The protective role of prebiotics and probiotics on diarrhea and gut damage in the rotavirus-infected piglets

Rotavirus is one of the pathogenic causes that induce diarrhea in young animals, especially piglets, worldwide. However, nowadays, there is no specific drug available to treat the disease, and the related vaccines have no obvious efficiency in some countries. Via analyzing the pathogenesis of rotavirus, it inducing diarrhea is mainly due to disturb enteric nervous system, destroy gut mucosal integrity, induce intracellular electrolyte imbalance, and impair gut microbiota and immunity. Many studies have already proved that prebiotics and probiotics can mitigate the damage and diarrhea induced by rotavirus infection in hosts. Based on these, the current review summarizes and discusses the effects and mechanisms of prebiotics and probiotics on rotavirus-induced diarrhea in piglets. This information will highlight the basis for the swine production utilization of prebiotics and probiotics in the prevention or treatment of rotavirus infection in the future.

Structural characterization and prebiotic potential of polysaccharides from Polygonatum sibiricum

Polygonatum sibiricum has been widely used due to its excellent biological activities.We prepared a novel polysaccharide from P.sibiricum(PSP)in this study.According a monosaccharide composition analysis,PSP was mainly composed of fructose and glucose with a molar percentage of 93.81:5.12.The main linkage types were identified asα-D-Glcp-1→and→2-β-D-Fruf-1→.The molecular weight of PSP showed no significant change after simulated salivary and gastrointestinal digestion.However,PSP could be broken down by intestinal bacteria.Our findings revealed that PSP administration increased the abundance of probiotics such as Bifidobacterium.Furthermore,the results showed that gut microbes could utilize PSP to produce short-chain fatty acids including acetic acid,propionic acid,and butyric acid.Also,the PSP fermentation broth displayed an excellent scavenging effect on free radicals,including 2,2-diphenyl-1-picrylhydrazyl radical,superoxide radical,and hydroxyl radical.In summary,this study will help to promote the application of PSP as prebiotics in functional food and the medical industry.

Impact of Inulin Extracted, Purified from (Chicory and Globe Artichoke) Roots and the Combination with Maltodextrin as Prebiotic Dietary Fiber on the Functional Properties of Stirred Bio-Yogurt

Inulin is a prebiotic dietary fiber that plays an integral role in producing functional dairy products with improved health benefits. Therefore, the objectives of this study are as follows: extract and purify inulin from chicory roots and globe artichoke roots;evaluate the physicochemical, functional properties and functional groups of the purified inulin;determine the functional properties of chicory roots inulin-maltodextrin and globe artichoke roots inulin-maltodextrin and compare it with that of the commercial inulin;examine the impact of various inulin on physiochemical, microstructural, textural, sensory characteristics and as prebiotic dietary fiber on probiotic bacteria’s viability of stirred bio-yogurt. The characteristics of the microstructure were investigated by scanning electron microscopy and, Fourier transforms infrared spectroscopy to detect the functional group. The resulting inulin exhibited a high yield and purity along with enhanced functional properties. Stirred bio-yogurt fortified with chicory roots inulin or globe artichoke roots inulin showed enhanced physicochemical, microstructural, microbiological, and overall sensorial acceptability followed by chicory roots inulin-maltodextrin or globe artichoke roots inulin-maltodextrin and the commercial inulin as compared to the control. Stirred bio-yogurt samples can offer various health benefits and wide applications as supplement of prebiotic dietary fiber in dairy industry.

Debranching enzymes decomposed corn arabinoxylan into xylooligosaccharides and achieved prebiotic regulation of gut microbiota in broiler chickens

