Gut flora and probiotics.

[Just Wondering]

Tangent said he would like to know some more.

I'm not sure where to start. I've studied it intensively since 1991 alongside endogenous e-coli endotoxemia, because they are intertwined. E-coli is an extensive topic and badly understood, but actually critical to understand, because it underpins many diseases in man. But we can talk about that elsewhere if you want.

This guy here, is one of many doing some really interesting work on probiotics:

Dr. Gregor Reid PhD MBA
Professor, Microbiology & Immunology, and Surgery, UWO
Program Leader, Advanced Surgical Technologies
Director, Canadian Research and Development Centre for Probiotics,
gregor@uwo.ca
www.crdc-probiotics.ca

This is one of his:


http://aem.asm.org/cgi/content/full/65/9/3763

The Scientific Basis for Probiotic Strains of Lactobacillus Gregor Reid*

Following the clickable references takes you further still.

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Here's another one:

http://www.medscape.com/viewarticle/470468

The Rationale for Probiotics in Female Urogenital Healthcare
Posted 03/29/2004

Gregor Reid PhD MBA, BSc (Hons); Jeremy Burton PhD; Estelle Devillard PhD


I contacted him and he sent me a couple of other really interesting pdfs. If you want them, PM me your e-mail and I'll flick them to you.


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Again, if you follow the links, you might find this interesting:


http://bmj.bmjjournals.com/cgi/content/full/329/7465/548


BMJ 2004;329:548 (4 September), doi:10.1136/bmj.38210.494977.DE


Primary care
Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial

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Another one:

http://www.medscape.com/viewarticle/501960


Probiotics and the Treatment of Infectious Diarrhea


Jonathan E. Teitelbaum, MD

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Many people are doing great work on the topic, but so few are listening. and the subject is so huge I don't know where to start.

But I think the best place isn't to discuss probiotics.

It's to discuss gut flora, and its function in the body and for the immune system..

But again, I'm not sure where to start so I'll ramble, and maybe I will get there.

I've read all of Tissier's works, but they are 1905, and while they formed the platform of knowledge, they aren't accessible or that useful to us today, becuase the world has changed.

Others I've read:

The classic texts like Erik Olsen's 1949 "Studies on the Intestinal Flora of Infants" That was a really good one, because he was so thorough, and really knew his craft.

Or another old classic: Drs B.S. Drasar and M.J. Hill's "Human Intestinal Flora"?

That would then lead on to say, Casky's "Intestinal Absorption and Malabsorption" That wasn't particularly easy reading.

And then more through the literature.... there is so much.

So for me the starting point is at a neonatal level in two areas, first why probiotics are important:

A couple of good places to start:


Developmental microbial ecology of the neonatal gastrointestinal tract1,


http://www.ajcn.org/cgi/content/full/69/5/1035S

Supplements
Probiotics, prebiotics, and synbiotics: approaches for modulating the microbial ecology of the gut1,2
M David Collins and Glenn R Gibson

http://www.ajcn.org/cgi/content/full/69/5/1052S

Probiotics: effects on immunity1,2,3
Erika Isolauri, Yelda Sütas, Pasi Kankaanpää, Heikki Arvilommi and Seppo Salminen


http://www.ajcn.org/cgi/content/full/73/2/444S

Probiotics in human disease1,2,3
Erika Isolauri

http://www.ajcn.org/cgi/content/full/73/6/1142S

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http://www.ajcn.org/cgi/content/abstract/77/2/517


Dietary supplements
Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureus, Streptococcus pneumoniae, and ß-hemolytic streptococci)1,2,3
Ulrich Glück and Jan-Olaf Gebbers

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For a more recent contribution, a "Discover" article is interesting (but like all American lay magazines, written in the mode of drama queen tones) , and I will put a few quotes to set a tone:

http://www.discover.com/issues/jun-99/features/featcancer/


When Catharina Svanborg and her research associates began mixing mothers' milk and cancer cells together seven years ago, she wasn't looking for a cure for cancer; she was after a way to fight germs. ....

It was here nearly seven years ago that her student Anders Håkansson rushed into Svanborg’s office with perplexing news. He had been experimenting with human cancer cells, microbes, and mothers’ milk. (Like lab mice, cancer cells make popular experimental models because they come in standardized lab strains. In many important respects they behave just like other human cells, and they live indefinitely in lab dishes.) The idea was to pinpoint how the milk, a terrific germ-fighter, blocks bacteria from infecting other cells. But the cancer cells in this experiment were acting up. “Their volume was decreasing,” Håkansson recalls. “Their nuclei were shrinking. Something was wrong.”

When Svanborg sat down at the microscope, she diagnosed the problem immediately. “The cancer cells,” she announced in her calm, deliberate manner, “are committing suicide.”

Cells commit suicide all the time, a phenomenon called apoptosis, in which the body rids itself of old or unnecessary cells (see “Apoptosis,” on page 73). They simply fall apart and are recycled. For cancer cells, however, suicide is rare indeed. Their defining characteristic is uncontrolled reproduction. Yet somehow, the breast milk induced these cancer cells to take their own lives.

The circumstance opened up an enormous vista of mysteries—which pleased Svanborg to no end. “Discovery is at the heart of science. If you ask me for specific goals, I wouldn’t be able to name them. The process is fascinating enough.” Svanborg was eager to dive into finding out what in mothers’ milk was killing the cancer cells.
...

She and her group had studied the nature and function of epithelial cells, the gut-lining cells that come into contact with breast milk in nursing infants. And they had experimented with mothers’ milk many times. They had shown that it does a terrific job of blocking infection by pneumococcus bacteria, the cause of pneumonia, and that breast-fed children suffer significantly fewer ear and upper respiratory tract infections than babies who don’t nurse.

And her team had already done much of the homework that would be needed. They had tracked down studies showing that breast milk also protects against cancer (the relative risk of childhood lymphoma is nine times higher in bottle-fed infants, and the risk for carcinoma is also elevated). She wondered what accounted for that discrepancy. Now she had at hand the results that might provide an answer. “We felt sheer excitement and enthusiasm,” she says.

...In August 1995 they announced that breast milk kills cancer cells and pinpointed the killer, which turned out to be one of the most abundant proteins in the milk. It’s called alpha-lactalbumin (alpha-lac for short), and it helps produce lactose, the sugar found in milk. Many scientists had already studied alpha-lac, but no one had ever noticed anything like this before. If the protein was persuading cancer cells to commit suicide, it must be the microscopic version of a comic-book superhero, leading a quiet life by day, transforming itself into a swashbuckling crime-fighter by night.

Pause here to :sniper1: the journalist and :roll: at the unnecessary verbiage...


The discovery also suggested a possible explanation of how breast milk protects against cancer. Perhaps, Svanborg reasoned, the errant cells that give rise to malignancies first show up in infants. The key is breakneck reproduction, a characteristic of the cells lining an infant’s gut. Some of these cells may proliferate out of control. That’s called cancer. Or they may never fully mature or stabilize, lurking in the system like time bombs, ever ready to burst forth into tumors. Transformed alpha-lac “targets not only cancer cells but all kinds of immature, rapidly growing cells, and leaves mature, stable cells alone,” Svanborg says.

Alpha-lac, then, may be conducting surveillance missions within the nursing child, rooting out potentially malignant cells and encouraging properly growing cells to mature. Because the lining of the gut, a prime meeting point between the inside of the body and the hazards of the outside world, is a headquarters of the immune system, the vigilance may help the child’s immune defenses develop.

That’s one scenario. Another possible one involves the mitochondria. Lurking within a cell’s cytoplasm, inactive, just waiting to be turned on, is a family of protein-cutting enzymes, or proteases, called caspaces. Like the Borgias, this family is not to be regarded lightly. Once persuaded to burst into action, caspaces can kill their host cells. Through what’s called a caspace cascade, the sequential activation of one enzyme after another, caspaces slash to pieces protein after protein, eventually bringing about the destruction of the cell’s DNA. In so doing the caspace cascade kills the cell—causing apoptosis.

Mitochondria can awaken these sleeping killers. They secrete a substance called cytochrome c that switches on a messenger protein that latches onto the caspaces and jars them awake. Alpha-lac, the Lund and Karolinska teams have demonstrated, can persuade mitochondria torelease cytochrome c. So alpha-lac may induce apoptosis by directly causing the destruction of DNA from within the cell’s nucleus, or it may instigate the suicide-generating caspace cascade through the mitochondria. Svanborg has a standing wager with co-researcher Anders Häkansson as to which strategy is the essential one. “He’s standing by the mitochondria,” she says. “I’m betting on the nucleus.” —P. R.
...

Breastfeeding
promotes the nursing infant’s general health, growth, and development, while significantly decreasing the risk of infection. Breast-feeding has also been related to possible enhancement of cognitive development. It protects the nursing infant against a slew of diseases, including diarrhea, lower respiratory infection, otitis media, bacteremia, bacterial meningitis, botulism, urinary-tract infection, necrotizing enterocolitis, sudden infant death syndrome, insulin-dependent diabetes mellitus, Crohn’s disease, ulcerative colitis, and allergic diseases. And, of course, there is evidence that mothers’ milk protects against lymphoma and carcinomas.

Imagine a mother nursing her baby. Her milk contains alpha-lac in its ordinary, lactose-producing form. It also contains lots of the secret component. Milk cascades into the child’s digestive tract, where it encounters an environment radically different from the mammary gland in which it was produced. The infant’s stomach is awash in powerful digestive acids. In fact, it almost exactly mimics the acid level of the milk solution that changed the alpha-lac to its cancer-killing form in Svanborg and Håkansson’s experiments. The acid content in the child’s gut probably implements the crucial shape shift, transforming alpha-lac into HAMLET.

“This is a substance that kills lots of tumor cells, every cancer we test it against,” Svensson says. “Lung cancer, throat cancer, kidney cancer, colon cancer, bladder cancer, lymphoma, leukemia, and pneumococcus bacteria too.”

So here's your start line. You have to get all mothers to feed, barring a bilateral mastectomy.

if as she says
Because the lining of the gut, a prime meeting point between the inside of the body and the hazards of the outside world, is a headquarters of the immune system, the vigilance may help the child’s immune defenses develop. what business does a parent have demanding antibiotics for every sniffle around?

This is why the subject is so very important. Firstly, formula fed babies get no probiotics, so when you give them antibiotics, they have nothing to recolonise their guts with. Even breastfed babies take 2 weeks after antibiotics stop, to get their gut flora back to where it was before.

If you do a pubmed search, or medline search, you see clearly that acetaminophen and antibiotics are associated with an increase in allergy, asthma and atopy, and I believe that's because they have a profound effect in diverse ways on the immunity system determined by gut flora and the fact that the body relies on that defence, in the GALT, BALT and MALT immune systems to provide a barrier to antigens.

Destroy that gut flora and that defence becomes a sieve.

And that know that. That's why this:

http://www.nzherald.co.nz/storydisplay.cfm?storyID=3557746&thesection=news&thesubsection=general&thesecondsubsection=&reportid=16


Unborn babies wanted for allergy trials

30.03.2004
By SIMON COLLINS, science reporter
Doctors are looking for unborn babies to test a new "probiotic" treatment to combat a worldwide surge of allergic diseases.

Researchers at the Auckland and Wellington medical schools are recruiting 225 pregnant women in each city who will agree to feed their babies a special daily mix of bacteria from the day they are born until they turn two.

The payoff is that the treatment - if it works - will break the cycle of parents passing allergies on to their children.

Wellington mother Rebecca Leach, whose baby Joseph started on the bacterial mix soon after he was born last Wednesday, said she agreed to take part because she is asthmatic.

"If it's going to help him not to have the asthma and allergy problems I've had, I see that as being really positive," she said.

The new treatment is the reverse of antibiotics, which kill the bacteria that cause ailments such as pneumonia.

Probiotics actually put extra bacteria into the body, on the theory that allergies and other health problems may be due to the body's mix of bacteria becoming unbalanced. So far, probiotics have been used mainly in yoghurts.

Associate Professor Peter Black of Auckland University said modern diet and antibiotics had completely changed the mix of bacteria in the guts of people in rich countries such as New Zealand in the past 30 or 40 years.

Scientists believe this at least partly explains why the rate of allergic diseases has doubled in these countries in the past 20 years.

Surveys show that 10 per cent of adult New Zealanders now take treatments for asthma, 10 to 20 per cent of babies get eczema, and one-third of 12 and 13-year-olds have had episodes of wheezing in the past year.

New Zealand has one of the highest asthma rates in the world and also has above-average rates of eczema.

"There is debate about what it is about the Western lifestyle," Professor Black said.

"One is that we live in a clean environment and the immune system responds inappropriately to the lack of exposure to bacteria. The other is diet."

He said high milk consumption in countries such as New Zealand did not seem to increase allergies, and genetically modified foods in the United States were too new to account for the worldwide allergy explosion over two decades.

But people who ate lots of fruit and vegetables had fewer allergy problems.

A Finnish study which gave probiotics to babies for their first six months in 2000 cut eczema rates by 50 per cent.

The New Zealand study will give babies one of two bacteria which have been isolated by Fonterra - lactobacillus and bifidobacterium - every day for two years.

Pregnant women will also take the bacteria in tablets for five weeks before their babies are due.

Once their babies are born, parents mix a capsule-worth of the bacteria with about 2ml of breast milk and squirt the mixture into their babies' mouths.

"It's like giving them a medicine," Mrs Leach said. "It's recommended that you don't introduce a bottle till eight weeks if you're breastfeeding."

Later the babies can be fed the mixture with a bottle, and after weaning, the contents of the capsule can be spooned on to their food.

VOLUNTEERS SOUGHT

Expectant parents who have had asthma, eczema or hay fever and wish to consider enrolling their babies may ring Susie Lester or Claire Arandjus at Auckland University (09 373-7999) or Bridgette Jones or Stephanie Malloy at the Wellington Medical School (0800 000-323)

Herald Feature: Health

There is no need for this study. All that is needed is for mothers to eat a proper diet, breastfeed longterm, and for them to only use antibiotics in life-threatening situations... AND for the use of acetaminophen to be banned except for pain relief.

(That's another topic, but acetaminophen has no place as an anti-pyretic, or as a teething remedy, or as is happening in this country, "mothers little helper to put baby to sleep.")

So this is the starting point.

What is normal gut flora? How do we encourage it? What is its role in inate immunity in the three arms of the mucosal immune system? What are the long term pay-offs for keeping gut flora at all times, intact?

And if we have to destroy it, what are we going to do about fixing it? So far the Russians are centuries ahead of the Western world in this regard.

[Just Wondering]

Let me clarify. I lumped acetaminophen and antibiotics together, but shouldn't have. The antibiotics destroy the gut flora. I believe the mechanism that acetaminophen uses to assist development of allergies etc, is completely different, based on my research, but no-one is interested in testing the hypothesis.

