Probióticos são microrganismos vivos que, quando administrados em quantidades adequadas, conferem benefícios à saúde do hospedeiro. Prebióticos são carboidratos não digeríveis que afetam beneficamente o hospedeiro, por estimularem seletivamente a proliferação e/ou atividade de populações de bactérias desejáveis no cólon. Um produto referido como simbiótico é aquele no qual um probiótico e um prebiótico estão combinados. O presente trabalho visou estudar a viabilidade da obtenção de queijo fresco cremoso simbiótico processado com a adição de uma cultura probiótica de Lactobacillus paracasei subsp. paracasei (LBC 82) e do ingrediente prebiótico inulina. Três tratamentos de queijo fresco cremoso foram produzidos (5 repetições de cada um): T1 (probiótico) - com Streptococcus thermophilus + Lactobacillus paracasei; T2 (simbiótico) - com St. thermophilus + L. paracasei + inulina; T3 (controle) - somente com St. thermophilus. As contagens de L. paracasei, St. thermophilus, bactérias láticas, coliformes, Escherichia coli, Staphylococcus spp., Staphylococcus DNAse positivos, bolores e leveduras e as análises de pH, acidez titulável, umidade, atividade de água e perfil de textura (dupla compressão, em analisador de textura TA-XT2), além da determinação do teor de frutanos dos queijos T2, foram realizadas até 21 dias de armazenamento dos produtos a 4ºC. Os queijos também foram comparados através de avaliação sensorial após 7 dias de armazenamento, empregando-se o teste de ordenação-preferência. Não foram detectadas diferenças significativas entre os queijos T1, T2 e T3 para acidez titulável, umidade e atividade de água (p>0,05). As contagens de St. thermophilus permaneceram constantes, próximas a 9,5 log ufc/g, em T1, T2 e T3. A viabilidade de L. paracasei foi suficiente para caracterizar os queijos T1 e T2 como potencialmente probióticos, apresentando populações sempre acima de 7 log ufc/g. Os níveis de contaminação estiveram sempre abaixo dos limites exigidos pela legislação brasileira (exceto para Staphylococcus DNAse positivos em uma amostra dos queijos T3 ao 1o dia) e E. coli não foi detectado. A presença de inulina nos queijos T2 não alterou significativamente o perfil de textura (p>0,05). Não houve variação significativa no teor de frutanos dos queijos T2 durante o armazenamento (p>0,05), permanecendo sempre superior a 7g / 100g. Os queijos T1 apresentaram a menor preferência na análise sensorial e diferiram significativamente de T2 e T3 (p<0,05), devido ao sabor ácido, de acordo com os provadores. Por outro lado, T2 foi o preferido, porém, não diferindo significativamente de T3 (p>0,05). A adição de inulina ao queijo fresco cremoso produzido com a adição de uma cepa potencialmente probiótica de Lactobacillus paracasei resultou em um produto com características adequadas e com propriedades funcionais agregadas. / Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Prebiotics are nondigestible carbohydrates that beneficially affect the host by selectively stimulating the growth and/or activity of a limited number of bacteria present in the colon. A product referred as synbiotic is one in which probiotics and prebiotics are combined. The present research aimed to study the viability of obtaining a synbiotic fresh cream cheese produced with the addition of a probiotic culture of Lactobacillus paracasei subsp. paracasei (LBC 82) and of the prebiotic ingredient inulin. Three fresh cream cheese-making trials were produced (5 repetitions of each one): T1 (probiotic) ¡V with Streptococcus thermophilus + Lactobacillus paracasei; T2 (synbiotic) ¡V with St. thermophilus + L. paracasei + inulin; T3 (control) ¡V only with St. thermophilus. Counts of L. paracasei, St. thermophilus, lactic acid bacteria, coliforms, Escherichia coli, Staphylococcus spp., DNAse-positive Staphylococcus, yeasts and moulds, and analysis of pH, titratable acidity, moisture content, water activity and texture profile (two-bite compression tests, employing a TA-XT2 texture analyser), besides determination of fructan content in cheeses T2, proceeded up to 21 days of storage of the products at 4„b1oC. Cheeses were also compared through sensory evaluation after 7 days of storage, using preference-ranking test. No significant differences were detected between cheeses T1, T2 and T3 for titratable acidity, moisture content and water activity (P>0.05). Counts of St. thermophilus remained constant, around 9.5 log cfu/g, in cheeses T1, T2 and T3. Viability of L. paracasei was enough to characterize cheeses T1 and T2 as potentially probiotic, and counts were always above 7 log cfu/g. Contamination levels were always bellow the recommended by Brazilian regulatory standards (except for a DNAse positive Staphylococcus sample of cheeses T3 at day 1), and E. coli was never detected. L. paracasei inhibited the growth of coliforms, Staphylococcus spp. and DNAse-positive Staphylococcus significantly (P<0.05) in cheeses T1 and T2. The presence of inulin in cheeses T2 did not alter the texture profile significantly (P>0.05). No significant changes in the fructan content during storage were observed (P>0.05), and it remained always above 7 g / 100 g. Cheeses T1 were the least preferred in the sensory evaluation and differed significantly from T2 and T3 (P<0.05), due to acidic taste, according to panelists. On the other hand, T2 was the most preferred one, though not significantly different from T3 (P>0.05). The addition of the prebiotic ingredient inulin to fresh cream cheese produced with a potentially probiotic Lactobacillus paracasei strain resulted in a product with appropriate features and with aggregated functional properties.

Bactérias probióticas, como Lactobacillus sp, são conhecidas como inibidoras do crescimento de microrganismos patogênicos, têm a capacidade de modificar o equilíbrio microbiológico do hospedeiro e reduzir o crescimento de patógenos, como o microoganismo Candida albicans. Para avaliar a colonização oral experimental e o seu tratamento com probióticos, 152 camundongos DBA/2 imunossuprimidos foram inoculados oralmente com uma suspensão (108 células viáveis) de C. albicans. Os animais foram divididos em 4 grupos: controle positivo (sem tratamento), tratados oralmente com nistatina, com Lactobacillus acidophilus e Lactobacillus rhamnosus. No grupo que recebeu nistatina, o tratamento foi iniciado um dia após a inoculação por Candida, já nos grupos que receberam as bactérias probióticas, os tratamentos foram iniciados 14 dias antes da inoculação. Tratamentos com nistatina e probióticos foram diários e duraram 13 dias. As avaliações foram realizadas 1, 3, 5, 7, 9, 11 e 13 dias após a inoculação inicial e feitas através de análises microbiológicas da mucosa oral dos animais. A colonização por C. albicans iniciou-se um dia após a inoculação, sendo o aumento das unidades formadoras de colônia progressivo e significante até o sétimo dia. Após este período, observou-se uma redução significativa no isolamento de leveduras. Todos os tratamentos probióticos reduziram significativamente a colonização de C. albicans na mucosa oral dos animais, comparada com a do grupo de animais não tratados. No grupo tratado com L. rhamnosus, a redução da colonização de levedura foi significativamente maior comparado ao grupo nistatina. Concluiu-se que o modelo animal DBA/2 imunossuprimidos é um bom modelo experimental para o estudo da colonização oral e o tratamento com probióticos, no presente modelo, pode ser uma alternativa eficaz para a redução da Candida na cavidade oral. / To evaluate experimental oral candidiasis and the treatment using probiotics, 152 DBA/2 mice after being immunosuppressed were orally inoculated with a suspension of C. albicans containing 108 viable cells of yeast. The animals were devided into four groups: positive control (untreated), trated oraly with nystatin, with Lactobacillus acidophilus and with Lactobacillus rhamnosus. In the group that received nystatin, the treatment was initiated one day after Candida inoculation, and in the groups that received the probiotic bacteria, the treatment began fourteen days before inoculation. Treatments with nystatin and probiotics were daily and lasted 13 days. Evaluations were performed at 1, 3, 5, 7, 9, 11 and 13 days (after the initial inoculation) and made by microbiological analysis of the oral mucosa of these animals. The colonization of C. albicans in the oral mucosa animals began one day after the initial challenge and it was progressive and significant until the seventh day, when there was a significant reduction in the isolation of yeast. All treatments with probiotic bacteria significantly reduced the colonization of C. albicans in oral mucosa of the animals, compared to the untreated animal group. In group treated with L. rhamnosus the reduction of colonization of yeast was significantly higher compared to the group receiving nystatin. Based on the findings of this study we suggest that animal model DBA/2 immunosuppressed is a good model for experimental oral candidiasis and the treatment with probiotics in this model may be an effective alternative to the treatment of oral candidiasis.

