complex reactions.

 

Probiotics as drugs (examples):

 

·        Bioflorin with Enterococcus faecium SF68®

·        Antibiophilus with Lactobacillus casei, var. Rhamnosus

Conditions

In the food sector, lactic acid bacteria (lactobacilli and bifidobacteria) are predominantly used. In the medical field, there are special mixtures from different cultures. Not all cultures can be used equally for all areas of application. The various species sometimes have very other effects. These depend not only on the species (e.g., Bifidum ) and on the strain (e.g., Bifidobacterium breve ).

 

Gastric Juice: There are stomach acid and pepsin in the stomach (low pH); in the upper small intestine, bile salts and pancreatic enzymes overcome and survive. Once in the lower sections of the small intestine, bacterial abilities to colonize or form defensins (antimicrobial substances) are other quality features.

 

Resistance: Besides, it should be possible to rule out resistance, and there should be little or no side effects.

 

Number: Ultimately, the amount of bacteria that reach the colon alive is also crucial. Because for the settlement and reproduction (colonization), the reaching of a certain number of germs is decisive. The exact amount required for effectiveness is not known and was once more or less arbitrarily set to at least 1 million colony-forming units [ Mar 2003 ]. The simultaneous presence of prebiotics such as inulin and oligofructose has a beneficial effect on colonization, as these act as growth promoters and as a source of nutrient substrates.

 

Lifespan / regular consumption: As some probiotic cultures are only viable for a few days (in exceptional cases a few weeks) after consumption, reproduce only to a limited extent, and do not settle permanently, regular consumption is recommended for a lasting effect. If there is no supply, probiotic germs are quickly displaced by other (pathogenic) germs. Populations that eat fermented products every day are less likely to develop bowel-associated diseases.

Physiological effects and functions

A large number of postulated health effects can be found in the literature. A distinction must be made between direct and indirect effects. The targeted supply of bacterial cultures should imitate and restore natural intestinal bacteria's function in the intestine. Medical products can also contain bacterial strains that expand or supplement the biological diversity and thus the human microbiota.

The preventive and therapeutic relevance

General

Microbial therapies have a high therapeutic potential for all types of dysbiosis because of the diverse effects. Dysbiosis is associated with reduced microbiota diversity in the intestine and the associated metabolic changes. This affects many clinical pictures. The possible fields of application, therefore, range from infectious (diarrheal diseases), allergic (asthma, allergies), and inflammatory (chronic inflammatory bowel diseases) to degenerative (Alzheimer's, multiple sclerosis) and metabolic diseases (diabetes mellitus, obesity). Due to the bacteria's high specificity, no concrete therapy recommendations can be derived despite initial success in experimental investigations.

 

The American Gastroenterological Association confirms this in a 2020 updated guideline. Accordingly, the available studies are difficult to compare with one another due to differently tested bacterial strains and, overall, of little evidence [ Su 2020 ].

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A preventive effect can only be assumed for diarrheal diseases caused by C. difficile, pouchitis in chronic inflammatory bowel diseases, and premature babies with a birth weight of less than 2500 g [ Su 2020 ].

 

In the following, we show examples of some therapeutic successes in various clinical pictures.