益生菌健康功能及机制研究-ztc-新.ppt

Effects of Probiotics on Human Health and Mechnisms Tong-Cun Zhang, Ph.D Tianjin Univ. of ScienceTechnology Outline What are probiotics？ How do they work？ Current proposed uses and a look at some of the evidence Issues in prescribing their use Probiotics concept Probiotics are defined as ‘living micro-organisms, which upon ingestion in certain numbers exert health benefits beyond general nutrition’ Probiotics Lactobacillus sp. reuteri casei ramnosus acidophilus Streptococcus sp. Bifidobacterium sp. infantis lactis longum breve Sacharomyces boulardii (non-human) Probiotics: Proposed uses Infectious diarrhea Antibiotic-associated diarrhea IBD, IBS, and pouchitis Necrotizing Enterocolitis Bacterial vaginosis Recurrent UTI’s Atopic diseases Immune system enhancement H pylori infections Dental caries Radiation induced diarrhea Cardiovascular risk reduction Constipation Rheumatoid arthritis Probiotics: Proposed uses Probiotics: Proposed uses Probiotics: the evidence Antibiotic-associated diarrhea: D’Souza et al (BMJ 2002) Systematic review of 9 placebo-controlled studies (2 in children) Various probiotics (4 uses S Bouladarii) 60% reduction in antibiotic associated diarrhea compared with placebo (OR 0.37, 95% CI 0.26-0.53) Vanderhoof et al (J Pediatr 1999) 202 children, 6 mo - 10 yr, otitis/pharyngitis, amox/amox-clav Oral antibiotics in an outpatient setting for 10 days Lactobacillus GG, 10 (12kg) or 20 (12kg) billion cfu’s for 10 d Rated stool consistency and frequency 26% of controls and 8% of L GG had diarrhea Of those with diarrhea, 5.9 days in placebo, 4.7 days in L GG Probiotics: the evidence Infectious diarrhea: Van Niel et al (Peds 2002) Systematic review of 9 studies (all outside US, 1-36 months) Various probiotics (4 used L GG) Mean reduction in diarrhea of 0.7 days (95% CI: 0.3-1.2) 1.6 fewer stools in L GG groups (95% CI: 0.7-2.6) Dose response curve with higher L GG dose Two other meta-analyses also showed benefits, particularly with L GG Allen et al