L’une des principales problématiques du développement de produits biologiques, comme les probiotiques, réside dans l’impact du processus de fabrication sur la souche d’intérêt. Le maintien de l’activité thérapeutique est d’un intérêt capital pour obtenir l’effet bénéfique et, des travaux ont également optimisé les propriétés de la souche Lcr35® au travers du procédé de fabrication. Ainsi, toutes les étapes de fabrication du produit sont autant d’étapes qui peuvent modifier les caractéristiques de la souche bactérienne. La compression a été reconnue comme étant une étape qui permet d’éliminer les contaminations bactériennes et a également été décrite comme néfaste pour la viabilité d’une souche probiotique. Ces données constituent donc un a priori négatif au développement de probiotiques comprimés.Inversement, cette forme galénique est reconnue pour améliorer la demi-Vie des produits et améliorer la stabilité des bactéries dans un milieu gastrique. Cependant, aucune étude complète des propriétés d’une souche probiotique, après compression, n’a été effectuée. Or, afin d’établir un dossier d’AMM, toutes ces propriétés se doivent d’être vérifiées sur le produit final.Les travaux présentés se sont donc attachés à étudier les principales propriétés de la souche Lcr35® après compression. Tout d’abord, la perte de viabilité initiale en fonction de la pression de compression a été évaluée expérimentalement et une loi de décroissance d’ordre 1 est proposée. Un tel modèle permet ainsi d’anticiper la perte de viabilité selon la formulation et les conditions de compression. D’autre part, le profil génétique ainsi que le profil d’expression des gènes de la souche Lcr35® ont été étudiés après compression. Ni l’un ni l’autre n’a été modifié par le stress mécanique généré par la compression. De même, les propriétés d’inhibition du pathogène vaginal C. albicans ainsi que la résistance à pH acide de la souche sont maintenues. La résistance au pH gastrique est même améliorée par une protection mécanique vis-À-Vis du milieu.Selon les données de stabilité (ICH Q1A), la viabilité de la souche Lcr35® n’est pas non plus affectée par la compression. Les données de stabilité ont fait l’objet d’une modélisation par l’équation d’Arrhenius permettant d’obtenir un modèle fiable de prédiction de la stabilité, à partir des données en conditions accélérées (40°C).Dans une approche QbD de développement des produits pharmaceutiques, ces données serviront de base de comparaison pour la caractérisation de formulations en développement où des éléments tels que le milieu de culture, la souche ou la forme galénique peuvent être modifiés.Cette caractérisation globale de la souche Lcr35®, après compression, a permis d’infirmer l’a priori négatif sur la compression des bactéries. Ces travaux ont permis de comprendre, de caractériser et de modéliser les aspects liés à la compression des probiotiques. Ils constituent un prérequis primordial au développement d’un nouveau produit sous la forme d’un comprimé. Suite à une étape de développement complémentaire, ils ont d’ailleurs permis d’aboutir au premier produit commercialisé sous la forme d’un comprimé à libération prolongée, par la société Probionov : Gynophilus® LP.Ces données sur la compression élargissent la connaissance fondamentale de l’effet des procédés pharmaceutiques sur les propriétés des probiotiques et ouvrent de manière considérable leur champ de développement. Cette forme est un atout considérable en termes de stabilité mais surtout, elle fait intervenir de nombreuses perspectives de développement : gastro-Résistants, effervescents, multicouches, etc. Par l’intermédiaire de cette technologie, une administration plus ciblée de la souche par exemple dans les parties distales de l’intestin pourra être envisagée pour optimiser le bénéfice thérapeutique des souches probiotiques. Le but final étant de pouvoir diminuer la posologie des traitements tout en améliorant l’observance et le confort des patients. / One of the main issues in the development of biological products, such as probiotics, is the impact of the manufacturing process on the strain of interest. Maintaining therapeutic activity is of great interest for the expected beneficial effect and work has even optimized the properties of the Lcr35® strain through the manufacturing process. Therefore, all process stages leading to the final product are steps that can alter the characteristics of the bacterial strain.Compression is recognized in some publications as being a step which eliminates bacterial contaminations present for example in the excipients. For the development of new probiotic products, compression has also been described as negative for bacterial viability. These data are therefore a negative a priori on development of probiotic products in the tablet form. Conversely, this dosage form is known to improve the half-Life of products and improve the stability of bacteria in gastric environment. However, no comprehensive study of the properties of a probiotic strain after compression was done. Nevertheless, to establish a marketing authorization, all the properties of the strain must be checked on the final product.This work has proposed a review of the main properties of the Lcr35® strain after compression. First of all, the initial loss of viability as a function of compression pressure was studied experimentally and was modeled by a first order law. It allows us to anticipate the loss of viability of a strain depending on the formulation and compression conditions. Furthermore, the genetic profile and the profile of gene expression have not been changed due to the compression step. We also noticed that the inhibition properties of the pathogen C. albicans growth and acid resistance of the strain are maintained. Resistance to gastric pH is also enhanced by a phenomenon of mechanical protection against the environment.According to the data of stability under ICH conditions, the viability of the compressed Lcr35® strain is not affected by the compression. Stability data have therefore been modeled by the Arrhenius equation to obtain a reliable model for predicting the stability data from accelerated conditions (40°C). In a QbD approach to pharmaceutical development, these data serve as a basis of comparison for the characterization of developing formulations where parameters such as the culture environment, the drying method, the strain or the galenic form can be changed. This global characterization of Lcr35® strain after compression has set aside the negative a priori against the compression of bacteria. This work helped to understand, characterize and model aspects linked to probiotics compression. They are an essential prerequisite for the development of a new probiotic product in the form of a tablet. Following a further development step, they also helped to lead to the first product in the tablet form, marketed by the company Probionov : Gynophilus® LP (vaginal administration). These compression data considerably broaden the field of development of probiotics. Indeed, this form is a considerable advantage in terms of stability but more importantly, the tablet form involves many development opportunities: gastro-Resistant, effervescent, multi-Layered tablets, etc. Through this technology, a more targeted administration of the strain such as up to the colon may be considered to maximize the therapeutic benefit of the probiotic strains. The ultimate goal is to be able to decrease the dosage of treatment while improving observance of the treatment and the patient comfort.

