13-08-02

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CLNING NC1LS
CLN ACCLSS
QIA1etro
#dcconf2013

1nANkS
Nest| Nutr|non
8|o-k |us
D|ennans of Canada
ou!
NUM8LkS 1C kLMLM8Lk
1 x 10
27-30

1 x 10
12-14

1 x 10
10

1 x 10
7

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13-08-02
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8u||d|ng 1he M|crob|ome
M|crob|ome comes |n|na||y from mother
Detectab|e w|th|n 3 days of b|rth
Numbers |ncrease w|th age
Dependent on how ch||d |s ra|sed
Lxposure |s key!
Spor eL al. !"#$%& (&)*&+, -*.%/0*/1/23 9, 279-290
13-08-02
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vael C, & uesager k. Curr Cpln edlaLr. 2009 uec,21(6):794-800
1nL 1nkLL I's of M|crob|ome & nea|th
IN1AkL

INILAMMA1ICN

IM8ALANCL
DLSCkI1IVL ANALSIS CI IN1AkL
lllnL eL al. CuL Mlcrobes 2012,3(4):298-306.
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1nL nLA kINCILL
Up to 10,000 bacter|a| spec|es may |nteract w|th us

Cannot descr|be a|| of them |nd|v|dua||y

Separated |nto Ma[or hy|a
I|rm|cutes - Gut co|on|zers
8actero|detes - Anaerob|c d|gesters
Acnnobacter|a - Comp|ex carbohydrate d|gesters
roteobacter|a - Co||forms
A DIVLkSL LNVIkCNMLN1
Intake |eads to d|erent m|crob|omes

Iactor of geography, age, d|et and genencs
D|snnct d|erences can be |dennhed
NC 1WC MICkC8ICMLS AkL ALIkL
8reak|ng Down 1he hy|a
Azad eL al, CMA! 2013,183(3):383-394
13-08-02
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U.S. CnILDkLN
8ANGLADLSnI
CnILDkLN
Lln eL al. LoS Cne 2013,8(1):e33838
ue llllppo eL al. nAS 2010,107(33):14691-14696
ILCkLNCL, I1AL
8UkkINA IASC
?aLsunenko eL al. naLure 2012,486(7402):222-227
IkCM CnILDnCCD..
13-08-02
7
?aLsunenko eL al. naLure 2012,486(7402):222-227
.1C ADUL1
IAC1CkS IN MICkC8ICML DIVLkSI1
Una|terab|e
Ceneucs
CllmaLe

D|mcu|t to A|ter
Socloeconomlc sLaLus
ollucal sLrlfe
Ceneral sanlLauon

A|terab|e
uleL & LlfesLyle
Mlcroblal SupplemenLauon
AkL 1nLkL AN CCMMCN 8AC1LkIA 1C ALL?
I|rm|cutes
4".#/0".*11$, ,556

Acnnobacter|a
7*89/0".#&%*$: ,556

8actero|detes
7".#&%/*9&, ,556
roteobacter|a
;6 ./1* <./::&=,"1>
Wn AkL 1nL IMCk1AN1?
13-08-02
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INILAMMA1ICN
Caused as a resu|t of unba|anced |mmun|ty
In|na||y be||eved to be due to |nfecnon
I|ght and hea|
More research has shown |nammanon can be:
n|gh|y acute and destrucnve (cytok|ne storm)
Low |eve| acute (hot ashes)
Low |eve| chron|c - assoc|ated w|th many d|seases
CbeslLy, dlabeLes, Cvu, auusm, Alzhelmer's, agelng, eLc.
GU1 INILAMMA1ICN AND CVD
Wang eL al. naLure. 2011 Aprll 7, 472(7341): 37-63.
8acter|a Can Contro|
Inammanon
Act as a phys|ca| barr|er to
pathogen|c m|crobes
ne|ps to prevent |nfecnons
rov|de a 'fr|end' to the |mmune
system |n the gut
Many 'fr|endsh|ps' deve|oped |n
hrst 2 years of ||fe
Modu|ates |mmune response
Comp|ex |nteracnons
keduce ||ke||hood of prob|ems |f
short term |mba|ance occurs
reldls and versalovlc. CasLroenLerol. 2009,136(6):2013-2031.
13-08-02
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IMMUNCMCDULA1ICN IS CCMLLk
1he mechan|sms |nvo|ve severa| components
1o||-||ke receptors
S|gna| transducnon
Cytok|nes snmu|anon
Adhes|on support
roducnon of short cha|n fauy ac|ds (butyrate)
keduces |epnn producnon and |ncreases fat ox|danon
A|| work to keep |nammanon down and ba|ance
between |mmune responses
1h1 vs 1h2
1h17
Inammanon Modu|anon by "# $%&'()*&+,-
.(/ "$%0(1$%&++,- -))# 2(',+$03-
keduces |nammanon ("# $%&'()*&+,-)
Downregu|ates pro|nammatory |mmune response
Increases funcnon of |nnate |mmun|ty
C||n|ca| |so|ates are beuer than LS contro|s
Sparks more robust |mmune funcnon
Inh|b|ts pathogen growth &4 5&06(
7# %(+&, 8# )43,9(4&$3, :# 0;)*&9,6&,9, :# <3=436&
A|| s|gn|hcant|y reduced growth over 24 hours
Sun eL al. ! 8lomed 8es 2013, 27(2):116-126
loye eL al. lLMS lmmunol Med Mlcroblol 2012,63(3):467-480
.but on|y when there |s a ba|ance!
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IM8ALANCL
A norma| occurrence over ||fenme
Can occur |n a number of ways
Infecnon
Annb|onc 1reatment
Dysb|os|s
rob|ems can occur |ead|ng to c||n|ca| symptoms
D|arrhea
Inammatory 8owe| D|seases
Cbes|ty, D|abetes, etc.
Auto|mmun|ty
sycho|og|ca| comp||canons
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Norma| I|ora Norma| I|ora
Annb|onc Use
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Changes |n m|crob|ome

keducnon of d|vers|ty
Loss of norma| m|crob|ota
Decrease |n Gm+ves
Lactobac|||us & 8|hdobacter|a
w|ped out
Increase |n Gm-ves
8actero|des
Lnterobacter|aceae
otenna| causes of AAD
No eect on C|ostr|d|a
Suggesnve of AAD & CDAD

