Human Health: The Contribution of Microorganisms PDF
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Springer Series in Applied Biology Human Health: The Contribution of Microorganisms Springer Series in Applied Biology Series Editor: Prof. Anthony W. Robards PhD, DSc, FIBiol Published titles: Foams: Physics, Chemistry and Structure The 4-Quinolones: Antibacterial Agents in Vitro Food Freezing: Today and Tomorrow Biodegradation: Natural and Synthetic Materials Immobilised Macromolecules: Application Potentials Human Health: The Contribution of Microorganisms Edited by S. A. W. Gibson Springer-Verlag London Berlin Heidelberg New York Paris Tokyo Hong Kong Barcelona Budapest Stewart A. W. Gibson Reckitt and Colman Phannaceuticals, Dansom Lane, Kingston upon Hull HU8 7DS Series Editor Professor Anthony William Robards, BSc, PhD, DSc, DipRMS, Fffiiol Director, Institute for Applied Biology, Department of Biology, University of York, York YOI 5DD, UK Cover illustration: Pathogenic E. coli adhered to gastric epithelium - courtesy of Dr Ashley Wilson, CCTR, Institute for Applied Biology, University of York ISBN 978-1-4471-3445-9 ISBN 978-1-4471-3443-5 (eBook) DOl 10.1007/978-1-4471-3443-5 British Library Cataloguing in Publication Data Human Health: Contribution of Microorganisms. -(Springer Series in Applied Biology) I. Gibson, Stewart A. W. D. Series 576.162 ISBN 978-1-4471-3445-9 Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. Ii:) Springer-Verlag London Limited 1994 Softcover reprint of the hardcover 1st edition 1994 The use of registered names, trademarks etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Set by Institute for Applied Biology, Department of Biology, University of York 12/3830-543210 Printed on acid free paper Foreword from Series Editor The Institute for Applied Biology was established by the Department of Biology at the University of York to consolidate and expand its existing activities in the field of applied biology. The Department of Biology at York contains a number of individual centres and groups specialising in particular areas of applied research which are associated with the Institute in providing a comprehensive facility for applied biology. Springer-Verlag has a long and successful history of publishing in the biosciences. The combination of these two forces leads to the "Springer Series in Applied Biology". The choice of subjects for seminars is made by our own editorial board and external sources who have identified the need for a particular topic to be addressed. The first volume, "Foams: Physics. Chemistry and Structure", has been followed by "The 4-Quinolones: Antibacterial Agents in Vitro", "Food Freezing: Today and Tomorrow", "Biodegradation: Natural and Synthetic Materials" and "/mmobilised Macromolecules: Application Potentials". The aim is to keep abreast of topics that have a special applied, and contemporary, interest. The current volume describes a group of non pathogenic, host-derived microorganisms, probiotics, which may beneficially affect the host by improving the microbial balance of the target niche. The chapters describe the theories and evidence behind the concept of probiosis and examines the possible contribution of these microorganisms to human health. The applications of Biology are fundamental to the continuing welfare of all people, whether by protecting their environment or by ensuring the health of their bodies. The objective of this series is to become an important means of disseminating the most up-to-date information in this field. York, December 1993 A. W. Robards Editor's Preface Probiotics could be defined as non-pathogenic, host derived microorganisms which beneficially affect the host by improving microbial balance of the target niche. This definition does not cover substances, such as lectins, which affect niche microbial balance chemically and may be considered narrow by those who wish to proffer non-viable microbes as probiotics. The use of these non-viable organisms and poorly contrived preparations in the early days of commercialisation in both the animal and human markets has bequeathed a biller legacy which effective probiotics must now strive to overcome. Modern scientific methodologies, properly formulated and tested products and rigorously controlled clinical trials have contributed to the partial re-establishment of probiotics. Many of the results are still inconclusive, however, and much work remains to be done. This volume, containing contributions by internationally recognised experts from science and industry, examines the development of the human microflora from birth, its function in health and dysfunction in disease, the theories and evidence behind the concept of probiosis, the impact of probiotics on the microbial populations of various niches in the human body, clinical studies which are now being carried out to quantitate the probiotic effect, the steps required for the large scale production of commercially feasible preparations and the registration of these medicines with the MeA for use in humans. With new European legislation (albeit slowly) set to target 'alternative' medicines, products will have to prove efficacy to the satisfaction of European authorities to survive. It is perhaps unfortunate that some potentially useful products, especially those from small or poorly financed organisations, will be lost during the ensuing purge. It is to the benefit of most companies and of the consumer that this process may help with the re-establishment of the health of probiotics in the minds (and bodies) of the scientific and medical communities and of end-users. Hopefully, this process will be completed before the now lengthy probation period for probiotics ends with the closing of the entry door to scientific and medical respectability. s. A. W. Gibson Contents 1 The Acquisition of the Normal Microflora of the Gastrointestinal Tract G. w. Tannock........................................................................ 