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      Productos y efectos Translated title: Products and effects


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          Los beneficios terapéuticos y los mecanismos de acción de los Probióticos han sido ampliamente demostrados, siendo locales y sistémicos. Saccharomyces boulardii, (levadura) se encuentra disponible como liofilizado y se utiliza principalmente en el tratamiento y prevención de diarrea y otras patologías gastrointestinales. El mecanismo de acción es múltiple e incluye modificación en la célula huésped, en la respuesta proinflamatoria, la secreción hidroelectrolítica, estimulación inmunologica, neutralización de las toxinas, disminución de la adherencia de las bacterias e inhibición de la translocación de los patógenos. Los Lactobacillus, presentes en el tracto gastrointestinal y la vagina, son bacterias Gram positivas que producen ácido láctico como principal producto de la fermentación. Bacillus clausii, Gram positivo formador de esporas, produce efectos beneficiosos en el tracto gastrointestinal, por medio de la liberación de compuestos antimicrobianos y modulación de la actividad inmune, aumentando la producción de inmunoglobulina A secretora. Los efectos farmacológicos de estos probióticos, son cepa especificos, por lo que su selección se debe basar de acuerdo a los efectos demostrados a cada uno.

          Translated abstract

          The therapeutic benefits and mechanisms of action of probiotics have been demonstrated, mainly systemic and at the intestinal lumen. Saccharomyces boulardii (yeast) is available in a lyophilized form and is primarily used in the treatment and prevention of diarrhea and other gastrointestinal diseases. The mechanism of action is multiple and includes modification of the host cell, the pro-inflammatory response, electrolyte secretion, immune stimulation, neutralization of toxins, reduced adherence of bacteria and inhibition of translocation of pathogens. Lactobacillus present in the gastrointestinal tract and vagina are Gram positive bacteria that produce lactic acid as a major fermentation product. Bacillus clausii, spore-forming Gram positive, produce beneficial effects in the gastrointestinal tract, through the release of antimicrobial compounds and modulating immune activity, increasing the production of secretory immunoglobulin. The pharmacological effects of these probiotics, are specific strain, so its selection should be based according to their demonstrated effects.

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          Most cited references41

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          Systematic review and meta-analysis of Saccharomyces boulardii in adult patients.

          This article reviews the evidence for efficacy and safety of Saccharomyces boulardii (S. boulardii) for various disease indications in adults based on the peer-reviewed, randomized clinical trials and pre-clinical studies from the published medical literature (Medline, Clinical Trial websites and meeting abstracts) between 1976 and 2009. For meta-analysis, only randomized, blinded controlled trials unrestricted by language were included. Pre-clinical studies, volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis, but included in the systematic review. Of 31 randomized, placebo-controlled treatment arms in 27 trials (encompassing 5029 study patients), S. boulardii was found to be significantly efficacious and safe in 84% of those treatment arms. A meta-analysis found a significant therapeutic efficacy for S. boulardii in the prevention of antibiotic-associated diarrhea (AAD) (RR = 0.47, 95% CI: 0.35-0.63, P < 0.001). In adults, S. boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea. Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Helicobacter pylori treatment-related symptoms. S. boulardii shows promise for the prevention of C. difficile disease recurrences; treatment of irritable bowel syndrome, acute adult diarrhea, Crohn's disease, giardiasis, human immunodeficiency virus-related diarrhea; but more supporting evidence is recommended for these indications. The use of S. boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.
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            Lactobacillus species: taxonomic complexity and controversial susceptibilities.

            The genus Lactobacillus is a taxonomically complex and is composed of over 170 species that cannot be easily differentiated phenotypically and often require molecular identification. Although they are part of the normal human gastrointestinal and vaginal flora, they can also be occasional human pathogens. They are extensively used in a variety of commercial products including probiotics. Their antimicrobial susceptibilities are poorly defined in part because of their taxonomic complexity and are compounded by the different methods recommended by Clinical Laboratory Standards Institute and International Dairy Foundation. Their use as probiotics for prevention of Clostridium difficile infection is prevalent among consumers worldwide but raises the question of will the use of any concurrent antibiotic effect their ability to survive. Lactobacillus species are generally acid resistant and are able to survive ingestion. They are generally resistant to metronidazole, aminoglycosides and ciprofloxacin with L. acidophilus being susceptible to penicillin and vancomycin, whereas L. rhamnosus and L. casei are resistant to metronidazole and vancomycin.
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              Molecular characterization and identification of Bacillus clausii Strains marketed for use in oral bacteriotherapy.

              A substantial number of Bacillus species have been marketed for use in oral bacteriotherapy because of their purported ability to prevent or treat various gastrointestinal disorders. Recently, some of the Bacillus strains in Enterogermina, which is made up of aqueous suspensions of viable Bacillus spores, have been partially characterized and aligned with members of the Bacillus alcalophilus subgroup rather than with Bacillus subtilis, as previously reported. With a view toward verifying the original taxonomic position of the Enterogermina strains, we catalogued both phenotypic and genotypic traits exhibited by the four Bacillus strains isolated from the spore mixtures found in original commercial preparations dated 1975 and 1984 and commercial preparations now being propagated industrially. Analyses of physiological and biochemical traits, complete 16S rRNA gene sequences, DNA-DNA reassociation, tRNA intergenic spacer length polymorphism, single-strand conformation polymorphism of PCR-amplified spacer regions of tRNA genes, and randomly amplified polymorphic DNA led to the finding that all of the Enterogermina strains belong to a unique genospecies, which is unequivocally identified as the alkalitolerant species Bacillus clausii. Moreover, we provide evidence that in contrast to several reference strains of B. clausii, the strains constituting Enterogermina are characterized by a notable low level of intraspecific genome diversity and that each strain has remained the same for the last 25 years.

                Author and article information

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                Archivos Venezolanos de Puericultura y Pediatría
                Arch Venez Puer Ped
                Sociedad Venezolana de Puericultura y Pediatría
                December 2015
                : 78
                : 4
                : 129-134
                [1 ] Hospital Domingo Luciani
                [2 ] Hospital de Niños J.M.de los Ríos
                [3 ] Hospital Los Samanes
                [4 ] Instituto Medico La Floresta
                [5 ] Hospital Las Garzas



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0649&lng=en
                HEALTH POLICY & SERVICES

                Pediatrics,Health & Social care,Public health
                mecanismo de acción,mechanism of action,probiotics,kids,adolescents,probióticos,niños,adolescentes


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