Assessment of the synbiotic properites of human milk oligosaccharides and Bifidobacterium longum subsp. infantis in vitro and in humanised mice.

The mode of delivery plays a crucial role in infant gastrointestinal tract colonisation, which in the case of caesarean section is characterised by the presence of clostridia and low bifidobacterial counts. Gut colonisation can be modified by probiotics, prebiotics or synbiotics. Human milk oligosaccharides (HMOs) are infant prebiotics that show a bifidogenic effect. Moreover, genome sequencing of Bifidobacterium longum subsp. infantis within the infant microbiome revealed adaptations for milk utilisation. This study aimed to evaluate the synbiotic effect of B. longum subsp. infantis, HMOs and human milk (HM) both in vitro and in vivo (in a humanised mouse model) in the presence of faecal microbiota from infants born by caesarean section. The combination of B. longum and HMOs or HM reduced the clostridia and G-bacteria counts both in vitro and in vivo. The bifidobacterial population in vitro significantly increased and produce high concentrations of acetate and lactate. In vitro competition assays confirmed that the tested bifidobacterial strain is a potential probiotic for infants and, together with HMOs or HM, acts as a synbiotic. It is also able to inhibit potentially pathogenic bacteria. The synbiotic effects identified in vitro were not observed in vivo. However, there was a significant reduction in clostridia counts in both experimental animal groups (HMOs + B. longum and HM + B. longum), and a specific immune response via increased interleukin (IL)-10 and IL-6 production. Animal models do not perfectly mimic human conditions; however, they are essential for testing the safety of functional foods.

Bifidobacteria from the gastrointestinal tract of animals: differences and similarities.

At present, the genus Bifidobacterium includes 48 species and subspecies, and this number is expected to increase. Bifidobacteria are found in different ecological niches. However, most were originally isolated from animals, mainly mammals, especially during the milk feeding period of life. Their presence in high numbers is associated with good health of the host. Moreover, bifidobacteria are often found in poultry and insects that exhibit a social mode of life (honeybees and bumblebees). This review is designed as a summary of currently known species of the genus Bifidobacterium, especially focused on their difference and similarities. The primary focus is on their occurrence in the digestive tract of animals, as well as the specificities of animal strains, with regard to their potential use as probiotics.

Beneficial effects of human milk oligosaccharides on gut microbiota.

Human milk is the gold standard for nourishment of early infants because it contains a number of bioactive components, such as human milk oligosaccharides (HMOs). The high concentration and structural diversity of HMOs are unique to humans. HMOs are a group of complex and diverse glycans that are resistant to gastrointestinal digestion and reach the infant colon as the first prebiotics. N-acetyl-glucosamine containing oligosaccharides were first identified 50 years ago as the 'bifidus factor', a selective growth substrate for intestinal bifidobacteria, thus providing a conceptual basis for HMO-specific bifidogenic activity. Bifidobacterial species are the main utilisers of HMOs in the gastrointestinal tract and represent the dominant microbiota of breast-fed infants, and they may play an important role in maintaining the general health of newborn children. Oligosaccharides are also known to directly interact with the surface of pathogenic bacteria, and various oligosaccharides in milk are believed to inhibit the binding of pathogens and toxins to host cell receptors. Furthermore, HMOs are thought to contribute to the development of infant intestine and brain. Oligosaccharides currently added to infant formula are structurally different from the oligosaccharides naturally occurring in human milk and, therefore, they are unlikely to mimic some of the structure-specific effects. In this review, we describe how HMOs can modulate gut microbiota. This article summarises information up to date about the relationship between the intestinal microbiota and HMOs, and other possible indirect effects of HMOs on intestinal environment.

[An unusual cause of duodenal obstruction--a case report]. / Neobvyklá prícina obstrukce duodena--kazuistika.

The article presents a patient operated for upper gastrointestinal tract obstruction caused by a tumour of the duodenum. The histological analysis described it as hyperplasia of the Brunner's gland. The article presents the clinical manifestation, diagnostics and therapy of this tumour. A summary of related literature to Brunner's gland adenoma follows. This very rare benign pathology of the small intestine presents itself with no specific clinical symptomatology, often as dyspepsia or ulcerous disease. Diagnosis is based on endoscopy and radiographic methods. Therapy is most commonly surgical.

[Nutritional status in patients with chronic obstructive pulmonary disease]. / Stav nutrice u nemocných s chronickou obstrukcní plicní nemocí (CHOPN).

The authors examined the nutritional status of 50 patients admitted on account of exacerbation of chronic obstructive lung disease. The mean height of patients was 168 +/- 8.8 cm, the body weight 72.2 +/- 16.2 kg, BMI 25.5 +/- 5.5 kg/m2. The mean albumin concentration was 33.1 +/- 4.6 g/l, transferrin 2.3 +/- 0.6 g/l, the skinfold thickness 17.3 +/- 9.9 mm, arm circumference 28.6 +/- 7.2 cm. The mean energy expenditure at rest (REE) was 122.1 +/- 12.3%. The total number of undernourished patients was 7 (14%), there were 27 obese patients (54%). The authors did not find a relationship between respiratory parameters and values of blood gases on the one hand and body weight, skinfold thickness, BMI, REE, arm circumference, albumin, transferrin and the number of lymphocytes on the other hand. This is obviously due to the fact that the group comprised more obese than undernourished patients. Obese and undernourished patients were found in all three stages of the disease.

[Cystic fibrosis--a serious disease affecting the nutritional status and energy requirements in adult patients]. / Cystická fibróza--závazné onemocnení ovlivnující nutricní stav a energetickou potrebu i u nemocných v dospelém veku.

At the Department for TB and Respiratory Diseases of the Faculty Hospital in Prague Motol at present half the patients with cystic fibrosis who in the Czech Republic reached adult age are being followed-up. The objective of the present work was to evaluate the nutritional profile of these adult patients with cystic fibrosis. The authors examined 15 patients, mean age 22.9 +/- 3.2 years. The examination included assessment of height, body weight, skinfold thickness above the triceps, brachii, the energy output transferrin, blood gases. Functional examination of the lungs was made by the method of the flow-volume curve. The body mass index (BMI) was 18.04 +/- 4.17, albumin 32.75 +/- 4.57. The resting energy expenditure was 112.1 +/- 20.8% of the basal energy output calculated according to the Harris-Benedict formula. The mean value of pO2 was 8,081 +/- 1,145 kPa, pCO2 5,841 +/- 1,197 kPa. The results indicate malnutrition of the examined patients: in general the findings can be considered as a sign of severe protein-energy malnutrition. The baseline study confirmed the assumption of a high prevalence of nutritional disorders in adult patients with cystic fibrosis. The next essential step must be to ensure comprehensive and individualized nutritional intervention.