Spectrumceuticals ProBioFlora MicroBiota

Indications

• Maintain/support general health and wellbeing.
• Maintain/support intestinal health.
• Maintain/support intestinal good/beneficial/friendly flora.
• Maintain/support small intestine good/beneficial/friendly flora.
• Maintain/support gastrointestinal system health.
• Maintain/support gastrointestinal mucosal membrane health.
• Maintain/support immune system health.
• Maintain/support healthy immune system function.
• Maintain/support healthy gastrointestinal immune function.

Ingredients

* CFU (Colony Forming Units)

Excipients

Maltodextrin (tapioca), colloidal anhydrous silica, magnesium stearate, microcrystalline cellulose, size 0 hard hypromellose capsule.

ProBioFlora probiotics use gluten/soy-free maltodextrin via multi-layered micro-encapsulated technology. The maltodextrin is free from crustacean shellfish, egg, milk, fish, peanuts, tree nuts (almonds, brazil nuts, cashews, coconut, filberts/hazelnuts, macadamia, pecans, pistachios, pine nuts, and walnuts), wheat, soy, sesame, cereals without gluten, celery, lupin, molluscan shellfish, mustard and gluten.

The micro-encapsulation contains the excipients, maltodextrin (tapioca starch), galactooligosaccharide, fructooligosaccharide, hypromellose, sodium alginate (agar), polysaccharide colloidal stabilizer (plant-derived).

Allergy Advice

No added yeast, gluten, wheat, dairy, preservatives or artificial colours and flavours. Suitable for vegans.

Dose & Administration

Adults: Take 1 capsule, once daily, or as directed by a healthcare practitioner.

Warnings

No ARTG mandatory warnings

Storage

Store at room temperature, below 25 degrees Celsius, away from direct sunlight. No need for refrigeration.

Do not use if the tamper evidence seal is missing, torn or broken.

Clinical Studies

Probiotic supplementation to maintain general health and wellbeing. Supplements An Evidence-based Guide, 4th Ed, Elsevier, 2015. Pp 771-796

Evidence Summary: Local signs and symptoms of disruption of the intestinal microflora leading to an imbalance (intestinal dysbiosis) include bloating, flatulence, abdominal pain, diarrhoea and/or constipation and fungal overgrowth (such as Candida). An imbalance in the gastrointestinal microflora can be caused by the use of antibiotics, GIT infections, stress and dietary factors. Administration of probiotics is often used as a means of restoring this microflora imbalance.

A growing body of evidence indicates that some probiotic strains are capable of modulating the immune system at both the systemic and the mucosal level, affecting many cell types (e.g. epithelial cells, dendritic cells, natural killer cells). This immune response may take the form of increased secretion of immunoglobulin A (IgA) via interaction with mesenteric lymph nodes, elevated numbers of natural killer cells to enhanced phagocytic activity of macrophages.

Recent research has demonstrated that dendritic cells in the lamina propria can extend their appendices between epithelial cells, and, via Toll-like receptors on their surface, sample probiotic-bacterial molecular patterns. This interaction leads to the maturation of the dendritic cells and to the release of cytokines, which orchestrate the conversion of naive T-helper cells (Th0) into a mature, balanced response of T-helper cells (Th1, Th2 and Th3/Tr1).

Probiotic strains have been shown to have anti-inflammatory effects via several different mechanisms. They can secrete metabolites with anti-inflammatory properties (anti-tumour necrosis factor-α [TNF-α] effects), they can interact with Toll-like receptors, downregulate the transcription of several genes encoding proinflammatory effectors and upregulate the production of anti-inflammatory cytokines.

Some probiotic strains can modify GIT transit. Two strains of bifidobacteria have been found to significantly speed colonic transit time, while a strain of propionibacteria has been shown to slow descending colon transit. The mechanisms by which probiotics alter GIT transit time have not yet been fully elucidated; however, it is postulated that a bacterial metabolite may impact sigmoid tone and alter colonic motility. The GIT microflora has been shown to play a crucial role in generating an adequate population of Th2 cells that are capable of oral tolerance induction.

In the presence of intestinal dysbiosis, some probiotic strains can also help induce oral tolerance and help protect against the development of food allergies. Many pathogenic organisms must associate with the GIT epithelium to colonise effectively. However, some strains of bifidobacteria and lactobacilli can adhere to the epithelium and act as ‘colonisation barriers’ by preventing pathogens from adhering to the mucosa. This effect has been demonstrated with LGG and L. plantarum 299v. Both of these organisms have shown the ability to inhibit attachment of Escherichia coli to human colon cells.

