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Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 23-33

Probiotics as Functional Foods: Potential Effects on Human Health and its Impact on Neurological Diseases

1 Department of Zoology, K.V.R. Govt College for Women, Rayalaseema University, Kurnool, AP, India
2 Department of Biotechnology, Rayalaseema University, Kurnool, AP, India
3 Department of Biochemistry, Rayalaseema University, Kurnool, AP, India
4 Department of Bionanotechnology, Gachon University, Seongnam Si, Gyeonggi Do, Republic of Korea
5 Department of Zoology, Acharya Nagarjuna University, Guntur, AP, India

Date of Web Publication27-Apr-2017

Correspondence Address:
Vanitha Venkataratnamma
Department of Zoology, Acharya Nagarjuna University, Guntur 522 510, AP
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijnpnd.ijnpnd_90_16

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Probiotics are live microbial food supplements that provide several health benefits, as they help in maintaining excellent stability and composition of the intestinal microbiota and boost the resistance against infection by pathogens. Probiotics can be considered as potential functional foods, as they offer health benefits much more than the traditional nutritional foods. The requirement for probiotic functional foods is rapidly and progressively on the rise because of increased awareness of the public regarding the impact of food on health. Probiotics are now emerging as a promising key category of food supplement around the globe. There are now plenty of evidences backed up with high-quality, scientific clinical data to advocate that probiotic involvement could indeed be successful in the different types of diarrheal diseases, the modulation of immune function, the prevention of colon cancer, and other chronic gastrointestinal inflammatory disorders. The potential effectiveness of probiotics in treating or preventing neurological diseases is becoming a theme of great interest. In recent years, substantial interest has been dedicated to discover the functions and therapeutic effects of probiotics in a wide range of neurological conditions. This review examines different major functions of probiotics such as probiotics as functional food, probiotics in the improvement of human health, and probiotics to treat and prevent neurobehavioral diseases.

Keywords: Autism spectrum disorder, functional foods, human health benefits, neurological diseases, probiotics

How to cite this article:
Begum PS, Madhavi G, Rajagopal S, Viswanath B, Razak MA, Venkataratnamma V. Probiotics as Functional Foods: Potential Effects on Human Health and its Impact on Neurological Diseases. Int J Nutr Pharmacol Neurol Dis 2017;7:23-33

How to cite this URL:
Begum PS, Madhavi G, Rajagopal S, Viswanath B, Razak MA, Venkataratnamma V. Probiotics as Functional Foods: Potential Effects on Human Health and its Impact on Neurological Diseases. Int J Nutr Pharmacol Neurol Dis [serial online] 2017 [cited 2022 Dec 8];7:23-33. Available from:

   Introduction Top

Globally, probiotics represent the novel buzzword in human dietary selection and are at present the main focus because of their vast health potential. Probiotic can be classically defined as a viable dietary microbial supplement that beneficially affects the host through its effects on the intestinal tract. Functional foods are supplements or substances that are consumed to obtain a specific result. Functional foods are also called as biotherapeutics and nutriceuticals. Probiotics are the ideal examples for functional foods.[1]

Currently, the consumption of probiotic cells via food products is most sought. Majority of the probiotic foodstuffs are categorized as functional foods. The worldwide market for functional foods has developed from $33 billion in 2000 to $176.7 billion in 2013 and accounts for 5% of the total food market.[2] It has been predicted that probiotic foods comprise about 60–70% of the total functional food market.[3]

In the past few decades, there had been significant success in the production of dairy products containing probiotic bacteria such as ice cream, flavored liquid milk, fermented milk, baby food, milk powder, frozen dairy desserts, cheese, buttermilk, whey-based beverages, and normal and sour cream. Because of lactose intolerance, in recent years, several nondiary probiotic products such as vegetarian-based products, including fruit juices, soya-based products, oat-based desserts, vegetarian-based products, baby foods, and breakfast cereal have developed.[4],[5]

The method by which probiotics expresses its good effects on health are mostly unknown, and there are still many research themes that need to be explored. On the other hand, probiotics are involved in inhibiting pathogen growth by synthesizing antimicrobial compounds, producing lactase, modifying gut pH, challenging the binding of pathogens and receptor sites as well as existing nutrients and growth factors, and stimulating immunomodulatory cells.[6]

