Irritable Bowel Syndrome (IBS)
In two independent studies, Lactobacillus plantarum 299v (LP299V®), was proven to have a positive effect on the intestinal health of people with irritable bowel syndrome (IBS). The symptoms for irritable bowel syndrome are alternating diarrhoea and constipation, the formation of gas and pain. Approximately 10-20% of the population periodically suffer from such problems.
The studies were double blind and placebo controlled and were conducted in Sweden (Nobaek et al. 2000) and in Poland (Niedzielin et al. 2001). In the studies, the test subjects with IBS were given a fruit drink with or without Lactobacillus plantarum 299v (400 ml/day) and the IBS symptoms were monitored over a period of four weeks.
The formation of gas in the intestines decreased rapidly and significantly in the group that ingested Lactobacillus plantarum 299v, compared with the placebo group in the Nobaek et al. (2000) study, (see graph). At a follow-up examination 12 months later, the test subjects who had ingested Lactobacillus plantarum 299v were deemed to have better gastrointestinal function, compared with the placebo group.
In the Niedzielin et al. (2001) study, there was an improvement in the IBS symptoms in 95% of the test subjects in the Lactobacillus plantarum 299v group, compared with 15% in the placebo group.
Clostridium difficile colitis
Recurring clostridium difficile colitis is a serious complaint that often requires long-term treatment with antibiotics. In a double-blind, placebo-controlled pilot study, an examination was conducted to see whether the intake of Lactobacillus plantarum 299v would prevent new diarrhoea episodes (Wullt et al. 2003). Fewer test subjects in the group that ingested LP299V®, combined with the antibiotic metronidazole, suffered from new diarrhoea attacks (4/11), compared with the placebo group (6/9). More studies are needed to confirm that LP299V® can prevent recurring clostridium difficile colitis.
It is generally known that probiotics have a beneficial effect on human health. This occurs through local effect in the intestinal tract but also through a systemic effect on other parts of the body. The latter of these effects is because about 70% of the body’s immune system is located in the intestinal tract. The bacteria’s interaction with the intestinal epithelial layer stimulates cooperation between various types of cells, such as dendritic cells, epithelial cells and lymphocytes, which, by producing a large number of signal substances, can lead to the activation or weakening of the immune system. Various probiotic bacteria strains stimulate and affect the immune system in different ways. Consequently, research and studies are vital to document the strain-specific immunological effects of probiotics and to increase knowledge to facilitate the correct choice of bacteria strain in connection with new applications.
Studies of healthy individuals who ingested Probi patented probiotics for two weeks showed that some bacteria can activate the natural immune system (Lactobacillus paracasei 8700:2), while others stimulate a cell-mediated immunity (Lactobacillus plantarum 299v). The phagocytic activity, the range of various cell populations, the stimulation of markers on the surface of cells and the secretion of various signal substances, such as cytokine, are examples of parameters examined to describe the effect of various strains on the immune system (Rask et al 2005). The immunological answer to Lactobacillus plantarum 299v has also been analyzed in vitro in various studies (Karlsson 2004, Denton-Peoples 2009, Christensen 2002).
In two placebo-controlled studies made on healthy subjects, the combination of two bacteria, Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9, was shown to affect the immune system beneficially.
The first study was performed during the winter/spring period 2007 at two different sites in Sweden. A total of 272 subjects participated in the study, of these 135 was randomized to consume the product containing Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9 the remaining subjects were given a product similar in taste and appearance but without any probiotic bacteria.
The number of days with common cold symptoms were significantly (p<0.05) reduced from 8.6 days in the control group to 6.2 days in the active group receiving probiotics for twelve weeks. Also, the incidence of acquiring one or more common cold episode was reduced from 67 % in the control group to 55 % in the active group (p<0.05). The total symptom-score was also significantly reduced during the study-period. The reduction of pharyngeal symptoms was significant (p<0.05) (Figure 1). In addition, after two weeks of intake a reduced proliferation in B cell population was also observed in the active group (p<0.05) in comparison with the placebo group.
