Properties of evidence-based probiotics for human health

Probiotics in Food Safety and Human Health

Volumn , Issue , 2005, Pages 109-137

  McFarland, Lynne V ^a   Elmer, Gary W ^a  

^a UNIVERSITY OF WASHINGTON   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BACILLI; LACTIC ACID;

ACID PRODUCING BACTERIUM; COMMERCIAL PRODUCTIONS; FERMENTED DAIRY PRODUCTS; HOST IMMUNE RESPONSE; MICROBIAL STRAIN; PHARMACOKINETIC PROPERTIES; PHARMACOLOGICAL ACTIVITY; PROBIOTIC LACTOBACILLI;

CONTROLLED DRUG DELIVERY;

EID: 85056072297     PISSN: None     EISSN: None     Source Type: Book    
DOI: None     Document Type: Chapter

References (135)

1. C. Dunne, L O'Mahony, L Murphy, G Thornton, D Morrissey, S O'Halloran, M Feeney, S Flynn, G Fitzgerald, C Daly, B Kiely, GC O’Sullivan, F Shanahan, and JK Collins. In vitro selection criteria for probiotic bacteria of human origin: correlation with in vivo findings. Am. J. Clin. Nutr., 73: 386S–392S, 2001.
2. YJ Lee, WK Yu, and TR Heo. Identification and screening for antimicrobial activity against Clostridium difficile of Bifidobacterium and Lactobacillus species isolated from healthy infant feces. Int. J. Antimicrob. Agents, 21: 340–346, 2003.
3. NW Mclean and IJ Rosenstein. Characterization and selection of a Lactobacillus species to re-colonize the vagina of women with recurrent bacterial vaginosis. J. Med. Microbiol., 49: 543–552, 2000.
4. L V McFarland. Quality control and regulatory issues for biotherapeutic agents, in Biotherapeutic Agents and Infectious Diseases (GW Elmer, LV McFarland, and CM Surawicz, Eds.), Humana Press, Totowa, NJ, 1999, pp. 159–193.
5. WH. Holzapfel, P Haberer, R Geisen, J Bjorkroth, and U Schillinger. Taxonomy and important features of probiotic microorganisms in food and nutrition. Am. J. Clin. Nutr., 73: 365S–373S, 2001.
6. ME Sanders and TR Klaenhammer. The scientific basis of Lactobacillus acidophilus NCFM functionality as a probiotic. J. Dairy Sci., 84: 319–331, 2001.
7. PSM Yeung, ME Sanders, CL Kitts, R Cano, and PS Tong. Species-specific identification of commercial probiotic strains. J. Dairy Sci., 85: 1039–1051, 2002.
8. MF Bernet-Camard, V Lievin, D Brassart, JR Neeser, AL Servin, and S Hudault. The human Lactobacillus acidophilus strain LA1 secretes a nonbacteriocin antibacterial substance(s) active in vitro and in vivo. Appl. Environ. Microbiol., 63: 2747–2753, 1997.
9. KJ Heller. Probiotic bacteria in fermented foods: product characteristics and starter organisms. Am. J. Clin. Nutr., 73: 374S–379S, 2001.
10. ML Clements, MM Levine, PA Ristaino, VE Daya, and TP Hughes. Exogenous lactobacilli fed to man — their fate and ability to prevent diarrheal disease. Prog. Food Nutr. Sci., 7: 29–37, 1983.
11. G Reid, ME Sanders, HR Gaskins, GR Gibson, A Mercenier, R Rastall, M Roberfroid, I Rowland, C Cherbut, and TR Klaenhammer. New scientific paradigms for probiotics and prebiotics. J. Clin. Gastroenterol., 37: 105–118, 2003.
12. P Mastromarino, P Brigidi, S Macchia, L Maggi, F Pirovano, V Trinchieri, U Conte, and D Matteuzzi. Characterization and selection of vaginal Lactobacillus strains for the preparation of vaginal tablets. J. Appl. Microbiol., 93: 884–893, 2002.
13. M Silva, NV Jacobus, C Deneke, and SL Gorbach. Antimicrobial substance from a human Lactobacillus strain. Antimicrobiol. Agents Chemother., 31: 1231–1233, 1987.