?oung and SchmldL. ! Clln Mlcroblol 2004,42(3) 1203-1206
0 Days 7 Days 21 Days 3 months 6 months 9 months 12 months 18 months 24 months
M
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!ackobsson eL al. LoS CnL 2010,3(3):e9836
ughoe & versalovlc. Annu 8ev aLhol Mech uls 2012,7:99-122
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A Sh|h |n the M|crob|ome
A |oss of "core" bacter|a
Cnes ga|ned from |nfancy

Cvergrowth of bacter|a
that cause |nammanon
Symptoms are due to
|ack of ba|ance between
bacter|a & |mmun|ty
Need to return to core
Spor eL al. naLure 8evlews Mlcroblology 9, 279-290 (Aprll 2011)
Walker and Lawley. harmacol 8es 2013,69(1):73-86
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kC8IC1ICS
Most|y made up of members of the core m|crob|ome
easts are not or|g|na| core members but show some beneht
nave been around us for m|||enn|a
Iermented foods
Lnv|ronmenta| exposure
Cn|y |n |ast S0 years has beneht been exam|ned
In|na||y seen as way to keep gut happy
kesearch has shown there |s so much more to the equanon
1nL kC8IC1IC INDUS1k
Iocused on severa| d|erent spec|es |n a few genera
"$%0(1$%&++,- -))#
>&?'(1$%036&,9 -))#
:063)0(%(%%,- 0*369()*&+,-
:$%%*$6(9;%3- 1(,+$6'&&
74036(%(%%,- -))#
A|| c|a|m to be benehc|a| yet on|y few have undergone
c||n|ca| tr|a|s
Iewer sn|| have been recommended by regu|atory
author|nes such as nea|th Canada
Choos|ng a rob|onc
Need to know:
Source
Growth med|a
Immune eects
ers|stence
kes|stance to annb|oncs
1o|erab|||ty
Lecnve concentranon
ILkMLN1 Ck
SULLMLN1?
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Ierment Ior 8eneht
Natura| fermentanon w|th same prob|onc stra|ns
8e|g|an beer concept
A p|ethora of stud|es show that the ferment has
benehc|a| propernes separate from the bacter|a
nappy gut
Improved mood
CVD reducnon
keduced potenna| for cytok|ne storm

Cannot prevent |nfecnon or |mba|ance!
Supp|ement 1o nea|
Must have demonstrated c||n|ca| eect on the host.
Must be non-pathogen|c, non-tox|c and free of adverse events.
Must be ab|e to surv|ve through the gastro|ntesnna| tract

Must be companb|e w|th product matr|x, process|ng and
storage cond|nons, and |abe||ed accurate|y.
Must have an adequate number of v|ab|e ce||s to confer c|a|ms

Must show no compennon to other stra|ns |n the supp|ement
8radley eL al. ?== @=#&%= -&96 2012,137(12):878-888.
kequ|red Concentranon of rob|oncs
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Compennon Lects
Chapman eL al. Anaerobe. 2012,18(4):403-413
Genera| ku|es for rob|onc Use
Choose a prob|onc that a||gns w|th natura| m|crob|ome
C|oser to the mother the beuer
"$%0(1$%&++,- -))# are known to be s|gn|hcant |n new stages of ||fe
Ierment a|so oers beneht
Choose a prob|onc that has proved |tse|f c||n|ca||y
Contro|||ng chron|c d|seases us|ng prob|oncs |s |ncreas|ng|y eecnve
Ierment for ma|ntenance, supp|ement to |mprove s|tuanon
If auempnng to hea|, ensure that the prob|onc has c|a|m
C||n|ca| tr|a|s and other data |s necessary to have conhdence
If not government c|a|m, use Cochrane and other k1 sources

Lnsure that the amount of bacter|a prov|ded |s sumc|ent
M|n|mum 10 b||||on for adu|ts
M|n|mum 1 b||||on for todd|ers
M|n|mum 100 m||||on for |nfants to todd|ers
NUM8LkS 1C kLMLM8Lk
1 x 10
27-30



1 x 10
12-14

8AC1LkIA CN LAk1n
8AC1LkIA IN GU1
MINIMUM ADUL1
kC8IC1IC kLUIkLD
NUM8Lk IN AVLkAGL
CGUk1 SLkVING
1 x 10
10



1 x 10
7

13-08-02
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SUMMAk
We are |earn|ng more about the m|crob|ome and |ts
|mportance |n hea|th
Cur m|crob|omes are set when we are |n ch||dhood
Changes happen over nme and resu|ts |n |nammanon and
potenna| for d|sease
Use of prob|oncs to return the m|crob|ome to natura| state
|s eecnve method
In the context of pharmaco|ogy, prob|oncs are the best ||nk
between the med|ca| need for prescr|pnons and the human
need for ba|ance
1nANk CU!
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