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Probiotics are found in everything from chocolate to gherkins to hand lotions and infant formula, and millions of people buy probiotic supplements to boost digestive health. But new research suggests that they may not be as effective as we think. Through a series of experiments inside the human intestine, researchers show that the digestive tract of many people prevents the colonization of standard probiotics. In addition, taking probiotics to counterbalance antibiotics could delay the return of normal intestinal bacteria and intestinal gene expression to their naive state. The research publishes two consecutive articles on September 6 in the journal Cell.
"People have been very supportive of probiotics, even though the literature underlying our understanding is very controversial, and we wanted to determine whether probiotics like those you buy at the supermarket colonize the GI tract as they are supposed to be. do, and then if these probiotics have an impact on the human host, "says lead author Eran Elinav, immunologist at the Weizmann Institute of Science in Israel." Surprisingly, we saw that many healthy volunteers were actually resistant to the extent that probiotics could not colonize their gastrointestinal tract. This suggests that probiotics should not be universally given as a single supplement. to be adapted to the needs of each individual. "
Although previous studies have studied similar issues, they have all used patient excrement as an indicator of microbial activity in the gastrointestinal tract. Instead, Elinav, his colleague Eran Segal (a computational biologist at the Weizmann Institute) and their teams led by Niv Zmora, Jotham Suez, Gili Zilberman Schapira and Uria Mor of the Elinav lab collaborated with Zamir Halpern, leader from the Tel Aviv Medical Center to directly measure intestinal colonization.
In the first study, 25 human volunteers underwent endoscopies and superior colonoscopies to sample their basic microbiome in the gut regions. 15 of these volunteers were then divided into two groups. The first group consumed generic probiotic strains, while the second group received a placebo. Both groups then underwent a second round of endoscopies and superior colonoscopies to assess their internal response before being followed for another two months.
Scientists have discovered that probiotics have successfully colonized the gastrointestinal tract of some people, called the "persistent", while the intestinal microbiomes of the "resistant" have expelled them. In addition, the persistence and persistence profiles would determine whether the probiotics in a given individual would have an impact on their native microbiome and gene expression. The researchers were able to predict whether a person would be a person persists or simply resist by examining their gene expression profile of the microbiome and intestine.
They also found that the stool is only partially correlated with the functioning of the microbiome inside the body;
"Although all of our volunteers who consume probiotics have presented probiotics in their stool, only some of them have shown them in their intestines, which is the case where they have to be," Segal says. . "If some people resist and some people allow it, the benefits of standard probiotics that we all take can not be as universal as we previously thought.These findings highlight the role of the gut microbiome in very specific clinical differences. "
In the second study, researchers wondered whether patients should take probiotics to counteract the effects of antibiotics, as they are often told to do to repopulate the gut microbiota after it has been eliminated by antibiotic treatment . To do this, 21 volunteers received antibiotics and were randomly divided into three groups. The first was a surveillance group that allowed its microbiome to recover on its own. The second group received the same generic probiotics used in the first study. The third group was treated with an autologous faecal microbiome transplant (aFMT) consisting of its own collected bacteria before administering the antibiotic.
After the disappearance of antibiotics, standard probiotics could easily colonize the bowel of all members of the second group, but to the team's surprise, this probiotic colonization prevented the profile of microbial and intestinal expression normal of the host to return to his state for months after. In contrast, AFT resulted in the native gut microbiome of the third group and the gene program returning to normal in a few days.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse effect of using probiotics with antibiotics that could even have long-term consequences," Elinav explains. . "In contrast, replenish the intestine with its own microbes is a personalized treatment, designed by the mother, which has completely reversed the effects of antibiotics."
Segal adds: "This opens the door to diagnoses that would lead us to an empirical universal use of probiotics, which seems useless in many cases, to a consumption adapted to each individual and that can be prescribed to different people according to their basic characteristics. "
Explore more:
Baby poop can be a source of beneficial probiotics
More information:
Cell, Zmora et al .: "Colonization resistance of the intestinal mucosa customized to empirical probiotics is associated with unique characteristics of the host and the microbiome" https://www.cell.com/cell/fulltext/ S0092-8674 (18) 31102-4, DOI: 10.1016 / j.cell.2018.08.041
Cell, Suez et al .: "Reconstitution of the microbiome of the post-antibiotic intestinal mucosa is altered by probiotics and enhanced by autologous FMT" https://www.cell.com/cell/fulltext/S0092-8674(18) 31108-5, DOI: 10.1016 / j.cell.2018.08.047
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