14. I Casas and W Dobrogosz. Validation of the probiotic concept: Lactobacillus reuteri confers broad-spectrum protection against disease in humans and animals. Microb. Ecol. Health Dis., 12: 247–285, 2000.
15. I Castagliuolo, JM Lamont, ST Nikulasson, and C Pothoulakis. Saccharomyces boulardii protease inhibits Clostridium difficile toxin an effects in the rat ileum. Infect. Immun., 64: 5225–5232, 1996.
16. VL Hughes and SL Hillier. Microbiologic characteristics of Lactobacillus products used for colonization of the vagina. Obstet. Gynecol., 75: 244–248, 1990.
17. W Zhong, K Millsap, H Bialkowska-Hobrzanska, and G Reid. Differentiation of Lactobacillus species by molecular typing. Appl. Environ. Microbiol., 64: 2418–2423, 1998.
18. LV McFarland. Normal flora: diversity and functions. Microb. Ecol. Health Dis., 12: 193–207, 2000.
19. LV McFarland and P Bernasconi. Saccharomyces boulardii — A review of an innovative biotherapeutic agent. Microb. Ecol. Health Disease, 6: 157–171, 1993.
20. P Brigidi, B Vitali, E Swennen, G Bazzocchi, and D Matteuzzi. Effects of probiotic administration upon the composition and enzymatic activity of human fecal microbiota in patients with irritable bowel syndrome or functional diarrhea. Res. Microbiol., 152: 735–741, 2001.
21. S Fujiwara, Y Seto, A Kimura, and H Hashiba. Intestinal transit of an orally administered streptomycin–rifampicin-resistant variant of Bifidobacterium longum SBT2928: its long-term survival and effect on the intestinal microflora and metabolism. J. Appl. Microbiol., 90: 43–52, 2001.
22. C Forestier, C De Champs, C Vatoux, and B Joly. Probiotic activities of Lactobacillus casei rhamnosus: in vitro adherence to intestinal cells and antimicrobial properties. Res. Microbiol., 152: 167–173, 2001.
23. PV Kirjavainen, AC Ouwehand, E Isolauri, and SJ Salminen. The ability of probiotic bacteria to bind to human intestinal mucus. FEMS Microbiol. Lett., 167: 185–189, 1998.
24. J. McCarthy, L O'Mahony, L O'Callaghan, B Sheil, EE Vaughan, N Fitzsimons, J Fitzgibbon, GC O'Sullivan, B Kiely, JK Collins, and F Shanahan. Double blind, placebo controlled trial of two probiotic strains in interleukin 10 knockout mice and mechanistic link with cytokine balance. Gut, 52: 975–980, 2003.
25. JP Buts, P Bernasconi, JP Vaerman, and C Dive. Stimulation of secretors IgA and secretors component of immunoglobulins in small intestine of rats treated with Saccharomyces boulardii. Dig. Dis. Sci., 35: 251–256, 1990.
26. E Isolauri, J Joensuu, H Suomalainen, M Luomala, and T Vesikari. Improved immunogenicity of oral D x rrv reassortant rotavirus vaccine by Lactobacillus casei GG. Vaccine, 13: 310–312, 1995.
27. G Perdigon, M Locascio, M Medici, APD Holgado, and G Oliver. Interaction of bifidobacteria with the gut and their influence in the immune function. Biocell, 27: 1–9, 2003.
28. N Ishibashi and S Yamazaki. Probiotics and safety. Am. J. Clin. Nutr., 73: 465S–470S, 2001.
29. S Salminen, C Bouley, MC Boutron-Ruault, JH Cummings, A Franck, GR Gibson, E Isolauri, MC Moreau, M Roberfroid, and I Rowland. Functional food science and gastrointestinal physiology and function. Br. J. Nutr., 80: S147–S171, 1998.
30. G MacGregor, AJ Smith, B Thakker, and J Kinsella. Yogurt biotherapy: contraindicated in immunosuppressed patients? Postgrad. Med. J., 78: 366–367, 2002.
31. M Rautio, H Jousimies-Somer, H Kauma, I Pietarinen, M Saxelin, S Tynkkynen, and M Koskela. Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from L rhamnosus strain GG. Clin. Infect. Dis., 28: 1159–1160, 1999.