Figure 1 . Bar graph illustrating the reduced risk of getting a cold after consumption of the probiotics Lactobacillus plantarum HEAL 9 and Lactobacillus paracasei 8700:2.
An additional study was performed during the winter/spring period the following year in Berlin. 310 healthy subjects with a history of at least two common cold infections the last 6 month period participated in the study. The study products were identical to those used in the previous study. In this study all recorded common cold symptoms were lower in the group receiving probiotics in comparison to the control group, and the total sum score of the symptoms was reduced with up to 33% (p<0.001) (Figure 2).
Figure 2. Graph illustrating the variation of the daily total sum score during the common cold episodes.
In addition, the subjects in the probiotic group recovered more quickly than the subjects in the control group if sick in a common cold infection (Figure 3) and only 37 % of the subjects in the probiotic group were sick for seven days or more in comparison to 88 % in the control group (Figure 3). This illustrates that intake of Lactobacillus paracasei 8700:2 and Lactobacillus plantarum Heal 9 reduces the duration of common cold episodes and promotes a quicker recovery.
Figure 3. Bar graph illustrating the length of the common cold episodes.
The common cold episodes were also evaluated by the subjects. The efficacy was globally evaluated by the subjects as “very good” or “good” for 70.1 % of the episodes occurring in the probiotic group and for 23.2% of the episodes occurring in the placebo group.
In another study, positive immunological response was measured in children infected with HIV who ingested Lactobacillus plantarum 299v for one month (Cunningam-Rundles 2000). The children’s general condition improved and Lactobacillus plantarum 299v was deemed safe to be used by people with suppressed immune systems.
In an animal model of multiple sclerosis (EAE; Enzyme-induced Autoimmune Encephalomyelitis), a combination of three probiotics, Lactobacillus paracasei 8700:2, Lactobacillus plantarum Heal 9 and Lactobacillus plantarum Heal 19 was shown to reduce the inflammatory conditions connected with the disease (Lavasani et al 2010).
Shahram Lavasani, Balik Dzhambazov, Mehrnaz Nouri, Frida Fåk, Sophia Buske, Göran Molin, Henrik Thorlacius, Jan Alenfall, Bengt Jeppsson, Björn Weström. 2010 A Novel Probiotic Mixture Exerts a Therapeutic Effect on Experimental Autoimmune Encephalomyelitis Mediated by IL-10 Producing Regulatory T Cells.
PLoS ONE, Vol 5, pp 1-10.
Metabolic syndrome is a term used for a number of different risk factors that can cause cardiovascular disease, which is the most common cause of deaths in Sweden (Swedish Board of Health and Welfare – Health report 2005).
The risk factors included in the metabolic syndrome are:
- Insulin resistance implying that the body’s cells are insensitive to insulin, which in turn leads to excess production of insulin and frequently results in type 2 diabetes.
- Elevated blood lipids including increased triglycerides and LDL cholesterol or low HDL cholesterol values.
- High blood pressure (≥130/85 mmHg).
- Overweight (BMI>25) and in particular, abdominal fat.
It has become evident that probiotics are able to affect these risk factors positively. In food trials on humans, it was observed that a fruit drink fermented with Lactobacillus plantarum had an insulin-saving effect (WO2008150212). In addition, the intake of a drink containing Lactobacillus plantarum (LP299V®) in a placebo-controlled, double-blind clinical study of 38 healthy smokers had a positive effect on the systolic blood pressure and insulin (Naruszewicz et al. 2002). In the same study, fibrinogen also decreased (an independent risk factor for cardiovascular diseases) and other inflammatory markers (IL-6 and F2 isoprostanes) decreased significantly. The same drink with Lactobacillus plantarum 299v was also used in an earlier placebo-controlled study on men with a mildly elevated cholesterol level (Bukowska 1998). Intake of the product for six weeks showed a statistically significant reduction in total cholesterol (7.3%), LDL (9.6%) and fibrinogen (13.5%).