Darmflora und Probiotika

Zusammenfassung

Die physiologische Darmflora ist eine entscheidende Voraussetzung für Immunkompetenz und Verdauungsfunktion. Sie bildet sich in den ersten Lebenstagen aus und ist lebenslang relativ stabil. Allerdings unterliegt sie auch verändernden Einflüssen sowohl in negativer als auch in positiver Richtung. Probiotika sind lebende Mikroorganismen, die mit dem Ziel einer günstigen Beeinflussung der Darmflora oral zugeführt werden. Der aktuelle Wissensstand über ihre Möglichkeiten und Grenzen wird diskutiert.

Summary

The physiological gut microflora is the decisive precondition for immunocompetence and digestion. It is developed during the first days of life and remains relatively constant throughout the life. Nevertheless it is affected by changing influences - negative as well as positive ones. Probiotics are living microorganisms which are administered orally aiming at a positive influence on the gut microflora. The recent knowledge about their possibilities and limits will be discussed.

Schlüsselwörter

Darmflora - Probiotika - Antibiotikatherapie - mikroökologisches Gleichgewicht - Darmkrebs

Key words

Intestinal flora - probiotics - antibiotic treatment - micro-ecological balance - intestinal carcinoma

Literatur

• 1 Bartlett JG. Pseudomembranous Colitis.  In: Hentges DJ (ed.): Human Intestinal Flora in Health and Disease.  New York: Academic Press. 1983;  447-479
• 2 Benno Y, Sawada K, Mitsuoka T. The intestinal microflora of infants: Composition of fecal flora in breast-fed and bottle-fed infants.  Microbiol Immunol. 1984;  28 975-986
• 3 Borriello SP. Influence of the Normal Flora of the Gut on Clostridium difficile.  In: Grubb R, Midtvedt T, Norin E (eds.): The Regulatory and Protective Role of the Normal Microflora.  London: Mac Millan Press/New York: Stockton Press. 1989;  239-251
• 4 Bouhnik Y, Pochart P, Marteau P. et al. . Fecal recovery in humans of viable Bifidobacterium sp ingested in fermented milk.  Gastroenterology. 1992;  102 875-878
• 5 Brandis H, Pulverer G. Lehrbuch der Medizinischen Mikrobiologie.  Stuttgart, New York: G Fischer Verlag. 1988; 
• 6 Braun OH. Effect of Consumption of Human Milk and Other Formulas on Intestinal Bacteria Flora in Infants: Textbook of Gastroenterology and Nutrition in Infancy, edited by Lebenthal E.  New York: Raven Press. 1981;  149-155
• 7 Buts JP. Mechanisms of Action of Biotherapeutic Agents.  In: Elmer GW, McFarland LV, Surawicz CM (eds.): Biotherapeutic Agents and Infectious Diseases.  Totowa NJ: Humana Press. 1999;  27-46
• 8 Colle R, Ceschia T. Batterioterapie orale.  Clin Ter. 1989;  131 397-402
• 9 Colombel JF, Cortot A, Neut C, Romond C. Yoghurt with Bifidobacterium longum reduces Erythromycin-induced gastrointestinal effects.  Lancet. 1987;  8549 43
• 10 Czerucka D, Roux I, Rampal P. Saccharomyces boulardii inhibits secretagogue-mediated adenosine 3',5'-cyclic monophosphate induction in intestinal cells.  Gastroenterology. 1994;  106 65-72
• 11 Elmer GW, Surawics CM, MacFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections.  JAMA. 1996;  275 870-876
• 12 Fabia R, Ar'Rajab A, Johansson ML. et al. . Impairment of bacterial flora in human ulcerative colitis and experimental colitis in the rat.  Digestion. 1993;  54 248-255
• 13 Fernandes CF, Chandan RC, Shanani KM. Fermented Diary Products and Health.  In: Wood BJB (ed.): The Lactic Acid Bacteria. Volume 1: The Lactic Acid Bacteria in Health & Disease.  London: Elsevier Science Publishers. 1992;  297-339