1 2 Metabolic Activities of the Normal Colonic Flora G. 1'. Macfarlane and G. R. Gibson............................................. 17 3 Intestinal Bacteria and Disease G. R. Gibson and G. T. Macfarlane............................................. 53 4 Probiotics: an Overview R. Fuller....................... ................... ................................ ...... 63 5 Strategies for the Isolation and Characterisation of Functional Probiotics P. L. Conway and A. Henriksson................................................ 75 6 Lactobacilli, Normal Human Microflora and Antimicrobial Treatment A. Lidbeck and C. E. Nord..... ................. ... ............ ..... ... ... ... ... ... 95 7 The Role of' Probiotics in the Urogenital Tract G. Reid, A. W. Bruce and L. Tomeczek........................................ 111 8 Recovery of a Probiotic Organism from Human Faeces after Oral Dosing S. A. W. Gibson and P. L. Conway............................................. 119 9 The Therapeutic use of Live Bacteria in Newborn Infants M. A. Hall and S. L. Smith....................................................... 145 10 Commercial Aspects of' Formulation, Production and Marketing of' Probiotic Products S. Laulund... ......... ......................... ......................... ................ 159 Subject Index...................................................................... 175 Contributors Professor A. W. Bruce Division of Urology, Department of Surgery, University of Toronto, Canada Dr. P. L. Conway University of G<itebotg, Department of General and Marine Microbiology, Carl Skottsbergs Gata 22, S-413 19 G<iteborg, Sweden Dr. R. Fuller 59 Ryeish Green, Three Mile Cross, Reading RG7 1£S Dr. G. R. Gibson Medical Research Council, Dunn Clinical Nutrition Centre, 100 Tennis Court Road, Cambridge CB2 1Q L Dr SAW Gibson Reckitt and Colman Pharmaceuticals, Dansom Lane, Kingston upon Hull HU87DS Dr. M. A. Hall The Princess Anne Hospital, Coxford Road, Southampton S09 4HA Dr. A. Henriksson University of G<itebotg, Department of General and Marine Microbiology, Carl Skottsbergs Gata 22, S-413 19 Goteborg, Sweden Mr. S. Laulund Chr. Hansen's Bio Systems A/S, H0rsholm, Denmark Dr. A. Lidbeck Department of Microbiology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden xii Contributors Dr. G. T. Macfarlane Medical Research Council. Dunn Clinical Nutrition Centre. 100 Tennis Court Road. Cambridge CB2 IQL Professor C. E. Nord Department of Microbiology. Huddinge University Hospital. Karolinska Institute. Huddinge and National Bacteriological Laboratory. Stockholm. Sweden DrG.Reid Department of Microbiology and Immunology. University of Western Ontario. SLB 328. London. Ontario, N6A 5B8 Canada and Division of Urology. Department of Surgery. University of Toronto, Canada Ms. S. L. Smith The Princess Anne Hospital, Coxford Road, Southampton S09 4HA Professor G. W. Tannock Department of Microbiology, University of Otago, Dunedin, New Zealand Ms. L. Tomeczek Division of Urology, Department of Surgery, University of Toronto, Canada and Department of Microbiology, University of Toronto, Canada Chapter 1 The Acquisition of the Normal Microflora of the Gastrointestinal Tract w. G. Tannock Introduction The birth of a mammal must be a moment of celebration in the microbial world. A new, potential host emerges from the uterus where it has been protected during development from contact with bacteria, fungi and protozoa. During passage of the young animal through the birth canal, members of the vaginal microflora have the opportunity to contaminate the pristine surfaces of the infant At the moment of birth, or shortly thereafter, microbes in faeces that have been involuntarily expelled by the mother during labour, and microbes that are present in the air or on inanimate materials enter the germfree ecosystems of the neonate and proliferate to a dramatic extent. Suckling, licking (kissing) and grooming (caressing) of the infant after birth enables transfer of skin and oral microbes from adult to neonate to occur. It might be thought, indeed, that the positioning of the orifice of the birth canal in close vicinity to the anus, and the nature of parental expressions of caring are of microbiological design, since they ensure the transmission of microbes comprising the normal microflora from one generation to the next (Carlsson and Gothefors 1975; Brunei and Gouet 1982; Brunei and Gouet 1989; Tannock et al. 1990b). Colonisation of the neonatal surfaces and internal cavities that have openings to the body's exterior occurs within the 24 h following birth. Proliferation of microbial types in these sites appears to be initially unchecked, resulting in a heterogeneous collection of microbes. Soon, however, regulatory mechanisms generated within habitats (autogenic factors) and by external forces (allogenic factors) permit the continuing presence of some microbial types in the gastrointestinal ecosystem but the elimination
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