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PROBI0TICS
Dr.B.V.Ramana Probiotic is a relatively new word meaning for life It is currently used to name bacteria associated with beneficial effects for humans and animals. A commonly used definition is live micro organisms, which when consumed in adequate amounts; confer a health effect on host. Fuller defined as A live microbial feed supplement that beneficially affects the host by improving its intestinal microbial balance. Probiotics have been defined recently as living microorganisms, which upon ingestion in certain numbers exert health benefits beyond general nutrition. The most commonly used probiotics are 1. Lactic acid bacteria, such as lacto bacilli, and bifidobacteria, 2. Other non-pathogenic bacterial strains, including Streptococcus, Escherichia coli. 3. Non-bacterial organisms, such as non-pathogenic yeast Sacharomyces boulardii. Criteria for a bacterium to be designated a probiotic include: 1. Human origin 2. Non-pathogenic properties 3. Resistance to technologic processing, including viability in delivery vehicles. 4. Stability in acid and bile 5. Adhesion to target epithelial tissue 6. Ability to persist within the gastrointestinal tract 7. Production of anti microbial substances 8. Ability to positively influence immune function 9. Ability to positively influence metabolic activities.

Available forms: Probiotics are available either in the form of fermented dairy foods such as yogurt and other dairy products fruit juices and other drinks, or as powdered supplements containing freeze-dried bacteria. In some countries medicinal probiotic products are sold for specific medical indications are available. Mode of action of probiotis: The exact mechanisms by which probiotics exert their effects in humans are unknown. The mechanisms include: 1. By the synthesis of anti microbial substances. 2. Competition for nutrients required for growth of pathogens. 3. Competitive inhibition of adhesion of pathogens. 4. Modification of toxins and toxin receptors. 5. Stimulation of specific and non-specific immune response to pathogens. 6. Increase the number of circulating lymphocytes and induce lymphocyte proliferation 7. Increase specific anti body response and cytokine secretion including interferon- (INF-). 8. Stimulate phagocytosis. 9. Enhance mucosal immune defenses. 10. Interfere with the cross-talk between pathogens and host cells inhibit pathogen induced cell signaling) Diseases in paediatrics for which treatment with probiotics have been suggested: Intestinal infections 1. Acute viral gastroenteritis 2. Acute bacterial gastroenteritis 3. Antibiotic associated diarrhoea (i.e.

3 4. Travelers diarrhoea Upper respiratory infections Invasive neonatal infections Allergic diseases Inflammatory bowel diseases Irritable bowel syndrome Lactose intolerance Dental caries Cancer and tumor growth So far the best documented is the efficiency of certain probiotic strains in children with Rota viral gastroenteritis. Optimal doses and treatment duration have not been established clearly. But the minimum effective dose for therapeutic purposes seen to be a daily intake of 109 CFU. Perhaps the most important is that the effects of distinct probiotic microorganisms are not equal. There fore future clinical trials should evaluate carefully selected, precisely defined probiotic strains and address clinically important end points. Further more the microbiological quality and labeling of probiotics must be improved.

Conclusion: