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Roberfroid M.,Catholic University of Louvain | Gibson G.R.,University of Reading | Hoyles L.,University of Reading | McCartney A.L.,University of Reading | And 17 more authors.
British Journal of Nutrition

The different compartments of the gastrointestinal tract are inhabited by populations of micro-organisms. By far the most important predominant populations are in the colon where a true symbiosis with the host exists that is a key for well-being and health. For such a microbiota, normobiosis characterises a composition of the gut ecosystem in which micro-organisms with potential health benefits predominate in number over potentially harmful ones, in contrast to dysbiosis, in which one or a few potentially harmful micro-organisms are dominant, thus creating a disease-prone situation. The present document has been written by a group of both academic and industry experts (in the ILSI Europe Prebiotic Expert Group and Prebiotic Task Force, respectively). It does not aim to propose a new definition of a prebiotic nor to identify which food products are classified as prebiotic but rather to validate and expand the original idea of the prebiotic concept (that can be translated in prebiotic effects), defined as: The selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host. Thanks to the methodological and fundamental research of microbiologists, immense progress has very recently been made in our understanding of the gut microbiota. A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept. Thus the prebiotic effect is now a well-established scientific fact. The more data are accumulating, the more it will be recognised that such changes in the microbiota's composition, especially increase in bifidobacteria, can be regarded as a marker of intestinal health. The review is divided in chapters that cover the major areas of nutrition research where a prebiotic effect has tentatively been investigated for potential health benefits. The prebiotic effect has been shown to associate with modulation of biomarkers and activity(ies) of the immune system. Confirming the studies in adults, it has been demonstrated that, in infant nutrition, the prebiotic effect includes a significant change of gut microbiota composition, especially an increase of faecal concentrations of bifidobacteria. This concomitantly improves stool quality (pH, SCFA, frequency and consistency), reduces the risk of gastroenteritis and infections, improves general well-being and reduces the incidence of allergic symptoms such as atopic eczema. Changes in the gut microbiota composition are classically considered as one of the many factors involved in the pathogenesis of either inflammatory bowel disease or irritable bowel syndrome. The use of particular food products with a prebiotic effect has thus been tested in clinical trials with the objective to improve the clinical activity and well-being of patients with such disorders. Promising beneficial effects have been demonstrated in some preliminary studies, including changes in gut microbiota composition (especially increase in bifidobacteria concentration). Often associated with toxic load and/or miscellaneous risk factors, colon cancer is another pathology for which a possible role of gut microbiota composition has been hypothesised. Numerous experimental studies have reported reduction in incidence of tumours and cancers after feeding specific food products with a prebiotic effect. Some of these studies (including one human trial) have also reported that, in such conditions, gut microbiota composition was modified (especially due to increased concentration of bifidobacteria). Dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase Ca absorption as well as bone Ca accretion and bone mineral density. Recent data, both from experimental models and from human studies, support the beneficial effects of particular food products with prebiotic properties on energy homaeostasis, satiety regulation and body weight gain. Together, with data in obese animals and patients, these studies support the hypothesis that gut microbiota composition (especially the number of bifidobacteria) may contribute to modulate metabolic processes associated with syndrome X, especially obesity and diabetes type 2. It is plausible, even though not exclusive, that these effects are linked to the microbiota-induced changes and it is feasible to conclude that their mechanisms fit into the prebiotic effect. However, the role of such changes in these health benefits remains to be definitively proven. As a result of the research activity that followed the publication of the prebiotic concept 15 years ago, it has become clear that products that cause a selective modification in the gut microbiota's composition and/or activity(ies) and thus strengthens normobiosis could either induce beneficial physiological effects in the colon and also in extra-intestinal compartments or contribute towards reducing the risk of dysbiosis and associated intestinal and systemic pathologies. © ILSI Europe 2010. Source

Background & aims: The pathogenesis of enteritis after abdominal radiotherapy is unknown, although changes in faecal microbiota may be involved. In several studies, Lactobacillus and Bifidobacterium have proven beneficial for the host. Prebiotics stimulate the proliferation of Lactobacillus and Bifidobacterium, and this may have positive effects on the intestinal mucosa during abdomi - nal radiotherapy. Methods: We performed a randomised double-blind, placebo-controlled trial including 31 patients with gynaecological cancer who received radiotherapy (29 sessions, 52.2 Gy) after surgery. Patients were randomised to two groups: prebiotic and placebo. The first group received a mixture of fibre (50% inulin and 50% fructo-oligosaccharide) and the second received 6 g of maltodextrin twice daily from one week before to three weeks after radiotherapy. Lactobacillus and Bifidobacterium counts were determined in faeces samples (day -7 before radiotherapy, day 15 of radiotherapy, at the end of treatment, and three weeks after radiotherapy) by culture in selective media and fluorescent in situ hybridization (FISH) using genus-specific probes. Bacterial counts by FISH were significantly higher than by culture method. Results: There were no differences in baseline microbiota between groups. At the end of radiotherapy, we observed a statistically significant decrease in Lactobacillus and Bifidobacterium counts in both groups. By cultural analysis, we observed higher numbers of Lactobacillus and Bifidobacterium three weeks after radiotherapy in the prebiotic group (5.6 vs. 6.3, p = 0.04 and 5.5 vs. 6 log cfu/g, p = 0.03). Conclusions: Abdominal radiotherapy negatively affects Lactobacillus and Bifidobacterium counts. The prebiotic mixture of inulin and fructoligosaccharide can improve the recovery of both genera after radiotherapy. Source