In order to figure out that mechanism, its pretty simple. Well, to me anyway.

But again, that's nothing to do with probiotics, so if there is discussion on that perhaps it should be in another thread.

What I will do now, is go to my probiotics folder and pull out other key pubmed abstract URLs and post them so that it gives you a broader sweep of why gut flora is so so important.

[Just Wondering]

This is one of the best pdfs on the web. 18 pages, "Probiotics as Biotherapeutic Agents: Present Knowledge and Future Prospects." Yes, at 2002 its out of date, but he puts it together very well, so as a primer its excellent.

http://www.univ-lille1.fr/lea/Menu_du_Site/Publications/CPD2/Mercenier_CPD.pdf

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9759211
Intestinal flora in the neonate: impact on morbidity and therapeutic perspectives.
Studies in recent years have focused on the role that intestinal flora plays in health and disease. At birth, infant gut colonization begins with bacteria which are derived from the mother during delivery. Environmental factors (hospital, hygiene, antibiotics administered to the mother or to the neonate) may contribute to modification of the type of primary colonizing germs. Afterwards, diet represents the most important variable by the end of the first postnatal week. Exclusive breast-feeding promotes growth of Bifidobacteria which have been associated with the healthy nature of stool flora in infants because of their potential role in resisting pathogen colonization. Clinical trials have been made to promote bifidobacteria growth in the feces of bottle-fed infants. In addition, administration of non-pathogenic micro-organisms (probiotics) has been claimed to exert a positive influence on host health or physiology, and is a new approach to the prevention or elimination of infection originating from gut.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12655412
Immunonutrients and neonates. ...The gastrointestinal tract is the largest surface area of the body and the primary site for microorganisms, foreign antigens and toxins to gain entry to the host's internal milieu. The use of enteral feedings enriched with immune-enhancing ingredients is attracting considerable interest because there is increasing application of enteral feeding and appreciation of the role of the gut in the development of infection and of multiple organ failure in critically ill patients. CONCLUSION: in this review, we will discuss nutrients, such as glutamine, arginine, omega 3 fatty acids, nucleotides, probiotics, and lactoferrin, and how they might be used as immunonutrients in neonatal clinics.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15971105&query_hl=1
The innate immune system plays a crucial role in maintaining the integrity of the intestine and protecting the host against a vast number of potential microbial pathogens from resident and transient gut microflora. Mucosal epithelial cells and Paneth cells produce a variety of antimicrobial peptides (defensins, cathelicidins, crytdinrelated sequence peptides, bactericidal/permeabilityincreasing protein, chemokine CCL20) and bacteriolytic enzymes (lysozyme, group IIA phospholipase A2) that protect mucosal surfaces and crypts containing intestinal stem cells against invading microbes. Many of the intestinal antimicrobial molecules have additional roles of attracting leukocytes, alarming the adaptive immune system or neutralizing proinflammatory bacterial molecules. Dysfunction of components of the innate immune system has recently been implicated in chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, illustrating the pivotal role of innate immunity in maintaining the delicate balance between immune tolerance and immune response in the gut.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12655412
The gastrointestinal tract is the largest surface area of the body and the primary site for microorganisms, foreign antigens and toxins to gain entry to the host's internal milieu. The use of enteral feedings enriched with immune-enhancing ingredients is attracting considerable interest because there is increasing application of enteral feeding and appreciation of the role of the gut in the development of infection and of multiple organ failure in critically ill patients. CONCLUSION: in this review, we will discuss nutrients, such as glutamine, arginine, omega 3 fatty acids, nucleotides, probiotics, and lactoferrin, and how they might be used as immunonutrients in neonatal clinics.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12801956
The colonic epithelium maintains a life long reciprocally beneficial interaction with the colonic microbiota. Disruption is associated with mucosal injury. AIMS: We hypothesised that probiotics may limit epithelial damage induced by enteroinvasive pathogens, and promote restitution.... CONCLUSIONS: Live ST/LA (Streptococcus thermophilus (ST), ATCC19258, and Lactobacillus acidophilus (LA), ATCC4356). interact with intestinal epithelial cells to protect them from the deleterious effect of EIEC via mechanisms that include, but are not limited to, interference with pathogen adhesion and invasion. Probiotics likely also enhance the barrier function of naive epithelial cells not exposed to any pathogen.



http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16127016&query_hl=1


Dysfunction of the innate and adaptive immune systems associated with mucosae (the major interface between the organism and its environment, e.g., microbiota, food) can conceivably cause impairment of mucosal barrier function and development of localized or systemic inflammatory and autoimmune processes....Activation of innate immunity cells by food proteins or components from gut microbiota thus could participate in the impairment of intestinal mucosa and the development of intestinal and/or systemic inflammation.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12420114
The intestine also contains a microbial ecosystem with a large body of microbes, 1-11/2 kg in an adult. The microbes and their activity have a major impact on the development and functioning of the intestinal immune system and vice versa. This mutual influence also affects the host beyond the intestine.The intestinal colonisation with a balanced microflora is of main importance for the correct development of the immune system. The importance of the intestinal microflora is most clearly seen in germfree animals, but also diseases like atopy are associated with disturbances in the intestinal microflora. This often manifests itself in a low number of bifidobacteria. The use of probiotics or prebiotics to correct this imbalance and modulate the immune activity has received increasing scientific documentation. The precise mechanisms behind these immune modulatory activities are not well understood and require further investigation.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12386516
Approximately 70% of the immune system is localized in the gastrointestinal tract: its glands, mucosa, and mucosa-associated lymphoid system. The system influences health conditions because it produces large amounts of important gastrointestinal secretions as rich as breast milk in health-supporting and disease-preventing factors, and because of its rich gastrointestinal flora. The intestine normally contains 10 times more microbes than there are eukaryotic cells in the entire body. The optimal function of these microbes depends on the supply of food destined for the colonic bacteria (fermentable fibers, complex proteins, gastrointestinal secretions). The consideration of these functions influences outcome. Unfortunately, the conditions (supply of drugs-especially antibiotics, and reduced supply of food-especially fruits and vegetables) in the modern ICU are extremely poor both for optimal gastrointestinal secretion and for flora and need more attention. To improve treatment, a supply of new and effective flora (probiotics) and food for the flora (prebiotics) is needed, from which numerous health-supporting products (synbiotics) will be produced and absorbed at the level of the mucosa, mainly in the lower gastrointestinal tract.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12215177
Intestinal flora during the first months of life: new perspectives.

Edwards CA, Parrett AM.

Department of Human Nutrition, Glasgow University, Yorkhill Hospitals, G3 8SJ, UK. cae1@clinmed.gla.ac.uk

Increasing awareness that the human intestinal flora is a major factor in health and disease has led to different strategies to manipulate the flora to promote health. The complex microflora of the adult is difficult to change in the long term. There is greater impact of diet on the infant microflora. Manipulation of the flora particularly with probiotics has shown promising results in the prevention and treatment of diarrhoea and allergy. Before attempting to change the flora of the infant population in general, a greater understanding of the gut bacterial colonisation process is required. The critical stages of gut colonisation are after birth and during weaning. Lactic acid bacteria dominate the flora of the breast-fed infant. The formula-fed infant has a more diverse flora. The faeces of the breast-fed infant contain mainly acetic and lactic acid whereas the formula fed-infant has mainly acetic and propionic acid. Butyric acid is not a significant component in either group. The formula-fed infant also has higher faecal ammonia and other potentially harmful bacterial products. The composition of the microflora diversifies shortly before and particularly after weaning. The flora of the formula-fed infant develops more quickly than that of the breast-fed infant. Before embarking on any strategy to change the flora, the following questions should be considered: Should we retain a breast-fed style flora with limited ability to ferment complex carbohydrates? Can pro- and prebiotics achieve a flora with adult characteristics but with more lactic acid bacteria in weaned infants? Are there any health risks associated with such manipulations of the flora?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12010580
Intestinal microflora of human infants and current trends for its nutritional modulation.

