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Functionality and Safety of Probiotics

프로바이오틱스의 기능성과 안전성

  • Seo, Yeongeun (Department of Food and Nutrition, Sookmyung Women's University) ;
  • Yoon, Yohan (Department of Food and Nutrition, Sookmyung Women's University) ;
  • Kim, Sejeong (Risk Analysis Research Center, Sookmyung Women's University)
  • 서영은 (숙명여자대학교 식품영양학과) ;
  • 윤요한 (숙명여자대학교 식품영양학과) ;
  • 김세정 (숙명여자대학교 위해분석연구센터)
  • Received : 2019.06.16
  • Accepted : 2019.06.19
  • Published : 2019.06.30

Abstract

Probiotics stabilize intestinal microflora, reduce constipation, reduce decay by inhibiting harmful bacteria, and prevent diseases. Probiotics have also been studied for their possible roles in immune activation, treatment of cancer, remediation of cholesterol, treatment of diabetes, alleviation of allergies, and relief of lactose intolerance. However, recent data concerning the side effects of probiotics have prompted debate regarding their efficacy and safety. Major adverse events associated with probiotics are gastrointestinal symptoms, such as diarrhea, gastrointestinal disorders, and vomiting, along with skin rash and urticaria. Probiotics occasionally cause sepsis in infants with poor immunity and elderly people with severe diseases. In contrast to previous studies that described the efficacy of probiotics in intestinal regulation, some recent studies have reported that the activity of intestinal microbes becomes weak as a result of the influx of probiotics. The data indicate that the safety of probiotics is not guaranteed and that further investigations are needed.

References

  1. Alander, M., Satokari, R., Korpela, R., Saxelin, M., Vilpponen-Salmela, T., Mattila-Sandholm, T. and von Wright, A. 1999. Persistence of colonization of human colonic mucosa by a probiotic strain, Lactobacillus rhamnosus GG, after oral consumption. Appl. Environ. Microbiol. 65:351-354.
  2. Axelsson, L. T., Chung, T. C., Dobrogosz, W. J. and Lindgren, S. E. 1989. Production of a broad spectrum antimicrobial substance by Lactobacillus reuteri. Microb. Ecol. Health Dis. 2:131-136. https://doi.org/10.3109/08910608909140210
  3. Ba, U. V., Seo, H. W., Seong, P. N., Kang, S. M., Kim, Y. S., Cho, S. H., Park, B. Y., Ham, J. S. and Kim, J. H. 2018. Lactobacillus plantarum (KACC 92189) as a potential probiotic starter culture for quality improvement of fermented sausages. Korean J. Food Sci. Anim. Resour. 38:189-202.
  4. Boumis, E., Capone, A., Galati, V., Venditti, C. and Petrosillo, N. 2018. Probiotics and infective endocarditis in patients with hereditary hemorrhagic telangiectasia: A clinical case and a review of the literature. BMC Infect. Dis. 18:65. https://doi.org/10.1186/s12879-018-2956-5
  5. Bruno-Barcena, J. M., Azcarate-Peril, M. A. and Hassan, H. M. 2010. Role of antioxidant enzymes in bacterial resistance to organic acids. Appl. Environ. Microbiol. 76:2747-2753. https://doi.org/10.1128/AEM.02718-09
  6. Caffarelli, C., Cardinale, F., Povesi-Dascola, C., Dodi, I., Mastrorilli, V. and Ricci, G. 2015. Use of probiotics in pediatric infectious diseases. Expert Rev. Anti-Infect. Ther. 13:1517-1535. https://doi.org/10.1586/14787210.2015.1096775
  7. Centers for Disease Control and Prevention [CDC]. Fatal gastrointestinal mucormycosis in an infant following use of contaminated ABC Dophilus powder from Solgar Inc. Accessed February 20, 2015. Available from: https://www.cdc.gov/fungal/outbreaks/rhizopus-investigation.html
  8. Cohen, P. A. 2018. Probiotic safety-no guarantees. JAMA Intern. Med. 178:1577-1578. https://doi.org/10.1001/jamainternmed.2018.5403
  9. Corthesy, B., Gaskins, H. R. and Mercenier, A. 2007. Cross-talk between probiotic bacteria and the host immune system. J. Nutr. 137:781S-790S. https://doi.org/10.1093/jn/137.3.781S
  10. de Vrese, M., Stegelmann, A., Richter, B., Fenselau, S., Laue, C. and Schrezenmeir, J. 2001. Probiotics-Compensation for lactase insufficiency. Am. J. Clin. Nutr. 73:421s-429s. https://doi.org/10.1093/ajcn/73.2.421s