One of the most significant aspects of probiotics is that they have proven to be safe, very cheap, and capable of hindering with microbial infection. In 1994, the World Health Organization considered probiotics to be the next-most significant immune defense system when regularly given antibiotics are made ineffective by antibiotic resistance. The use of probiotics in antibiotic resistance is called as microbial interference therapy.[7],[8]

The potential role of probiotics in the treatment and prevention of neurological diseases puts forth an attractive possibility. However, an improved understanding of their method of action is essential to attribute to them the role in improving neurological manifestations or declining the occurrence of neurodevelopmental disorders. Until recently, most of the research on this topic concentrated on the mechanisms of the microbiota–gut–brain axis, and encouraging results were reported in children with autism spectrum disorder (ASD). Thorough investigations on the effectiveness of probiotics in altering these connections will facilitate to make clear the etiopathogenesis of ASD and a few other neurological disorders and recognize novel possible targets, which need intervention.[9] The review covers the following aspects of probiotics: different health benefits of probiotics as nutritional food, health improvement, infection control and disease management, and the beneficial claims of probiotics in patients with neurological diseases.

   The Role of Probiotics as a Functional Food Ingredient Top

In the global market, more than 500 probiotic food products have been launched in the past few years, and the number of probiotic foods in the market is continuously increasing. The probiotic foods produced by the fermentation of fruits and vegetables, cereals, and meat products are gaining attention by the consumers as well as those from the scientific world.[10],[11] Nowadays, probiotics are commercially found in fruit juices, milk, sour milk, oat-based products, and ice-creams. Mayonnaise edible spreads, meat-based products, cheese, and cheese-based dips are the recently developed foods having probiotics. [11, 12, 13]

The uniqueness, actions, properties, and significance of probiotics have merited a good popularity in the present-day civilization, but probiotics are very old history. The Roman naturalist named Pliney the Elder suggested consuming fermented milk to treat intestinal problems. Henry Tissler, a researcher at the Pasteur Institute in Paris, reported that infants with bifidobacteria in their digestive system had less gastrointestinal troubles, as evidenced by low diarrheal problems.

Eli Metchnikoff hypothesized that the lactic acid bacteria offer a kind of protection from intestinal autointoxication. In 1908, Metchnikoff got the Nobel Prize in medicine for research representing that destructive microbes could be substituted by helpful microbes to improve intestinal illnesses. Metchnikoff had observed that the countryside residents in Bulgaria lived to very old ages, in spite of severe poverty and unfavorable climatic conditions. They had an average lifespan more than the richer Europeans, and he reported that they drank fermented milk products. Metchnikoff concluded that the lactic acid bacteria present in the fermented milk products had anti-aging health benefits.

At the time of probiotic food preparation, the probiotic microbes are artificially introduced into the food. Majority of the culture preparations are commercially available in extremely concentrated form, and most of them are synthesized for different applications either in the form of freeze-dried powders or highly concentrated freezed cultures.[14]

The aroma and taste of the food products may be modified on adding probiotic microbes because of the production of several metabolic components such as acetic acid synthesis by Bifidobacterium spp. at the time of fermentation. Therefore, necessary steps should be undertaken while adding probiotic microbes to the food products, so that they might not severely affect the product quality or the sensory characteristics.[15]

The medicinal effectiveness of probiotic food products depends on the active cells or the total number of viable cells per milliliter or gram of the product at the time of consumption by the individual.[16] To keep up the consumer’s confidence in probiotic food products, it is mandatory that we have make sure that a high survival rate of the probiotics is maintained at the time of production and also at the time of the product’s shelf life.[17]

Several factors influence the viability of probiotic microbes in food products at the time of manufacturing, processing, and storage. The identified factors are chemicals such as bacteriocins, hydrogen peroxide, coloring agents, and artificial flavors; food parameters such as titratable acidity, water activity, molecular oxygen, and the presence of sugar and salt; processing parameters such as incubation temperature, the cooling rate of food product and heat treatment, storage methods, and packing materials and methods; and microbiological parameters such as the percentage of inoculums and the strains of the probiotics. One of the important factors affecting qualitative parameters and the viability of probiotic microbes is the fermentation temperature. Generally, the temperature favorable for the growth of most probiotic bacteria is between 37 and 43°C.[18]