• 14 Finegold SM. Anaerobic infections and Clostridium difficile colitis emerging during antibacterial therapies.  Scand J Infect Dis. 1986;  49 160-204
• 15 Finegold SM, Sutter VL, Mathisen GE. Normal Indigenous Intestinal Flora.  In: Hentges DJ (ed.): Human Intestinal Microflora in Health and Disease.  New York: Academic Press. 1983;  3-31
• 16 Goldin BR, Gorbach SL. The effect of milk and Lactobacillus feeding on human intestinal bacterial enzyme activity.  Amer J Clin Nutr. 1984;  39 756-761
• 17 Goldin BR, Gorbach SL. Alterations of the intestinal microflora by diet, oral antibiotics and Lactobacillus. Decreased production of free amines from aromatic nitro compounds, azo dyes and glucuronides.  J Natl Cancer Inst. 1984;  73 689-695
• 18 Golding BR, Gorbach SL, Saxelin M. et al. . Survival of Lactobacillus species (strain GG) in human gastrointestinal tract.  Digestive Diseases Sci. 1992;  37 121-128
• 19 Groeneveld M, Leitzmann C. Zum Vorkommen antikanzerogener Substanzen in Lebensmitteln speziell in milchsauren Produkten.  Aktuel Ernähr. 1987;  12 202-204
• 20 Hahn H, Falke D, Kaufmann SHE, Ullmann U. Medizinische Mikrobiologie und Infektiologie.  Berlin, Heidelberg, New York: Springer. 2001; 
• 21 Hill MJ. Nutrition and prevention of human cancer.  Eur Cancer Prev Org News. 2001;  19 7-10
• 22 Isolauri E, Arvola T, Sütas Y, Moilanen E, Salminen S. Probiotics in the management of atopic eczema.  Clin Exp Allergy. 2000;  30 1604-1610
• 23 Kageyama T, Tomoda T, Nakano Y. The effect of Bifidobacterium administration in patients with leukaemia.  Bifidobacteria Microflora. 1984;  3 29-33
• 24 Kalliomäki M, Salminen S, Arvilommi H. et al. . Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial.  Lancet. 2001;  357 1076-1079
• 25 Knoke M, Bernhardt H. Mikroökologie des Menschen.  Weinheim: VCH Verlagsgesellschaft. 1986;  79-88
• 26 Lidbeck A, Gustafsson JA, Nord CE. Impact of lactobacillus acidophilus supplements on the human oropharyngeal and intestinal microflora.  Scand J Infect Dis. 1987;  19 531-537
• 27 Loeschke K, Ruckdeschel G. Antibiotikaassoziierte Kolitis - aktualisiert.  Internist. 1989;  30 345-351
• 28 Majamaa H, Isolauri E. Probiotics: A novel approach in the management of food allergy.  J Allergy Clin Immunol. 1997;  99 179-185
• 29 Malin M, Suomalainen H, Saxelin M, Isolauri E. Promotion of IgA immune response in patients with Crohn's disease by oral bacteriotherapy with Lactobacillus GG.  Ann Nutr Metab. 1996;  40 137-145
• 30 Mitsuoka T. The Human Gastrointestinal Tract.  In: Wood BJB (ed.): The Lactic Acid Bacteria. Volume 1: The Lactic Acid Bacteria in Health & Disease.  London: Elsevier Science Publishers. 1992;  69-114
• 31 McCann ML, Abrams RS, Nelson RP jr. Recolonization therapy with nonadhesive E. coli for treatment of inflammatory bowel disease.  Ann NY Acad Sci. 1994;  730 243-245
• 32 McFarland LV. Biotherapeutic Agents for Clostridium difficile-associated Diarrhea.  In: Elmer GW, McFarland L, Surawics C (eds.): Biotherapeutic Agents and Infectious Diseases.  Totowa NJ: Humana Press. 1999;  159-193
• 33 Müting D, Reikowski J, Leimbeck R, Flaßhoff H-J, Rausche A. Untersuchungen über die Wirkung einer Bacterium bifidum-Milch auf Darmflora und Leberfunktion bei Leberzirrhosekranken mit portaler Hypertension.  Therapiewoche. 1983;  33 6856-6865