Background Corn arabinoxylan(AX)is a complicated and multibranched antinutritional factor,thereby proving the use of endo-xylanase(EX)to be marginally valid.This study focused on specific types of AX-degrading enzymes(ADEs)to exert the synergy of debranching enzymes and track the prebiotic potential of enzymatic hydrolysates.This study investigated the effects of ADEs on the growth performance,intestinal histomorphology,absorption functions,changes in polysaccharide components,fermentation,and gut microbiota of broiler chickens.Five hundred seventysix five-day-old Arbor Acres male broiler chickens were randomly allocated into eight treatments with six replicates each.Corn basal diets supplemented with or without enzymes were fed for a 21-day period,specifically including EX,its compatible use with arabinofuranosidase(EXA)or ferulic acid esterase(EXF),and compound groups with the above three enzymes(XAF).Results Specific ADEs stimulated the jejunal villus height and goblet cell number and evidently decreased the crypt depth(P<0.05),while the ratio of ileal villus height to crypt depth was significantly increased in EXF(P<0.05).Maltase activities of ileal mucosa in XAF groups were extremely enhanced(P<0.01),and EX boosted the activity of Na+-K+ATPase in the small intestine(P<0.01).The insoluble AX concentrations comparatively lessened,thereby notably raising the sundry xylooligosaccharide(XOS)yield in the ileal chyme(P<0.05),which was dominant in xylobiose and xylotriose.Improvements in the abundance and diversity of ileal microbial communities within the EXA,EXF,and XAF treatments were observed(P<0.05).Positive correlations between microbiota and XOS were revealed,with xylobiose and xylotriose being critical for ten beneficial bacteria(P<0.05).EXF increased the BWG and FCR of broiler chickens in this phase(P<0.05),which was attributed to the thriving networks modified by Lactobacillus.The intracecal contents of acetic acid,butyric acid,and propionic acid were greatly enhanced in most ADE groups,such as EXF(P<0.05).Conclusions Debranching enzymes appreciably targeted corn AX to release prebiotic XOS in the posterior ileum and facilitated intracaecal fermentation.It was beneficial for improving gut development,digestion and absorption and modulating the microflora to promote the early performance of broiler chickens.

Heat stress in pigs and broilers:role of gut dysbiosis in the impairment of the gut-liver axis and restoration of these effects by probiotics,prebiotics and synbiotics

Heat stress is one of the most challenging stressors for animal production due to high economic losses resulting from impaired animal’s productivity,health and welfare.Despite the fact that all farm animal species are susceptible to heat stress,birds and pigs are particularly sensitive to heat stress due to either lacking or non-functional sweat glands.Con-vincing evidence in the literature exists that gut dysbiosis,a term used to describe a perturbation of commensal gut microbiota,develops in broilers and pigs under heat stress.Owing to the protective role of commensal bacteria for the gut barrier,gut dysbiosis causes a disruption of the gut barrier leading to endotoxemia,which contributes to the typical characteristics of heat stressed broilers and growing and growing-finishing pigs,such as reduced feed intake,decreased growth and reduced lean carcass weight.A substantial number of studies have shown that feeding of probiotics,prebiotics and synbiotics is an efficacious strategy to protect broilers from heat stress-induced gut barrier disruption through altering the gut microbiota and promoting all decisive structural,biochemical,and immunologi-cal elements of the intestinal barrier.In most of the available studies in heat stressed broilers,the alterations of gut microbiota and improvements of gut barrier function induced by feeding of either probiotics,prebiotics or synbiot-ics were accompanied by an improved productivity,health and/or welfare when compared to non-supplemented broilers exposed to heat stress.These findings indicate that the restoration of gut homeostasis and function is a key target for dietary interventions aiming to provide at least partial protection of broilers from the detrimental impact of heat stress conditions.Despite the fact that the number of studies dealing with the same feeding strategy in heat stressed pigs is limited,the available few studies suggest that feeding of probiotics might also be a suitable approach to enhance productivity,health and welfare in pigs kept under heat stress conditions.

Analyzing the Prebiotic Potential of Glucosamine for Targeting the Gut Microbiome Health

Recognizing the composition and modulation of the microbiome, a viable therapeutic tool for multi-targeted therapy is a new strategy that has recently been explored. Glucosamine (GS) is being studied for its prebiotic potential in addition to being the most abundant and naturally occurring amino monosaccharide. The current study focuses on glucosamine’s prebiotic potential by assessing the stability of various GS concentrations (1% - 5%) in the gastrointestinal tract (GIT) and its ability to be fermented by the gut microbiota. The results showed that GS stimulated the most growth in L. acidophilus even after a longer incubation time than B. bifidum and L. acidophilus growth was concentration-dependent, with maximum growth at 3% with a simultaneous decrease in pH (5.6 - 1.7). The decrease in GS concentration with time also represented the growth of bacterial species, demonstrating the species’ utilization of GS. Furthermore, at 3%, GS also represented the prebiotic index of 1.9. In addition, the concentration of GS in various simulated GIT fluids was estimated in both fast and fed conditions to examine GS stability at various levels in the gut. The results showed that GS remained unaffected and non-digestible in all of the simulated GIT fluids (salivary, gastric, intestinal, and colonic), but there was a slight decrease in GS concentration (2.8%) in the fasted state of gastric fluid due to low pH levels (1.6). As a result, the findings are conclusive and suggest that GS possesses prebiotic properties.