Infants supplemented with a probiotic bacterial strain of Lactobacillus casei have a high concentration of circulating immunoglobulin A, which correlates with a reduced duration of rotavirus-induced diarrhea.[19] Moreover, the supplementation of probiotic foods with Bifidobacterium bifidum and Lactobacillus acidophilus appreciably improves the nonspecific immune phagocytic activity of circulating blood granulocytes. It was reported that intake of yogurt with probiotic bacteria can stimulate the production of cytokines by blood mononuclear cells.[20] The proposed health benefits of probiotics can only be attained when the food possess the necessary minimum viable microorganism count at the time of consumption. The food industry has commonly adopted the least recommended level of 106 CFU ml−1 at the time of consumption.[21]

The minimum probiotic count recommended by United States Food and Drug Administration (US FDA) in probiotic food products is 106 CFU ml−1. Depending on the quantity ingested and considering the effect of storage on the viability of probiotics, a daily dosage of 108 to 109 probiotic microorganisms is very crucial to attain probiotic action in the human beings.[22] It has also been stated that probiotic products should be consumed daily, with an approximate amount of 100 g/day to deliver about 109 viable cells into the intestine.[23] In the United States, the probiotic foods are sold in the form of powder, capsule, liquid, and tablet, and, generally, they contain one or more strains of probiotic bacteria. One should select a specific strain or species of probiotic bacteria for good health maintenance, because not all probiotics have the same features and activities. Even though a minimum regular dosage of a probiotic is necessary to attain a beneficial health effect, one needs to be conscious that there is an upper safe limit as reported in animal studies. [Table 1] illustrates the different probiotic food supplements available in the market.
Table 1: A list of the probiotic food supplements available in the market

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   Probiotics for Human Health Improvement Top

Healthy people should be the first to take probiotics, because it makes their general health better and defends them from diverse kinds of illnesses. The most intelligent and preventive step for protecting us from different types of illnesses is to improve health. Nevertheless, how do probiotics improve health? The subsequent paragraphs will emphasize the concept of how probiotics make better or improve our health directly or indirectly.

Human bodies have several groups of microorganisms, which work collectively to perform several functions. The most key functions are those existing in our digestive system. These microorganisms enhance food consumption and digestion. These microbes reduce much burden on our digestive systems. These microbes reduce the steps required by the human body to modify complex food structures to simpler ones.[24] The relation of probiotics to human health improvement can be summarized by the following facts and points:

  1. Probiotic microbes are functional and user friendly.

  2. Probiotic microbes help to ferment our food from a complex form to simpler byproducts and can promote our health by several diverse methods.

  3. They can compete with the pathogenic microbes and take possession of our digestive system.

  4. The viable count of probiotic microbes could be decreased because of many factors such as inappropriate diet, age, alcohol, and several other factors. That is why probiotics should be supplemented through our daily diet.

  5. In specific cases, such as after consumption of antibiotics, they are supposed to be affected severely; hence, they should be consumed orally in significant amounts along with food.

  6. They provide the human body with necessary useful byproducts.

  7. They eliminate the side effects of the pathogenic microbes.

  8. They trim down the quantity of food required by the human body by enabling correct digestion and metabolism of any amount of food.

  9. They decrease the additional burden on the human digestive system.

  10. As they form biofilms, they eliminate the effect of the first attack of harmful compounds on our cells.

  11. In many cases, probiotics could balance the deficiency in our genetic materials by serving to make use of the products of their genes such as in the case of lactose insufficiency.

   Probiotics in Infection Control Top

Probiotics are reported to play crucial roles in the prevention of diarrhea prevention and control after antibiotic treatment. Saccharomyces boulardii, bifidobacteria spp., Lactobacillus reuteri, and Lactobacillus GG are generally employed for the treatment of diarrhea.[25],[26] Probiotics are very effective in inhibiting diarrheal diseases caused by rotaviruses in infants and traveler’s diarrhea.[27],[28] Probiotics inhibit diarrhea-causing microbes by producing bacteriocins or by competing with pathogenic bacteria or viruses and stopping them from binding to the epithelial cells.[29],[30] Only few reports prove that probiotic bacteria can suppress gastric colonization and functions of Helicobacter pylori, which is responsible for peptic ulcers, gastric cancers, and gastritis. It is also proved that Lactobacillus salivarius has the ability to produce high amounts of lactic acid and suppress the growth of H. pylori in vitro and in mice.[31],[32] The utilization of probiotics in the against H. pylori has been proposed to progress the tolerability, eradication rate, and compliance of several antibiotic therapies used for the infection.[33] Much interest has been shown regarding the possible role of the probiotics to cure inflammatory bowel diseases. The synthesis of butyric acid by the colonic bacterial fermentation of polysaccharides and the usage of butyric acid for the treatment of diversion colitis led to several clinical trials to investigate the role of butyric acid in ulcerative colitis treatment. However, the disadvantage of butyric acid in ulcerative colitis treatment is because of the complexity in administering butyric acid rectally.[34],[35] [Figure 1] demonstrates the health benefits of probiotics on consumption.
Figure 1: Health benefits on consumption of probiotics