Mountzouris KC, McCartney AL, Gibson GR.

Food Microbial Sciences Unit, School of Food Biosciences, The University of Reading, Whiteknights, PO Box 226, RG6 6AP, UK.

Diet, among other environmental and genetic factors, is currently recognised to have an important role in health and disease. There is increasing evidence that the human colonic microbiota can contribute positively towards host nutrition and health. As such, dietary modulation has been proposed as important for improved gut health, especially during the highly sensitive stage of infancy. Differences in gut microflora composition and incidence of infection occur between breast- and formula-fed infants. Human milk components that cannot be duplicated in infant formulae could possibly account for these differences. However, various functional food ingredients such as oligosaccharides, prebiotics, proteins and probiotics could effect a beneficial modification in the composition and activities of gut microflora of infants. The aim of the present review is to describe existing knowledge on the composition and metabolic activities of the gastrointestinal microflora of human infants and discuss various possibilities and opportunities for its nutritional modulation.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11852581
Physiology of microflora in the digestive tract]

[Article in Czech]

Zboril V.

Interni gastroenterologicka klinika FN Brno, pracoviste Bohunice.

The microflora of the digestive tract is a complex microbial ecosystem, well balanced, which in an aboral direction undergoes specific changes as to the ratio of aerobic and anaerobic microorganisms the functions of which supplement each other--the aerobes ensure for the whole ecosystem the scavenger effect. The microbial profile of the digestive tract is typical by the absence of anaerobic microorganisms in the stomach and conversely their absolute predominance in the distal colon. The basic physiological functions of the microflora of the digestive tract can be characterized as follows: 1. microbial barrier against pathogens and potential pathogens, 2. formation of products of the microflora and their influence on the blood supply of the intestinal mucosa and peristaltics, 3. stimulation of the immune system in the gut, 4. reduction of bacterial translocation, 5. production of vitamins. To this problem in the world literature, contrary to ours, deserved attention has been paid for many years. Knowledge of the problem opens the door to expedient manipulation with the microbial flora of the digestive tract by the use of diet or prebiotics, probiotics as well as antibiotic treatment. The author presents a summary of basic findings which developed on the subject of physiological microflora of the digestive tract successively up to their present shape.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10851996
Bacterial endotoxinemia in children with intestinal dysbacteriosis]

[Article in Russian]

Lykova EA, Bondarenko VM, Vorob'ev AA, Sudzhan EV, Minaev VI, Malikov VE.

Gamaleya Research Institute of Epidemiology and Microbiology, Sechenov Medical Academy, Moscow, Russia.

34 children with gastrointestinal diseases of infectious, allergic and mixed etiology were examined. The state of normal microflora in the large intestine as indicated by fecal bacterial charts and the level of secretory immunoglobulin A (sIgA) in the contents of the intestine as indicated by the results of radial immunodiffusion were studied. In addition, the content of endotoxin in the children's plasma was determined with the use of the Limulus (LAL) test. The presence of endotoxin in the plasma of children with intestinal dysbiosis was determined in 71.1% of cases. The frequency of the detection of antigenemia was found to be related to the severity of manifestations of dysbiotic changes in the intestine and to the level of sIgA in fecal supernatants. The inclusion of the probiotic preparation Bifidumbacterin forte containing live bifidobacteria adsorbed on activated charcoal into the complex therapy of digestive tract diseases ensured a decrease in the detection rate of endotoxinemia, which correlated with the tendency towards the normalization of defective intestinal microflora.

It is tempting to hypothesis that the reason indigenous people who haven't had "white man's poisonous diet" or antibiotics etc, have a good dental arch and rarely have caries because their gut flora hasn't been messed up:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11799281
Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children.

Nase L, Hatakka K, Savilahti E, Saxelin M, Ponka A, Poussa T, Korpela R, Meurman JH.

Institute of Dentistry, University of Helsinki, Finland. leena.nase@helsinki.fi

Lactobacillus rhamnosus GG, ATCC (LGG), has shown antagonism to many bacteria including mutans streptococci. This randomized, double-blind, placebo-controlled intervention study was designed to examine whether milk containing LGG has an effect on caries and the risk of caries in children when compared with normal milk. 594 children, 1-6 years old, from 18 municipal day-care centres were included. The children received the milk with meals from coded containers 5 days a week in the day-care centres for 7 months. The children's oral health was recorded at baseline and at the end, using WHO criteria. The caries risk was calculated based on clinical and microbiological data, comprising mutans streptococcus levels from dental plaque and saliva. The risk was classified as high if the child had a dmft/DMFT or initial caries score >0, and a mutans streptococcus count > or = 10(5) CFU/ml. The results showed less dental caries in the LGG group and lower mutans streptococcus counts at the end of the study. LGG was found to reduce the risk of caries significantly (OR = 0.56, p = 0.01; controlled for age and gender, OR = 0.51, p = 0.004). The effect was particularly clear in the 3- to 4-year-olds. Thus, milk containing the probiotic LGG bacteria may have beneficial effects on children's dental health.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11040166
Importance of intestinal colonisation in the maturation of humoral immunity in early infancy: a prospective follow up study of healthy infants aged 0-6 months.

Gronlund MM, Arvilommi H, Kero P, Lehtonen OP, Isolauri E.

Department of Paediatrics, Turku University Central Hospital, Turku, Finland. minna-maija.gronlund@utu.fi

AIM: To evaluate the role of intestinal microflora and early formula feeding in the maturation of humoral immunity in healthy newborn infants. STUDY DESIGN: Sixty four healthy infants were studied. Faecal colonisation with Bacteroides fragilis group, Bifidobacterium-like, and Lactobacillus-like bacteria was examined at 1, 2, and 6 months of age, and also the number of IgA-secreting, IgM-secreting, and IgG-secreting cells (detected by ELISPOT) at 0, 2, and 6 months of age. RESULTS: Intestinal colonisation with bacteria from the B fragilis group was more closely associated with maturation of IgA-secreting and IgM-secreting cells than colonisation with the other bacterial genera studied or diet. Infants colonised with B fragilis at 1 month of age had more IgA-secreting and IgM-secreting cells/10(6) mononuclear cells at 2 months of age (geometric mean (95% confidence interval) 1393 (962 to 2018) and 754 (427 to 1332) respectively) than infants not colonised (1015 (826 to 1247) and 394 (304 to 511) respectively); p = 0.04 and p = 0.009 respectively. CONCLUSIONS: The type of bacteria colonising the intestine of newborns and the timing may determine the immunomodulation of the naive immune system.

This article is important to me because I have dysgammaglobulinemia:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9706796
Effect of a probiotic formula on intestinal immunoglobulin A production in healthy children.

Fukushima Y, Kawata Y, Hara H, Terada A, Mitsuoka T.