32. PG Rogasi, S Vigano, P Pecile, and F Leoncini. Lactobacillus casei pneumonia and sepsis in a patient with AIDS. Case report and review of the literature. Ann. Ital. Med. Int. 13: 180–182, 1998.
33. Y Schoon, B Schuurman, AG Buiting, SE Kranendonk, and SJ Graafsma. Aortic graft infection by Lactobacillus casei: a case report. Neth. J. Med., 52: 71–74, 1998.
34. M Pletinex, J Legain, and Y Vandenplas. Fungemia with Saccharomyces boulardii in a 1-year-old girl with protracted diarrhea. J. Ped. Gastroenterol. Nutr., 21: 113–115, 1995.
35. P Zunic, J Lacotte, M Pegoix, G Buteux, G Leroy, B Mosquet, and M Moulin. Fungemy associated with Saccharomyces boulardii — about one case. Therapie, 46: 498, 1991.
36. JA Vanderhoof, DB Whitney, DL Antonson, TL Hanner, JV Lupo, and RJ Young. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J. Ped., 135: 564–568, 1999.
37. BR Goldin, SL Gorbach, M Saxelin, S Barakat, L Gualtieri, and S Salminen. Survival of Lactobacillus species (strain GG) in human gastrointestinal tract. Dig. Dis. Sci., 37: 121–128, 1992.
38. S Hudault, V Lievin, MF BernetCamard, and AL Servin. Antagonistic activity exerted in vitro and in vivo by Lactobacillus casei (strain GG) against Salmonella typhimurium C5 infection. Appl. Environ. Microbiol., 63: 513–518, 1997.
39. M Alander, R Satokari, R Korpela, M Saxelin, T Vilpponen-Salmela, T Mattila- Sandholm, and A von Wright. Persistence of colonization of human colonic mucosa by a probiotic strain, Lactobacillus rhamnosus GG, after oral consumption. Appl. Environ. Microbiol., 65: 351–354, 1999.
40. MR Millar, C Bacon, SL Smith, V Walker, and MA Hall. Enteral feeding of premature infants with Lactobacillus GG. Arch. Dis. Childhood, 69: 483–487, 1993.
41. R Goldin, LJ Gualtieri, and RP Moore. The effect of Lactobacillus GG on the initiation and promotion of DMH-induced intestinal tumors in the rat. Nutr. Cancer Int. J., 25: 197–204, 1996.
42. AC Ouwehand, E Isolauri, PV Kirjavainen, S Tolkko, and SJ Salminen. The mucus binding of Bifidobacterium lactis Bb12 is enhanced in the presence of Lactobacillus GG and Lact. delbrueckii subsp bulgaricus. Lett. Appl. Microbiol., 30: 10–13, 2000.
43. JH Meurman, H Antila, A Korhonen, and S Salminen. Effect of Lactobacillus rhamnosus strain GG (ATCC-53103) on the growth of Streptococcus sobrinus in vitro. Eur. J. Oral Sci., 103: 253–258, 1995.
44. JH Meurman, H Antila, and S Salminen. Recovery of Lactobacillus strain GG (ATCC-53103) from saliva of healthy volunteers after consumption of yogurt prepared with the bacterium. Microb. Ecol. Health Dis., 7: 295–298, 1994.
45. L Nase, K Hatakka, E Savilahti, M Saxelin, A Ponka, T Poussa, R Korpela, and JH Meurman. Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res., 35: 412–420, 2001.
46. Q Shu and HS Gill. Immune protection mediated by the probiotic Lactobacillus rhamnosus HN001 (DR20 (TM)) against Escherichia coli O157: H7 infection in mice. FEMS Immunol. Med. Microbiol., 34: 59–64, 2002.
47. YH Sheih, BL Chiang, LH Wang, CK Liao, and HS Gill. Systemic immunityenhancing effects in healthy subjects following dietary consumption of the lactic acid bacterium Lactobacillus rhamnosus HN001. J. Am. Coll. Nutr., 20: 149–156, 2001.
48. HS Gill, KJ Rutherfurd, ML Cross, and PK Gopal. Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019. Am. J. Clin. Nutr., 74: 833–839, 2001.
49. GW Tannock, K Munro, HJM Harmsen, GW Welling, J Smart, and PK Gopal. Analysis of the fecal microflora of human subjects consuming a probiotic product containing Lactobacillus rhamnosus DR20. Appl. Environ. Microbiol., 66: 2578–2588, 2001.