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   Probiotics in Maternal Health Top

The interplay between the environmental and hereditary factors plays a crucial role in each step of development from the beginning to the early postnatal period, with effective long-term effects on the mother and the child’s health. The gut microbiota plays a very important role as environmental factor they control the development of both immune and metabolic functions at the time of pre and post neonatal life.[36]

Few reports gave a novel touch to the application of probiotic bacteria by changing the focus from gut health to vaginal health. The application of probiotics predominantly in the perspective of management of general vaginal infections is also one of the interested novel research areas. The decline or absence of lactobacilli in the vagina could be one of the key causes for bacterial vaginosis, and the affected cases have a significantly increased risk of gonorrhea, herpes simplex, chlamydia, and human immunodeficiency virus viral infections. The use of probiotic lactobacilli is one of the successful and effective approaches to prevent vaginal infection; even though only few strains have been clinically proven to be effective, they have reported as outstanding safety record. Many researchers emphasized that it is significantly important that probiotic strains are characterized and examined clinically in the context of vaginal infections using different delivery systems such as oral suspension or tablets, dried powder, or vaginal pessary.[37]

The introduction of lactobacilli into the vagina through capsule or pessary is a successful way of improving the content of the flora and to avoid some pathogens or decrease their capability to govern. This method seems to be a real solution for the treatment of urinary tract infections and bacterial vaginosis. It was scientifically proved that a combination of lactobacilli strains diminishes both bacterial pathogens and yeast in the vagina even when taken orally. It also provides a more cure rate when treated with metronidazole in spite of an antibiotic alone. A regular oral dose of 108 viable probiotic lactobacilli can re-establish and preserve the urogenital health of women.[37]

   Probiotics in Child Health Top

Based on the statistics obtained by the meta-analyses of a few clinical investigations related to many diarrheal diseases, probiotic bacteria, predominantly S. boulardii, L. reuteri and Lactobacillus rhamnosus GG, have been revealed to significantly decrease the duration of acute diarrhea especially acute rotaviral diarrhea by one day and the number of stools with a potential effect starting after 3 days. Likewise, when used as a preventive agent, probiotics have shown a declined occurrence of antibiotic-associated diarrhea by an average of 60%.[38] One of the recent community-based clinical trials conducted in Kolkata, India reported that L. casei shirota was orally fed to children of 1–5 years old. The results of the study stated that the daily intake of this strain demonstrated a defensive efficacy of 14% in preventing acute diarrhea.[39]

In spite of noteworthy progress in the neonatal care, the mortality resulting because of necrotizing enterocolitis (NEC), a grave gastrointestinal disorder occurring in neonates, has not improved over the last three decades as can be echoed by the mortality rates that keep on ranging from 10 to 30%.[40] There are only some novel interventions that are promising in the treatment of this life-taking disease. In this circumstance, breast milk has been documented as the most excellent choice in the prevention of NEC. However, there are increasing data that the supplementation of probiotics to preterm infants in the Neonatal Intensive Care Unit may offer adequate relief to the affected infants.[41] Currently, the probiotic therapy is an exciting new approach. The motivation for probiotic supplementation of preterm infants is dependent on the data representing dissimilarity in the organization of intestinal microbiota in preterm infants. The administration of probiotics to susceptible infants may be an effective method to modify their gut colonization with the healthy and beneficial bacteria and support exploring the same for disease management in preterms. One of the most recent meta-analysis investigations conducted in India provided adequate scientific proof to establish the effectiveness of probiotics in decreasing death and disease in preterm neonates. From the results of this study, it was suggested that probiotics should now be presented as a regular therapy for preterm neonates.[42]

Although probiotic supplementation has proved to be a hopeful approach for the prevention of NEC in very low birth weight babies, advanced research is required to address several problems. At present, there are no well-definite regulatory guidelines to make certain the safety and quality of commercially supplied probiotic preparations. Furthermore, the optimal probiotic combination and dosing approach needs to be evidently explained.

