A pilot study to assess oral colonization and pH buffering by the probiotic Streptococcus dentisani under different dosing regimes.

Bacterial colonization in the oral cavity is critical for efficient action of probiotics. However, limited colonization rates have been reported in many clinical trials. The aim of this pilot clinical study was to evaluate the colonization efficiency of Streptococcus dentisani under different dosing schedules and pre-treatment conditions. Eleven adult volunteers enrolled in the study. A professional ultrasound cleaning was performed in quadrants 1 and 4. The probiotic was applied in all four quadrants at a total dose of 1010 CFUs, administered in a buccoadhesive gel for 5 min, either in a single dose (n = 5) or daily for a week (n = 6). Dental plaque and saliva samples were collected at baseline and after 14 and 28 days of first application. Amounts of S. dentisani and the cariogenic organism Streptococcus mutans were measured by qPCR and salivary pH was measured by reflectometry. There was a significant increase in S. dentisani cells at day 14 but not at day 28 under both dosing schedules. A non-significant higher colonization was found in the half-mouth with previous professional cleaning as compared to the intact half. There was a significant increase in salivary pH at day 14 (p = 0.024) and day 28 (p = 0.014), which was stronger in multi-dose patients, and a significant decrease in S. mutans at day 28 (p < 0.01). The results indicate that S. dentisani is transiently able to colonize the oral cavity and that it buffers oral pH, especially after multiple dosing. Future randomized, placebo-controlled clinical trials should evaluate its use to prevent tooth decay.

Effect of the Degree of Polymerization of Fructans on Ex Vivo Fermented Human Gut Microbiome.

Prebiotic supplements are used to promote gastrointestinal health by stimulating beneficial bacteria. The aim of this study was to compare the potential prebiotic effects of fructans with increasing degrees of polymerization, namely fructooligosaccharides (FOS) and inulins with a low and high polymerization degree (LPDI and HPDI, respectively), using an ex vivo fermentation system to simulate the colonic environment. The system was inoculated with pooled feces from three healthy donors with the same baseline enterotype. Changes in microbiota composition were measured by 16S metagenomic sequencing after 2, 7, and 14 days of fermentation, and acid production was measured throughout the experiment. Alpha-diversity decreased upon inoculation of the ex vivo fermentation under all treatments. Composition changed significantly across both treatments and time (ANOSIM p < 0.005 for both factors). HPDI and LPDI seemed to be similar to each other regarding composition and acidification activity, but different from the control and FOS. FOS differed from the control in terms of composition but not acidification. HDPI restored alpha-diversity on day 14 as compared to the control (Bonferroni p < 0.05). In conclusion, the prebiotic activity of fructans appears to depend on the degree of polymerization, with LPDI and especially HPDI having a greater effect than FOS.

The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis.

Studies of probiotics, fructan-type prebiotics, and synbiotics in patients with ulcerative colitis (UC) show significant heterogeneity in methodology and results. Here, we study the efficacy of such interventions and the reasons for the heterogeneity of their results. Eligible random controlled trials were collected from the PUBMED and SCOPUS databases. A total of 18 placebo-controlled and active treatment-controlled (i.e., mesalazine) studies were selected with a Jadad score ≥ 3, including 1491 patients with UC. Data for prebiotics and synbiotics were sparse and consequently these studies were excluded from the meta-analysis. The UC remission efficacy of probiotics was measured in terms of relative risk (RR) and odds ratio (OR). Significant effects were observed in patients with active UC whenever probiotics containing bifidobacteria were used, or when adopting the US Food and Drug Administration (FDA)-recommended scales (UC Disease Activity Index and Disease Activity Index). By the FDA recommended scales, the RR was 1.55 (CI95%: 1.13⁻2.15, p-value = 0.007, I² = 29%); for bifidobacteria-containing probiotics, the RR was 1.73 (CI95%: 1.23⁻2.43, p-value = 0.002, I² = 35%). No significant effects were observed on the maintenance of remission for placebo-controlled or mesalazine-controlled studies. We conclude that a validated scale is necessary to determine the state of patients with UC. However, probiotics containing bifidobacteria are promising for the treatment of active UC.