Nestle Japan Ltd., Tokyo. qzc04363@niftyserve.or.jp

The anti-infectious effect of probiotics has recently been reported and one mechanism may be the non-specific stimulation of immunity. This study was performed to elucidate the influence of a probiotic formula on intestinal microflora and local immunity in healthy children. A follow-up formula containing viable bifidobacteria was given to seven healthy Japanese children (15 to 31 months old) for 21 days. During intake of the formula, the administered strain was detected in feces from five subjects (71%) and total fecal bifidobacteria slightly increased. Fecal levels of total IgA and anti-poliovirus IgA during intake of the formula were significantly higher than those before intake (P < 0.05). The increase in local IgA levels resulting from ingestion of the probiotic formula may contribute to enhancement of the mucosal resistance against gastrointestinal infections.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11297952
Toll of allergy reduced by probiotics.

Murch SH. no abstract

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12583961
Gut flora in health and disease.

Guarner F, Malagelada JR.

Digestive System Research Unit, Hospital General Vall d'Hebron, Barcelona, Spain. fguarnera@medynet.com

The human gut is the natural habitat for a large and dynamic bacterial community, but a substantial part of these bacterial populations are still to be described. However, the relevance and effect of resident bacteria on a host's physiology and pathology has been well documented. Major functions of the gut microflora include metabolic activities that result in salvage of energy and absorbable nutrients, important trophic effects on intestinal epithelia and on immune structure and function, and protection of the colonised host against invasion by alien microbes. Gut flora might also be an essential factor in certain pathological disorders, including multisystem organ failure, colon cancer, and inflammatory bowel diseases. Nevertheless, bacteria are also useful in promotion of human health. Probiotics and prebiotics are known to have a role in prevention or treatment of some diseases.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12495459
The immune system: a target for functional foods?

Calder PC, Kew S.

Institute of Human Nutrition, School of Medicine, University of Southampton, Bassett Crescent East, UK. pcc@soton.ac.uk

The immune system acts to protect the host from infectious agents that exist in the environment (bacteria, viruses, fungi, parasites) and from other noxious insults. The immune system is constantly active, acting to discriminate 'non-self' from 'self'. The immune system has two functional divisions: the innate and the acquired. Both components involve various blood-borne factors (complement, antibodies, cytokines) and cells. A number of methodologies exist to assess aspects of immune function; many of these rely upon studying cells in culture ex vivo. There are large inter-individual variations in many immune functions even among the healthy. Genetics, age, gender, smoking habits, habitual levels of exercise, alcohol consumption, diet, stage in the female menstrual cycle, stress, history of infections and vaccinations, and early life experiences are likely to be important contributors to the observed variation. While it is clear that individuals with immune responses significantly below 'normal' are more susceptible to infectious agents and exhibit increased infectious morbidity and mortality, it is not clear how the variation in immune function among healthy individuals relates to variation in susceptibility to infection. Nutrient status is an important factor contributing to immune competence: undernutrition impairs the immune system, suppressing immune functions that are fundamental to host protection. Undernutrition leading to impairment of immune function can be due to insufficient intake of energy and macronutrients and/or due to deficiencies in specific micronutrients. Often these occur in combination. Nutrients that have been demonstrated (in either animal or human studies) to be required for the immune system to function efficiently include essential amino acids, the essential fatty acid linoleic acid, vitamin A, folic acid, vitamin B6, vitamin B12, vitamin C, vitamin E, Zn, Cu, Fe and Se. Practically all forms of immunity may be affected by deficiencies in one or more of these nutrients. Animal and human studies have demonstrated that adding the deficient nutrient back to the diet can restore immune function and resistance to infection. Among the nutrients studied most in this regard are vitamin E and Zn. Increasing intakes of some nutrients above habitual and recommended levels can enhance some aspects of immune function. However, excess amounts of some nutrients also impair immune function. There is increasing evidence that probiotic bacteria improve host immune function. The effect of enhancing immune function on host resistance to infection in healthy individuals is not clear.

We use kefir at home because of stomach ulcers, and since we've used it, my husband has been stomach ulcer free. Which just proves again to me that stomach ulcers are caused by gut dysbiosis, pure and simple. But sometimes that is courtesy of a drug company's largesse:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12452966
Folk yoghurt kills Helicobacter pylori.

Oh Y, Osato MS, Han X, Bennett G, Hong WK.

Department of Head & Neck/Thoracic Medical Oncology, MD Anderson Cancer Center, Houston, TX 77030, USA. ywoh@mdanderson.edu

AIMS: To evaluate a traditional yoghurt used as folk medicine for its ability to kill Helicobacter pylori in vitro. METHODS AND RESULTS: Micro-organisms from the yoghurt were identified and tested in different food substrates for their effects on H. pylori in a co-culture well system. Two yeasts and several strains of lactobacilli were isolated from the yoghurt, and both the yeast and the lactobacilli independently showed cidal activity against H. pylori. The microbes from the original yoghurt also retained their cidal effect when grown in corn meal and soy milk. CONCLUSIONS: The yeast and lactobacilli found in this yoghurt form a hardy symbiotic culture. The organisms secrete soluble factors capable of killing H. pylori, and these factors may include some organic by-products of fermentation. SIGNIFICANCE AND IMPACT OF THE STUDY: These yoghurt-derived food preparations could become simple and inexpensive therapies to suppress H. pylori infections in endemic countries.

Pneumonia, something which has been talked about. If I suggested to you it could also be caused by gut dysbiosis, spilling over into flora dysbiosis in the bronchial mucosa, would you think I was nuts?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9700889
[Intestinal microbiocensosis and immune status in young children with severe forms of acute pneumonia after the use of different therapy regimens]

[Article in Russian]

Dolgushin II, Ogoshkova IA, Rusanova NN.

Medical Academy, Chelyabinsk, Russia.

As revealed in this study, the inclusion of bifidumbacterin and carbolen into the complex therapy of severe forms of acute pneumonia in young children leads to the most complete correction of shifts with respect to immune status and intestinal microbiocenosis, thus reducing the duration of the disease.

combine that with studies showing that you don't get pneumonia if you aren't subclinically vitamin C deficient... there's a lot to think about...

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11826802
Probiotics in health and disease in the pediatric patient.

Markowitz JE, Bengmark S.

Department of Pediatrics, Division of Gastroenterology and Nutrition, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. MarkowitzJ@email.chop.edu

Probiotics are truly a timeless concept. Initially standard components of the human diet, potentially beneficial bacteria and yeast have been eliminated systematically through modern methods of preparing and preserving foods. Although the concept of probiotics is not new, the science of probiotics is in its infancy. Only recently have techniques been developed to identify, culture, and produce the probiotics that are suitable for medical use consistently. Furthermore, the potential uses for these organisms may extend far beyond what originally was thought. In no way should probiotics be thought of as a panacea for the diseases described earlier; however, when used appropriately, they represent a potentially beneficial adjunct to other proved therapies and have the added benefit of providing a stabilizing influence on the delicate balance between the ecosystem that consists of the human and its flora.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11698781
CONCLUSIONS: There is evidence of a clinically significant benefit of probiotics in the treatment of acute infectious diarrhea in infants and children, particularly in rotaviral gastroenteritis. Lactobacillus GG showed the most consistent effect, although other probiotic strains may also be effective. Further research is needed. Clinical and statistical heterogeneity of the prophylactic interventions preclude drawing firm conclusions about the efficacy of probiotics in preventing acute gastroenteritis.

balanced gut flora is vital for absorption of minerals (and as we know, manufacture of b vitamins.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11157358
Effects of prebiotics on mineral metabolism.