Probiotics and prebiotics in chronic inflammatory bowel diseases

The prokaryotic and eukaryotic cells of the colon exist in a highly complex, but harmonious relationship. Disturbances in this remarkable symbiosis can result in the development of inflammatory bowel diseases (IBD). Although the etiology of IBD is not entirely understood, it is known that the chronic inflammation of Crohn’s disease, ulcerative colitis and chronic pouchitis are a result of an overly aggressive immune response to the commensal intestinal flora in genetically susceptible hosts. Recent studies have enhanced our ability to understand the interaction between the host and its intestinal microflora and the role the microflora plays in maintaining intestinal homeostasis. As we begin to understand the benefi ts conferred to the intestine by the microflora, the notion of modifying the composition of the bacterial load to improve human health has arisen. A signifi cant body of research now exists investigating the role of probiotics and prebiotics in ameliorating chronic intestinal inflammation. This article will begin with an overview of the role of the commensal microflora in maintaining mucosal immune homeostasis, and how a dysregulated immune response to the intestinal microflora results in IBD. This will be followed by a summary of the use of probiotics and prebiotics in experimental and human IBD.

Intestinal microbiota, probiotics and prebiotics in inflammatory bowel disease

It has been presumed that aberrant immune response to intestinal microorganisms in genetically predisposed individuals may play a major role in the pathogenesis of the inflammatory bowel disease, and there is a good deal of evidence supporting this hypothesis. Commensal enteric bacteria probably play a central role in pathogenesis, providing continuous antigenic stimulation that causes chronic intestinal injury. A strong biologic rationale supports the use of probiotics and prebiotics for inflammatory bowel disease therapy. Many probiotic strains exhibit anti-inflammatory properties through their effects on different immune cells, pro-inflammatory cytokine secretion depression, and the induction of anti-inflammatory cytokines. There is very strong evidence supporting the use of multispecies probiotic VSL#3 for the prevention or recurrence of postoperative pouchitis in patients. For treatment of active ulcerative colitis, as well as for maintenance therapy, the clinical evidence of efficacy is strongest for VSL#3 and Escherichia coli Nissle 1917. Moreover, some prebiotics, such as germinated barley foodstuff, Psyllium or oligofructose-enriched inulin, might provide some benefit in patients with active ulcerative colitis or ulcerative colitis in remission. The results of clinical trials in the treatment of active Crohn&#x02019;s disease or the maintenance of its remission with probiotics and prebiotics are disappointing and do not support their use in this disease. The only exception is weak evidence of advantageous use of Saccharomyces boulardii concomitantly with medical therapy in maintenance treatment.

Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution:A prospective randomized double-blind study

AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who required stoppage of oral feeding for 48 h, were randomly assigned to nasojejunal EN with or without prebiotics. APACHE Ⅱ score, Balthazar’s CT score and CRP were assessed daily during the study period.RESULTS: The median duration of hospital stay was shorter in the study group [10 ± 4 (8-14) d vs 15 ± 6 (7-26) d] (P < 0.05). The median value of days in intensive care unit was also similar in both groups [6 ± 2 (5-8) d vs 6 ± 2 (5-7) d]. The median duration of EN was 8 ± 4 (6-12) d vs 10 ± 4 (6-13) d in the study and control groups, respectively (P > 0.05). Deaths occurred in 6 patients (20%), 2 in the study group and 4 in the control group. The mean duration of APACHE Ⅱ normalization (APACHE Ⅱ score < 8) was shorter in the study group than in the control group (4 ± 2 d vs 6.5 ± 3 d, P < 0.05). The mean duration of CRP normalization was also shorter in the study group than in the control group (7 ± 2 d vs 10 ± 3 d, P < 0.05).CONCLUSION: Nasojejunal EN with prebiotic fiber supplementation in severe AP improves hospital stay, duration nutrition therapy, acute phase response and overall complications compared to standard EN therapy.