Pseudomonas aeruginosa est un pathogène opportuniste responsable de pneumonies. Il est particulièrement impliqué dans la mortalité des patients sous ventilation mécanique et des patients atteints de la mucoviscidose. Ces infections sont difficiles à traiter en raison de l’existence de nombreuses résistances aux antibiotiques chez cette bactérie et des alternatives thérapeutiques s’avèrent donc nécessaires. Nous avons ainsi émis l’hypothèse qu’une application oropharyngée de lactobacilles pourrait permettre de limiter les infections à P. aeruginosa et leurs effets chez les patients concernés. L’objectif principal de ce travail était d’évaluer les effets d’un mélange de lactobacilles dans un modèle murin de pneumonie à P. aeruginosa. Les effets de lactobacilles isolés dans les cavités orales de volontaires sains sur la formation de biofilm et l’activité élastolytique de P. aeruginosa PAO1 ont été mesurés in vitro. Les effets des lactobacilles sélectionnés ont ensuite été évalués dans un modèle d’infection de cellules épithéliales respiratoires(A549) par P. aeruginosa PAO1 puis dans un modèle murin de pneumonie à P. aeruginosa PAO1. Les effets de 87 lactobacilles sur la formation de biofilm et l’activité élastolytique de P. aeruginosa PAO1 ont été déterminés in vitro,aboutissant à la sélection de 3 et 5 souches ayant respectivement inhibé la formation de biofilm et l’activité élastolytique de P. aeruginosa PAO1. Parmi ces souches, L. fermentum K.C6.3.1E, L. paracasei ES.D.88 et L. zeae Od.76,qui étaient les souches les plus actives contre la formation de biofilm ou l’activité élastolytique et les plus acidifiantes lors de croissances dans une salive artificielle, ont été associées dans un mélange testé dans un modèle cellulaire d’infection à P. aeruginosa PAO1. Ce mélange n’a pas eu d’effet cytotoxique et a démontré un effet cytoprotecteur vis-à-vis de l’infection à P. aeruginosa PAO1. In vivo, l’administration intratrachéale de ces mêmes bactéries de façon prophylactique a permis d’une part de réduire les charges pulmonaires en P. aeruginosa PAO1 et d’autre part de réduire ses effets pro-inflammatoires au niveau pulmonaire (IL-6, TNF-α). Ces résultats prometteurs laissent entrevoir la possibilité de nouvelles applications thérapeutiques pour les probiotiques. / Pseudomonas aeruginosa is an opportunistic pathogen that causes pneumonia and which is involved in themortality of mechanically-ventilated or cystic fibrosis patients.These infections are difficult to treat because of the existence of many antibiotic resistances in P. aeruginosa and therapeutic alternatives are needed. Our hypothesis was that the use of probiotics could be an alternative to antibiotic therapy in order to reduce P. aeruginosa infections and its injurious and pro-inflammatory effects in lungs.The main goal of this work was to evaluate the effects of lactobacilli in a murine model of P. aeruginosa pneumonia.The first step of this work was to screen lactobacilli isolated from oral cavities of healthy volunteers against biofilmformation and elastolytic activity of P. aeruginosa PAO1. The effects of selected lactobacilli were then evaluated in amodel of infection of lung epithelial cells by P. aeruginosa PAO1 and in a murine model of P. aeruginosa PAO1pneumonia. Eighty-seven lactobacilli were tested in vitro, leading to the selection of 3 and 5 strains respectively active against biofilm formation and elastolytic activity. The most active strains (L. fermentum K.C6.3.1E, L. paracasei ES.D.88and L. zeae Od.76) toward biofilm formation and elastolytic activity were chosen to be tested in vitro, in a cell model of P. aeruginosa PAO1 infection. This mix showed cytoprotective effect against P. aeruginosa PAO1. Finally, the prophylactic intratracheal administration of the mix of lactobacilli in mice allowed to reduce the pulmonary loads in P.aeruginosa PAO1. In the same time, the pro-inflammatory effects(IL-6 and TNF- α) of the infection were reduced. These promising results suggest the possibility of new therapeutic applications for probiotics.

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Hospital Universitário Antonio Pedro / O uso de probióticos tem sido apontado como estratégia terapêutica promissora na disbiose intestinal presente nos pacientes com doença renal crônica (DRC). Os probióticos emergiram em um contexto no qual a microbiota intestinal se tornou fator importante envolvido na progressão e nas complicações da DRC. Assim, o objetivo deste estudo foi avaliar os efeitos da suplementação com probióticos sobre o perfil da microbiota intestinal e inflamação em pacientes renais crônicos em hemodiálise (HD). Neste estudo radomizado, duplo cego, placebo controlado, 46 pacientes foram recrutados na clínica Renal Vida/RJ para receberem probiótico (n=23; Streptococcus thermophilus, Lactobacillus acidophilus e Bifidobacteria longum - 90 bilhões de Unidades Formadoras de Colônias (UFC) por dia, ou placebo (n=23). Amostras de sangue e fezes foram coletadas no momento inicial e após 3 meses de intervenção. Marcadores inflamatórios plasmáticos como Proteína C-Reativa (PCR) e Interleucina-6 (IL-6),bem como os níveis plasmáticos de lipopolissacarídeos (LPS) foram analisados por ensaio imunoenzimático (ELISA). Os níveis plasmáticos das toxinas urêmicas indoxil sulfato (IS), p-cresil sulfato (p-CS), ácido indol-3-acético (AIA) e trimetilamina n-oxidase (TMAO), além dos compostos colina e betaína, foram obtidos por Cromatografia Líquida de Fase Reversa (RP-HPLC) e o perfil da comunidade microbiana das amostras fecais foi determinado através da Reação em Cadeia da Polimerase (PCR) e Eletroforese em Gel com Gradiente Desnaturante (DGGE). Foi realizada avaliação antropométrica e análise da ingestão alimentar através do recordatório de 24h de 3 dias. A análise estatística foi realizada através do programa SPSS 19.0. Permaneceram no estudo até o momento final da intervenção, 16 pacientes do grupo probiótico [11 homens, 53,6 ±11,0 anos, 25,3± 4,6 kg/m2, tempo em HD de 75,1± 53,9 meses] e 17 do grupo placebo [10 homens, 50,3 ±8,5 anos, 25,2 ±5,7 kg/m2, tempo em HD de 52,0 ± 44,7 meses]. Após a intervenção, o número médio de bandas avaliado pelo DGGE não se modificou (de 21,2 ± 4,9 para 22,4 ± 6,7, p=0,62). Observou-se aumento significativo, após suplementação com probiótico, nos níveis plasmáticos de ureia pré-diálise [de 149,6 ±34,2 mg/dL para 172,6 ±45,0 mg/dL (p=0,02)], potássio [de 4,4 ± 0,41 mg/dL para 4,8 ± 0,47 mg/dL (p=0,02)] e IS [de 31,2 ± 15,9mg/dL para 36,5 ± 15,0mg/dL (p=0,02)] e redução significativa do pH fecal [de 7,2 ± 0,8 para 6,5 ± 0,5 (p=0,01)]. Não houve alteração significativa dos níveis de PCR e IL-6.O número médio de bandas apresentou associação negativa com o pH fecal (r= -0,504; p= 0,02). Os níveis de ureia foram preditores independente do número médio de bandas (β= -0,25; p= 0,02). A toxina AIA correlacionou-se negativamente com hematócrito (r= - 0,416; p= 0,043) e foi preditora independente para os níveis de hemoglobina (β= -0,49; p= 0,05). Em conclusão, não se observou mudança no perfil micobiano intestinal e nos níveis de marcadores inflamatórios tradicionais com o uso de probióticos, no entanto, alterações observadas em parâmetros bioquímicos como ureia e IS