Aim: To determine the immune response of healthy adults to the ingested Probiotic.
Methods: Daily ingestion of a probiotic drink containing Lactobacillus casei Shirota (LcS; 1.3 x 1010 live cells) by healthy adults for (i) 4-weeks LcS, (ii) 6-weeks discontinuation of LcS, and (iii) final 4-weeks of LcS, was investigated.
Results: There was a significant increase in expression of the T-cell activation marker CD3+ CD69+ in ex vivo unstimulated blood cells at weeks 10 and 14 and a significant increase in the Natural Killer (NK) cell marker CD3+ CD16/56+ in ex vivo unstimulated blood cells at weeks 4, 10 and 14. Expression of the NK cell activation marker CD16/56+ CD69+ in ex vivo unstimulated blood cells was 62% higher at week 10 and 74% higher at week 14. Intracellular staining of IL-4 in ex vivo unstimulated and PMA/ionomycin-stimulated CD3+ β7+ integrin blood cells was significantly lower at week 10 and 14. Intracellular staining of IL-12 in ex vivo unstimulated and LPS-stimulated CD14+ blood cells was significantly lower at weeks 4, 10 and 14. Intracellular staining of TNF-α in LPS-stimulated CD14+ blood cells was significantly lower at weeks 4, 10 and 14. Mucosal salivary IFN-γ, IgA1 and IgA2 concentrations were significantly higher at week 14 but LcS did not affect systemic circulating influenza A-specific IgA or IgG and tetanus specific IgG antibody levels.
Conclusions: In addition to the decrease in CD3+ β7+ integrin cell IL-4 and a CD14+ cell anti-inflammatory cytokine profile, at week 14 increased expression of activation markers on circulating T cells and NK cells and higher mucosal salivary IgA1 and IgA2 concentration indicated a secondary boosting effect of LcS.
Aim: To evaluate the effect of Lactobacillus casei strain Shirota-fermented milk (LcS-FM) on the incidence of Upper Respiratory Tract Infections (URTI) in healthy idle aged office workers.
Methods: Study was conducted in 96 healthy middle-aged office workers in the age group of 30 – 49 years. The office workers consumed LcS-Fermented Milk containing 1.0 × 1011 LcS bacteria or control milk (CM) once daily for 12 weeks during the winter season. URTI episodes were evaluated by a physician via a questionnaire of URTI symptoms.
Results: The results of the study showed that the incidence of URTI’s during the intervention period were significantly lower in the LcS-FM group as compared to the CM group (22.4 vs. 53.2 %, P = 0.002). The time to-event analysis showed that the LcS-FM group had a significantly higher URTI-free rate than the CM group over the test period (log-rank test: χ2 11.25, P = 0.0008). The cumulative number of URTI episodes and cumulative days with URTI symptoms per person was lower in the LcS-FM group, and the duration per episode was also shorter. There was no reduction in NK cell activity in peripheral blood mononuclear cells and no increase in salivary cortisol levels in the LcS-FM group.
Conclusions: The conclusion of the study suggests that the daily intake of fermented milk with LcS may reduce the risk of URTI’s in healthy middle-aged office workers, probably through modulation of the immune system.
Aim: The efficacy of probiotic Lactobacillus casei (Shirota strain) in reducing incidence of ventilator-associated pneumonia (VAP) in medical patients who received mechanical ventilation at Siriraj Hospital was evaluated.
Method: A prospective, randomized, open-label controlled trial was conducted on 150 adult hospitalized patients in medical wards who were on mechanical ventilation for 72 hours or longer: The patients were randomized to the probiotic group or the control group. The patients in the probiotic group received 80 ml of a probiotic fermented milk drink containing 8 billion Lactobacillus casei (Shirota strain) for oral care after having standard oral care once daily and additional 80 ml of the aforementioned fermented dairy product was given via enteral feeding once daily. The primary outcomes were incidence of VAP and incidence rate of VAP episodes per 1,000 ventilator-days. The secondary outcomes were length of hospital stay, mortality at day 28 and 90, incidence of diarrhea, and presence of resistant bacteria in oropharyngeal and rectal swab samples taken from the patients at baseline, day 7 and day 28 after enrollment.
Results: The baseline characteristics of the patients in the probiotic group (75) and the control group (75) were not significantly different. The patients in the probiotic group were less likely to develop VAP compared with the control group (24% vs. 29.3%, p = 0.46). The incidence rates of VAP in the probiotic and control groups were 22.64 and 30.22 episodes per 1,000 ventilator-days, respectively (p = 0.37). A trend of lower prevalence of resistant bacteria cultured from oropharyngeal swabs in the probiotic group than that in the control group was observed. Overall 28 and 90-day mortality and length of hospital stay of the patients in both groups was not significantly different.