50. TL Talarico, IA Casas, TC Chung, and WJ Dobrogosz. Production and isolation of Reuterin, a growth inhibitor produced by Lactobacillus reuteri. Antimicrob. Agents Chemother., 32: 1854–1858, 1988.
51. T Toba, SK Samant, E Yoshioka, and T Itoh. Reutericin-6, a new bacteriocin produced by Lactobacillus reuteri La-6. Lett. Appl. Microbiol., 13: 281–286, 1991.
52. T Wadstrom, K Andersson, M Sydow, L Axelsson, S Lindgren, and B Gullmar. Surface properties of Lactobacilli isolated from the small intestine of pigs. J. Appl. Bacteriol., 62: 513–520,1987.
53. CN Jacobsen, VR Nielsen, AE Hayford, PL Moller, KF Michaelsen, A Paerregaard, B Sandstrom, M Tvede, and M Jakobsen. Screening of probiotic activities of forty-seven strains of Lactobacillus spp. by in vitro techniques and evaluation of the colonization ability of five selected strains in humans. Appl. Environ. Microbiol., 65: 4949–4956, 1999.
54. BW Wolf, KA Garleb, DG Ataya, and IA Casas. Safety and tolerance of Lactobacillus reuteri in healthy adult male subjects. Microb. Ecol. Health Dis., 8: 41–50, 1995.
55. BW Wolf, KB Wheeler, DG Ataya, and KA Garleb. Safety and tolerance of Lactobacillus reuteri supplementation to a population infected with the human immunodeficiency virus. Food Chem. Toxicol., 36: 1085–1094, 1998.
56. P Marteau, P Pochart, Y Bouhnik, S Zidi, I Goderel, and JC Rambaud. Survival of Lactobacillus acidophilus and Bifidobacterium sp ingested in a fermented milk in the small intestine — a rational basis for the use of probiotics in man. Gastroenterol. Clin. Biol., 16: 25–28, 1992.
57. P Marteau, E Cuillerier, S Meance, MF Gerhardt, A Myara, M Bouvier, C Bouley, F Tondu, G Bommelaer, and JC Grimaud. Bifidobacterium animalis strain DN- 173 010 shortens the colonic transit time in healthy women: a double-blind, randomized, controlled study. Aliment. Pharmacol. Ther., 16: 587–593, 2002.
58. PK Gopal, J Prasad, J Smart, and HS Gill. In vitro adherence properties of Lactobacillus rhamnosus DR20 and Bifidobacterium lactis DR10 strains and their antagonistic activity against an enterotoxigenic Escherichia coli. Int. J. Food Microbiol., 67: 207–216, 2001.
59. M Matsumoto, H Tani, H Ono, H Ohishi, and Y Benno. Adhesive property of Bifidobacterium lactis LKM512 and predominant bacteria of intestinal microflora to human intestinal mucin. Curr. Microbiol., 44: 212–215, 2002.
60. Y Shimakawa, S Matsubara, N Yuki, M Ikeda, and F Ishikawa. Evaluation of Bifidobacterium breve strain Yakult-fermented soymilk as a probiotic food. Int. J. Food Microbiol., 81: 131–136, 2003.
61. MH Coconnier, MF Bernet, S Kerneis, G Chauviere, J Fourniat, and AL Servin. Inhibition of adhesion of enteroinvasive pathogens to human intestinal Caco- 2 cells by Lactobacillus acidophilus strain Lb decreases bacterial invasion. FEMS Microbiol. Lett., 110: 299–305, 1993.
62. MH Coconnier, TR Klaenhammer, S Kerneis, MF Bernet, and AL Servin. Protein- mediated adhesion of Lactobacillus acidophilus Bg2Fo4 on human enterocyte and mucus-secreting cell-lines in culture. Appl. Environ. Microbiol., 58: 2034–2039, 1992.
63. MF Bernet, D Brassart, JR Neeser, and AL Servin. Lactobacillus acidophilus La-1 binds to cultured human intestinal cell lines and inhibits cell attachment and cell invasion by enterovirulent bacteria. Gut, 35: 483–489, 1994.