  11. Doron, S. and Snydman, D. R. 2015. Risk and safety of probiotics. Clin. Infect. Dis. 60:S129-S134. https://doi.org/10.1093/cid/civ085
  12. Dufour, A., Hindre, T., Haras, D. and Le Pennec, J. P. 2007. The biology of lantibiotics from the lacticin 481 group is coming of age. FEMS Microbiol. Rev. 31:134-167. https://doi.org/10.1111/j.1574-6976.2006.00045.x
  13. Falcinelli, S., Rodiles, A., Hatef, A., Picchietti, S., Cossignani, L., Merrifield, D. L., Unniappan, S. and Carnevali, O. 2018. Influence of probiotics administration on gut microbiota core: A review on the effects on appetite control, glucose, and lipid metabolism. J. Clin. Gastroenterol. 52:S50-S56. https://doi.org/10.1097/MCG.0000000000001064
  14. FAO/WHO. 2002. Guidelines for the evaluation of probiotics in food. Accessed June 15, 2019. Available from: https://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf
  15. Fleming, P., Hall, N. J. and Eaton, S. 2015. Probiotics and necrotizing enterocolitis. Pediatr. Surg. Int. 31:1111-1118. https://doi.org/10.1007/s00383-015-3790-0
  16. Franz, C. M., Muscholl-Silberhorn, A. B., Yousif, N. M., Vancanneyt, M., Swings, J. and Holzapfel, W. H. 2001. Incidence of virulence factors and antibiotic resistance among Enterococci isolated from food. Appl. Environ. Microbiol. 67:4385-4389. https://doi.org/10.1128/AEM.67.9.4385-4389.2001
  17. Gaspar, P., Carvalho, A. L., Vinga, S., Santos, H. and Neves, A. R. 2013. From physiology to systems metabolic engineering for the production of biochemicals by lactic acid bacteria. Biotechnol. Adv. 31:764-788. https://doi.org/10.1016/j.biotechadv.2013.03.011
  18. Haase, S., Haghikia, A., Wilck, N., Muller, D. N. and Linker, R. A. 2018. Impacts of microbiome metabolites on immune regulation and autoimmunity. Immunology. 154:230-238. https://doi.org/10.1111/imm.12933
  19. Jang, H. J., Jung, J., Yu, H. S., Lee, N. K and Paik, H. D. 2018. Evaluation of the quality of yogurt using ginseng extract powder and probiotic Lactobacillus plantarum NK181. Korean J. Food Sci. Anim. Resour. 38:1160-1167. https://doi.org/10.5851/kosfa.2018.e47
  20. Jasberg, H., Tervahartiala, T., Sorsa, T., Soderling, E. and Haukioja, A. 2018. Probiotic intervention influences the salivary levels of Matrix Metalloproteinase (MMP)-9 and Tissue Inhibitor of metalloproteinases (TIMP)-1 in healthy adults. Arch. Oral Biol. 85:58-63. https://doi.org/10.1016/j.archoralbio.2017.10.003
  21. Kang, C. H., Kim, Y. G., Han, S. H., Jeong, Y. and Peak, N. S. 2017. Antibacterial activity and probiotic properties of lactic acid bacteria from Korean Intestine Origin. Korean. Soc. Biotechnol. Bioeng. J. 32:153-159.
  22. Kho, Z. Y. and Lal, S. K. 2018. The human gut microbiome: A potential controller of wellness and disease. Front. Microbiol. 9:1835. https://doi.org/10.3389/fmicb.2018.01835
  23. Kim, S. K. and Lim, S. D. 2018. Functionality and research trend of probiotics. Food Ind. Nutr. 23:18-24.
  24. Kitazawa, H., Ino, T., Kawai, Y., Itoh, T. and Saito T. 2002. A novel immunostimulating aspect of Lactobacillus gasseri: Induction of "Gasserokine" as chemoattractants for macrophages. Int. J. Food Microbiol. 77:29-38. https://doi.org/10.1016/S0168-1605(02)00045-4
  25. Kopp, M. V., Hennemuth, I., Heinzmann, A. and Urbanek, R. 2008. Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: No clinical effects of Lactobacillus GG supplementation. Pediatrics. 121:e850-6. https://doi.org/10.1542/peds.2007-1492
  26. Kyriakidis, D. A., Theodorou, M. C. and Tiligada, E. 2012. Histamine in two component system-mediated bacterial signaling. Front. Biosci. 17:1108-1119. https://doi.org/10.2741/3976
  27. Ledoux, D., LaBombardi, V. J. and Karter, D. 2006. Lactobacillus acidophilus bacteraemia after use of a probiotic in a patient with AIDS and hodgkin's disease. Int. J. STD AIDS. 17:280-282. https://doi.org/10.1258/095646206776253507
  28. Lee, I. H., Lee, S. H., Lee, I. S., Park, Y. K., Chung, D. K. and Choue, R. 2008. Effects of probiotic extracts of Kimchi on immune function in NC/Nga mice. Korean J. Food Sci. Technol. 40:82-87.