Scholz-Ahrens KE, Schaafsma G, van den Heuvel EG, Schrezenmeir J.

Institute of Physiology and Biochemistry of Nutrition, Federal Dairy Research Center, Kiel, Germany. scholz-ahrens@bafm.de

Nondigestible oligosaccharides (NDOs) have been found to stimulate absorption of several minerals and to improve mineralization of bone. Hence, these substances are potential ingredients for "functional foods." In addition to a nutritional effect, functional foods have physiologic and psychological benefits that result in improved health or reduced risk of chronic disease. Most of the scientific evidence for the functional effects of NDOs is based on animal experiments in which NDOs increased the availability of calcium, magnesium, zinc, and iron. This stimulatory effect of some NDOs is assumed to be mainly due to their prebiotic character. A prebiotic is defined as a substrate or food ingredient that is nondigestible for the host but is fermented selectively by some of the intestinal microflora. Thus, it stimulates the growth and activity of bacteria with beneficial consequences for the host's health. Recently, these findings were confirmed in human studies for some NDOs. The effects seem to be specific for the type of carbohydrate and are likely related to the rate of fermentation by the intestinal flora and appear to depend on the ingested dose. Contradictory results of the effect of prebiotics in literature may be due to the experimental design because the effect of NDOs depends on the dose, the time of administration, the content of calcium in the diet, the part of the skeleton investigated, and the age of the subjects studied.

That enough. :D: You all know how to use related articles links, so you should be away home and hosed in terms of the medical literature.

The next step for those interested is to look at historical probiotic foods. There was once a huge array, even including cheese made the old way, and even unpasteurised butter could act in a probiotic fashion. Most of those foods have gone by the wayside, because of people's obsession with past-your-eyezzzdddd everything.

Gotta be sterile. Kill it all off. And that's where we've gone horribly wrong IMO.

[goatlady]

After reading through most of what you have posted I notice almost ALL the study conclusions stipulate MAY, MIGHT, POSSIBLY, etc. I realize from the articles this is a fairly new area of science so no critisism intended. H. pylori is acknowledge NOW as the major cause of ulcer disease and has been/ is being treated very successfully with a 7-10 day course of antibiotics and diet changes. I feel diet is critical to the body's overall health, and yes, our foods nowdays are processed to death BUT that does not mean one HAS TO eat theat dead food. There are alternatives available which, in the long run, probably are cheaper than purchasing supplements and additives for a piss poor diet. JMO

[Just Wondering]

goatlady, :D: ALL medical research even in well established areas specialises in the butt-protecting terms of may, might, possibly, perhaps. It's standard legal procedures on anything these days.

with H Pylori, why use antibiotics when natural food will suffice? In a situation such as "Austere" medicine, where there are no antibiotics, what then?

I agree, there is no need to eat dead food. But so much of what is considered to be prep food, is dead food. That is a major omission in the thinking of some people. people need to consider what probiotics they can possible do in a TEOTWASKI, and I don't mean beer either. :D: (That stuff tastes like sheep dags wrung out in muslin anyway!!! :sycho1: )

[Reasonable Rascal]

people need to consider what probiotics they can possible do in a TEOTWASKI, and I don't mean beer either. :D: (That stuff tastes like sheep dags wrung out in muslin anyway!!! :sycho1: )

You just haven't drank to right beer. Pale ales do little for me personally. I much prefer porter, stout or a black and tan. Guiness stout has been - in the past at least - been thought to have some beneficial properties, and was on occasion even prescribed. Pretty unrefined stuff compared to most beers consumed in the USA at least. I prefer my beer to match my bread - heavy and dark.

RR

[Just Wondering]

Well, then Rascal, :P: do you have a decent recipe to share with us, so that we can imbibe in stuff that is not only good to drink, but functions as a decent priobiotic?

[tangent]

> ALL medical research even in well established areas specialises in the butt-protecting terms of may, might, possibly, perhaps. It's standard legal procedures on anything these days.

legal? - nonsence! Scientific papers state provable facts and observations as facts. Hedging is only done when something has not been proven and inferences are being drawn that may or may not be correct. It's a way to say: I think this is what's going on, but I don't know for sure.

Has absolutely nothing to do with the damb lawyers!


Your refs look interesting, I'll have to look into that deeper at some point, but I have a date with a 5-7 page paper...

-t

[Just Wondering]

Here's why I say this tangent. Just about every paper I look at on any topic where there is dispute, uses hedging language, no matter how certain the author is about certain things.

Sometimes that isn't the case. I was checking on some older information on tournequets and they were adamant that their information was right, there was no hedging, and... they are wrong. And that can be applied to some studies I've read about SSRI's, Vioxx etc...

So you are right. There are SOME studies where ambiguous language isn't used, where perhaps it should have been.

Ambiguous language doesn't make somethign suspect, and neither does non ambiguous language make an article accurate.

But what lay behind my thinking was an outrageous situation I had to face recently when dealing with a case where a doctor on the witness stand said that the contraindications in the product sheet weren't relevant: that they were put there for legal reasons only. He also went one step further and stated that this applied to all product sheets.

When I discussed this with the head defence lawyer, they just shrugged and said that it was a very commonly held medical belief. They also told me that many doctors don't believe drugs have reactions unless they actually see it with their own eyes, and SOME don't believe it was the drug unless they give it to the person (challenge, dechallenge, rechallenge) and it happens again.

Therefore, I don't take much notice of ambiguous language as a marker of credibility because when you go through medical history, looking at those things that have been abandonned for either safety or lack of efficacy reasons, you often find that the studies stating that those things were just wonderful had no ambiguity at all.

Therefore, I hold everything in suspended consideration. Probiotics are a different area, in that the Russians have no ambiguity with the issues, becuase they know what they're on about.

The western world in my opinion, holds research from other countries at arms length, and wouldn't consider it, until they have "proven" it for themselves. It could also be argued that for the western world to accept probiotics eventually, will be a bit of a come down, becuase the russians will just sit there and wonder what took them so long.

So there are lots of reasons for both ambiguity or non-ambiguity in "scientific" articles, but that doesn't mean that all the reasons are actually scientific.

If you know what I mean.

[Just Wondering]

so tangent, which restaurant do you take a 5 - 7 pager to :P:

[tangent]

I've read a ton of papers - have 2 boxes full of um... and all of them state observed results as observed results. State established facts as fact (though sometimes this is found to be incorrect later) and state thinking about why something might be so by using the soft words you are refering to.

We are not talking about product sheets or articles in mass market publications but rather the scientific literature - peer reviewed journals.

The lawyers don't even come into it.

what kind of documents are you refering to?

-t

[Just Wondering]

At the moment, I have two screens open. One with an article entitled "Epidemiology and pathogenesis of Neisseria Meningitidis" from a Journal called "Microbes and infection" and another called "Development of natural immunity to Neisseria Meningitidis" from a journal called VACCINE.

Even in these amongst areas you would think they would use "sure" language, they use words like "may" and other equivocal terms.

There will always be aspects about something that they aren't sure on.

And even with probiotics, in areas they think they are certain on, they will use equivocal language.

[tangent]

OK - I usually research pharmacology and emergency medicine as well as surgery... maybe this is an edge area and is different.

-t

[Just Wondering]

I can understand why I got you mad tangent. I was loose with my words, and shouldn't have been.