One of the mechanisms by which probiotics exert their beneficial effects is via inducing changes to the GIT microflora; specifically by inhibiting the growth of potentially pathogenic organisms. Some probiotic strains are capable of producing inhibitory substances such as bacteriocins, lactic acid and toxic oxygen metabolites. Of the toxic oxygen metabolites, hydrogen peroxide is of major importance as it exerts a bactericidal effect on many pathogens.

Some probiotic strains (LGG and Bifidobacterium lactis Bb12) can also bind to viruses, such as rotaviruses, helping to prevent mucosa-associated viral infections. Several probiotic strains have also demonstrated the ability to bind or remove toxins, such as aflatoxins and cyanotoxins, as well as inhibit the effects of bacterial toxins, such as Clostridium difficile toxins A and B. Specific strains have also been found to reduce the expression of virulence factors via inhibition of pathogen gene encoding.

Ingestion of selected probiotic strains has been found to significantly increase gastrointestinal populations of beneficial bacteria (i.e. lactobacilli or bifidobacteria), while simultaneously decreasing populations of less health-promoting genera. Other probiotic strains can help restore normal small intestinal architecture and upregulate intestinal brush border enzyme expression via the luminal release of polyamines.

These strains will have clinical utility in situations of small intestinal damage and decreased brush border enzyme activity, such as coeliac disease, Crohn’s disease, or after small intestinal infections. Several probiotic strains have been found to increase mucin production in the gut via increases in mucin gene expression, which provides a protective coating between the lumen and intestinal epithelial cells. Probiotics are also capable of directly strengthening the intestinal barrier. A strain of Lactobacillus plantarum (WCSF1) has been found to decrease paracellular intestinal permeability by increasing the relocation of occludin and zonulin into the tight junction between duodenal epithelial cells. Other strains appear to enhance barrier function via the preservation of enterocyte cytoskeleton architecture and enhancement of tight junctional protein structures. Such strains should prove useful in the treatment and prevention of intestinal permeability.

Antibiotic use frequently results in significant perturbations in the GIT microflora and gastrointestinal adverse events, such as diarrhoea. It was once believed that taking probiotics concurrently with antibiotics would be a waste of time and money as the antibiotic would be likely to destroy all the administered probiotic bacteria. However, research conducted over the past 20 years clearly shows that concurrent administration of specific probiotic strains alongside antibiotics is effective and significantly decreases the incidence of antibiotic-related side effects

The research examining the impact of probiotics on antibiotic-related gastrointestinal adverse events, primarily antibiotic-associated diarrhoea shows the probiotic strains with the highest level of substantiating evidence are L. rhamnosus GG and Saccharomyces cerevisiae var. boulardii, but a number of other strains have also demonstrated efficacy.

The intestinal microflora plays a major protective role against the development of allergy because it reduces antigen transport through the intestinal mucosa and helps induce oral tolerance. Consequently, probiotics may have a protective role in the prevention and management of atopic dermatitis and eczema because of their proposed actions. Several clinical trials have investigated probiotic therapy to prevent atopic eczema development, and some have evaluated the efficacy of probiotic therapy in the treatment of atopic eczema. Constipation affects a significant proportion of the population. Probiotics have long been touted as useful for the treatment of constipation and recent randomised controlled trials have demonstrated efficacy for some probiotic strains.

In a randomised, controlled trial, Yang et al (2008) evaluated the effect of consuming a fermented milk containing Bifidobacterium animalis DN-173 010 (1.25 × 1010 CFU/day) on stool parameters in constipated women (n = 135). Compared to controls, stool frequency was significantly increased in the bifidobacteria group after 1 week (3.5 movements/week vs 2.5; P < 0.01) and after 2 weeks’ consumption (4.17 vs 2.6; P < 0.01).

Defecation condition and stool consistency also significantly improved after 1 and 2 weeks (all P < 0.01) of bifidobacteria consumption (Yang et al 2008). Another randomised, double-blind, placebo-controlled trial compared the efficacy of a placebo to a probiotic drink containing Lactobacillus casei Shirota (6.5 × 109 CFU/day) in constipated subjects (n = 70). After a 4-week treatment period, there was a significant decrease in the occurrence of moderate and severe constipation (P < 0.001) and in the occurrence of hard stools (P < 0.001) in the probiotic group. There was also an increase in defecation frequency (P = 0.004) and improvement in stool consistency (P < 0.001). General wellbeing was also significantly improved in the probiotic group (P = 0.008).

Conclusions: Concentrations >109 bacteria/ dose, unless research has demonstrated that the specific strain contained in the supplement is effective in smaller amounts. If a product contains multiple strains, then each strain should be present at levels of ≥109 to ensure effectiveness.