sugerem que essa terapia pode ser contra-indicada em pacientes com DRC em HD. Além disso, as correlações encontradas reforçam o link entre microbiota intestinal e DRC / Probiotics have been suggested as a promising alternativetherapeutic in treatment of Chronic Kidney Disease (CKD) due to their various health-promoting effects. They emerged in a context in which the intestinal microbiota has become an important factor involved in the progression and complications of CKD. Thus, the aim of this study was to evaluate the effects of oral probiotic supplementation onintestinal microbiota profile and inflammation in CKD patients on hemodialysis (HD). In this randomized, double-blind, placebo-controlled study, 46 patients were recruited from Renal Vida/RJ clinic, to receive probiotic (n= 23; Streptococcus thermophilus, Lactobacillus acidophilus e Bifidobacteria longum- 90 billion CFU per day or placebo (n = 23). Blood and feces were collected at baseline and after 3 months. The inflammatory markers C - reactive protein (CRP)and interleukin-6 (IL-6), and plasma levels of lipopolysaccharides (LPS) were analyzed by Immunoenzymatic Assay (ELISA). Plasma levels of uremic toxins indoxyl sulfate (IS), p-cresil sulfate (p-CS), indole-3-acetic acid (IAA) and trimethylamine n-oxidase (TMAO), and choline and betaine compounds, were obtained by Reverse Phase High Performance Liquid Chromatography (RP-HPLC) and, the profile of the microbial community of fecal samples was determined by Polymerase Chain Reaction (PCR) and Denaturing Gradient Gel Electrophoresis (DGGE). The feces pH was measured by colorimetric method. Anthropometric assessment was carried out, analysis of food intake was assessment by 24-hour recall for 3 days. Statistical analysis was performed using the SPSS 19.0 program.Until the end of the intervention, 16 patients remained in probiotic group [11 men, 53.6 ± 11.0 years, 25.3 ± 4.6 kg/m2, HD times of 75.1± 53.9 months] and 17 in placebo group [10 men, 50.3 ± 8.5 years, 25.2 ± 5.7 kg/m2, HD time of 52.0 ± 44.7 months]. The number of bands was not different after intervention (21.2 ± 4.9 to 22.4 ± 6.7, p=0.62).After probiotic supplementation there was a significant increase on urea plasma levels (from 149.6 ± 34.2 mg/dL to 172.6 ± 45.0 mg/dL, p = 0.02), potassium (from 4.4 ± 0.41 mg/dL to 4.8 ± 0.47 mg/dL, p = 0.02) and IS (from 31.2 ± 15.9 to 36.5 ± 15.0 mg/dL, p = 0.02). Thefecal pH was reduced from 7.2 ± 0.8 to 6.5 ± 0.5 (p = 0.01).There was no significant change in CRP and IL-6 levels. Predialysis urea was an independent predictor of the average number of bands (β = -0.25; p = 0.02). The average number of bands was negatively associated with fecal pH (r = -0.504; p = 0.02). IAA levels were negatively correlated with hematocrit (r = - 0.416, p = 0.043) and were an independent predictor for hemoglobin (β = -0.49; p = 0.05). In conclusion, there was no observed change the intestinal microbial profile and levels of traditional inflammatory markers after probiotics supplementation, however, changes were observed in biochemical parameters and IS plasma lvels, suggesting that this therapy may be contraindicated in CKD patients on HD. In addition, this study showed that there is a strong correlation between gut microbiota and CKD

Lors d’infections vaginales, divers pathogènes se développent au détriment de la flore locale. L’utilisation de lactobacilles en traitement prophylactique et/ou curatif pourrait pallier ce problème. Le but de ce travail de thèse a été de développer des microparticules mucoadhésives à base de pectine et d’acide hyaluronique (HA) pour la libération intravaginale de probiotiques. Quatre souches probiotiques ont été associées à des prébiotiques afin d’obtenir un effet symbiotique. Les microparticules ont été formulées par émulsification-gélification ionique. Dans un premier temps, l’étude de l’influence de différents paramètres de procédé et de formulation a permis de définir les conditions opératoires pour l’obtention de microparticules d'environ 140 µm de diamètre encapsulant des probiotiques viables. Puis, les propriétés mucoadhésives des microparticules ont été évaluées in-vitro et ex-vivo par des mesures rhéologiques en mode dynamique et par des tests d’indentation. La présence d’HA entraine une augmentation importante du pouvoir bioadhésif des particules. Enfin, ces microparticules ont été incorporées dans des comprimés par un procédé de granulation humide. L’encapsulation des bactéries permet leur protection lors du procédé de compression. De plus, contrairement aux formes classiques d'administration des probiotiques, les microparticules permettent d'obtenir un profil de libération prolongée des bactéries sur environ 10h contre 1h dans le cas d’un comprimé comportant des probiotiques non encapsulés. Un début de prolifération bactérienne s’opère entre 16 et 24 heures. Le comprimé ainsi développé est tout-à-fait adapté à une application vaginale / More than 300 millions of women around the world have urinary or vaginal infections, including yeast vaginitis and bacterial vaginosis. Vaginal use of probiotics offers a potential alternative approach to health restoration and maintenance of the vaginal microflora. Moreover, prebiotics may be combined with probiotics to obtain a symbiotic effect. The aim of this work was to develop pro- and pre-biotics-loaded bioadhesive microparticles by using pectin and hyaluronic acid (HA). Four probiotic strains classically used in vaginal applications and one prebiotic have been selected. Microparticles were produced by emulsification/gelation method using calcium as cross-linking agent. The study of process and formulation parameters allowed obtaining microparticles with a mean diameter of 140 µm which encapsulated between 1010 to 1011 cfu/g of microparticles. Their mucoadhesive properties have been proved both by rheological and indentation measurements in in-vitro and ex-vivo conditions. Moreover, results have shown that HA addition in pectin solutions enhanced the bioadhesive properties of the gel-based microparticles. Afterwards, microparticles have been incorporated inside tablet by wet granulation. Microencapsulation of probiotics allowed protecting them during the compression process. The kinetic release of probiotics studies in in-vitro conditions exhibited a sustained release profile for 10 hours against 1h for unencapsulated probiotics. A beginning of probiotic strain proliferation was observed between 16 to 24 hours. The developed tablet is well-suited to vaginal application