   Probiotics as Future Biotherapeutics to Control Diabetes Top

Several researchers are trying to discover the prospects of new dietary-based approaches including probiotic interventions in the control of type 2 diabetes such as by altering gut hormones. Because of the discovery of gut hormones such as glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) incretins and their implications in glucose homeostasis, the gut connection to type 2 diabetes has now been recognized much more than peripheral insulin resistance and the failure of the beta cell. There are some reports stating that microbial populations in the gut are dissimilar in lean and obese individuals and, similarly, in diabetic from nondiabetic individuals, suggesting that obesity or diabetes may have different microbial constituents. Taking into account the connection between alterations in metabolic diseases and intestinal microbiota, researchers state that probiotic interventions could act as potential modulators of gut flora that modify the gut composition in a favorable manner and put forth a variety of health beneficial effects on the host. Some of the strains of Lactobacillus spp. could exert a beneficial effect by reducing the body fat percentage in individuals suffering from diet-induced obesity, particularly by reducing the cell size of the white adipose tissues.[43] Keeping in mind the enormous potential and possibility of utilizing the new dietary-based approaches to effectively control type 2 diabetes, scientific investigators are researching to securely and efficiently change human gut microflora, future research activities need to be focused to emphasize the immunomodulatory, complex hormonal, and metabolic mechanisms underlying the microbiota–host interaction in diverse tissues. In addition, it is required that the clinical treatments be evaluated in well-designed trials with patient-oriented endpoints.

   The Possibility to Prevent Colon Cancer With Probiotics Top

Colon cancer is a one of the commonly occurring cancer throughout the globe. The current proposed steps in carcinogenesis comprises the initial mutations of several genes such as oncogenes and tumor suppressor genes followed by the formation of carcinoma or adenoma, the development of dysplastic aberrant crypt foci (ACF), and then metastases.[44],[45]

Different possible mechanisms for the beneficial effects of probiotics on colon cancer include the following: (1) attaching and removing potential carcinogens by the probiotics; (2) synthesizing antimutagenic or antitumorigenic compounds in the colon; (3) supporting the host’s immune response; (4) modifying the intestinal microflora qualitatively and quantitatively; (5) altering the metabolic functions of the intestinal microflora; (6) beneficial effects on the physiology of the host; and (7) changing the physicochemical environment in the colon.[46] The probiotic Streptococcus thermophilus, bifidobacteria, and lactobacilli have been shown to be very effective in preventing the mutation process in carcinogenesis and to avoid gene mutation in the Ames assay. The Ames assay tests the mutagenicity of  Salmonella More Details typhimurium strains His. It has recognized around 90% of the known carcinogens. [47, 48, 49] There are reports stating that rodents fed with probiotics could reduce the mammary lesions induced by chemical carcinogens and the occurrence of colon ACF. [50, 51, 52] Few scientific investigation had proved that the supplementation of L. acidophilus could reduce the mutagenicity of urine and the feces of human individuals who intake a fried meat diet.[53]

In the past, it had been demonstrated that broiled meat or fish contain 2-amino-3-methyl-imidazo [4,5-f]quinoline, which is a mutagenic, heterocyclic, aromatic amine compound that can provoke colon lesions in rodents. The supplementation of B. bifidum and L. acidophilus to patients who had colon adenomas decreased the proliferation of the mucosal cells in their upper colonic crypts.[54] Even though the aforementioned scientific data, in general, support the important role of probiotics on colon cancer, direct facts from human investigation are still not available.

   The Task of Probiotics in Disease Treatment Top

Probiotics can not only control pathogenic infections or better our health but can also help in real disease treatment and management. However, one could doubt as to how probiotics could support real disease treatment and management. The main significant aspects lie in understanding the disease behavior and its causative driving forces.

