What is the value of bifidobacteria and lactobacilli for the human body

lactobacilli

prebiotics

probiotics

metaprebiotics

Human digestion, regardless of gender and age, cannot be comfortable without maintaining the balance of beneficial and opportunistic microorganisms living in the intestinal lumen. Beneficial microflora is represented by bifidobacteria and lactobacilli, which not only form up to 70% of the general immunity, but also take an active part in the digestion process, and also synthesize certain biologically active substances and vitamins. Under the influence of various external and internal negative factors, the balance of the intestinal microbiota can be disrupted, which entails a number of negative consequences.

Difference between bifidobacteria and lactobacilli

Despite the fact that bifidobacteria and lactobacilli are united by the benefits they bring to the body, there are characteristic differences between the two species. These differences include:

Percentage. When the balance of the intestinal microbiota is maintained, about 95% is bifidobacteria, and only 5% is represented by lactobacilli.
Area of life activity. Bifidobacteria live primarily in the lumen of the large intestine, while lactobacilli are located in the large intestine, on the mucous membrane of the vulva and in the vagina in women, as well as in the oral cavity.

Bifidobacteria are gram-positive anaerobic microorganisms that do not require oxygen to maintain their vital functions. One of the main functions of these microorganisms is to maintain parietal digestion. In addition, bifidobacteria create a natural barrier in the intestinal cavity and prevent the penetration of pathogens and toxins into the internal environment.

Lactobacilli can equally exist both in the presence of oxygen and in its absence. One of the main functions of lactobacilli is the production of the enzyme lactase, which breaks down milk sugar (lactose). Lactobacilli form a natural immune defense, accelerate the process of epithelial regeneration, and also take an active part in the process of phagocytosis. Both types of microorganisms are beneficial to the human body, so it is very important to take care of maintaining a balance between them and opportunistic bacteria.

Who are lactobacilli and what types are they?

Lactobacilli , also known as lactobacilli, are, in fact, the first microorganisms that a person encounters in his life. Moving along the birth canal, the child receives these microbes from his mother, which, fortunately, are not dangerous for the newborn. Moreover, they are very useful, but more on that later.

What are lactobacilli ? Externally (under a microscope) they are predominantly oblong rods , although spherical ones (cocci) can also be found. Lactobacilli usually either located singly or combined into short chains (streptobacilli) as a result of the fact that the bacteria did not separate from the “mother” organism after division. Most lactobacilli do not have bacterial organs of movement (flagella), so they are immobile .

Who discovered lactobacilli is still not entirely clear. Some researchers are inclined to believe that the honor of the discoverer belongs to Louis Pasteur in 1857, while others believe that this interesting type of bacteria was discovered in 1905 by Stamen Grigorov, while studying ayran, a type of Bulgarian kefir. Gynecologists have historically referred to the lactobacillus as Doderlein's bacillus (Doderlein) in honor of their German colleague who discovered it in 1895 in humans. But, in principle, it doesn’t matter who discovered it. Moreover, it is typical for science to appropriate (perpetuate) the names of pioneers in the titles of discoveries. Therefore, it often happens that the same phenomenon, microorganism or law can have several names.

Lactobacilli L.lactis, L.acidophilus

Currently, more than 100 species of Lactobacillus (lactobacteria) are known. The most common are cheese stick (Lactobacillus casei), acidophilus , Delbrueckii subsp. delbrueckii, Lactobacillus bulgaricus and Lactobacillus plantarum. In addition to individual species, there are many more strains (genetic subspecies), which are designated, according to the international classification, by capital letters and a set of numbers following the species name. For example, the strain Lactobacillus delbrueckii subsp. bulgaricus ATCC 11842 contains 2217 genes, and Lactobacillus delbrueckii subsp. bulgaricus strain ATCC BAA-365 includes 2040 genes. As you can see, the very name of the above lactobacilli consists of the name of the genus (Lactobacillus), species (delbrueckii), subspecies (bulgaricus) and the name of the strain (ATCC...).

Scientists continue to work with the genome of lactobacilli, trying to enhance and improve their beneficial properties, so new strains appear every year in huge quantities.

Deficiency Symptoms

Under the influence of external and internal negative factors, the balance between beneficial and opportunistic intestinal microbiota may be disrupted. This condition is called dysbiosis. In addition to unpleasant symptoms, intestinal dysbiosis can cause negative consequences from the digestive system. The main symptoms of intestinal dysbiosis include:

Increased gas formation in the intestines (flatulence).
Alternating constipation and diarrhea.
Diffuse or localized abdominal pain.
Nausea.
Increased irritability, sleep disturbance, apathy.
In addition, with intestinal dysbiosis, the condition of the skin and hair worsens due to the development of vitamin deficiency.