Subprodutos de frutas são rotineiramente descartados pelas indústrias. Porém, são ricos em compostos bioativos, podendo ser utilizados como ingredientes em produtos funcionais, promovendo a saúde e minimizando o impacto ambiental. O objetivo deste trabalho foi estudar o potencial funcional de subprodutos desidratados de acerola e de laranja, como fontes de compostos fenólicos, e desenvolver leites fermentados probióticos adicionados deste resíduo, avaliando suas características físico-químicas durante o armazenamento sob refrigeração (28 dias; 4 ± 1 °C), bem como o impacto das condições gastrointestinais sobre os flavonoides e as cepas probióticas. Os subprodutos foram obtidos em indústrias de processamento de frutas do estado de São Paulo, e foram realizadas as seguintes análises para caracterizá-los: composição centesimal, teores de vitamina C, minerais, fibras alimentares, compostos fenólicos totais e proantocianidinas, capacidade antioxidante in vitro e perfil cromatográfico de flavonoides (CLAE). Foram elaboradas quatro formulações de leites fermentados: F0 (controle), sem adição de resíduo de acerola (RA); F2, com 2% de RA; F5, com 5% de RA; F10, com 10% de RA. Adicionou-se a cultura probiótica ABT-4 nos produtos, constituída de duas cepas probióticas: Bifidobacterium animalis subsp lactis Bb-12 e Lactobacillus acidophilus La-5, além da cultura starter Streptococcus thermophilus. As seguintes análises foram realizadas com as formulações de leites fermentados, durante o armazenamento sob refrigeração (28 dias, 4 ± 1 °C): composição centesimal, pH, acidez, viabilidade dos microrganismos, teor de compostos fenólicos totais (CF), cor e textura instrumentais. Além disso, os leites fermentados foram submetidos a condições gastrointestinais simuladas in vitro, para avaliação do impacto na viabilidade das cepas probióticas e nos compostos fenólicos. O RA mostrou-se excelente fonte de vitamina C (605 mg/100 g b.u.), além de apresentar melhor capacidade antioxidante in vitro do que o RL. Proantocianidinas foram encontradas apenas no RA, na concentração de 617 &#181;g EC/g b.s. O teor de compostos fenólicos totais do RA (3240 &#181;g EAG/100 g b.s.) foi 3,6 vezes maior que o do RL. Os principais compostos fenólicos encontrados no RA foram: derivados de quercetina, procianidina B1, rutina, e derivados de caempferol. No RL, foram identificados: naringenina, sinensetina, homorientina, isovitexina e derivados de ácido clorogênico. Os subprodutos estudados apresentaram elevados teores de fibras totais (acima de 60%) e proteínas totais (RA: 10,4%; RL: 9,9%), além de reduzido teor de lipídeos totais (RA: 1,6%; RL: 2,6%). Os principais minerais identificados em ambos os resíduos foram: potássio, magnésio, cálcio e fósforo. Quanto às quatro formulações de leites fermentados, estas apresentaram baixo teor de lipídeos totais (menor que 1%), e o teor de proteínas totais variou entre 3,9 e 5,1 g/100 g, estando de acordo com a legislação vigente para este tipo de produto. O pH das formulações F0 (controle) e F2 manteve-se estável significativamente (p > 0,05) ao longo do período de armazenamento sob refrigeração (28 dias; 4 ± 1 °C), e das outras formulações sofreu pequena queda, mesmo assim mantendo-se acima de 4,5. A acidez das formulações, que variou entre 0,92 a 1,28 mg de ácido lático/g, aumentou entre os dias 1 e 14 de armazenamento, depois se manteve até o final da vida de prateleira. O RA não interferiu de maneira negativa nas populações de microrganismos analisadas durante o armazenamento, já que as formulações F2, F5 e F10 mantiveram suas populações em torno de 8 log UFC/g. Quanto ao teor de CF, as amostras diferiram significativamente entre si (p < 0,05), sendo que F0 apresentou teor em torno de 5 vezes inferior a F10 (21,13 e 101,13 &#181;g EAG/100 g, respectivamente, no dia 1). A cor dos produtos se manteve até o final da vida de prateleira, e diferiram significativamente (p < 0,05) entre si. O RA influenciou pouco nos parâmetros de textura dos leites fermentados, mas a formulação controle foi a única que perdeu adesividade. Após a fase gástrica da digestão simulada in vitro, no 7° dia de armazenamento, as populações de bactérias probióticas diminuíram drasticamente (quedas em torno de 3 a 5 log UFC/g), e após a fase entérica não foram detectadas contagens. Por outro lado, os flavonoides encontrados nos leites fermentados adicionados de RA aumentaram em torno de 2 a 5 vezes, após a fase gástrica, mantendo-se ou sofrendo pequena queda após fase entérica. Estes resultados mostram que o pó de subprodutos de acerola é um valioso ingrediente a ser utilizado em alimentos funcionais, pois é rico em vitamina C, fibras e compostos fenólicos, agregando valor nutricional, além de servir como antioxidante natural. Seus flavonoides parecem ser altamente resistentes aos ácidos e sais da digestão, podendo, assim, exercer efeitos positivos sobre a saúde. / Fruits by-products are routinely discarded by industries. However, they are rich in bioactive compounds, and can be used as ingredients in functional foods, promoting health and minimizing environmental impact. The objective of this study was to investigate the functional potential of acerola and orange dehydrated by-products, as sources of phenolic compounds, and to develop probiotic fermented milks suplemented with this residues, evaluating its physico-chemical characteristics during refrigerated storage (28 days, 4 ± 1 °C), as well as the impact of gastrointestinal conditions on flavonoids and probiotic strains. The by-products were obtained from fruit processing industries of São Paulo, and the following analyzes were performed to characterize them: contents of moisture, ash, lipids, proteins, vitamin C, minerals, dietary fibers, total phenolic compounds and proanthocyanidins, antioxidant capacity in vitro and flavonoids chromatographic profile (HPLC). Were elaborated four formulations of fermented milks: F0 (control), without addition of acerola residue (AR); F2, with 2% AR; F5, with 5% AR; F10, with 10% AR. Was used the probiotic culture ABT-4, composed of two probiotic strains, Bifidobacterium animalis subsp lactis Bb-12 and Lactobacillus acidophilus La-5, in addition to the starter culture Streptococcus thermophilus. During the refrigerated storage (28 days, 4 ± 1 °C), the following analyzes were performed with the fermented milks: contents of moisture, ash, lipids and proteins, pH, acidity, viability of microorganisms, total phenolic compounds (PC), instrumental color and texture. In addition, the fermented milks were submitted to in vitro simulated gastrointestinal conditions to evaluate the impact on the viability of probiotic strains and phenolic compounds. AR presented excellent content of vitamin C (605 mg/100 g), in addition to presenting better antioxidant capacity in vitro than orange residue (OR). Proanthocyanidins were found only in AR (617 &#181;g CE/g). The PC content of AR (3240 &#181;g GAE/100 g) was 3.6 higher than in OR. The phenolic compounds identified in AR were quercetin-3-rhamnoside, rutin and others quercetin derivatives, procyanidin B1 and kaempferol derivatives. In OR, were identified naringenin, sinensetin, homorientin, isovitexin and chlorogenic acid derivatives. The by-products studied showed high total fibers content (above 60%) and total proteins (AR: 10.4%, OR: 9.9%), as well as reduced total lipids content (AR: 1.6%; OR: 2.6%). Both residues showed high levels of potassium, calcium, magnesium and phosphorus. The four formulations of fermented milks presented low total lipids content (below 1%), and the total proteins content ranged from 3.9 to 5.1 g/100 g, being in agreement with the legislation. The pH of F0 (control) and F2 formulations remained stable (p > 0.05) throughout the refrigerated storage period (28 days, 4 ± 1 °C), and the other formulations showed a small decreased, even thus remaining above 4.5. The acidity of the formulations, ranging from 0.92 to 1.28 mg of