For instance, diseases that are connected to genetic disorders will source certain sort of deficiencies such as lactose intolerance. The function of probiotics in such types of cases will be in eliminating such deficiencies by diverse mechanisms such as supplying our bodies with suitable alternative products or supplying our bodies with the products of the missed gene products. Probiotics will be an excellent support system for us when we become old. It will decrease the burden on our biological system and will facilitate us to do additional activity, mainly those associated in the enhancement of our capability to make use of the consumed food. Probiotics could support a defected or a weak pathway that is a result of an imperfection in a single allele rather than the imperfection in both the alleles. Accurately like in the case of individuals who have retinoblastoma. In such a case, the significant basis for the Knudson hypnosis’s will be totally interfered with while a single gene will not be a theme to too much stress that could show the way to a mutation.[55] Some of the important and crucial roles for probiotics in maintaining human health, disease treatment, and management are the following:

  1. Maintaining good condition of the genitourinary tract.[56]

  2. Checking the serum cholesterol levels.[57]

  3. Control of hypertension.[57]

  4. In curing diarrheal diseases. Saccharomyces cerevisiae var boulardii is very effective in treating different diarrheal disorders.[58],[59]

  5. Probiotics are supplemented to trim down the antibiotic negative effect and to restore any type of loss in the beneficial microflora.[60]

  6. Inhibition of the putrefactive-type fermentation, which is one of the Metchnikoff postulations regarding the benefits of probiotics.[61]

  7. Probiotics support the defensive functions of the intestinal mucosa including the production and secretion of antibacterial peptides.[60]

  8. Enhanced digestion of lactose against food possessing lactose.

  9. Decreasing the occurrence of allergy in susceptible individuals.[58]

  10. Supporting bioavailability and synthesis of nutrients and enhancing the immune system.[32]

  11. Probiotics are very effective in treating diarrheal disorders.

  12. Improving intestinal tract health.[27]

   The Potential Effects of Probiotics in Neurological Diseases Top

The microbiota–gut–brain axis

A increasing number of evidences has proven that the gut microbiota influences the human brain developments and its activities. [62, 63, 64, 65] The exchange of regulatory signals through bidirectional and integrative communication between the central nervous system and the gastrointestinal tract represents the gut–brain axis.[59],[66] In microbiota–gut–brain axis, the microbiota present in the gut plays a crucial role. This complex system acts through direct and indirect mechanisms that comprises immunological, hormonal, and neural pathways. [67, 68, 69]

In a top-down signaling system, the central nervous system has great impact on the gut microbiota, particularly via the hypothalamus–pituitary–adrenal axis and the autonomic nervous system. In fact, many studies have reported that a stressful experience particularly in early life can interrupt the microbiota profile, restricting its multiplicity and richness and affecting the mircrobial species, including a shift in microbial component that may promote the translocation of the species known to provoke inflammation, such as Clostridia, and decrease the population of anti-inflammatory bacteria, such as Lactobacillus. [70, 71, 72, 73, 74]

An additional pathway that can show effects on the behavior and brain involve the vagus nerve.[75] The modulation of the gut microbiota employing L. rhamnosus initiated the transcription of γ-aminobutyric acid (GABA) receptors and stimulated psychological and behavioral responses with marked dependence on the vagal integrity.[76] On the other hand, vagus-independent mechanisms are involved as well.[77] The intestinal microbiota has a intense influence on many neuromodulators and neurotransmitters such as GABA, serotonin, monoamines, and brain-derived neurotrophic factors, which carry signals to the brain via the enterochromaffin cells, the enteric nerves, and the systemic circulation crossing the blood–brain barriers, in which permeability appears to be controlled by the microbiota in experimental models.[78]

The potential effects of probiotics in neurological diseases

The current facts on this subject are poor and incomplete, and most of the investigations are based on preclinical research in animals such as germ-free mice exposed to early-life gut modulation of the microbiota or supplemented to particular probiotics; [78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89] some of the studies are related to adults, [90, 91, 92, 93, 94, 95, 96, 97, 98, 99] and some involve children. [100, 101, 102, 103, 104, 105]

Preclinical studies on the role of probiotics in the treatment of neurological diseases

As the task of probiotics in treating neurological disorder is the theme of current interest, there are several preclinical investigations in the recent literature. Overall, these scientific investigations demonstrate the potential effects of probiotics in curing neurological diseases and describe the immunological, neural, and metabolic pathways involved.[101]

The Lactobacillus strains of Lactobacillus plantarum DSM 15313, L. plantarum DSM 15312, and Lactobacillus paracasei DSM 13434 if supplemented for five days suppressed the succession of mice-developed experimental autoimmune encephalomyelitis (EAE) and also downregulated myelin oligodendrocyte glycoprotein (MOG)-reactive T-cells and changed the central immune response from Th1 to Th2. It was also reported that only the combination of three strains together showed the therapeutic effect; the supplementation of a monostrain probiotic will not yield the expected result.[80] The combination of L. casei, L. acidophilus, B. bifidum, L. reuteri, and S. thermophilus showed a very effective therapeutic and prophylactic activity in EAE mice.[81] [Table 2] illustrates the results of probiotics in preclinical studies.
Table 2: The main neurological effects of probiotics in preclinical studies

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Clinical trials on human adults on the role of probiotics in the treatment of neurological diseases

The clinical trials conducted on adults appear to prove the results obtained in animal investigations. The results achieved in the clinical trials addressed the potential role of probiotics in the treatment of many neurological diseases. Particular strains of probiotic bacteria showed very optimistic effects on the human brain function even in healthy individuals.