Fiber and prebiotic supplementation in enteral nutrition:A systematic review and meta-analysis

AIM:To investigate fiber and prebiotic supplementation of enteral nutrition(EN) for diarrhea,fecal microbiota and short-chain fatty acids(SCFAs).METHODS:MEDLINE,EMBASE,Cochrane Library,CINAHL,Academic Search Premier,and Web of Science databases were searched for human experimental and observational cohort studies conducted between January 1990 and June 2014.The keywords used for the literature search were fiber,prebiotics and enteral nutrition.English language studies with adult patient populations on exclusive EN were selected.Abstracts and/or full texts of selected studies were reviewed and agreed upon by two independent researchers for inclusion in the meta-analysis.Tools used for the quality assessment were Jadad Scale and the Scottish Intercollegiate Guidelines Network Critical Appraisal of the Medical Literature.RESULTS:A total of 456 possible articles were retrieved,and 430 were excluded due to lack of appropriate data.Of the 26 remaining studies,only eight investigated the effects of prebiotics.Results of the meta-analysis indicated that overall,fiber reduces diarrhea in patients receiving EN(OR = 0.47;95%CI:0.29-0.77;P = 0.02).Subgroup analysis revealed a positive effect of fiber supplementation in EN towards diarrhea in stable patients(OR = 0.31;95%CI:0.19-0.51;P < 0.01),but not in critically ill patients(OR = 0.89;95%CI:0.41-1.92;P = 0.77).Prebiotic supplementation in EN does not improve the incidence of diarrhea despite its manipulative effect on bifidobacteria concentrations and SCFA in healthy humans.In addition,the effect of fiber and/or prebiotic supplementation towards fecal microbiota and SCFA remain disputable.CONCLUSION:Fiber helps minimize diarrhea in patients receiving EN,particularly in non-critically ill patients.However,the effect of prebiotics in moderating diarrhea is inconclusive.

Role of probiotics,prebiotics and synbiotics in chemoprevention for colorectal cancer

Colorectal cancer is the third most common form of cancer.Current treatments are all associated with a high risk of complications and a low success rate.Recently,synbiotics have been proposed as a new preventive and therapeutic option.There is no direct experimental evidence for cancer suppression in humans as a result of the consumption of pro-,pre-or synbiotics.However,there is a wealth of evidence emerging from laboratory studies.The mechanisms by which pro-,pre-and synbiotics may inhibit colon cancer are now beginning to be understood and will be addressed in the present review.

Prebiotic UG1601 mitigates constipation-related events in association with gut microbiota: A randomized placebo-controlled intervention study

BACKGROUND Constipation is a common functional gastrointestinal disorder and its etiology is multifactorial.Growing evidence suggests that intestinal dysbiosis is associated with the development of constipation.Prebiotics are subjected to bacterial fermentation in the gut to produce short-chain fatty acids(SCFAs),which can help relieve constipation symptoms.The prebiotic UG1601 consists of inulin,lactitol,and aloe vera gel,which are known laxatives,but randomized,controlled clinical trials that examine the effects of this supplement on gut microbiota composition are lacking.AIM To assess the efficacy of the prebiotic UG1601 in suppressing constipation-related adverse events in subjects with mild constipation.METHODS Adults with a stool frequency of less than thrice a week were randomized to receive either prebiotics or a placebo supplement for 4 wk.All participants provided their fecal and blood samples at baseline and at the end of intervention.Gastrointestinal symptoms and stool frequency were evaluated.The concentrations of serum endotoxemia markers and fecal SCFAs were determined.The relative abundance of SCFA-producing bacteria and the gut microbial community in the responders and non-responders in the prebiotics supplementation group were evaluated.RESULTS There were no significant differences in gastrointestinal symptoms between groups,although the prebiotic group showed greater symptom improvement.However,after prebiotic usage,serum cluster of differentiation(CD)14 and lipopolysaccharide(LPS)concentrations were significantly decreased(CD14,P=0.012;LPS,P<0.001).The change in LPS concentration was significantly larger in the prebiotic group than in the placebo group(P<0.001).Fecal SCFAs concentrations did not differ between groups,while the relative abundance of Roseburia hominis,a major butyrate producer,was significantly increased in the prebiotic group(P=0.045).The abundances of the phylum Firmicutes and the family Lachnospiraceae(phylum Firmicutes,class Clostridia)(P=0.009)were decreased in the responders within the prebiotic group.In addition,the proportions of the phylum Firmicutes,the class Clostridia,and the order Clostridiales were inversely correlated with several fecal SCFAs(P<0.05).CONCLUSION Alterations in gut microbiota composition,including a decrease in the phylum Firmicutes and an increase in butyrate-producing bacteria,following prebiotic UG1601 supplementation might help alleviate symptom scores and endotoxemia.

