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Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity

  • Michael de Vrese (a1), Holger Kristen (a1), Peter Rautenberg (a2), Christiane Laue (a3) and Jürgen Schrezenmeir (a1) (a3)...


To investigate matrix-specifity of probiotic effects and particularly of the reduction of antibiotics-associated diarrhea, a controlled, randomized, double-blind study was performed, in which 88 Helicobacter pylori-infected but otherwise healthy subjects were given for eight weeks either a) a probiotic fruit yoghurt “mild” containing Lactobacillus acidophilus LA-5 plus Bifidobacterium lactis BB-12, n=30), b) the same product but pasteurized after fermentation (n=29) or c) milk acidified with lactic acid (control, n=29). During week five, a Helicobacter eradication therapy was performed. Helicobacter activity was measured via 13C-2-urea breath tests and antibiotic-associated diarrhoea and other gastrointestinal complaints were recorded by validated questionnaires. In intervention group a, b and c the mean number of days with diarrhoea was 4, 10 and 10 (P<0·05), the frequency of episodes 17%, 7% and 27% (n.s.), and the change in total symptoms score before antibiotics treatment was −1·4±1·1, −1·2±1·1, 2·6±1·1 points/four weeks (P<0·05). All milk products decreased Helicobacter activity by 18 to 45% without significant differences between groups. The observed decrease in Hel. pylori activity seems to be not or not only due to probiotic bacteria but (rather) to components of acidified milk (most probably lactic acid). Fruit-yogurt-like fermented milk products with living probiotic bacteria significantly shorten the duration of antibiotics-associated diarrhoea and improve gastrointestinal complaints. Fruit yogurt-like fermented milk is a matrix suitable for probiotic bacteria.