Conclusions: Administration of probiotic containing Lactobacillus casei (Shirota strain) resulted in a tendency to reduce the incidence of VAP and colonization with resistant bacteria in oropharyngeal cavity without significant effects on mortality and length of hospital stay.
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Aim: To demonstrate the gastrointestinal survival of Lactobacillus casei strain Shirota (LcS) in healthy Vietnamese adults.
Methods: Twenty-six healthy Vietnamese adults took part in the study. Each participant consumed 65 mL of a fermented milk drink containing LcS daily for 14 days. The drink contained a dose of 10 8 CFU/mL LcS. Fecal samples were collected before, during and after consuming the fermented milk drink.
Results: LcS was confirmed by culture and ELISA. After 7 and 14 days of ingesting fermented milk drink, LcS was recovered from fecal samples at average of 5.0×10 7 CFU/g feces (n=26) and 5.4×10 7 CFU/g feces (n=26), respectively. LcS persisted in 8 volunteers until day 42 (after 14 days stopping fermented milk drink) at 0.0033×10 7 CFU/g feces (n=8).
Conclusions: Confirmed the survival of LcS after passage through the gastrointestinal tract of Vietnamese adults.
Aim: Although several studies have demonstrated the efficacy of probiotics for preventing upper respiratory tract infections (URTIs) in at-risk populations, including children and the elderly. Few studies have investigated the efficacy of probiotics in healthy adults living normal, everyday lives. Thus, this study evaluated the effect of Lactobacillus casei strain Shirota-fermented milk (LcS-FM) on the incidence of URTIs in healthy middle-aged office workers.
Method: In a randomized controlled trial, 96 male workers aged 30–49 years consumed LcS-FM containing 1.0 × 1011 LcS bacteria or control milk (CM) once daily for 12 weeks during the winter season. URTI episodes were evaluated by a physician via a questionnaire of URTI symptoms.
Results: The incidence of URTIs during the intervention period was significantly lower in the LcS-FM group as compared to the CM group (22.4 vs. 53.2 %, P = 0.002). The time to-event analysis showed that the LcS-FM group had a significantly higher URTI-free rate than the CM group over the test period (log-rank test: χ2 11.25, P = 0.0008). The cumulative number of URTI episodes and cumulative days with URTI symptoms per person was lower in the LcS-FM group, and the duration per episode was shorter. Inhibition of both reductions in NK cell activity in peripheral blood mononuclear cells and increase in salivary cortisol levels was observed in the LcS-FM group.
Conclusions: The results suggest that the daily intake of fermented milk with LcS may reduce the risk of URTIs in healthy middle-aged office workers, probably through modulation of the immune system.
Aim: There is insufficient evidence of preventive effect of probiotics on upper respiratory tract infections (URTIs) in an elderly population.
Method: A multicenter, double-blinded, randomized, placebo-controlled parallel group study was conducted. Elderly persons had participated who used day care at 4 facilities in Tokyo. We used fermented milks containing Lactobacillus casei strain Shirota (LcS) and placebo drinks as test drinks.
Results: A total of 154 subjects was analyzed. The number of persons diagnosed with an acute URTIs was almost identical in both groups (LcS: 31, placebo: 32), whereas the number of acute URTIs events (LcS: 68, placebo: 51) and the symptom score (LcS: 425, placebo: 396) were both higher in the LcS group. Permutation tests performed using the total number of acute URTIs infection events/total days of observation and the total symptom score/total days of observation found no statistically significant difference respectively (P values of .89 and .64, respectively). Comparing the mean duration of infection per infection event found a shorter mean duration in the LcS group (LcS: 3.71 days, placebo: 5.40 days), and the difference was statistically significant.
Conclusions: The results suggest that fermented milk containing LcS probably reduces the duration of acute URTIs.
Aim: This study investigated relationships between the frequent intake of fermented milk products containing Lactobacillus casei strain Shirota (LcS) and the onset of hypertension (resting systemic pressure ≥140 mmHg [systolic]/≥90 mmHg [diastolic].
Method: A 5-year period of study was conducted in 352 Japanese who were in the age group of 65 to 93 years, (125 men and 227 women). The subjects were divided into two groups (n=254 and n=98) on the basis of their intake of fermented milk products (less than 3 times a week or more than 3 times a week).