Azpiroz F.,Digestive System Research Unit | Azpiroz F.,Autonomous University of Barcelona | Feinle-Bisset C.,University of Adelaide | Grundy D.,University of Sheffield | Tack J.,Catholic University of Leuven
Journal of Gastroenterology

Both reflex and sensory mechanisms control the function of the stomach, and disturbances in these mechanisms may explain the pathophysiology of disorders of gastric function. The objective of this report is to perform a literature-based critical analysis of new, relevant or conflicting information on gastric sensitivity and reflexes, with particular emphasis on the comprehensive integration of basic and clinical research data. The stomach exerts both phasic and tonic muscular (contractile and relaxatory) activity. Gastric tone determines the capacity of the stomach and mediates both gastric accommodation to a meal as well as gastric emptying, by partial relaxation or progressive recontraction, respectively. Perception and reflex afferent pathways from the stomach are activated independently by specific stimuli, suggesting that the terminal nerve endings operate as specialized receptors. Particularly, perception appears to be related to stimulation of tension receptors, while the existence of volume receptors in the stomach is uncertain. Reliable techniques have been developed to measure gastric perception and reflexes both in experimental and clinical conditions, and have facilitated the identification of abnormal responses in patients with gastric disorders. Gastroparesis is characterised by impaired gastric tone and contractility, whereas patients with functional dyspepsia have impaired accommodation, associated with antral distention and increased gastric sensitivity. An integrated view of fragmented knowledge allows the design of pathophysiological models in an attempt to explain disorders of gastric function, and may facilitate the development of mechanistically orientated treatments. © 2013 Springer Japan. Source

Drozdzal M.,Computer Vision Center | Segui S.,Computer Vision Center | Segui S.,University of Barcelona | Radeva P.,Computer Vision Center | And 5 more authors.
Computers in Biology and Medicine

Wireless Capsule Endoscopy (WCE) provides a new perspective of the small intestine, since it enables, for the first time, visualization of the entire organ. However, the long visual video analysis time, due to the large number of data in a single WCE study, was an important factor impeding the widespread use of the capsule as a tool for intestinal abnormalities detection. Therefore, the introduction of WCE triggered a new field for the application of computational methods, and in particular, of computer vision. In this paper, we follow the computational approach and come up with a new perspective on the small intestine motility problem. Our approach consists of three steps: first, we review a tool for the visualization of the motility information contained in WCE video; second, we propose algorithms for the characterization of two motility building-blocks: contraction detector and lumen size estimation; finally, we introduce an approach to detect segments of stable motility behavior. Our claims are supported by an evaluation performed with 10 WCE videos, suggesting that our methods ably capture the intestinal motility information. © 2015 Elsevier Ltd. Source

Drozdzal M.,University of Barcelona | Drozdzal M.,Autonomous University of Barcelona | Segui S.,University of Barcelona | Segui S.,Autonomous University of Barcelona | And 6 more authors.
Computerized Medical Imaging and Graphics

The Wireless Capsule Endoscopy (WCE) technology allows the visualization of the whole small intestine tract. Since the capsule is freely moving, mainly by the means of peristalsis, the data acquired during the study gives a lot of information about the intestinal motility. However, due to: (1) huge amount of frames, (2) complex intestinal scene appearance and (3) intestinal dynamics that make difficult the visualization of the small intestine physiological phenomena, the analysis of the WCE data requires computer-aided systems to speed up the analysis. In this paper, we propose an efficient algorithm for building a novel representation of the WCE video data, optimal for motility analysis and inspection. The algorithm transforms the 3D video data into 2D longitudinal view by choosing the most informative, from the intestinal motility point of view, part of each frame. This step maximizes the lumen visibility in its longitudinal extension. The task of finding " the best longitudinal view" has been defined as a cost function optimization problem which global minimum is obtained by using Dynamic Programming. Validation on both synthetic data and WCE data shows that the adaptive longitudinal view is a good alternative to the traditional motility analysis done by video analysis. The proposed novel data representation a new, holistic insight into the small intestine motility, allowing to easily define and analyze motility events that are difficult to spot by analyzing WCE video. Moreover, the visual inspection of small intestine motility is 4 times faster then by means of video skimming of the WCE. © 2012 Elsevier Ltd. Source

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