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Aiba, Y, Suzuki, N, Kabir, AM, Takagi, A and Koga, Y 1998 Lactic acid-mediated suppression of Helicobacter pylori by the oral administration of Lactobacillus salivarius as a probiotic in a gnotobiotic murine model. American Journal of Gastroenterology 93(11) 20972101
Armuzzi, A, Cremonini, F, Bartolozzi, F, Canducci, F, Candelli, M, Ojetti, V, Cammarota, G, Anti, M, De Lorenzos, A, Pola, P, Gasbarrini, G and Gasbarrini, A 2001 The effects of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Alimentary Pharmacology and Therapeutics 15 163169
Bekar, O, Yilmaz, Y and Gulten, M 2011 Kefir improves the efficacy and tolerability of triple therapy in eradicating Helicobacter pylori. Journal of Medicinal Food 14(4) 344347
Bode, G, Rothenbacher, D and Brenner, H 2001 Helicobacter pylori colonization and diarrhoeal illness, results of a population-based cross-sectional study in adults. European Journal of Epidemiology 17 823827
Bounous, G and Molson, JH 2003 The antioxidant system. Anticancer Research 23 14111415
Buttriss, JL and Benelam, B 2010 Nutrition and health claims: the role of food composition data. European Journal of Clinical Nutrition 64 S8S13
Clare, DA, Catignani, GL and Swaisgood, HE 2003 Biodefensive properties of milk, the role of antimicrobial proteins and peptides. Current pharmaceutical design 9 12391255
Cook, IJ, Irvine, EJ, Campbell, D, Shannon, S, Reddy, SN and Collins, SM 1990 Effect of dietary fiber on symptoms and rectosigmoid motility in patients with irritable bowel syndrome – A controlled, crossover study. Gastroenterology 98 6672
Cummings, JH and Wiggins, HS 1976 Transit through the gut measured by analysis of a single stool. Gut 17 219223
de Vrese, M and Offick, B 2010 Probiotics and Prebiotics: Effects on Diarrhea. In Bioactive Foods in Promoting Health, pp. 205227 (eds Watson, RR & Preedy, VR). Oxford: Academic Press
de Vrese, M and Schrezenmeir, J 2002 Probiotics and non-intestinal infectious conditions. British Journal of Nutrition 88 5966
de Vrese, M, Rautenberg, P, Laue, C, Koopmans, M, Herremans, T and Schrezenmeir, J 2005 Probiotic bacteria stimulate virus-specific neutralizing antibodies following a booster polio vaccination. European Journal of Nutrition 44(7) 406413
Dial, EJ, Hall, LRE, Serna, H, Romero, JJ, Fox, JG and Lichtenberger, LM 1998 Antibiotic properties of bovine lactoferrin on Helicobacter pylori. Digestive Diseases and Sciences 43 27502756
Early, EM, Hardy, H, Forde, T and Kane, M 2001 Bactericidal effect of a whey protein concentrate with anti-Helicobacter pylori activity. Journal of Applied Microbiology 90 741748
FAO/WHO 2001 Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria, Cordoba, Argentina 5
Felley, CP, Corthesy-Theulaz, I, Rivero, JL, Sipponen, P, Kaufmann, M, Bauerfeind, P, Wiesel, PH, Brassart, D, Pfeiffer, A, Blum, AL and Michetti, P 2001 Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. European Journal of Gastroenterology and Hepatology 13 2529
Ghadimi, D, Fölster-Holst, R, de Vrese, M, Winkler, P, Heller, K and Schrezenmeir, J 2008 Effects of probiotic bacteria and their genomic DNA on TH1/TH2-cytokine production by peripheral blood mononuclear cells (PBMCs) of healthy and allergic subjects. Immunobiology 213 677692
Gotteland, M, Cruchet, S and Verbeke, S 2001 Effect of Lactobacillus ingestion on the gastrointestinal mucosal barrier alterations induced by indometacin in humans. Alimentary Pharmacology and Therapeutics 15(1) 1117
Hirmo, S, Kelm, S, Iwersen, M, Hotta, K, Goso, Y, Ishihara, K, Suguri, T, Morita, M, Wadstrom, T and Schauer, R 1998 Inhibition of Helicobacter pylori sialic acid-specific haemagglutination by human gastrointestinal mucins and milk glycoproteins. FEMS Immunology and Medical Microbiology 20 275281
IDF 2010 Vote on new work item proposal 10/12-A “to install a working group on plasticity of a given probiotic strain in differenet food forms”. International Dairy Federation (IDF), Brussels
Kabir, AM, Aiba, Y, Takagi, A, Kamiya, S, Miwa, T and Koga, Y 1997 Prevention of Helicobacter pylori infection by lactobacilli in a gnotobiotic murine model. Gut 41(4) 4955
Kailasapathy, K, Harmstorf, I and Phillips, M 2008 Survival of Lactobacillus acidophilus and Bifidobacterium animalis ssp. lactis in stirred fruit yogurts. LWT - Food Science and Technology 41 13171322
Kandulski, A, Selgrad, M and Malfertheiner, P (2008) Helicobacter pylori infection: a clinical overview. Digestive and Liver Disease 40(8) 619626
Kato-Mori, Y, Orihashi, T, Kanai, Y, Sato, M, Sera, K and Hagiwara, K 2010 Fermentation metabolites from Lactobacillus gasseri and Propionibacterium freudenreichii exert bacteriocidal effects in mice. Journal of Medicinal Food 13(6) 14601467