How to make up for the deficit

If characteristic symptoms of dysbiosis occur, a special diet is recommended, which excludes the consumption of fried and too fatty foods, alcohol, fresh baked goods, hot seasonings and spices. Preference is given to natural fermented milk products, fresh vegetables and fruits. For therapeutic and prophylactic purposes, when the balance of intestinal microflora is disturbed, drugs from the group of prebiotics and probiotics are prescribed. Prebiotics are a nutrient substrate that creates favorable conditions for the proliferation of bifidobacteria and lactobacilli. Probiotics contain directly beneficial bacteria.

Despite the improvement of technologies for the production of probiotics, when using these drugs, no more than 30% of the taken amount of beneficial bacteria reaches the intestines, so the effectiveness of such therapy continues to raise doubts.

Also, to restore the normal balance of the intestinal microbiota, so-called synbiotics are used, which contain both prebiotics and probiotics. Such drugs are prescribed at any age, even to infants. Probiotics, prebiotics and synbiotics are equally relevant for dysbiosis due to regular stress and poor nutrition, as well as for dysbiosis caused by taking antibiotics.

Reception features

Despite the variety of drugs with lactobacilli and bifidobacteria for the intestines, there are general rules of administration that allow you to get the maximum benefit from taking these medications. These rules include:

The frequency of taking prebiotics is 3-4 times a day, while the total duration of the course of treatment is individual for each person. As a rule, it is necessary to continue treatment until the symptoms of intestinal dysbiosis disappear. Prebiotics are often prescribed for prophylactic purposes, to stimulate a person’s own intestinal microflora.
Probiotics must be taken 3-4 times a day, 20-40 minutes before meals, with a course of treatment ranging from 14 to 21 days. Bifidobacteria and lactobacilli to restore microflora are prescribed for therapeutic purposes in cases of already developed dysbacteriosis. If dysbiosis has developed during antibiotic therapy, then probiotics should be taken from the first day of using antibacterial agents.
If you have increased stomach acidity, before taking probiotics you should drink any antacid drug or 1 glass of alkaline mineral water.

Rumyantseva, md.

The basis of the microflora of a healthy woman of reproductive age is lactobacillus (Lactobacillus) . The vagina is dominated by:

Lactobacillus crispatus,
Lactobacillus jensenii,
Lactobacillus gasseri, and
Lactobacillus iners.

These types of lactobacilli are collectively called Lactobacillus acidophilus.

Very often, drugs containing lactobacilli are prescribed to women with gynecological diseases (bacterial vaginosis, aerobic vaginitis, cervicitis and others). The drugs come in the form of suppositories/vaginal capsules/tablets. In this article we will try to figure out when this is justified and when it is not.

First of all, it is worth clarifying that to date, insufficient data has been accumulated on the stability of these drugs (that is, it cannot yet be said that it is the lactobacilli contained in the suppository/tablet that have reached the desired place and established themselves there).

“Drying” lactobacilli before placing them in a suppository or tablet can significantly affect their future viability.

Lactobacilli in the treatment of bacterial vaginosis

One of the most important questions is whether lactobacilli are needed in the treatment of bacterial vaginosis? Let me remind you that with this disease the number of lactobacilli is sharply reduced, and they are replaced by other bacteria (Gardnerella and others), that is, it is with this disease that “introducing” lactobacilli from the outside seems most appropriate. If you try to summarize the available data on the use of lactobacilli in the treatment of bacterial vaginosis, you will get something like this:

Some studies show that lactobacilli increase the effectiveness of treatment of bacterial vaginosis,
Some studies show that lactobacilli reduce the number of relapses of bacterial vaginosis,
but more than half of the studies show that lactobacilli have no effect on the course/exacerbation/prevention of bacterial vaginosis.

That is why drugs containing lactobacilli are not included in any global treatment and prevention regimens for bacterial vaginosis (!). Why does this happen: with bacterial vaginosis, the number of lactobacilli sharply decreases, but treatment with lactobacilli does not give the expected effect? There are several reasons:

firstly, it is still unclear what is the trigger for the development of bacterial vaginosis (reduction in the number of lactobacilli/changes in the properties of the vaginal mucosa/introduction of certain subspecies of Gardnerella, etc.);
secondly, as mentioned above, lactobacilli preparations may be unstable, and a sufficient amount of lactobacilli simply will not get into the vagina;
thirdly, some lactobacilli preparations contain bacteria that are familiar to the intestines, and not to the vagina, and therefore you should not expect any effect from them.