Gut microbiota and obesity:Impact of antibiotics and prebiotics and potential for musculoskeletal health

Obesity is a complex disease with multiple contributing factors.One of the most intensely studied factors during the past decade has been the gut microbiota,which is the community of all microbes in the intestinal tract.The gut microbiota,via energy extraction,inflammation,and other actions,is now recognized as an important player in the pathogenesis of obesity.Dysbiosis,or an imbalance in the microbial community,can initiate a cascade of metabolic disturbances in the host.Early life is a particularly important period for the development of the gut microbiota,and perturbations such as with antibiotic exposure can have long-lasting consequences for host health.In early life and throughout the life span,diet is one of the most important factors that shape the gut microbiota.Although diets high in fat and sugar have been shown to contribute to dysbiosis and disease,dietary fiber is recognized as an important fermentative fuel for the gut microbiota and results in the production of short-chain fatty acids that can act as signaling molecules in the host.One particular type of fiber,prebiotic fiber,contributes to changes in the gut microbiota,the most notable of which is an increase in the abundance of Bifidobacterium.This review highlights our current understanding of the role of gut microbiota in obesity development and the ways in which manipulating the microbiota through dietary means,specifically prebiotics,could contribute to improved health in the host,including musculo skeletal health.

The influence of in ovo injection with the prebiotic DiNovoon the development of histomorphological parameters of the duodenum, body mass and productivity in large-scale poultry production conditions

Background: Among various feed additives currently used in poultry nutrition, an important role is played by bioactive substances, including prebiotics. The beneficial effect of these bioactive substances on the gastrointestinal tract and immune system give rise to improvements in broiler health and performance nutrition, thus increasing the productivity of these birds. An innovative method for introducing bioactive substances into chickens is the in ovo injection into eggs intended for hatching. The aim of the study was to evaluate the development of histomorphological parameters of the duodenum and productivity in chickens injected in ovo with the prebiotic DiNovo~?(extract of Laminaria species of seaweed, BioA tlantis Ltd., Ireland) on d 12 of incubation, under large-scale, high density poultry production conditions.Results: There was no significant impact of the injection of DiNovo~? prebiotic on the production parameters of broiler chickens(body weight, FCR, EBI and mortality) obtained on d 42 of rearing. No significant impact of the DiNovo~? injection on the duodenum weight and length was observed, as wel as on the CSA, diameter and muscular layer thickness of the duodenum. The in ovo injection of DiNovo~? significantly increased the width of the duodenal vil i(P < 0.05) and crypt depth(P < 0.01) of chickens on d 21 of rearing. Other histomorphological parameters of duodenal vil i at d 42 of chickens rearing such as: the height, width, and cross section area of vil i were significantly greater in chickens from the control group compared to those from the DiNovo~? group(P < 0.05 and P < 0.01).Conclusions: In conclusion, this study demonstrates that injection of DiNovo~? prebiotic into the air chamber of egg significantly influences the histomorphological parameters on d 21 of rearing without negatively affecting productivity in chickens at the end of rearing.

Microbiota shaping — the effects of probiotics, prebiotics, and fecal microbiota transplant on cognitive functions: A systematic review

BACKGROUND Dementia is a chronic progressive neurological disease affecting millions of people worldwide,and represents a relevant economic burden for healthcare systems.Although its pathogenesis is still unknown,recent findings have reported that a dysregulated gut-brain axis communication,a fundamental relationship mediated by several host and microbial molecules,is associated with cognitive disorders.In addition,gut microbiota manipulation reduces neuroinflammation,improving cognitive function by restoring the functional gut-brain axis.AIM To better define the effects of probiotics,prebiotics,synbiotics,and fecal microbiota transplant(FMT)on cognitive function.METHODS We performed a literature search of human randomized clinical trials to examine the effects of the administration of probiotics,prebiotics,synbiotics,or FMT on cognition outcomes in healthy or sick people of every age,sex,and nationality.We systematically searched Embase,Medline/PubMed,Cochrane Library,central and clinicaltrials.gov databases with a combination of comprehensive terms related to cognition and gut microbiota manipulation.Then we carefully reviewed and synthesized the data by type of study design and setting,characteristics of the studied population,kind of intervention(strain type or mixture type,dosage,and frequency of administration),control treatment,inclusion and exclusion criteria,follow-up duration,and cognitive or memory outcomes.RESULTS After examining the titles and abstracts,the initial literature screening identified 995 articles,but we added 23 papers in our systematic review.The analyses of these selected studies highlighted that both probiotic supplementation and FMT improved cognitive function regardless of the type and posology of administration and the adopted cognitive tests and questionnaires.We found that most of the studies conducted in healthy people showed a significant positive effect of the intervention on at least one of the performed cognitive tests.Regarding unhealthy subjects,while FMT and especially probiotic administration had multiple beneficial effects on different cognitive functions,supplementation with prebiotics did not provide any cognitive improvement.CONCLUSION Probiotic supplementation and FMT may represent a promising strategy to restore gut eubiosis and enhance the cognitive functions of healthy people and patients with neurological disorders.