lactic acid/g, increased between days 1 and 14 of storage, then remained until the end of shelf life. The AR did not negatively interfere in the populations of microorganisms analyzed during storage, since the formulations F2, F5 and F10 maintained their populations around 8 log CFU/g. Regarding PC content, the samples differed significantly (p < 0.05), with F0 being about 5 lower than F10 (21.13 and 101.13 &#181;g GAE/100 g, respectively, in the day 1). The instrumental color of the products remained until the end of shelf life, and differed significantly (p < 0.05) from each other. The AR influenced a little in the texture parameters of the fermented milks, but the control formulation was the only one that lost adhesiveness. After the gastric phase of the simulated digestion in vitro, on the 7th day of storage, the populations of probiotic bacteria decreased dramatically (of 3 to 5 log CFU/g), and after the enteric phase no colonies were detected. On the other hand, the flavonoids found in the fermented milks that were suplemented with AR increased from 2 to 5 times, after the gastric phase, maintaining or suffering small decreased after enteric phase. These results show that acerola by-products powder is a valuable ingredient to be used in functional foods because it is rich in vitamin C, dietary fibers and phenolic compounds, adding nutritional value, and serving as a natural antioxidant. Its flavonoids appear to be highly resistant to the acids and salts of digestion and can thus have positive effects on health.

A microbiota vaginal saudável é constituída, majoritariamente, por espécies de lactobacilos que representam uma barreira natural contra microrganismos causadores de doenças como a candidíase vulvovaginal (CVV), vaginose bacteriana (VB) e infecções do trato urinário (ITU), que juntas acometem cerca de um bilhão de mulheres no mundo anualmente. Um melhor entendimento da ecologia microbiana vaginal pode ser útil na otimização de tratamentos existentes para as infecções urogenitais, os quais podem destruir parcialmente a microbiota autóctone, predispor a novas infecções, contribuir para a seleção de microrganismos resistentes e causar efeitos colaterais indesejáveis. A utilização de microrganismos certificadamente probióticos, Lactobacillus rhamnosus GR-1 e Lactobacillus reuteri RC-14, representa uma alternativa terapêutica promissora na abordagem de VB e CVV, uma vez que são capazes de colonizar o trato vaginal, apresentam atividade inibitória frente a diversos patógenos do trato urogenital, exibem risco mínimo para a seleção de microrganismos resistentes e podem auxiliar na restauração da microbiota vaginal. Os objetivos deste trabalho foram: (i) avaliar a prevalência de espécies de lactobacilos na microbiota vaginal de mulheres saudáveis e diagnosticadas com infecções vaginais (CVV e VB) da cidade de Ribeirão Preto (São Paulo, Brasil), (ii) avaliar a capacidade de isolados de lactobacilos produzirem peróxido de hidrogênio (H2O2) e (iii) determinar a eficácia da utilização de L. rhamnosus GR-1 e L. reuteri RC-14 no tratamento de CVV e VB, quando co-administrados com medicamentos antimicrobianos tradicionais. Participaram deste estudo, 196 pacientes voluntárias, atendidas por médicos ginecologistas de centros de saúde ligados à Universidade de São Paulo, campus de Ribeirão Preto (64 saudáveis, 68 diagnosticadas com CVV e 64 diagnosticadas com VB) e duas amostras vaginais de cada paciente foram coletadas com o auxílio de zaragatoas esterilizadas. Uma zaragatoa foi utilizada para semeadura em ágar MRS (de Man, Rogosa & Sharpe), os isolados de bactérias láticas obtidos foram analisados através da técnica de PCR-ARDRA (Reação em cadeia da polimerase Análise de restrição do DNA ribossomal amplificado) e a habilidade de Lactobacillus spp. produzir H2O2 foi determinada semi-quantitativamente. A outra zaragatoa foi utilizada para a análise das espécies de lactobacilos da microbiota vaginal pela técnica independente de cultivo PCR-DGGE (Reação em cadeia da polimerase Eletroforese em gel de gradiente de desnaturação). As leveduras do gênero Candida foram obtidas através da semeadura das amostras vaginais provenientes de pacientes saudáveis e com CVV no meio Chromagar® Candida e identificadas através de provas bioquímicas de referência. As pacientes diagnosticadas com CVV participaram de um estudo randomizado, duplo-cego, placebo-controlado e foram tratadas com dose única de fluconazol (150mg) e suplementação diária durante 28 dias com (i) duas cápsulas contendo os microrganismos probióticos L. rhamnosus GR-1 e L. reuteri RC-14 (Urex-Cap-5®) ou (ii) duas cápsulas de placebo. As pacientes com VB também participaram de um estudo randomizado, duplo-cego, placebo-controlado e foram tratadas com dose única de tinidazol (2g) e suplementação diária com cápsulas do probiótico (Urex-Cap-5®) ou placebo, conforme descrito acima. Todas as pacientes foram reavaliadas ao final do tratamento, no 28º dia. Foram realizados experimentos para averiguar o possível efeito de L. rhamnosus GR-1 e L. reuteri RC-14 na modulação in vitro da infecção por Candida albicans em culturas de células epiteliais vaginais humanas (VK2/E6E7) Os resultados mostraram que, pela técnica de PCR-ADRA, L. crispatus foi a espécie mais prevalente nos grupos de pacientes saudáveis (37,0%) e com CVV (35,9%), enquanto que L. gasseri foi predominante no grupo de pacientes com VB (34,6%). De acordo com o método de PCR-DGGE, L. iners foi o microrganismo mais prevalente nos três grupos de pacientes avaliados: saudáveis, com CVV e VB (48,7%, 44,7% e 65,0%, respectivamente). A maioria dos isolados de Lactobacillus spp. obtidos nos grupos de pacientes saudáveis (98,6%) e diagnosticadas com CVV (97,4%) foram capazes de produzir H2O2 (1 a 100mg/L), em comparação a apenas 68,2%, determinado no grupo de pacientes com VB (p<0,05). L. crispatus e L. johnsonii produziram as maiores quantidades médias de H2O2 (30mg/L). A taxa de colonização por leveduras do gênero Candida foi de 26,6% no grupo de pacientes saudáveis (C. albicans correspondeu a 52,4% de todos os isolados), enquanto que no grupo de pacientes com CVV, 89,2% dos isolados leveduriformes foram identificados como C. albicans. Para as análises estatísticas dos dados obtidos com os testes clínicos, foram consideradas 55 pacientes diagnosticadas com CVV (pela presença de sinais e sintomas da infecção e cultura positiva para Candida sp.) e foi observado que a utilização de dose única de fluconazol e suplementação diária com o probiótico, resultou em taxa de cura mais elevada para a infecção (89,7%) em comparação com aquela verificada no grupo placebo (65,4%) (p<0,05). A utilização de tinidazol em associação com a ingestão diária de Urex-Cap-5® no tratamento de pacientes com VB também resultou em taxa de cura mais elevada para a condição (87,5%), em comparação àquela observada no grupo placebo (50,0%) (p<0,05). A atividade anti-Candida de L. rhamnosus GR-1 e L. reuteri RC-14 foi observada através do modelo in vitro para infecção vaginal. Em conclusão, quando as técnicas de PCR-ARDRA e PCR-DGGE foram comparadas entre si, foi observado que ambas apresentaram limitações, evidenciando a importância do emprego de diferentes metodologias para avaliação adequada