Results: The incidence of hypertension over the 5-year interval was significantly lower in those who took fermented milk products more than 3 times rather than less than 3 times/week (6.1 vs 14.2%, P=0.037). A multivariate-adjusted proportional hazards model predicted that blood pressures were significantly more likely to remain normal over 5 years in subjects who took more than 3 times fermented milk products rather than less than 3 times/ week (relative risk 0.398 [95% confidence interval 0.167-0.948], P=0.037).
Conclusions: These results suggest that after adjustment for potential confounders, the risk of developing hypertension is substantially lower in elderly people who take fermented milk products containing LcS at least 3 times a week.
Aim: To clarify the usefulness of Lactobacillus casei strain Shirota (LcS) - fermented milk in the normalization of bowel movements and improvement of infection control for the elderly residents and staff of facilities for the elderly.
Method: The study was performed on elderly residents (average age, 85) and staff members (average age, 37) of facilities for the elderly. Participants were divided into two groups based on their intake of Lactobacillus casei strain Shirota (LcS) fermented milk or a placebo once daily for 6 months.
Results: A significantly lower incidence of fever and improved bowel movement was seen in the LcS - fermented milk group (n=36) in comparison to the placebo group (n=36). The numbers of Bifidobacterium and Lactobacillus were higher (p < 0.01) whereas pathogenic organisms such as Clostridium difficile were significantly lower (p < 0.05), fecal acetic acid concentration and total acidity was higher in the LcS group. A significant difference in the intestinal microbiota, fecal acetic acid, and pH was also observed between the LcS and placebo groups among the staff members.
Aim: To determine whether a fermented milk drink containing probiotics could improve the bowel habits of frail elderly individuals living in a nursing home.
Method: The bowel habit (stool quality and bowel movements) of 135 participants was recorded by nursing staff during a baseline period of 3 weeks. After this period participants received daily a fermented milk drink containing minimally 6.5×109 colony forming units of Lactobacillus casei Shirota (LcS) for 6 weeks. During this period, bowel habits was recorded and compared to baseline period. 44 participants (74-99 years old) was compliant and used for analysis.
Results: Consumption of fermented milk containing LcS significantly increased the percentage of ideal stool types per week (P<0.01), lowered the percentage of constipation stool types per week (P<0.01) and significantly lowered the percentage of diarrhoea stool types per week (P=0.016) as compared to the baseline period.
Conclusions: The results suggest that a fermented milk containing LcS significantly improves the bowel habits of frail elderly residents in a nursing home. The results of this study need further substantiation.
Conclusions: The study concludes that long-term consumption of LcS -fermented milk may be useful in decreasing the daily risk of infection and improving the quality of life among the residents and staff in facilities for the elderly.
Aim: This pilot study investigated the effects of the probiotic Lactobacillus casei strain Shirota (LcS) on psychological and physical stress responses in medical students undertaking an authorized Nationwide examination for promotion.
Method: In a double-blind, placebo-controlled trial, 24 and 23 healthy medical students consumed a fermented milk containing LcS and a placebo milk, respectively, once a day for 8 weeks until the day before the examination. Psychological state, salivary cortisol, faecal serotonin and plasma L-tryptophan were analysed on 5 different sampling days (8 weeks before examination, 2 weeks before examination, 1 day before examination, immediately after examination and 2 weeks after the examination). Physical symptoms were also recorded in a dairy by subjects during the intervention period for 8 weeks.
Results: In association with a significant elevation of anxiety at 1 day before the examination, salivary cortisol and plasma L-tryptophan levels were significantly increased in only the placebo group (P < 0.05). Two weeks after the examination, the LcS group had significantly higher faecal serotonin levels (P < 0.05) than the placebo group. Moreover, the rate of subjects experiencing common abdominal and cold symptoms and total number of days experiencing these physical symptoms per subject were significantly lower in the LcS group than in the placebo group during the pre-examination period at 5-6 weeks (each P < 0.05) and 7-8 weeks (each P < 0.01) during the intervention period.
Conclusions: The results suggest that daily consumption of fermented milk containing LcS may exert beneficial effect by preventing the onset of physical symptoms in healthy subjects exposed to stressful situations.
8. Decreased duration of acute upper respiratory tract infections with daily intake of fermented milk: A multicenter, double-blinded, randomized comparative study in users of day care facilities for the elderly population.
Fujita R, Iimuro S, Shinozaki T, Sakamaki K, Uemura Y et al (2013) Am J Infect Control pii: S0196-6553(13)00846-8. doi: 10.1016/j.ajic.2013.04.005.