Even when I write, I do use equivocal words, because I know that none of us know everything, and there is a chance I've inadvertently left something out. So even when I write something, or... explain something to the children, I am always careful not to make it sound absolutely certain. Life is full of unknowns, and so when I research something, equivocal language doesn't upset me too much. Particularly in probiotics, because when you've read the texts it just makes sense.

And as for infectious diseases and the immune system. There is so much they don't know about both, that its hard to be unequivocally definitive. As soon as you are one of the many diverse unique individuals will come along and prove you wrong.

So I'm sorry I hackled yer comb.

Now, I looked for one of those nice warm fuzzy emoticons, but the board doesn't have one...

[goatlady]

I think tangent and I are looking at research from the same perspective - I want only documented lab reports, double-blind studies that state point blank "this test showed without a doubt this result. There is no need for hedging if the test results are clear-cut and provable upon retesting time after time, in vitro, in double blind tests, in trial testing. Without those clear results, I reserve judgment personally, and do not recommend or tout the herb, drug, probiotic, whatever. Hope does spring eternal, but hope does not cure much in my mind. Guess I'm too practicle, left-brained, and a sceptic to boot! Hang in there JW and keep your search going for more current, provable results. By the way, those journals you "quote" are NOT peer- review journals - they accept admissions from anyone for publication without verification of the article as closely as a peer review journal such as JAMA, or the Infectious Diseases Journal or any journal designated by AMA (or in the case of herbs by the ABC) as a peer review which means the article is reviewed by OTHER experts in that particular field as to authenticity, documentation of the study, qualifications of the test originators, etc. Very strict qualifications must be met to get published in peer review journal because once published there it IS accepted world wide as a reproducible test giving the same results time after time. Bottom line is if you can't get published in a peer review your work needs more work to be considered valid.

[tangent]

> I think tangent and I are looking at research from the same perspective - I want only documented lab reports, double-blind studies that state point blank "this test showed without a doubt this result. There is no need for hedging if the test results are clear-cut and provable upon retesting time after time,...

YEPPERS!


> By the way, those journals you "quote" are NOT peer- review journals...

>> One with an article entitled "Epidemiology and pathogenesis of Neisseria Meningitidis" from a Journal called "Microbes and infection" and another called "Development of natural immunity to Neisseria Meningitidis" from a journal called VACCINE.

Actually, I think VACCINE is, don't know about Microbes and Infection", but in general, yes - most of the journals she lists are a bit lax in that department.

I'm not sure how stringent the Russian journals are, however. I'll have to ask.

-t

[goatlady]

Those 2 journals plus several others are published by 1 umbrella company and according to the info listed about them, one just submits articles and their editors decide what gets printed. I MAY be way off on this, but I don't think so right now.
Publisher info

Elsevier is . . .

WHO
A world leading, multiple-media publisher of scientific, technical and health information products and services, with 7,000 employees in 73 locations around the globe.

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Publisher of more than 20,000 products and services, including journals, books, electronic products, services, databases and portals serving the global scientific, technical and medical (STM) communities.

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WHERE
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WHY
To fuel a continuous cycle of exploration and discovery and inspire meaningful action.

Elsevier is part of the Reed Elsevier Group plc, a leading international publisher and information provider. Reed Elsevier shares are listed on the Amsterdam and London Stock Exchanges.

VACCINE journal info

Editor:
R.E. Spier
See editorial board for all editors information

Description
VACCINE is the pre-eminent journal for those interested in vaccines and vaccination. It serves as an interface between academics, those in research and development, and workers in the field. Relevant topics range from basic research through to applications, safety and legislation.

Key aspects include
• human • veterinary • disease prevention
• physiological manipulation • molecular biology • synthetic peptides
• recombinant antigens • vectors • new immunogens
• adjuvants • animal models • immunity
• immunology of protection • fertility • academic research
• developmental applications • field trials • clinical trials
• laboratory productions • industrial production • social implications
• epidemiology • efficacy • safety
• legislation • regulation • cost/benefit

These aspects may be applied to diseases caused by: viruses, bacteria, mycoplasma, protozoa, fungi, helminths, arthropods,prions

Please bookmark this URL: http://www.elsevier.com/locate/vaccine

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Research workers, product developers, clinicians and practitioners with interests in virology, bacteriology, parasitology, mycology, immunology, genetics, biotechnology and biochemistry in the medical and veterinary fields.

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I don't see where it says anything about peer review.

[Reasonable Rascal]

Vaccine's articles are reviewed, but it doesn't state whether this is a peer review process or not. It merely states referees.

From their website:



Review process
All contributions are read by two or more referees to ensure both accuracy and relevance, and revisions to the script may thus be required. On acceptance, contributions are subject to editorial amendment to suit house style. When a manuscript is returned for revision prior to final acceptance, the revised version must be submitted as soon as possible after the author's receipt of the referee's reports. Revised manuscripts returned after four months will be considered as new submissions subject to full re-review.

RR

[Just Wondering]

I think tangent and I are looking at research from the same perspective - I want only documented lab reports, double-blind studies that state point blank "this test showed without a doubt this result. There is no need for hedging if the test results are clear-cut and provable upon retesting time after time, in vitro, in double blind tests, in trial testing. Without those clear results, I reserve judgment personally, and do not recommend or tout the herb, drug, probiotic, whatever. Hope does spring eternal, but hope does not cure much in my mind. Guess I'm too practicle, left-brained, and a sceptic to boot! Hang in there JW and keep your search going for more current, provable results. By the way, those journals you "quote" are NOT peer- review journals - they accept admissions from anyone for publication without verification of the article as closely as a peer review journal such as JAMA, or the Infectious Diseases Journal or any journal designated by AMA (or in the case of herbs by the ABC) as a peer review which means the article is reviewed by OTHER experts in that particular field as to authenticity, documentation of the study, qualifications of the test originators, etc. Very strict qualifications must be met to get published in peer review journal because once published there it IS accepted world wide as a reproducible test giving the same results time after time. Bottom line is if you can't get published in a peer review your work needs more work to be considered valid.

Tangent asked me what I was reading right then.

Right now, I have in front of me several British Medical Journal articles, some Journal of Infectious Diseases, 4 Lancets, and 3 New England J MEds... so what I read comes from a vast array.

I was asked to put up some information on probiotics. I've done it. If you read the references and the pdfs, you can make what you will of them. I've just done as asked.

I have no problems considering seriously the information I have put here, as I have read everything thoroughly, including texts and a vast amount of information not put here. I have no problems with equivocal language when dealing with concepts which can't be put into a box. Probiotics is not something that can be tested like drugs, or even perhaps like herbs, for the reason that everyone's immune system is unique, as is their gut flora, as is their diet, and therefore the degree of modification of problems by gut flora will be dependant upon bedrock conditions.

Though having said that, I would suspect that in some people herbs can throw nasty reactions depending on their uniquenesses too. Just as if you inject rabbits with an allergen, some with show anaphylactic symptoms straight away, some later, and some very very delayed.

I understand the desire for cut and dried simple acceptable to the left-brained approach goatlady, but I don't believe real life works that way, and consider that I'm living proof.

Like you, I don't recommend anything. Why? Because I'm living proof that someone with a fairly serious immunodeficiency can do very very well on what some doctors consider quackery. (aka, decent diet including probiotic foods, vitamins, minerals and herbs). My health has broken all the rules, so I no longer subscribe to rules.

Though once upon a time I was very sure on things. Before I hand children, I had child-rearing theories. After the first, I modified my theories, and after the second, and the grandchildren, I chucked all the theories out the window. Now, we just have children, and no theories, and different theories work, for the different children.

