**10. Conclusion**

The direct introduction of probiotics, can positively influence the intestinal microbial population, include a reduction in the bowel reservoir of more pathogenic species, improve enteral nutrition, and reduce dependence on intravenous nutrition, favour an increased gut mucosal barrier to bacteria and bacterial products, and up regulation in protective immunity.

It is important to establish what probiotic it should be used, the right dosage, the right time of use, and furthermore controlled studies should answer to these questions, in order to describe specific indications on the type of probiotic that must be used in a specific situation, thus better clarifying the structure of the probiotic and its characteristics, selecting the right probiotic for each kind of disease.

It is important to underline that the use of probiotics is safe even at high dosages, without any side effect in preterm infants. After birth the rapid development of the intestinal microflora regulates all the different gastro-intestinal and immunologic functions that are included in the so called mutualism bacteria- host organism. This kind of relationship starts from birth and regulate different aspects of the immune system of the newborn.

Recent epidemiologic data support the hypothesis that in the last 20 years some immunologic modification can find a cause in the modification of the intestinal microflora.

Different therapeutic actions could be potentially able to alter the normal relationship between the intestinal microbiota and the host organism. The international medical community has to be aware of the increasing importance that initial colonising intestinal microflora could have on the health and well-being of the host later in life. It is of great importance to know that the initial bacterial colonisation of the neonate appears to play a crucial role in inducing immunity in the immature human being, and that a suboptimal process could have definite consequences. The optimal early interface between the microbes and the intestinal mucosa of the host may have been somewhat disturbed by modern perinatal care. It is fundamental to try to decrease these possible negative influences and to discover in the near future the possible means to help manipulate positively the gut microbiotia of infants (Rautava, 2007).

#### **11. References**

16 New Advances in the Basic and Clinical Gastroenterology

infections, the probiotic mixture was significantly more effective than the single strains. This may be due to the exceptionally high dose given in the multi-strain treatment, resulting in larger numbers of probiotic bacteria competing with pathogens for binding sites and or

Another point of interest in this study is that despite large differences in dose, the two single strains did not have statistically different effects, suggesting strain-specificity in dose and effect for individual species. These data support the theory that supplementation with certain multi-strain probiotics can reduce severity, duration, and possibly incidence of RTIs, and in the case of Lin et al. (2009) that a multi-strain probiotic may be more effective than a single-strain. There is some evidence for immunostimulation, even in cases where illness still occurs. Further consistency could be added to this evidence with the establishment, by testing varied concentrations of probiotic bacteria, of an optimum dose that prevents pathogenic colonisation of the mucosa as well as the incidence and severity of illness. Testing this dose with and without vitamin and mineral supplementation may reveal a

Further work should be done to determine the relative efficacy of single- and multi-strain

The direct introduction of probiotics, can positively influence the intestinal microbial population, include a reduction in the bowel reservoir of more pathogenic species, improve enteral nutrition, and reduce dependence on intravenous nutrition, favour an increased gut mucosal barrier to bacteria and bacterial products, and up regulation in protective

It is important to establish what probiotic it should be used, the right dosage, the right time of use, and furthermore controlled studies should answer to these questions, in order to describe specific indications on the type of probiotic that must be used in a specific situation, thus better clarifying the structure of the probiotic and its characteristics, selecting the right

It is important to underline that the use of probiotics is safe even at high dosages, without any side effect in preterm infants. After birth the rapid development of the intestinal microflora regulates all the different gastro-intestinal and immunologic functions that are included in the so called mutualism bacteria- host organism. This kind of relationship starts

Recent epidemiologic data support the hypothesis that in the last 20 years some immunologic modification can find a cause in the modification of the intestinal microflora. Different therapeutic actions could be potentially able to alter the normal relationship between the intestinal microbiota and the host organism. The international medical community has to be aware of the increasing importance that initial colonising intestinal microflora could have on the health and well-being of the host later in life. It is of great importance to know that the initial bacterial colonisation of the neonate appears to play a crucial role in inducing immunity in the immature human being, and that a suboptimal process could have definite consequences. The optimal early interface between the microbes

from birth and regulate different aspects of the immune system of the newborn.

nutrients in the gut.

probiotics in this area.

probiotic for each kind of disease.

**10. Conclusion** 

immunity.

synergy between both types of supplement.


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**Probiotics – What They Are,** 

**Their Benefits and Challenges** 

M.S. Thantsha, C.I. Mamvura and J. Booyens

This chapter reviews literature on probiotics. Probiotics are defined and different microbial cultures used as probiotics will be considered. It further discusses delivery vehicles for probiotic cultures, with their advantages and disadvantages. Since the presence of viable probiotic cultures in products is vital to their functionality, different methods used for their detection in products will be examined. The beneficial health effects of probiotics, the methods that are currently used in an attempt to overcome some of the challenges faced will also be discussed. Different strategies for protection of probiotic cultures and challenges for the probiotic industry are highlighted. In addition to these, alternative strategies increasing numbers of beneficial microorganisms through administration of prebiotics and synbiotics

The definition of probiotics has been modified with increasing knowledge in the field of how they function. The term is derived from the Greek language meaning 'for life'. In the past there have been many attempts to define the term 'probiotic', one of the first being described by Lilly & Stillwell in 1965. They defined probiotics as "substances secreted by one microorganism, which stimulates the growth of another". The focus of this definition was to distinguish them from and make it clear that they are the opposite of antibiotics. Subsequently, in 1974, Parker defined them as "organisms and substances which contribute to intestinal microbial balance" (Schrezenmier & de Vrese, 2001). In 1989, Fuller tried to improve on Parker's definition by proposing the following definition: "live microbial feed supplement, which beneficially affect the host (animal or human) by improving its intestinal microbial balance" (Salminen et al., 1999; Vilsojevic & Shah, 2008). Then, Havenaar & Huis In't Veld (1992) defined probiotics acceptably as 'a viable mono- or mixed culture of microorganisms which applied to animal or man, beneficially affects the host by improving the properties of the indigenous microflora'. Schrezenmeir & de Vrese (2001) defined the term probiotic as "a preparation of or a product containing viable, defined microorganisms in sufficient numbers, which alter the microflora by implantation or colonization, in a compartment of the host and by that, exert beneficial effects on host health". Among these descriptions and definitions, there were many others, until the Food and Agriculture Organization of the United Nations-World Health Organization (FAO-WHO) officially

**1. Introduction** 

are briefly mentioned.

**2. What are probiotics?** 

*University of Pretoria* 

*South Africa* 

Zoetendal, E.G.; Collier, C.T.; Koike, S.; Mackie, R.I. & Gaskins, H.R. (2004) Molecular ecological analysis of the gastrointestinal microbiota: a review. J Nutr, 134:465-72. **2** 