das espécies de lactobacilos presentes na microbiota vaginal. As espécies de lactobacilos vaginais determinadas nas mulheres saudáveis do presente trabalho foram semelhantes àquelas verificadas em estudos prévios descritos na literatura com pacientes com dieta e localização geográfica notadamente distintas. Os dados do presente trabalho sugerem que a presença de lactobacilos produtores de H2O2, isoladamente, não confere proteção contra CVV, enquanto que a ausência desses microrganismos pode ser um fator contribuinte para VB. Além disso, foi demonstrado que a utilização de medicamentos antimicrobianos tradicionais e suplementação com os microrganismos probióticos L. rhamnosus GR-1 e L. reuteri RC-14 foi mais eficiente no tratamento de CVV e VB em comparação com medicamentos clássicos e placebo. Estes resultados podem contribuir para prolongar a vida útil de medicamentos cuja eficácia pode ser comprometida devido à seleção de microrganismos resistentes e também reduzir o tempo de tratamento para pacientes que necessitam de terapias clássicas por períodos prolongados. / The vaginal microbiota is mainly constituted by lactobacilli species, which represent a natural barrier against microorganisms that cause vulvovaginal candidiasis (VVC), bacterial vaginosis (BV), and urinary tract infections (UTI). Together, these conditions afflict each year an estimated one billion women worldwide. A better understanding of the vaginal microbial ecology may be useful to improve the current available treatments for urogenital infections, which can partially destroy the autochthonous microbiota, predispose to other infections, contribute for the selection of resistant microorganisms and cause undesirable collateral effects. The use of microorganisms with demonstrated probiotic properties, Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, represents a promising therapeutic alternative for BV and VVC, since they are able to colonize the vaginal tract, present inhibitory against several urogenital pathogens, pose minimal risk for the selection of resistant microorganisms and can help to restore the vaginal microbiota. The objectives of this work were: (i) to evaluate the prevalence of lactobacilli species in the vaginal microbiota of healthy women and those diagnosed with vaginal infections (VVC and BV) in the city of Ribeirão Preto (São Paulo, Brazil), (ii) to evaluate the ability of the lactobacilli isolates to produce hydrogen peroxide (H2O2) and (iii) to determine the efficacy of the use of L. rhamnosus GR-1 and L. reuteri RC-14 in the treatment of VVC and BV, in co-administration with traditional antimicrobials. 196 voluntary subjects were examined by the gynecologists team from health centers affiliated with Universidade de São Paulo, campus at Ribeirão Preto (64 healthy, 68 diagnosed with VVC and 64 diagnosed with BV) and two vaginal samples from each patient were collected by the use of two sterile swabs. One swab was cultured in MRS (de Man, Rogosa & Sharpe) agar, the isolates of lactic acid bacteria obtained were analyzed by PCR-ARDRA (Polymerase chain reaction - Amplified ribosomal DNA restriction analysis) and the ability of Lactobacillus spp. to produce hydrogen peroxide was determined semi-quantitatively. The other swab was used for the analysis of lactobacilli species from the vaginal microbiota using the culture-independent PCR-DGGE (Polymerase chain reaction Denaturating gradient gel electrophoresis). The yeasts belonging to Candida genus were obtained also by culturing the vaginal material from healthy and VVC patients in Chromagar® Candida and were identified by standard biochemical tests. VVC patients were enrolled in a randomized, double-blind, placebo-controlled trial and treated with a single dose fluconazole (150mg) and daily supplementation for 28 days with (i) two capsules containing the probiotic microorganisms L. rhamnosus GR-1 and L. reuteri RC-14 (Urex-Cap-5®) or (ii) two placebo capsules. BV patients were also enrolled in a randomized, double-blind, placebo controlled trial and treated with a single dose of tinidazole (2g) and supplementation with probiotic capsules (Urex-Cap-5®) or placebo, as described above. All patients were re-evaluated at the end of treatment, on the 28th day. Experiments were also conducted to assess the possible effect of L. rhamnosus GR-1 and L. reuteri RC-14 in the in vitro modulation of vaginal infection by Candida albicans on cultures of human vaginal epithelial cells (VK2/E6E7). The results revealed that according to PCR-ADRA, L.crispatus was the most prevalent species in the groups of healthy women (37.0%) and those with VVC (35.9%), while L. gasseri was dominant in BV patients (34.6%). By PCR-DGGE method, L. iners was the most prevalent Lactobacillus species in all the three groups evaluated: healthy, VVC and BV (48.7%, 44.7% and 65.0%, respectively). The majority of the isolates of Lactobacillus spp. from healthy women (98.6%) and those with VVC (97.4%) were able to produce H2O2 (1 to 100mg/L) in comparison with only 68.2% assessed for the BV group (p<0.05). L. crispatus and L. johnsonii produced the highest average levels of H2O2 (30mg/L). Colonization rate by yeasts belonging to Candida genus was 26.6% in the group of healthy patients (C. albicans represented 52.4% of all isolates), whereas in the VVC group, 89.2% of yeast isolates were identified as C. albicans. For the performance of statistical analysis of the results obtained with the clinical trials, 55 patients diagnosed with VVC (by the presence of symptoms and signals of the infection and positive culture for Candida sp.) were taken into consideration and it was observed that the use of a single dose of fluconazole and daily supplementation with probiotics, yielded a higher cure rate (89.7%), in comparison with the placebo group (65.4%) (p<0.05). The use of tinidazole plus probiotic also resulted in higher cure rate of the infection (87.5%), compared to placebo group (50.0%) (p<0.05). An anti-Candida activity of L. rhamnosus GR-1 and L. reuteri RC-14 was observed in the in vitro model of vaginal infection. In conclusion, when PCR-ARDRA and PCR-DGGE were compared, it was verified that both presented limitations, which evidences the need of using different techniques for a better knowledge of lactobacilli species present in the vaginal microbiota. The lactobacilli species found in healthy women in this work were similar to those reported in previous studies described in the literature for patients with distinctly different diet and geographic localization. The data of the present work indicate that solely the presence of H2O2-producing isolates does not render protection against VVC, whereas the absence of those microorganisms may be a contributing factor for BV. Moreover, it was demonstrated that the use of classical medicines supplemented with the probiotics L. rhamnosus GR-1 and L. reuteri RC-14 was more efficient to treat VVC and BV in comparison with classical medicines plus placebo. These results may contribute to extend the longevity of drugs whose efficacy is compromised due to the selection of resistant microorganisms and also to shorten the length of treatment courses for patients that require long regimens with standard therapy.