To me, medicine is exactly the same.

So I'm sorry if my ideas of what constitutes useful information falls short.

The question then remains as to whether or not you want any further defective input :D:

[Just Wondering]

A question.

If the only criteria of proof is an in vitro, double blind, presumably placebo controlled trial, then I suspect a lot of things could never be proven.

The question then being, if any other study, other than the narrow focus above isn't considered worthwhile, why even bother having any journal that publishes anything else?

[tangent]

OK - Lancet and NEJM are both though well respected, though the latter has earned a reputation like the NYT or Wash Post due to some questionalble articals about gun violence - ie: crossing the line from medicine to politics.

Medically, I believe both are peer reviewed unless it's a letter to the editor.

You've really found "hedging" language common in Lancet? - to the best of my knowledge, that's the worlds oldest and most respected medical journal. Believe it started publication back in the 1800's.

-t

[Just Wondering]

Depends what the topic is, tangent. When it comes to things like infectious diseases, or subjects relating to development of immunity, or interesting observations, yes, the language can be pretty hedgey. However that is spelled. spelt. thingy.

[abutler]

Well, then Rascal, :P: do you have a decent recipe to share with us, so that we can imbibe in stuff that is not only good to drink, but functions as a decent priobiotic?

Yes, there are many probiotic recipes. The best sources I have found are from the book Nourishing Traditions by Fallon and Enig. Also from the book Wild Fermentation--don't know the author.

These recipes include Kombucha (nasty in the bottled form from health food store, but fabulous grown int he kitchen), beet Kvass, fermented sauerkraut, many others. Fermented sauerkraut contains 10 times the vita C as fresh cabbage.

I don't know if these beverages and foods contain PREbiotics or not.

[abutler]

In medical research whether it is double blind crossover or not the researcher begins with a hypothesis (a statement that a certain thing is this) which is either supported by the results or not suported by the results. This is shown in the statistics used to evaluate the research question.

In the discussion section of the published article the researcher(s) may expound on their research. This is where the statistics are translated for the reader.The researcher may translate the statistics truthfully or not. When a person gets paid, the payor wants to see a certain outcome. This is very hard to resist.

In research one can NEVER state "I did this therefore I can make an irrefutable statement that this is true". The only truthful thing that can be said is "My hypothesis was supported or My hypothesis was not supported".

[Reasonable Rascal]

A new thread discussing what constitutes validation vs. opinion might be useful.

One thing often seen when promoting "alternative" remedies and/or treatments is "proof" via a single personal experience, or cut and paste proclamations found on the net. To use an example colloidal silver (CS) proponants often use the same statement over and over, quoting differing sources such as they happen to favor. If one looks carefully they can date the same statement to various sources going backs years if not decades. Who originally made the statement (whichever one of the oft-quoted versions we are talking about) remains to be discovered.

Just an example off the top of my head. abulter is correct regarding the basic beginning premise of valid research. Hypothesis' can be validated or not, or researched to an inconclusive result. It is in the conclusion of the findings that people often find disagreement.

RR

[Just Wondering]

In all the years that I've studied medical history, I've realised that its only in the last 30 or so, that people have got seriously hung up about what constitutes proof. Its the great new mantra; the gold standard of proof. Well hello? Proof doesn't always constitute proof. What "works" can often depend on the person. I am allergic to every antibiotic under the sun, so any study giving gold standard proof of antibiotic safety and efficacy is totally irrelevant to me.

A lot of medicine is like that.

You talk about proof; well what can you say when people say things like this?

http://news.independent.co.uk/world/science_medical/story.jsp?story=471139


Glaxo chief: Our drugs do not work on most patients
By Steve Connor, Science Editor
08 December 2003


A senior executive with Britain's biggest drugs company has admitted that most prescription medicines do not work on most people who take them.

Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them.

It is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public. His comments come days after it emerged that the NHS drugs bill has soared by nearly 50 per cent in three years, rising by £2.3bn a year to an annual cost to the taxpayer of £7.2bn. GSK announced last week that it had 20 or more new drugs under development that could each earn the company up to $1bn (£600m) a year.

Dr Roses, an academic geneticist from Duke University in North Carolina, spoke at a recent scientific meeting in London where he cited figures on how well different classes of drugs work in real patients.

Drugs for Alzheimer's disease work in fewer than one in three patients, whereas those for cancer are only effective in a quarter of patients. Drugs for migraines, for osteoporosis, and arthritis work in about half the patients, Dr Roses said. Most drugs work in fewer than one in two patients mainly because the recipients carry genes that interfere in some way with the medicine, he said.

"The vast majority of drugs - more than 90 per cent - only work in 30 or 50 per cent of the people," Dr Roses said. "I wouldn't say that most drugs don't work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don't work in everybody."


People who work in pharmaceutical companies, and I know a lot of them, know darned well that much of the time their work is meaningless in the real world, and if you get alongside them they will often admit that what constitutes proof is as abutler says, often a possibly plausible hypothesis.

Had meidcal people required the sort of proof demanded by goatlady and others, from the 1800's onwards, a lot of things like digitalis et al, would never have even got off the ground.

In many way, medicine is as dangerous today as it was 150 years ago.

To spend time ARGUING over the quality of information I put up as references is self defeating.

As far as I am concerned the only valid assessment is to read it yourself, analyse the biochemical plausibility, and see if its worth a try.

Anything else is not just semantics it can also come across as very petty messenger shooting.

The information was put here in good faith. It would have been nice to have read a lot more thoughtful responses, rather than dispute about the validity of any particular "medical" journal. . But hey, ... what is life if its not about surprises.

Or I guess some could say that medical journals exist so that people can argue about whether research is valid or not, and whether those journals are worth reading in the first place. Personally, I don't know of one medical journal, peer reviewed or not, that hasn't produced a load of bunk at some time or other.

To get scrunched up in this sort of fruitless argument is pointless. When it comes to austere medicine, a lot of what now constitutes proof will go right out the window.

Probiotics are in my opinion, the least of all possible "therapies" in terms of dangers to the recipients.

Rather than quibble over the research, or the credibility of the messenger therefore, why not TALK about the issue?

[kays]

Hello Everybody,
I am really confused what sort of information you all are trying to convey. You have posted a lot of links and very little information regarding the topic. Could you post some useful information.
---------------
Kays

[goatlady]

You'll have to talk to justwondering about that, Kays. I have no useful info on the subject.

[Craig]

Kays, what are you looking for. While I dont agree with some of this thread - its an excellent example of a discussion board discussion! Plenty of information here and pointers to a vast amount more. What specifically do you want?

Craig

[FlightERDoc]

OK - Lancet and NEJM are both though well respected, though the latter has earned a reputation like the NYT or Wash Post due to some questionalble articals about gun violence - ie: crossing the line from medicine to politics.

Medically, I believe both are peer reviewed unless it's a letter to the editor.

You've really found "hedging" language common in Lancet? - to the best of my knowledge, that's the worlds oldest and most respected medical journal. Believe it started publication back in the 1800's.

-t


Lancet has gone over that line too, at least for me. The recent scandal they had with their Autism 'peer reviewed' articles (where their author, and then 'peer', was in the pay of an advocacy group correlating autism and vaccination), and the 'October suprise' BS article on civilian fatalities in Iraq following the war (subsequently discredited in terms of methodology, analysis, etc but released right before the 2004 Presidential election), show that the current editors of Lancet are at best idiots and at worst ... crooks.