From the results of a randomized, restricted clinical trial on healthy women, it was confirmed that by taking fermented milk containing Lactococcus lactis subsp. lactis, Lactobacillus bulgaricus, Streptococcus thermophiles, and Bifidobacterium animalis subsp. lactis for 1 month, decreased the reactivity of a broadly dispersed network of brain areas to an emotional attention job including affective, somatosensory, and viscerosensory cortices, and this as a result affected the responsiveness to negative emotional stimuli.[102]

There are plenty of data regarding individuals suffering from neurological diseases. The patients suffering from Human T-Lymphotropic Virus type I (HTLV-1) connected tropical spastic paraparesis/myelopathy when administered with oral suspension of L. casei strain shirota for 1 month showed reduced urinary symptoms and very significant improvement in the motor function because of a significant increase in the Natural killer (NK) cell activity.[93] In addition, the oral administration of the same probiotic L. casei strain shirota for 2 months in individuals suffering from chronic fatigue syndrome resulted in a considerable reduction in anxiety symptoms compared to the controls.[96] [Table 3] shows the results of the clinical trials on probiotics in human adults.
Table 3: The key clinical trials conducted in adults on the effects of probiotics on neurological diseases

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Clinical trials on children regarding the role of probiotics in the treatment of neurological diseases

Till date, from the publisher’s data, only a small number of clinical investigations have been conducted on the use of probiotic strains to treat neurological diseases in children, and the most of the clinical trials were performed on those having ASD. All the clinical trials share several restrictions related to sample size, design, inclusion criteria, and assessment for clinical scores. In addition, none were particularly performed to find out the undesirable effects of probiotics supplementation or to conclude differences in neurological results.[99]

In one of the case reports, the intake of probiotic food in a 6-year-old child with ASD had improved the health of the child and discontinuation of the probiotic food led to a regression of symptoms, which was reversed with the reintroduction of probiotics.[100] From the group study on 22 children with age ranging from 4 to 10 years suffering with ASD, it was proved that oral administration with L. acidophilus strain Rosell-11 for 8 weeks improved the capability to focus and fulfill orders but did not influence the behavioral responses to eye contact or other people’s emotions.[103]

One of the neurological evaluations conducted in 1-year-old children using Hammersmith infant neurological examination demonstrated a statistically noteworthy higher occurrence of suboptimal scores in the control group than in the probiotic group. The results of this study confirm that probiotics are very successful in defending infants from neurological damage due to sepsis by extensively reducing invasive infections and Candida gastrointestinal colonization, which were more common in the control group than in the groups treated with L. rhamnosus and L. reuteri [105, 106, 107, 108] [Table 4] shows the results of clinical trials on probiotics in human adults.
Table 4: The key clinical trials conducted in children on the effects of probiotics on neurological diseases

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   Conclusion Top

In our life, there are several aspects that upset our beneficial microflora; under these circumstances, exosources should be used. Such exosources, which possess such functional microbes or what is named probiotics could be present in several types of foods, fermented foods, milk and milk products. In addition, science, many researchers, and several industries provide us with different forms of probiotics for diverse types of illness. Currently, the successful utilization of probiotics in treating and preventing neurological disorders is a new trend. Until recently, most of the studies on the role of probiotic research in neurological disease are confined to the mechanisms of the microbiota–gut–brain axis, and excellent results were seen in children with ASD. Furthermore, detailed studies into the efficacy of probiotics in altering these connections will assist to elucidate the etiopathogenesis of ASD and several neurological diseases and categorize novel possible targets on which to interfere. Further research on the deeper evaluation of tolerability and the evaluation of probiotics in the prevention of neurological disorders is in very urgent need. However, additional clinical research must be encouraged because of the effective influence on neurological diseases, which are grave public health issues, and for which there is still no ultimate therapy.

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   References Top

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