Side effects when using lactobacilli preparations

Lactobacillus preparations have one excellent property: they have practically no side effects (“side effects” are observed in approximately 3% of patients, and in all of them they are temporary and mild in nature: burning, irritation, redness of the genitals, etc.) .

Therefore, if you feel an improvement (perhaps this is a placebo effect, but perhaps this drug really works for you), there is nothing dangerous in taking drugs (suppositories or tablets) containing lactobacilli. However, you should not neglect the main treatment regimens (lactobacteria can be added as another component of treatment, but do not replace the main therapy). Separately, I note that there is also no data on ideal dosage regimens, and therefore the prescribed treatment regimens are entirely the responsibility of the attending physician.

As for other vaginal diseases (candidiasis and other infections of the vagina and cervix), there is no evidence yet of the effectiveness of the use of lactobacilli in their treatment regimens.

Use of lactobacilli during pregnancy

In theory, the use of lactobacilli should not negatively affect the course and outcomes of pregnancy. However, the small number of studies on this topic does not allow us to say that the safety of these drugs in pregnant women has been thoroughly studied.

The use of lactobacilli to restore microflora after antibiotic use

It should be noted that there are situations in which the use of lactobacilli to restore the vaginal microflora may be justified: this is the restoration of normal flora after the use of antibiotics to treat any other disease (otitis media, pneumonia, etc.). The fact is that in some women, their own lactoflora can take an extremely long time to recover (up to 6 months) after one course of antibiotics. The use of lactobacilli to restore vaginal flora is assessed by many experts as advisable, but this approach has not yet been included in any recommendations. Therefore, the prescription or non-prescription of lactobacillus preparations after a course of antibiotic therapy remains at the discretion of the attending physician.

I would like to draw your attention to the following:

On most drugs containing lactobacilli, there is the inscription “Dietary supplement. It is not a medicine." Therefore, these drugs cannot replace traditional treatment of the disease; they can only be used as auxiliary;
Many lactobacilli preparations do not contain vaginal lactobacilli, and therefore the effectiveness of “colonizing” the vagina with lactoflora when using these medications remains highly controversial. When choosing a drug, you should give preference to those options that contain vaginal lactobacilli (their names are at the beginning of the article).
The indications for the use of different versions of lactobacilli preparations, oddly enough, differ significantly. This does not mean that a drug whose indications include “bacterial vaginosis” is better than one whose indications do not include this disease, since none of these drugs are included in the treatment regimens and standards for bacterial vaginosis.

The use of yogurt and fermented milk products containing lactobacilli

And one more small point that I would like to draw your attention to. Recently, advice has appeared on the Internet on the use of yogurt and fermented milk products containing lactobacilli to restore vaginal microflora. Fermented milk products are very useful for the functioning of the gastrointestinal tract; they contain valuable proteins and microelements. However, no evidence has been obtained that these products affect the vaginal microflora (including when rubbed/infused into the immediate site of action). One explanation for this is that many yoghurts contain Lactobacillus casei, a lactobacilli that is not typical for vaginal microflora.

Let's sum it up!

Is it possible to use lactobacilli preparations? - Can!

If necessary? - In fairly rare cases. If you use them, do not rely on their miraculous power and do not neglect the basic treatment.

Sources:

Abad CL, Safdar N. The role of lactobacillus probiotics in the treatment or prevention of urogenital infections—a systematic review. J Chemother. 2009 Jun;21(3):243-52.
Barrons R, Tassone D. Use of Lactobacillus probiotics for bacterial genitourinary infections in women: a review. Clin Ther. 2008 Mar;30(3):453-68. doi: 10.1016/j.clinthera.2008.03.013.
Unlü C, Donders G. Use of lactobacilli and estriol combination in the treatment of disturbed vaginal ecosystem: a review. J Turk Ger Gynecol Assoc. 2011 Dec 1;12(4):239-46. doi: 10.5152/jtgga.2011.57. eCollection 2011.
CDC – Center for Disease Control and Prevention, USA (2015 Sexually Transmitted Diseases Treatment Guidelines)
IUSTI – Guild of Specialists in Sexually Transmitted Infections (2011 European (IUSTI/WHO) Guideline on the Management of Vaginal Discharge)
RODVIK - Russian Society of Dermatovenerologists and Cosmetologists (FEDERAL CLINICAL GUIDELINES FOR THE MANAGEMENT OF PATIENTS WITH BACTERIAL VAGINOSIS).