  29. Lerner, A., Shoenfeld, Y. and Matthias, T. 2019. Probiotics: If it does not help it does not do any harm. Really?. Microorganisms. 7:104. https://doi.org/10.3390/microorganisms7040104
  30. Muthu Selvam, R., Vinothini, G., Palliyarai Thaiyammal, S., Latha, S., Chinnathambi, A., Dhanasekaran, D., Padmanabhan, P., Alharbi, S. A. and Archunan G. 2016. The cell aggregating propensity of probiotic actinobacterial isolates: Isolation and characterization of the aggregation inducing peptide pheromone. Biofouling. 32:71-79. https://doi.org/10.1080/08927014.2015.1122759
  31. Nagy, G., Pinczes, G., Pinter, G., Pocsi, I., Prokisch, J. and Banfalvi, G. 2016. In situ electron microscopy of lactomicroselenium particles in probiotic bacteria. Int. J. Mol. Sci. 17:E1047. https://doi.org/10.3390/ijms17071047
  32. Naqvi, S. S. B., Nagendra, V. and Hofmeyr, A. 2018. Probiotic related Lactobacillus rhamnosus endocarditis in a patient with liver cirrhosis. IDCases. 13:e00439. https://doi.org/10.1016/j.idcr.2018.e00439
  33. Ohishi, A., Takahashi, S., Ito, Y., Ohishi, Y., Tsukamoto, K., Nanba, Y., Ito, N., Kakiuchi, S., Saitoh, A., Morotomi, M. and Nakamura, T. 2010. Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J. Pediatr. 156:679-681. https://doi.org/10.1016/j.jpeds.2009.11.041
  34. Ortolani, C. and Pastorello, E. A. 2006. Food allergies and food intolerances. Best Pract. Res. Clin. Gastroenterol. 20:467-483.
  35. Park, H. E., Kim, Y. J., Do, K. H., Kim, J. K., Ham, J. S. and Lee, W. K. 2018. Effects of queso blanco cheese containing Bifidobacterium longum KACC 91563 on the intestinal microbiota and short chain fatty acid in healthy companion dogs. Korean J. Food Sci. Anim. Resour. 38:1261-1272. https://doi.org/10.5851/kosfa.2018.e62
  36. Park, H. Y., Park, S. K., Kim, B. G., Ryu, D. G., Lim, E. S. and Kim, Y. M. 2017. Isolation and characterization of cholesterol-lowering lactic acid bacteria from kimchi. Korean J. Food Sci. Technol. 49:377-382.
  37. Park, Y. H., Hamidon, F., Rajangan, C., Soh, K. P., Gan, C. Y., Lim, T. S., Abdullah, W. N. and Liong, M. T. 2016. Application of probiotics for the production of safe and high-quality poultry meat. Korean J. Food Sci. Anim. Resour. 36:567-576. https://doi.org/10.5851/kosfa.2016.36.5.567
  38. Pessione, E. 2012. Lactic acid bacteria contribution to gut microbiota complexity: Lights and shadows. Front. Cell Infect. Microbiol. 2:1-15.
  39. Pugin, B., Barcik, W., Westermann, P., Heider, A., Wawrzyniak, M., Hellings, P., Akdis C. A. and O'Mahony, L. 2017. A wide diversity of bacteria from the human gut produces and degrades biogenic amines. Microb. Ecol. Health Dis. 28:1-9.
