Modulatory effects of Bifidobacterium longum BB536 on defecation in elderly patients receiving enteral feeding

AIM:To investigate the effects of the probiotic Bifidobacterium longum BB536 on the health management of elderly patients receiving enteral feeding.METHODS:Two double-blind,placebo-controlled trials were performed with long-term inpatients receiving enteral tube feeding at Kitakyushu Hospital Group,Fukuoka,Japan.BB536 was administered as BB536-L and BB536-H powders that contained approximately 2.5 × 10 10 and 5 × 10 10 cfu of BB536,respectively.In the first trial,83 patients(age range:67-101 years) were randomized into 2 groups that received placebo(placebo group) or BB536-H(BB536 group) powders.In the second trial,123 patients(age range:65-102years) were randomized into 3 groups,and each group received placebo(placebo group),BB536-L(BB536-L group),or BB536-H(BB536-H group) powders.Each patient received the study medication for 16 wk after 1 wk of pre-observation.Fecal samples were collected from each patient prior to and after the intervention during Trial 2.Clinical observations included body temperature,occurrence of infection,frequency of defecation,and fecal microbiota.RESULTS:No significant changes were observed in the frequency of defecation for either treatment in Trial 1.However,a significant change was noted in the BB536-L group(P = 0.0439) in Trial 2 but not in the placebo or BB536-H groups.Subgroup analyses based on the frequency of defecation for each patient during the pre-observation period for both trials revealed significant increases in bowel movements in patients with a low frequency of defecation and significant decreases in the bowel movements of patients with a high frequency of defecation during the intervention period in the BB536 groups.The combination of Trials 1 and 2 data revealed a modulatory effect of BB536 ingestion on the changes in bowel movements.Significantly increased bowel movements were observed in patients in the low frequency subgroup with significant intergroup differences(P < 0.01).Significantly decreased bowel movements were observed in patients in the high subgroup,but no significant intergroup differences were observed compared with the placebo group.BB536 ingestion increased the prevalence of normally formed stools.BB536 intake also significantly(P < 0.01) increased the cell numbers of bifidobacteria in fecal microbiota,and significant intergroup differences were observed at week 16.No adverse events were reported in any group.CONCLUSION:Our results suggest that BB536 ingestion modulated the intestinal environment and may have improved the health care of elderly patients receiving enteral feeding.

Bifidobacteria Upregulate Expression of Toll-Like Receptor Negative Regulators Counteracting Enterotoxigenic <i>Escherichia coli</i>Mediated Inflammation in Bovine Intestinal Epitheliocytes

We previously established a bovine intestinal epithelial cell line (BIE cells) and showed that BIE cells are useful in vitro model system for the study of interactions between pathogenic and beneficial microorganisms and bovine intestinal epithelial cells (IECs). In the present study, we aimed to select potential immunomodulatory bifidobacteria that may be used to beneficially modulate the inflammatory response in bovine IECs. We also aimed to gain insight into the molecular mechanisms involved in the anti-inflammatory effect of bifidobacteria by evaluating the role of Toll-like receptor (TLR)-2 and TLR negative regulators in the regulation of proinflammatory cytokines production and MAPK, NF-κB and PI3K pathways activation in BIE cells. Five bifidobacteria strains were evaluated in this study and according to their capacity to modulate the inflammatory response of BIE cells. Despite the unique effect of each strain, four common points were found when comparing the effect of the high and moderate anti-inflammatory strains: 1) Upregulation of TLR negative regulators and the intensity of that upregulation was related to the different immunomodulatory capacity of each bifidobacteria strain;2) The balance between MAPK activation and MKP-1 upregulation affected the anti-inflammatory effect of bifidobacteria in BIE cells;3) The inhibition of PI3K pathway was related to the anti-inflammatory effect of bifidobacteria;4) The immunoregulatory effect of bifidobacteria in BIE cells is partially dependent on TLR2. This study shows that BIE cells can be used for the selection of immunoregulatory bifidobacteria and for studying the mechanisms involved in the protective activity of immunobiotics against TLR4-induced inflammatory damage. In addition, we have demonstrated that the anti-inflammatory effect of bifidobacteria was achieved by a complex interaction of multiple TLRs negative regulators as well as the inhibition/activation of multiple signaling pathways.