64. J Sui, S Leighton, F Busta, and L Brady. 16S ribosomal DNA analysis of the faecal lactobacilli composition of human subjects consuming a probiotic strain Lactobacillus acidophilus NCFM (R). J. Appl. Microbiol., 93: 907–912, 2002.
65. AA Aroutcheva, JA Simoes, and S Faro. Antimicrobial protein produced by vaginal Lactobacillus acidophilus that inhibits Gardnerella vaginalis. Infect. Dis. Obstet. Gynecol., 9: 33–39, 2001.
66. MH Coconnier, V Lievin, MF Bernet-Camard, S Hudault, and AL Servin. Antibacterial effect of the adhering human Lactobacillus acidophilus strain LB. Antimicrob. Agents Chemother., 41: 1046–1052, 1997.
67. T Asahara, K Nomoto, M Watanuki, and T Yokokura. Antimicrobial activity of intraurethrally administered probiotic Lactobacillus casei in a murine model of Escherichia coli urinary tract infection. Antimicrob. Agents Chemother., 45: 1751–1760, 2001.
68. R de Waard, J Garssen, GCAM Bokken, and JG Vos. Antagonistic activity of Lactobacillus casei strain Shirota against gastrointestinal Listeria monocytogenes infection in rats. Int. J. Food Microbiol., 73: 93–100, 2002.
69. T Hori, J Kiyoshima, K Shida, and H Yasui. Augmentation of cellular immunity and reduction of influenza virus titer in aged mice fed Lactobacillus casei strain Shirota. Clin. Diagn. Lab. Immunol., 9: 105–108, 2002.
70. MJ Park, JS Kim, HC Jung, IS Song, and JJ Lee. The suppressive effect of a fermented milk containing lactobacilli on Helicobacter pylori in human gastric mucosa. Gastroenterology, 120: A590, 2001.
71. S Spanhaak, R Havenaar, and G Schaafsma. The effect of consumption of milk fermented by Lactobacillus casei strain Shirota on the intestinal microflora and immune parameters in humans. Eur. J. Clin. Nutr., 52: 899–907, 1998.
72. N Yuki, K Watanabe, A Mike, Y Tagami, R Tanaka, M Ohwaki, and M Morotomi. Survival of a probiotic, Lactobacillus casei strain Shirota, in the gastrointestinal tract: selective isolation from feces and identification using monoclonal antibodies. Int. J. Food Microbiol., 48: 51–57, 1999.
73. S Fujiwara, Y Seto, A Kimura, and H Hashiba. Establishment of orally-administered Lactobacillus gasseri SBT2055SR in the gastrointestinal tract of humans and its influence on intestinal microflora and metabolism. J. Appl. Microbiol., 90: 343–352, 2001.
74. A Ushiyama, K Tanaka, Y Aiba, T Shiba, A Takagi, T Mine, and Y Koga. Lactobacillus gasseri OLL2716 as a probiotic in clarithromycin-resistant Helicobacter pylori infection, J. Gastroenterol. Hepatol., 18, 986–991, 2003.
75. G Reid. Safety of Lactobacillus strains as probiotic agents. Clin. Infect. Dis., 35: 349–350, 2002.
76. G Reid and AW Bruce. Selection of Lactobacillus strains for urogenital probiotic applications. J. Infect. Dis., 183: S77–S80, 2001.
77. G Reid. Probiotic agents to protect the urogenital tract against infection. Am. J. Clin. Nutr., 73: 437S–443S, 2001.
78. G Reid, D Charbonneau, J Erb, B Kochanowski, D Beuerman, R Poehner, and AW Bruce. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol. Med. Microbiol., 35: 131–134, 2003.
79. GE Gardiner, C Heinemann, AW Bruce, D Beuerman, and G Reid. Persistence of Lactobacillus fermentum RC-14 and Lactobacillus rhamnosus GR-1 but not L rhamnosus GG in the human vagina as demonstrated by randomly amplified polymorphic DNA. Clin. Diagn. Lab. Immunol., 9: 92–96, 2002.
80. GE Gardiner, C Heinemann, ML Baroja, AW Bruce, D Beuerman, J Madrenas, and G Reid. Oral administration of the probiotic combination Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 for human intestinal applications. Int. Dairy J., 12: 191–196, 2002.
