Die Abwehr unterstützen

Zusammenfassung

Die Darmmikrobiota unterstützt die Abwehr pathogener Bakterien: Sie sezerniert Bakteriozine, induziert Wirtszellen zur Produktion von Defensinen, konkurriert mit pathogenen Keimen um Adhäsionsmoleküle in der Mukosa und sorgt für eine intakte Darmbarriere. Darüber hinaus moduliert die Mikrobiota Komponenten des lymphatischen Systems. So sind bestimmte Mikroorganismen in vitro, aber auch nach oraler Aufnahme (Probiotika) in der Lage, die Th1-Immunantwort zu stimulieren. Diese geht mit einer vermehrten Bildung von neutralisierenden Antikörpern (adaptives Immunsystem) sowie einer Stimulierung des angeborenen Immunsystems z. B. von Phagozyten einher, was insgesamt die Infektabwehr stärkt. Humanstudien belegen, dass Probiotika das Immunsystem modulieren und die mukosale Barrierefunktion erhöhen. Des Weiteren ist belegt, dass bei Impfungen gegen Rotavirus, Polio und Influenza mehr spezifische Antikörper gebildet werden, wenn gleichzeitig Probiotika eingenommen werden. Mehrere Metaanalysen bestätigen außerdem, dass Probiotikagabe das Risiko für Diarrhöen bei Erwachsenen und Kindern senkt, inkl. Reisediarrhöen und antibiotikaassoziierten Diarrhöen. Einzelne Studien zeigten, dass auch Atemwegserkrankungen hinsichtlich Schwere, Dauer und Inzidenz unter dem Einfluss von Probiotika reduziert werden können; erste Metaanalysen bestätigen solche Effekte.

Abstract

The intestinal microbiota supports the defence against pathogenic bacteria: it secretes bacteriocins, induces host cells to produce defensins, competes with pathogenic strains for adhesion molecules in the mucosa, and ensures an intact intestinal barrier. Furthermore the microbiota modulates components of the lymphatic system. Certain micro-organisms are able, in vitro but also after oral ingestion (probiotics), to stimulate the Th1 immune response. This is accompanied by increased formation of neutralising antibodies (adaptive immune system) and stimulation of the congenital immune system (for example, of phagocytes), strengthening resistance to infections. Human studies have shown that probiotics modulate the immune system and increase the mucosal barrier function. Furthermore it has been shown that vaccinations against rotavirus, polio, and influenza result in increased antibody formation in people who are simultaneously taking probiotics. Several meta-analyses have shown that administration of probiotics lowers the risk of diarrhoea in children and adults, including traveller’s diarrhoea and antibiotic-associated diarrhoea. Individual studies have shown that infections of the respiratory tract are also less severe in patients taking probiotics, in terms of severity, duration, and incidence; initial meta-analyses have confirmed such effects.

Schlüsselwörter

GALT - Darmbakterien - Th1-Immunantwort - Probiotika - Impfungen - Diarrhö - Atemwegserkrankungen - Winterinfekte

Keywords

gut-associated lymphoid tissue (GALT) - intestinal bacteria - Th1 immune response - probiotics - vaccinations - diarrhoea - respiratory tract infections - seasonal infections

• Literatur

• 1 Winkler P, Ghadimi D, Schrezenmeir J et al. Molecular and Cellular Basis of Microflora-Host Interactions. J Nutr 2007; 137: 756S-772S
• 2 de Vrese M, Rautenberg P, Laue C et al. Probiotic bacteria stimulate virus-specific neutralizing antibodies following a booster polio vaccination. Eur J Nutr 2005; 44: 406-413
• 3 Boge T, Rémigy M, Vaudaine S et al. A probiotic fermented dairy drink improves antibody response to influenza vaccination in the elderly in two randomised controlled trials. Vaccine 2009; 27: 5677-5684
• 4 Rizzardini G, Eskesen D, Calder PC et al. Evaluation of the immune benefits of two probiotic strains Bifidobacterium animalis ssp. lactis, BB-12w and Lactobacillus paracasei ssp. paracasei, L. casei 431w in an influenza vaccination model: a randomised, double-blind, placebo-controlled study. Brit J Nutr doi:
• 5 McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of clostridium difficile disease. Am J Gastroenterol 2006; 101: 812-822
• 6 Szajewska H, Skorka A, Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther 2007; 25: 257-264
• 7 Szajewska H, Ruszczynski M, Radzikowski A. Probiotics in the prevention of antibiotic-associated diarrhea in children: A meta-analysis of randomized controlled trials. J Pediatr 2006; 149: 367-372
• 8 Szajewska H, Mrukowicz J. Meta-analysis: Non-pathogenic yeast saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2005; 22: 365-372
• 9 Hawrelak JA, Whitten DL, Myers SP. Is lactobacillus rhamnosus gg effective in preventing the onset of antibiotic-associated diarrhoea: A systematic review. Digestion 2005; 72: 51-56
• 10 Cremonini F, Di Caro S, Nista EC et al. Meta-analysis: The effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2002; 16: 1461-1467
• 11 D'Souza AL, Rajkumar C, Cooke J et al. Probiotics in prevention of antibiotic associated diarrhoea: Meta-analysis. BMJ 2002; 324: 1361
• 12 McFarland LV. Systematic review and meta-analysis of saccharomyces boulardii in adult patients. World J Gastroenterol 2010; 16: 2202-2222
• 13 Sazawal S, Hiremath G, Dhingra U et al. Efficacy of probiotics in prevention of acute diarrhoea: A meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis 2006; 6: 374-382
• 14 Kale-Pradhan PB, Jassal HK, Wilhelm SM. Role of lactobacillus in the prevention of antibiotic-associated diarrhea: A meta-analysis. Pharmacotherapy 2010; 30: 119-126
• 15 Offick B. Effects of probiotics on immunity – studies on mechanism and clinical outcome in infectious and allergic diseases. Dissertation, Kiel: CAU; 2009
• 16 Tubelius P, Stan V, Zachrisson A. Increasing work-place healthiness with the probiotic Lactobacillus reuteri: a randomised, double-blind placebo-controlled study. Environ Health 2005; 4: 25
• 17 Guillemard E, Tanguy J, Flavigny A et al. Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-110001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial. J Am Coll Nutr 2010; 29: 455-468
• 18 Guillemard E, Tondu F, Lacoin F et al. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 reduces the duration of respiratory infections in the elderly in a randomised controlled trial. Br J Nutr 2010; 103: 58-68
• 19 Leyer GJ, Li S, Mubasher ME et al. Probiotic Effects on Cold and Influenza-Like Symptom Incidence and Duration in Children. Pediatrics 2009; 124: 172-179
• 20 Merenstein D, Murphy M, Fokar A et al. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study A patient-oriented, double-blind, cluster-randomized, placebo controlled, clinical trial. Eur J Clin Nutr 2010; May 19 [Epub ahead of print]
• 21 Merenstein D, Smith KH, Scriven M et al. The study to investigate the potential benefits of probiotics in yogurt, a patient-oriented, double-blind, cluster-randomised, placebo-controlled, clinical trial. Eur J Clin Nutr 2010; Mar 10 [Epub ahead of print]
• 22 Niborski V, Tanguy J, Ernouf C, Jost D. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei CNCM I-1518 improves clinical outcome of common infections and quality of life in adults under stress (firemen students) in a randomized controlled trial. 7th EFSMA Congress, Salzburg, Austria, 26th−29th October 2011