In vitro prebiotic effects of seaweed polysaccharides

Although prebiotic activities of alginate and agar oligosaccharides isolated from seaweeds have been reported, it remains unknown whether seaweed polysaccharides have prebiotic activity. In this study, we isolated polysaccharides from four species of seaweeds, such as Grateloupia fi licina(GFP), Eucheuma spinosum(ESP), Ulva pertusa(UPP), and A scophyllum nodosum(ANP), and characterized their structures and prebiotic ef fects in vitro. The results showed that these polysaccharides were dif ferent in total sugar and sulfate contents as well as monosaccharide composition. GFP and ESP significantly promoted bifi dobacterium proliferation and 0.1% ESP and 0.4% GFP resulted in the highest proliferation rates of beneficial bacteria, whereas UPP and ANP inhibited the growth of beneficial bacteria at all tested concentrations(0.1%–0.5%). The different behaviors of the four seaweed-originated polysaccharides might be refl ected by differences in monosaccharide composition and structure. Therefore, polysaccharides isolated from GFP and ESP could be utilized as prebiotics. However, more studies must be carried out in vivo.

The Importance of Prebiotics in Functional Foods and Clinical Practice

Prebiotics are substances that can promote the growth of beneficial microorganisms, mainly in the intestinal tract, and will modify the colonic microbiota. The following health benefits are attributed to prebiotics: relief from poor digestion of lactose, increased resistance to bacterial infection, better immune response and possible protection against cancer, reduction of the risk of diseases such as intestinal disease, cardiovascular disease, non-insulin dependent diabetes, obesity and osteoporosis. This article presents a discussion of prebiotics, with descriptions of the concepts and its use in clinical practice, and a review of some recent research showing the benefits that these ingredients provide to human health and providing data on the recommended intakes for consumption.

Resolution of acute gastroenteritis symptoms in children and adults treated with a novel polyphenol-based prebiotic

AIM: To test efficacy and durability of a polyphenol-based prebiotic treatment for acute gastroenteritis in a 300 patient double-blinded clinical study.

Prebiotic-Like Effects of SweetPearl&#174;Maltitol through Changes in Caecal and Fecal Parameters

Prebiotic-like effects of maltitol were investigated supplementing two groups of rats with either 5% maltodextrin (control group) or 5% maltitol (maltitol group). A third group was supplemented with 5% maltitol at first and then with 5% maltodextrin (maltitol/maltodextrin group). Faecal parameters were monitored throughout the experiment and caecal parameters at the end. The weights of caecal content and caecal wall were significantly higher in the maltitol group than in the control group, but not in the maltitol/maltodextrin group. Propionic acid concentration was significantly higher in the maltitol group compared to both control and maltitol/maltodextrin group. Faecal parameters were also influenced by the dietary supplementation with maltitol: the amount of dry matter in feces decreased and alpha-glucosidase activity increased. These effects lasted 28 days in the maltitol only group, whereas they stopped some days after the switch to maltodextrin in the maltitol/maltodextrin group. Maltitol could induce prebiotic-like effects.

Immunomodulation by probiotics and prebiotics in hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is the most prevalent primary malignancy in patients suffering from chronic liver diseases and cirrhosis.Recent attention has been paid to the involvement of the gut-liver axis(GLA)in HCC pathogenesis.This axis results from a bidirectional,anatomical and functional relationship between the gastrointestinal system and the liver.Moreover,the complex network of interactions between the intestinal microbiome and the liver plays a crucial role in modulation of the HCC-tumor microenvironment,contributing to the pathogenesis of HCC by exposing the liver to pathogen-associated molecular patterns,such as bacterial lipopolysaccharides,DNA,peptidoglycans and flagellin.Indeed,the alteration of gut microflora may disturb the intestinal barrier,bringing several toll-like receptor ligands to the liver thus activating the inflammatory response.This review explores the new therapeutic opportunities that may arise from novel insights into the mechanisms by which microbiota immunomodulation,represented by probiotics,and prebiotics,affects HCC through the GLA.