Introduction: Gut microbial composition has been associated with immune-mediated diseases. Breastfeeding yields a microbiota rich in bifidobacteria and promotes colonization by lactobacilli. Bifidobacteria and lactobacilli are considered health-promoting and are used as probiotics, i.e. live microbial food supplements which when ingested in adequate amounts confer a beneficial effect on the host. During weaning the developing gut immune system is exposed to an increasing variety of antigens from both foods and gut microbiota. Aims: We aimed to determine if daily feeding of 1x108 colony-forming units (CFU) of the probiotic Lactobacillus paracasei ssp. paracasei strain F19 (LF19) to healthy term infants from 4 to 13 months of age could maintain some of the beneficial effects conferred by breastfeeding on gut microbial composition, with possible effects on gut microbial function, T cell function, Th1/Th2 immune balance and eczema incidence. Study design: Infants were randomized to daily intake of cereals with (n=89) or without LF19 (n=90) from 4-13 months of age. Clinical outcome measures were monitored by diaries and a questionnaire. Stool and blood samples were obtained at 4, 6½, 9, 13 and 5½, 6½, 12 and 13 months of age, respectively. Stool samples were analyzed for lactobacilli counts by conventional culture methods and the presence of LF19 was verified by randomly amplified polymerase chain reaction (RAPD-PCR). Fecal short-chain fatty acid (SCFA) pattern, a proxy for gut microbial function, was determined by gas-liquid chromatography. After polyclonal or specific activation of T cells, the cytokine mRNA expression levels [interleukin 2 (IL2), IFN-, IL4 and IL10] were determined on isolated mRNA by quantitative real time reverse transcriptase-PCR. Serum concentrations of total and specific IgE antibodies, Haemophilus influenzae type b, diphtheria and tetanus toxoid specific IgG antibodies were analyzed by enzyme immunoassay. Results: Feeding LF19 maintained high fecal lactobacilli counts during weaning. Persistent colonization with LF19 induced differences in the fecal SCFA pattern. The cumulative incidence of eczema was lower in the probiotic group, in conjunction with a higher IFN-γ/IL4 mRNA ratio in polyclonally activated T cells. Even though there was an effect by LF19 on Th1/Th2 immune balance, there was no effect on IgE sensitization. Infants in both groups increased their capacity to express both Th1 and Th2 cytokines during the second half of infancy but the expression was still lower than that of adults. Infants in the probiotic group had lower IL2 levels after polyclonal T cell activation at 13 months of age compared with infants in the placebo group. Infants fed LF19 did not have fewer infections, but had fewer days with antibiotic prescription compared with infants fed placebo. In addition, compared to placebo, persistent colonization by LF19 enhanced specific vaccine responses to protein antigens during the course of vaccination. Conclusions: We conclude that feeding LF19 was safe, based on no observed adverse effects in our study. Infants in both groups demonstrated maturation of adaptive immune responses during weaning. Adding probiotics in complementary foods during weaning reduced the risk of eczema by 50%, with a concomitant shift towards an enhanced Th1/Th2 ratio. The reduction of eczema might be explained by probiotic effects on both T cell-mediated immune responses and reinforced gut microbial function.

Nous avons démontré la présence d'apoptose dans le système limbique suivant un infarctus du myocarde. Cette mort cellulaire serait partiellement reliée à l'augmentation de cytokines pro-inflammatoires. Des études démontrent que certains probiotiques ont des effets bénéfiques en diminuant le ratio de cytokines pro/anti-inflammatoires. La prise de probiotiques en prévention, avant l’occlusion d’une artère coronarienne, pourrait-elle diminuer l’apoptose dans le système limbique? Méthodes : La combinaison de probiotiques Lactobacillus helveticus R0052 et Bifidobacterium longum R0175 ou son véhicule fut additionné dans l’eau des rats pendant 28 jours consécutifs. Un infarctus du myocarde fut provoqué par l’occlusion de l’artère coronaire gauche. Après 40 minutes d'occlusion, les régions ischémiques ont été reperfusées pour 72 heures. Les animaux furent sacrifiés et la taille de l'infarctus mesurée. L'amygdale et l'hippocampe furent prélevés pour déterminer l'activité de la caspase-3 (pro-apoptotique), le ratio Bax/Bcl2(proapoptotique/ anti-apoptotique) et l'activité d'Akt (survie cellulaire). Résultats : La taille de l’infarctus n'est pas diminuée dans le groupe probiotique (45% de la région à risque)comparé au groupe placebo. Nos marqueurs d’apoptose démontrent une diminution dans les régions du gyrus denté, de l’amygdale latérale et médiane dans le groupe probiotique par rapport au placebo. L’activité de la caspase-3 et le ratio Bax:Bcl2 furent réduits dans le groupe probiotique de 50% et 40% respectivement (p < 0.05) et phosphorylation d’Akt fut augmentée de 35% (p<0.05). Aucune différence fut observée pour les régions Ca1 et Ca3. Conclusion : La combinaison de probiotiques utilisée réduit l’apoptose dans différentes régions du système limbique 72 heures après un IM. / Apoptosis is observed in limbic system after a myocardial infarction (MI). This cell death is due to the release of pro-inflammatory cytokines. Since probiotics reduce the pro/anti-inflammatory cytokine ratio, we hypothesise that probiotics will lessen apoptosis in the limbic system following MI. Methods: Rats were given probiotics or placebo for 4 consecutive weeks. Rat in the probiotic group received a daily dose of over 1 billion live bacterial cells of Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 in combination. A MI was then induced in anesthetised rats by a 40-minute occlusion of the left anterior coronary artery followed by a 72 hours of reperfusion. Infarct size was measured and apoptosis was determined in the amygdala and hippocampus in both groups. Results: Infarct size was not diminished in the probiotic group (45% of the risk area), apoptosis was lessened in the dentate gyrus (DG), the lateral (LA) and medial (MA)amygdala compared to the placebo group. Caspase-3 and Bax/Bcl2 ratio were reduced in the probiotic group by about 50% and 40% respectively. Akt activity was increased by 35% in these regions. No difference was observed in the hippocampus Ca1 and Ca3 regions. Conclusion: This probiotic combination can reduce the apoptosis found in specific regions of the limbic system following a MI, which may have significance for post-MI depression.