81. G Reid, D Beuerman, C Heinemann, and AW Bruce. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol. Med. Microbiol., 32: 37–41, 2001.
82. B Lund and C Edlund. Probiotic Enterococcus faecium strain is a possible recipient of the van A gene cluster. Clin. Infect. Dis., 32: 1384–1385, 2001.
83. B Lund, C Edlund, L Barkholt, CE Nord, M Tvede, and RL Poulsen. Impact on human intestinal microflora of an Enterococcus faecium probiotic and vancomycin. Scand. J. Infect. Dis., 32: 627–632, 2000.
84. H Blehaut, J Massot, GW Elmer, and RH Levy. Disposition kinetics of Saccharomyces boulardii in man and rat. Biopharm. Drug Disposition, 10: 353–364, 1989.
85. R Ducluzeau and M Bensaada. Comparative effect of a single or continuous administration of Saccharomyces boulardii on the establishment of various strains of Candida in the digestive tract of gnotobiotic mice. Ann. Microbiol., B133: 491–501, 1982.
86. GW Elmer and G Corthier. Modulation of Clostridium difficile induced mortality as a function of the dose and the viability of the Saccharomyces boulardii used as a preventative agent in gnotobiotic mice. Can. J. Microbiol., 37: 315–317, 1991.
87. SW Martin, AC Heatherington, and GW Elmer. Pharmacokinetics of biotherapeutic agents, in Biotherapeutic Agents and Infectious Diseases (Elmer GW, Mc- Farland LV, and Surawicz CM, Eds.), pp. 47–84, Humana Press, Totowa, NJ, 1999.
88. SM Klein, GW Elmer, LV McFarland, CM Surawicz, and RH Levy. Recovery and elimination of the biotherapeutic agent, Saccharomyces boulardii, in healthy human volunteers. Pharm. Res., 10: 1615–1619, 1993.
89. GW Elmer, KA Moyer, R Vega, CM Surawicz, AC Collier, TM Hooton, and LV McFarland. Evaluation of Saccharomyces boulardii for patients with HIV-related chronic diarrhea and in healthy volunteers receiving antifungals. Microecol. Ther., 25: 157–171, 1995.
90. KL Horner, RC LeBoeuf, LV McFarland, and GW Elmer. Dietary fiber affects the onset of Clostridium difficile disease in hamsters. Nutr. Res., 20: 1103–1112, 2000.
91. MC Rigothier, J Maccario, and P Gayral. Inhibitory activity of Saccharomyces yeasts on the adhesion of Entamoeba histolytica trophozoites to human erythrocytes in vitro. Parasitol. Res., 80: 10–15, 1994.
92. MC Rigothier, J Maccario, PN Vuong, and P Gayral. Effects of Saccharomyces boulardii yeast on trophozoites of Entamoeba histolytica in vitro and in cecal amebiasis in young rats. Ann. Parasitol. Hum. Compar., 65: 51–60, 1990.
93. R Berg, P Bernasconi, D Fowler, and M Gautreaux. Inhibition of Candida albicans translocation from the gastrointestinal tract of mice by oral administration of Saccharomyces boulardii. J. Infect. Dis., 168: 1314–1318, 1993.
94. N Vidon, B Huchet, and JC Rambaud. Effect of S boulardii on water and sodium secretions induced by cholera-toxin. Gastroenterol. Clin. Biol., 10: 13–16, 1986.
95. D Czerucka, I Roux, and P Rampal. Saccharomyces boulardii inhibits secretagogue- mediated adenosine 3',5'-cyclic-monophosphate induction in intestinal cells. Gastroenterology, 106: 65–72, 1994.
96. CM Surawicz, LV McFarland, G Elmer, and J Chinn. Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii. Am. J. Gastroenterol., 84: 1285–1287, 1989.
97. CM Surawicz, LV McFarland, RN Greenberg, M Rubin, R Fekety, ME Mulligan, RJ Garcia, S Brandmarker, K Bowen, D Borjal, and GW Elmer. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin. Infect. Dis., 31: 1012–1017, 2000.
98. C Pothoulakis, CP Kelly, MA Joshi, N Gao, CJ Okeane, I Castagliuolo, and JT Lamont. Saccharomyces boulardii inhibits Clostridium difficile toxin-a binding and enterotoxicity in rat ileum. Gastroenterology, 104: 1108–1115, 1993.