  40. Rao, S. S. C., Rehman, A., Yu, S. and De Andino, N. M. 2018. Brain fogginess, gas and bloating: A link between SIBO, probiotics and metabolic acidosis. Clin. Transl. Gastroenterol. 9:162. https://doi.org/10.1038/s41424-018-0030-7
  41. Rathnayake, I. U., Hargreaves, M. and Huygens, F. 2012. Antibiotic resistance and virulence traits in clinical and environmental Enterococcus faecalis and Enterococcus faecium isolates. Syst. Appl. Microbiol. 35:326-333. https://doi.org/10.1016/j.syapm.2012.05.004
  42. Sanders, M. E., Akkermans, L. M., Haller, D., Hammerman, C., Heimbach, J., Hormannsperger, G., Huys, G., Levy, D. D., Lutgendorff, F., Mack, D., Phothirath, P., Solano-Aguilar, G. and Vaughan, E. 2010. Safety assessment of probiotics for human use. Gut. Microbes. 1:164-185. https://doi.org/10.4161/gmic.1.3.12127
  43. Seo, J. G., Lee, G. S., Kim, J. E. and Chung, M. J. 2010. Development of probiotic products and challenges. Korean. Soc. Biotechnol. Bioeng. J. 25:303-310.
  44. Sherid, M., Samo, S., Sulaiman, S., Husein, H., Sifuentes, H. and Sridhar, S. 2016. Liver abscess and bacteremia caused by Lactobacillus: Role of probiotics? Case report and review of the literature. BMC Gastroenterol. 16:138. https://doi.org/10.1186/s12876-016-0552-y
  45. Suez, J., Zmora, N., Zilberman-Schapira, G., Mor, U., Dori-Bachash, M., Bashiardes, S., Zur, M., Regev-Lehavi, D., Ben-Zeev Brik. R., Federici, S., Horn, M., Cohen, Y., Moor, A. E., Zeevi, D., Korem, T., Kotler, E., Harmelin, A., Itzkovitz, S., Maharshak, N., Shibolet, O., Pevsner-Fischer, M., Shapiro, H., Sharon, I., Halpern, Z., Segal, E. and Elinav E. 2018. Post-antibiotic gut mucosal microbiome reconstitution is impaired by probiotics and improved by autologous FMT. Cell. 174:1406-1423. https://doi.org/10.1016/j.cell.2018.08.047
  46. Trautmann, M., Synowzik, I., Nadji-Ohl, M., Von Voigt, T. B. and Reiter, W. 2008. Fungemia due to Saccharomyces cerevisiae var. boulardii. Chemotherapie J. 17:57-61.
  47. Washington, E. J., Banfield, M. J. and Dangl, J. L. 2013. What a difference a Dalton makes: Bacterial virulence factors modulate eukaryotic host cell signaling systems via deamidation. Microbiol. Mol. Biol. Rev. 77:527-539. https://doi.org/10.1128/MMBR.00013-13
  48. Zein, E. F., Karaa, S., Chemaly, A., Saidi, I., Daou-Chahine, W. and Rohban, R. 2008. Lactobacillus rhamnosus septicemia in a diabetic patient associated with probiotic use: A case report. Ann. Biol. Clin. 66:195-198.
  49. Zmora, N., Zilberman-Schapira, G., Suez, J., Mor, U., Dori-Bachash, M., Bashiardes, S., Kotler, E., Zur, M., Regev-Lehavi, D., Brik, R. B., Federici, S., Cohen, Y., Linevsky, R., Rothschild, D., Moor, A. E., Ben-Moshe, S., Harmelin, A., Itzkovitz, S., Maharshak, N., Shibolet, O., Shapiro, H., Pevsner-Fischer, M., Sharon, I., Halpern, Z., Segal, E. and Elinav, E. 2018. Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell. 174:1388-1405. https://doi.org/10.1016/j.cell.2018.08.041
  50. 식품의약품안전처. 2017. 2016 건강기능식품 국내 시장 규모 동향 분석. Accessed June 15, 2019. Available from: https://www.mfds.go.kr/brd/m_386/view.do?seq=29358
  51. 식품의약품안전처. 2018. 건강기능식품의 기준 및 규격 고시 제2018-67호.
  52. 식품의약품안전처. 2019. 식품안전나라 건강기능식품 이상사례 신고 신고현황. Accessed June 15, 2019. Available from: http://www.foodsafetykorea.go.kr/minwon/sideeffect/stats.do
  53. 신채민, 서성우, 박주연, 박은정, 유근주, 손수경. 2016. 프로바이오틱스의 안전한 사용을 위한 연구. 한국보건의료연구원, 서울. pp. 1-258.
  54. 지광석, 김재영, 이승진. 2018. 소비자안전법제 개선방안 연구. 한국소비자원, 음성. pp. 1-209.
  55. 지근억. 2011. Probiotic Bifidobacterium의 인간 건강증진에 대한 입증. 한국식품영양학회 동계학술대회 초록집. pp. 77-89.