• 34 Neut C, Bezirtzoglou E, Romond C. et al. . Bacterial colonization of the large intestine in newborns delivered by cesarean section.  Zbl Bakt Hyg. 1987;  266 330-337
• 35 Nord CE. The effect of antimicrobial agents on the ecology of the human intestinal microflora.  Vet Microbiol. 1993;  35 193-197
• 36 Reid G. The scientific basis for probiotic strains of Lactobacillus.  Appl Environ Microbiol. 1999;  65 3763-3766
• 37 Rote Liste - Arzneimittelverzeichnis für Deutschland. . Aulendorf.  ACV - Editio Cantor. 2002; 
• 38 Sakata H, Yoshioka H, Fujita K. Development of the intestinal flora in very low birth weight infants compared to normal full-term newborns.  Eur J Pediat. 1985;  144 186-190
• 39 Simon G, Sherwood L, Gorbach MD. Intestinal microflora.  Med Clin N Amer. 1982;  66 557-574
• 40 Sonnenborn U, Stobernack H-P, Proppert Y. Die Entwicklung der aeroben Darmflora bei Neugeborenen.  Fortschr Med. 1990;  108 420-424
• 41 Spencker FB, Goltzsch M, Handrick W, Braun W. Untersuchungen zur bakteriellen Besiedelung gesunder sowie kranker und/oder untergewichtiger Neugeborener. 1. Bakterielle Besiedelung gesunder Neugeborener.  Pädiatr. Grenzgeb. 1987;  26 185-192
• 42 Spencker FB, Braun W, Goltzsch M, Handrick W. Untersuchungen zur bakteriellen Besiedelung gesunder sowie kranker und/oder untergewichtiger Neugeborener. 3. Vergleich der Besiedelungsflora gesunder mit derjenigen kranker und/oder untergewichtiger Neugeborener.  Pädiatr. Grenzgeb. 1987;  26 201-213
• 43 Stark C, Edlund C, Nord CE. Ecological balance and disturbance in the oropharyngeal and gastrointestinal microflora.  Rev Es Quimioterapia. 1996;  9 250-259
• 44 Surawics CM. Biotherapeutic Agents in the Prevention of Antibiotic-associated Diarrhea.  In: Elmer GW, McFarland LV, Surawics CM (eds.): Biotherapeutic Agents and Infectious Diseases.  Totowa NJ: Humana Press. 1999;  145-158
• 45 Tamura Z. Nutriology of Bifidobacteria.  Bifidobacteria Microflora. 1983;  2 3-16
• 46 Terada A, Hara H, Kataoka M, Mitsuoka T. Effect of lactulose on the composition and metabolic activity of the human fecal flora.  Microbial Ecol Health Disease. 1992;  5 43-50
• 47 Van der Waaij D. The digestive tract in immuno-compromised patients: importance of maintaining its resistance to colonization, especially in hospital-in-patients and those taking antibiotics.  Antonie van Leeuwenhoek. 1984;  50 745-761
• 48 Van der Waaij D. The ecology of the human intestine and its consequences for overgrowth by pathogens such as Clostridium difficile.  Ann Rev Microbiol. 1989;  43 69-87
• 49 Vandenplas Y. Bacteria and yeasts in the treatment of acute and chronic infectious diarrhea. Part I.  Bacteria. Clin Microbiol Infect. 1999;  5 299-307
• 50 Vogel F, Knothe H. Changes in aerobic faecal bacterial flora of severely ill patients during antibiotic treatment.  Klin Wschr. 1985;  63 1174-1209
• 51 Wood BJB. Series Preface.  In: Wood BJB (ed.): The Lactic Acid Bacteria. Volume 1; The Lactic Acid Bacteria in Health & Disease.  London: Elsevier Science Publishers. 1992; 
• 52 Zbinden R, Gönczi EE, Altwegg M. Inhibition of Saccharomyces boulardii (nom. inval.) on cell invasion of Salmonella typhimurium and Yersinia enterocolitica.  Microbial Ecol Health Disease. 1999;  11 158-162
• 53 Zdenek K. Neue Technologie und Technik der Herstellung von Sauermilcherzeugnissen und anderen Spezialitäten.  Dt. Molkerei Z. 1983;  16 127-138