Katz, JA 2006 Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile diarrhea. Journal of Clinical Gastroenterology 40 249255
Kim, TS, Hur, JW, Yu, MA, Cheigh, CI, Kim, KN, Hwang, JK and Pyun, YR 2003 Antagonism of Helicobacter pylori by bacteriocins of lactic acid bacteria. Journal of Food Protection 66(1) 312
Kim, MN, Kim, N, Lee, SH, Park, YS, Hwang, JH, Kim, JW, Jeong, SH, Lee, DH, Kim, JS, Jung, HC and Song, IS 2008 The effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication. Helicobacter 13 261268
Lin, WH, Wu, CR, Fang, TJ, Guo, JT, Huang, SY, Lee, MS and Yang, HL 2011 Anti-Helicobacter pylori activity of fermented milk with lactic acid bacteria. Journal of the Science of Food and Agriculture 28. doi: 10.1002/jsfa.4327. [Epub ahead of print]
Malfertheiner, P, Megraud, F, O'Morain, C, Hungin, AP, Jones, R, Axon, A, Graham, DY, Tytgat, G and EHPSG 2002 Current concepts in the management of Helicobacter pylori infection-the Maastricht 2-2000 Consensus Report. Alimentary Pharmacology and Therapeutics 16(2) 167180
McFarland, LV 2006 Meta-analysis of probiotics for the prevention of antibiotic-associated diarrhea and the treatment of Clostridium difficile disease. American Journal of Gastroenterology 101 812822
Midolo, PD, Lambert, JR, Hull, R, Luo, F and Grayson, ML 1995 In vitro inhibition of Helicobacter pylori NCTC 11637 by organic acids and lactic acid bacteria. Journal of Applied Microbiology 79(4) 475479
Möller, C and de Vrese, M 2004 Review: probiotic effects of selected acid bacteria. Milchwissenschaft 59 597601
Nord, CE, Lidbeck, A, Orrhange, K and Sjostedt, S 1997 Oral supplementation with lactic acid bacteria during intake of clindamycin. Clinical Microbiology and Infection 3(1) 124132
Perri, F, Clemente, R, Pastore, M, Quitadamo, M, Festa, V, Bisceglia, M, Li Bergoli, M, Lauriola, G, Leandro, G, Ghoos, Y, Rutgeerts, P and Andriulli, A 1998 The 13C-urea breath test as a predictor of intragastric bacterial load and severity of Helicobacter pylori gastritis. Scandinavian Journal of Clinical and Laboratory Investigation 58 1927
Sachdeva, A and Nagpal, J 2009 Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials. European Journal of Gastroenterology and Hepatology 21(21) 4553
Safdar, N, Barigala, R, Said, A and McKinley, L 2008 Feasibility and tolerability of probiotics for prevention of antibiotic-associated diarrhoea in hospitalized US military veterans. Journal of Clinical Pharmacy and Therapeutics 33 663668
Schrezenmeir, J and de Vrese, M 2001 Probiotics, prebiotics, and synbiotics – approaching a definition. American Journal of Clinical Nutrutrition 73 361364
Sgouras, D, Maragkoudakis, P, Petraki, K, Martinez-Gonzalez, B, Eriotou, E, Michopoulos, S, Kalantzopoulos, G, Tsakalidou, E and Mentis, A 2004 In vitro and in vivo inhibition of Helicobacter pylori by Lactobacillus casei strain Shirota. Applied and Environmental Microbiology 70(1) 518526
Shin, K, Yamauchi, K, Teraguchi, S, Hayasawa, H and Imoto, IJ 2002 Susceptibility of Helicobacter pylori and its urease activity to the peroxidase-hydrogen peroxide-thiocyanate antimicrobial system. Journal of Medical Microbiology 51 231237
Smoot, D and Hamilton, F 1995 Summary of the National Institutes of Health Consensus Development Conference of Helicobacter pylori. Gastrointestinal Diseases Today 4 110
Sun, CQ, O'Connor, CJ and Roberton, AM 2003 Antibacterial actions of fatty acids and monoglycerides against Helicobacter pylori. FEMS Immunology and Medical Microbiology 36 917
Szajewska, H, Ruszczynski, M and Radzikowski, A 2006 Probiotics in the prevention of antibiotic-associated diarrhea in children: A meta-analysis of randomized controlled trials. Journal of Pediatrics 149 367372
von Der, WT, Bulliard, C and Schiffrin, EJ 2001 Induction by a lactic acid bacterium of a population of CD4(+) T cells with low proliferative capacity that produce transforming growth factor beta and interleukin-10. Clinical and diagnostic laboratory immunology 8(4) 695701
Wang, KY, Li, S-N, Liu, CS, Perng, DS, Su, YC, Wu, DC, Jan, CM, Lai, CH, Wang, TN and Wang, WM 2004 Effects of ingesting Lactobacillus- and Bifidobacterium-containing yogurt in subjects with colonized Helicobacter pylori. American Journal of Clinical Nutrition 80 737741
Wenus, C, Goll, R, Loken, EB, Biong, AS, Halvorsen, DS and Florholmen, J 2008 Prevention of antibiotic-associated diarrhoea by a fermented probiotic milk drink. European Journal of Clinical Nutrition 62 299301
Winkler, P, Ghadimi, D, Schrezenmeir, J and Kraehenbuhl, JP 2007 Molecular and cellular basis of microflora-host interactions. Journal of Nutrition 137 756772.


Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity

  • Michael de Vrese (a1), Holger Kristen (a1), Peter Rautenberg (a2), Christiane Laue (a3) and Jürgen Schrezenmeir (a1) (a3)...


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