99. I Castagliuolo, MF Riegler, L Valenick, JT Lamont, and C Pothoulakis. Saccharomyces boulardii protease inhibits the effects of Clostridium difficile toxins A and B in human colonic mucosa. Infect. Immun., 67: 302–307, 1999.
100. GW Elmer and LV McFarland. Suppression by Saccharomyces boulardii of toxigenic Clostridium difficile overgrowth after vancomycin treatment in hamsters. Antimicrob. Agents Chemother., 31: 129–131, 1987.
101. JP Buts, N DeKeyser, C Stilmant, E Sokal, and S Marandi. Saccharomyces boulardii enhances N-terminal peptide hydrolysis in suckling rat small intestine by endoluminal release of a zinc-binding metalloprotease. Pediatr. Res., 51: 528–534, 2002.
102. A Qamar, S Aboudola, M Warny, P Michetti, C Pothoulakis, JT Lamont, and CP Kelly. Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response to Clostridium difficile toxin A in mice. Infect. Immun., 69: 2762–2765, 2001.
103. JAM Caetano, MT Parames, MJ Babo, A Santos, AB Ferreira, AA Freitas, MRC Coelho, and AM Mateus. Immunopharmacological effects of Saccharomyces boulardii in healthy human volunteers. Int. J. Immunopharmacol., 8: 245–247, 1986.
104. JP Buts, P Bernasconi, MP Vancraynest, P Maldague, and R Demeyer. Response of human and rat small intestinal mucosa to oral administration of Saccharomyces boulardii. Pediatr. Res., 20: 192–196, 1986.
105. HU Jahn, R Ullrich, T Schneider, RM Liehr, HL Schieferdecker, H Holst, and M Zeitz. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion, 57: 95–104, 1996.
106. JP Buts, N Dekeyser, and L Deraedemaeker. Saccharomyces boulardii enhances rat intestinal enzyme expression by endoluminal release of polyamines. Pediatr. Res., 36: 522–527, 1994.
107. JP Buts, N Dekeyser, J Kolanowski, E Sokal, and F Vanhoof. Maturation of villus and crypt cell functions in rat small intestine — role of dietary polyamines. Dig. Dis. Sci., 38: 1091–1098, 2003.
108. LV McFarland. A review of the evidence of health claims for biotherapeutic agents. Microb. Ecol. Health Dis., 12: 65–76, 2000.
109. P Marteau, P Seksik, and R Jian. Probiotics and intestinal health effects: a clinical perspective. Br. J. Nutr., 88: S51–S57, 2002.
110. L Agerholm-Larsen, ML Bell, GK Grunwald, and A Astrup. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur. J. Clin. Nutr., 54: 856–860, 2000.
111. F Cremonini, S Di Caro, EC Nista, F Bartolozzi, G Capelli, G Gasbarrini, and A Gasbarrini. Meta-analysis: the effect of probiotic administration on antibioticassociated diarrhoea. Aliment. Pharmacol. Ther., 16: 1461–1467, 2002.
112. AL D'Souza, C Rajkumar, J Cooke, and CJ Bulpitt. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. Br. Med. J., 324: 1361–1364, 2002.
113. JS Huang, A Bousvaros, JW Lee, A Diaz, and EJ Davidson. Efficacy of probiotic use in acute diarrhea in children — A meta-analysis. Dig. Dis. Sci., 47: 2625–2634, 2002.
114. H Szajewska and JZ Mrukowicz. Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials. J. Pediatr. Gastroenterol. Nutr., 33: S17–S25, 2001.
115. CW Van Niel, C Feudtner, MM Garrison, and DA Christakis. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics, 109: 678–684, 2002.
116. LV McFarland. Epidemiology, risk factors and treatments for antibiotic-associated diarrhea. Dig. Dis., 16: 292–307, 1998.
117. LV McFarland, CM Surawicz, RN Greenberg, GW Elmer, KA Moyer, SA Melcher, KE Bowen, and JL Cox. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am. J. Gastroenterol., 90: 439–448, 1995.
118. CM Surawicz, GW Elmer, P Speelman, LV McFarland, J Chinn, and G Vanbelle. Prevention of antibiotic associated diarrhea by Saccharomyces boulardii — a prospective study. Gastroenterology, 96: 981–988, 1989.
