*4.4.6 Prebiotics for the improvement of enzyme activity and phosphate uptake*

Prebiotics improve the activity of enzymes and phosphate uptake in the intestine. One of study was conducted to recognize the impact of prebiotics supplementation in infant formula on enzyme activity and phosphate uptake in the small intestine of Sprague Dawley (SD) rats. Forty-eight fifteen days old SD rats of similar weight were divided into three groups randomly: A was selected as control group in which SD rats were fed with standard infant formula with no prebiotics treatment. Rats in groups B, C were nourished standard infant formula supplemented with oligosaccharides, and the standard infant formula supplemented with polysaccharides, correspondingly. The results were checked at 28 days. It was observed that as compared to group A, group B and C showed the following: (1) In SD rats group C showed greater activities of sucrose and lactase in the small intestine; (2) In SD rats of group C comparative expressions of lactase gene in the anterior and posterior segments of the small intestine were increased by 1.68 and 2.26, and the *Mgam* gene relative expression in the posterior segment of the small intestine was improved by 0.99 in SD rats of group C; (3) the relative expressions of *Na/Pi-IIb* gene in the anterior and posterior segments of the small intestine were increased by 1.85 and 2.28 in SD rats of group C. These results specify that the supplementation of prebiotics in infant formula can stimulate enzyme movement in the small intestine by improving the relative expression of enzyme gene and *Na/Pi-IIb* gene and by reducing the intestinal injury. The polysaccharides improved to be healthier than that of oligosaccharides [124].

## *4.4.7 Prebiotics and the bioavailability of minerals and trace elements*

Prebiotic carbohydrates have positive influence in the absorption of minerals and trace elements. There exist a promising evidence about the stimulatory impact of prebiotic carbohydrates (non-digestible oligosaccharides and lactulose) on the bioavailability of minerals and trace elements. However, most of the studies is on the rats because, the studies on the human is limited. It has been hypothesized that prebiotics create strong osmotic effect that reduce the pH and stimulate the exchange of protons and increase level of calbindin and butyrate. Colon surface area also enlarged that is a good source to increase the minerals and trace elements absorption [125].

### *4.4.8 Prebiotics in diabetes and cardiovascular diseases*

Prediabetes is linked with the long term inflammation that is associated with greater risk of developing type 2 diabetes and cardiovascular diseases. Increased concentration of lipopolysaccharides is linked with dysbiosis of the natural microbiota that is involved in the development of type 2 diabetes and cardiovascular diseases. Prebiotics involved in the selective functioning of natural micro biota such as inulin decreases the concentration of endotoxin, reduces permeability of the intestines and limit the metabolic dysfunction in rodents. The impact of prebiotics on the cardiovascular functions in patients at the risk of type 2 diabetes is still unknown. The prebiotic supplementation along with inulin could be used as preventive strategy for limiting the risk of cardiovascular diseases in the patients at risk of type 2 diabetes. This strategy can affect the clinical practices by setting and accepting dietary recommendation of prebiotics by medical and scientific community [126].

#### *4.4.9 Prebiotics and renal profile*

It is well documented that prebiotics, probiotics and the symbiotic supplementation had resulted in the improvement of renal function. Firouzi and Haghighatdoost [127] studied renal profile of a meta-analysis of a clinical trial. They pointed out that level of glomerular filtration rate was reduced whereas the concentration of creatinine was increased in the intervention group in comparison to the placebo group and the results were non-significant. The combined effect on the blood urea nitrogen demonstrated that the level declined as compared to the placebo group. Whereas the levels of uric acid increased in intervention group in comparison with the placebo group. The supplementation of prebiotics, probiotics and symbiotic should be limited among those in which renal function is compromised until well designed and large scale randomized controlled trials prove the efficiency and safety of prebiotics, probiotics and symbiotic supplementation for having improved effects on the renal function.

#### *4.4.10 Prebiotics in controlling cancer*

A study was conducted to check the impact of prebiotics intake consisting of xylo-oligosaccharides, fructo-oligosaccharides, resistant dextrin and polydextrose on immunity and the structure of gut microbiota in perioperative colorectal cancer patients.

A double blind, randomized clinical trial was conducted that consisted of 140 perioperative colorectal cancer patients involving 50 females and 90 males having age between 40 and 75 years. Patients were divided on random basis into two groups consisting of intervention group that received 30 g/day of prebiotic supplementation for the period of 7 days and control group that did not receive supplementation. The immunological and nutritional indices of both groups were evaluated before and after operation and were compared with their baseline levels. Also the fecal samples of random 40 patients from the both groups were taken to examine the gut microbiota. There was significant reduction in the abundance of intestinal microbiata from pre to post operation in the control group. Intake of prebiotics is recommended to improve immunological indices in patient having colorectal cancer for 7 days before operation. Prebiotics enhanced the concentration of four commensal microorganism containing opportunistic pathogens in patients having colorectal cancer. Surgical stress decreased the population of intestinal microbiota

**21**

*Therapeutic Potential of Probiotics and Prebiotics DOI: http://dx.doi.org/10.5772/intechopen.86762*

on the mechanism of prebiotics [128].

the impact of stress on the microbiota [129].

\*, Iqra Muqaddas Saleem1

1 University of Veterinary and Animal Sciences, Lahore, Pakistan

2 University of Poonch Rawalakot, Azad Kashmir, Pakistan

\*Address all correspondence to: nabila.gulzar@uvas.edu.pk

provided the original work is properly cited.

**5. Conclusion**

available as drug.

**Author details**

Nabila Gulzar1

*4.4.11 Anxiolytic effect of prebiotics*

but increased the population of commensal microbiota and opportunistic microorganisms. *For further research Bacteroides* is considered as a relevant bacterial species

Long term treatment of prebiotics particularly combination of fructooligosaccharides and galactooligosaccharides have antidepressant effects and also involved in combating the issues related to anxiety. The effect of Galactooligosaccharide (GOS) and the combination of fructooligosaccharides and galactooligosaccharides is involved in reducing the level of corticosterone level in the body by mainly limiting its release. Prebiotics are involved in modifying the expression of specific genes related to the concentration of short chain fatty acids in the hypothalamus and hippocampus. Administration of Prebiotics resulted in the increased level of acetate and propionate and reduction in the concentration of isobutyrate that have significant correlation with the positive effects on behavior. Moreover, the administration fructooligosaccharides and galactooligosaccharides reduced the level of corticosterone and proinflammatory cytokines resulted from the chronic stress as well as normalizing the anxiety and depression like behavior along with mitigating

Probiotics and prebiotics are functional foods that have significant biotechnological benefits with wonderful potential for invention. Though probiotics and prebiotics are likely to be used in treating many communicable and non-communicable disorders but it is very hard to draw conclusions from a number of researches that indicating the therapeutic potential of probiotics and prebiotics because scientists used different strains and prescriptions for various disorders. Further research using reliable regulations will permit more decisive results on the effects of probiotics and prebiotics for treatment of various diseases. Although various products with probiotic, prebiotics and symbiotic are usually available in food and supplement formats, in near future these products will target to specific disease and will be

, Saima Rafiq2

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

and Muhammad Nadeem1

but increased the population of commensal microbiota and opportunistic microorganisms. *For further research Bacteroides* is considered as a relevant bacterial species on the mechanism of prebiotics [128].
