Probiotics and alternative medicine September 25, 2006Posted by Hegemony in Health, Science.
It has been illustrated that the human immune system can benefit from certain plant and bacterial substances. While the mechanisms are not yet known there is a great deal of research being done on this. Some studies seem to indicate clear benefits but others show none at all. Still others warn of possibly dangerous side-effects.
These “non-medical” treatments are divided into two categories. Probiotics are live organisms (usually bacteria) believed to benefit mucosal and systemic immunity. They are also believed to benefit the balance of microbial flora in the digestive tract. Most of these probiotic organisms are lactic acid bacteria of the genuses lactobacillus, streptococci, and bifidobacteria. Nutraceuticals are defined as a food or part of a food that is intended to provide beneficial health effects. In practice it usually means a supplement with the beneficial substance in a concentrated form. Efforts to determine the mode of action of these concentrated substances have so far been unsuccessful.
One infection in which probiotics and nutraceuticals have been studied is Helicobacter pylori. H. pylori is known to contribute to the development of peptic ulcers and gastric cancer. The standard treatment for this infection is combination antibiotic therapy. The use of multiple strains of lactobacillus was able to attenuate the growth of H. pylori in vitro. However, using probiotics and nutraceuticals in a clynical setting have been hit and miss. Some success has been seen with the use of sulforaphane an isothiocynate common in broccoli sprouts. This substance seems to inhibit the growth of certain strains of H. pylori as well as prevent the resulting gastric tumors.
It has been set fourth that probiotics may be able to treat irritable bowel syndrome (IBS). Currently treatment focuses on treating the symptoms themselves as opposed to the disease. Two recent studies using probiotics have been undertaken to study this possibility. The first used eight different probiotic species. They found that no difference was made in the symptoms of IBS. The second study found that treatment with B. infantis actually did decrease symptoms in most patients.
Encouraging results have been obtained in the treatment of C. difficile related diarrhea. Review of the data indicates there is an odds ratio of .37 in favor of probiotic treatments over placebo. One study found that treatment with Saccharomyces boulardii was able to prevent further infection by C. difficile in individuals prone to the infection.
It is known that problems with the gastrointestinal flora is a contributing factor to inflammatory bowel disease (IBD). Included in this class of illness are Ulcerative Colitis And Crohn’s Disease. One study tracked the use of E. coli Nissle 1917 against the common treatment of mesalamine. The results showed no difference between the two groups so it was assumed that the E. coli was as effective as the standard treatment. A second study seemed to confirm these results. However, another study showed that E. coli Nissle 1917 is no better than a placebo at prolonging remission. A separate study gave patients BIFICO capsules containing Lactobascilli, Enterococci, and Bifidobacteria. In this case remission was significantly improved over the placebo. Lab tests indicate that they had much lower levels of inflammatory cytokines than patients on the placebo.
Probiotics effect on Crohn’s Disease has not been studied sufficiently at this time to establish its effectiveness. Trials of both E. coli Nissle 1917 and L. rhamnosus showed no effect on the symptoms or continued remission if the disease. Omega-3 fatty acids have also been proposed as a possible treatment but initial results are not particularly encouraging. Early studies had positive results in the use of fish oil to prolong remission of Crohn’s Disease. More recent studies indicate that such treatments may be acting as adjunctives rather than a true therapy.
While it does seem that probiotics and nutraceuticals hold promise, more work is needed. In some cases clear benefits are observed but the danger is that people will forgo medical treatment in favor of probiotics. As these substances are not tightly controlled there have been cases of contamination by harmful bacteria as well as heavy metals and pesticides. There is not even any guarantee that a particular supplement has the substance it advertises. As time goes on we may see better studies that will focus on the effects of single strains of bacteria that will hopefully lead us to the most therapeutically useful ones. For now the jury is out on the usefulness of this therapy.