119. SL Gorbach, TW Chang, and B Goldin. Successful treatment of relapsing Clostridium difficile colitis with Lactobacillus GG. Lancet, 2: 1519, 1987.
120. JA Biller, AJ Katz, AF Flores, TM Buie, and SL Gorbach. Treatment of recurrent Clostridium difficile colitis with Lactobacillus GG. J. Pediatr. Gastroenterol. Nutr., 21: 224–226, 1995.
121. LV McFarland, CM Surawicz, M Rubin, R Fekety, GW Elmer, and RN Greenberg. Recurrent Clostridium difficile disease: epidemiology and clinical characteristics. Inf. Control Hosp. Epidemiol., 20: 43–50, 1999.
122. LV McFarland, CM Surawicz, RN Greenberg, R Fekety, GW Elmer, KA Moyer, SA Melcher, KE Bowen, JL Cox, Z Noorani, G Harrington, M Rubin, and D Greenwald. Randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. J. Am. Med. Assoc., 271: 1913–1918, 1994.
123. PJ Oksanen, S Salminen, M Saxelin, P Hamalainen, A Ihantolavormisto, L Muurasniemiisoviita, S Nikkari, T Oksanen, I Porsti, E Salminen, S Siitonen, H Stuckey, A Toppila, and H Vapaatalo. Prevention of travelers diarrhea by Lactobacillus GG. Ann. Med., 22: 53–56, 1990.
124. E Hilton, P Kolakowski, C Singer, and M Smith. Efficacy of Lactobacillus GG as a diarrheal preventive in travelers. J. Travel. Med., 4: 41–43, 1997.
125. H Kollaritsch, H Holst, P Grobara, and G Wiedermann. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo controlled doubleblind study. Fortschr. Med., 111: 152–156, 1993.
126. RA Oberhelman, EH Gilman, P Sheen, DN Taylor, RE Black, L Cabrera, AG Lescano, R Meza, and G Madico. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J. Pediatr., 134: 15–20, 1999.
127. JM Saavedra, NA Bauman, I Oung, JA Perman, and RH Yolken. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in-hospital for prevention of diarrhea and shedding of rotavirus. Lancet, 344: 1046–1049, 1994.
128. H Szajewska, M Kotowska, JZ Mrukowicz, M Armanska, and W Mikolajczyk. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J. Pediatr., 138: 361–365, 2001.
129. GW Elmer, CM Surawicz, and LV McFarland. Biotherapeutic agents — A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. J. Am. Med. Assoc., 275: 870–876, 1996.
130. GW Elmer. Probiotics: "Living drugs". Am. J. Health Syst. Pharm., 58: 1101–1109, 2001.
131. MC Lee, LH Lin, KL Hung, and HY Wu. Oral bacterial therapy promotes recovery from acute diarrhea in children. Acta Paediatr. Taiwan, 42: 301–305, 2001.
132. G Boudraa, M Benbouabdellah, W Hachelaf, M Boisset, JF Desjeux, and M Touhami. Effect of feeding yogurt versus milk in children with acute diarrhea and carbohydrate malabsorption. J. Pediatr. Gastroenterol. Nutr., 33: 307–313, 2001.
133. V Rosenfeldt, KF Michaelsen, M Jakobsen, CN Larsen, PL Moller, M Tvede, H Weyrehter, NH Valerius, and A Paerregaard. Effect of probiotic Lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending daycare centers. Pediatr. Infect. Dis. J., 21: 417–419, 2002.
134. V Rosenfeldt, KF Michaelsen, M Jakobsen, CN Larsen, PL Moller, P Pedersen, M Tvede, H Weyrehter, NH Valerius, and A Paerregaard. Effect of probiotic Lactobacillus strains in young children hospitalized with acute diarrhea. Pediatr. Infect. Dis. J., 21: 411–416, 2002.
135. S Guandalini, L Pensabene, MA Zikri, JA Dias, LG Casali, H Hoekstra, S Kolacek, K Massar, D Micetic-Turk, A Papadopoulou, JS de Sousa, B Sandhu, H Szajewska, and Z Weizman. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J. Pediatr. Gastroenterol. Nutr., 30: 54–60, 2000.