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Quest Vitamins LTD,
8 Venture Way,
Aston Science Park,
Birmingham,
B7 4AP.

Tel: 0121 359 0056
Fax: 0121 359 0313
Email: info@questvitamins.co.uk
Registered in England No. 2530437

Lp299v - Lactobacillus Plantarum

DESCRIPTION

L.plantarum is a member of the Lactobacillus family of microorganisms and has been found to populate a healthy human gastrointestinal tract. Scientific studies show that this particular strain of probiotic has adhesion properties which allow it to temporarily colonise the large intestine.

Babies are born axenic (sterile), and the colonisation of the digestive tract by population of microorganisms specific to each person is done in the first few days of life. The most significant changes in the intestinal flora take place from birth until weaning and again in the later stages of life. In between, the microbial population of the dominant flora remains relatively stable and prevent potentially pathogenic bacteria from adhering to the intestinal wall. This has been termed The Barrier Effect.

Ingesting high levels of animal fats, sugars and alcohol can inhibit the friendly bacteria, while complex carbohydrates from vegetables, beans and grains are of benefit to them. Highly processed foods and fast foods can increase acid levels in the intestines and this highly acidic environment will damage the microflora. Re-colonising the intestines with friendly bacteria, can help prevent illnesses by depriving the pathogenic bacteria of the opportunity to overgrow and flourish.

Lactobacillus plantarum 299v (Lp299v) is a highly specific strain from the plantarum group of friendly bacteria. This strain differs from other plantarum species because it has been extensively researched regarding its use for those with digestive conditions and, in particular, Irritable Bowel Syndrome (IBS). Studies have shown that Lp299v could decrease the frequency and severity of up to 95% of symptoms experienced by IBS sufferers. Of this, 45% of sufferers experienced complete improvement of symptoms. However, this particular strain has also been associated with a therapeutic role for conditions such as diarrhoea and heart disease and has also been shown to help boost the immune system at the gut level.


SUPPLEMENTAL USES

Irritable Bowel Syndrome:

Irritable Bowel Syndrome (IBS) may be diagnosed on the presence of symptoms, according to Rome II criteria* and some studies have shown that abnormal colonic fermentation may be an important factor in the development of symptoms in some patients with IBS. In conclusion, short-term therapy with Lactobacillus plantarum 299v may be considered as a promising approach to the therapy for IBS. (3)

* The Rome II criteria is a method of diagnosing irritable bowel syndrome based on the length and frequency of the symptoms experienced. For example, a person with IBS related symptoms (constipation, diarrhoea, bloating, abdominal pain) for only a couple of days a year would not be diagnosed with IBS. However, the Rome II criteria states that if symptoms of IBS are experienced for a number of days (approx. 10) each month then IBS may be diagnosed.

Because treatment of irritable bowel syndrome (IBS) patients can be frustrating to the clinician and patient as well, the physician should strive to gain the patient's confidence with a concise, appropriate diagnosis and by offering reassurance and education that IBS is a functional disorder without significant long-term health risks. First-line treatment should be aimed at treating the most bothersome symptom. Probiotic therapy using Lactobacillus plantarum 299v has demonstrated superiority to placebo in improving pain, regulating bowel habits, and decreasing flatulence. (5)

Irritable bowel syndrome (IBS) is a widespread functional disorder of the digestive tract. Its aetiology is unknown and therapeutic options are limited. Recent reports suggest that probiotics may have a role in regulating the motility of the digestive tract. The results of this study showed that Lactobacillus plantarum 299v seems to have a beneficial effect in patients with IBS, and therefore supplements containing this bacterium may be useful for the treatment of this condition.
(6)

The influence of the gastrointestinal (GI) microflora in patients with irritable bowel syndrome (IBS) has not been clearly elucidated. This study was undertaken to see if patients with IBS have an imbalance in their normal colonic flora, as some bacterial taxa are more prone to gas production than others. The results of the study indicate that the administration of L. plantarum 299v with known probiotic properties decreased pain and flatulence in patients with IBS. The fiber content of the test solution was minimal and it is unlikely that the fiber content could have had any effect. This type of probiotic therapy warrants further studies in IBS patients. (7)

Lactic acid fermentation is the simplest and safest way of preserving food and has probably always been used by humans. Species such as Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus paracasei, Lactobacillus acidophilus, and Lactobacillus salivarius are common in the human mucosa, from the mouth to the rectum. In food, L. paracasei and L. rhamnosus are usually associated with dairy products whereas L. plantarum is found in fermented foods of plant origin. The strain L. plantarum 299v originates from the human intestinal mucosa and has been shown to decrease translocation, improve mucosal status, improve liver status, improve the immunologic status of the mucosa, and reduce mucosal inflammation. In humans, L. plantarum 299v can increase the concentration of carboxylic acids in feces and decrease abdominal bloating in patients with irritable bowel disease. It can also decrease fibrinogen (a protein involved in the clotting of blood) concentrations in blood. Should probiotics be administrated through foods, the probiotic organism must remain vigorous in the food until consumption and the food must remain palatable, ie, the food carrier and the organism must suit each other. L. plantarum 299v not only affects the bacterial flora of the intestinal mucosa but may also regulate the immunologic defense. (10)

Inflammatory Bowel Disease:

Inflammatory bowel disease (IBD) is another condition of the intestine and the symptoms of this disease are closely related to those of IBS. Research has shown that Lactobacillus plantarum 299v is also useful for controlling IBD and it thought that its ability to inhibit the growth of E.coli is a major method of this action. (24)

Immunity:

A liquid culture containing a bacteriocin (a compound produced by probiotics which helps prevent the growth and development of pathogenic bacteria), produced by Lactobacillus plantarum 299v, was shown to inhibit the growth of, Pseudomonas aeruginosa, Enterococcus faecalis, Klebsiella pneumoniae and Escherichia coli. All of these bacteria have the potential to cause harm to the intestines. (2)

The present study determined the pattern of cytokine secretion (interleukin [IL]-1beta, tumor necrosis factor [TNF]-alpha, interferon [IFN]-gamma and IL-10). Lactobacillus plantarum 299v demonstrates beneficial immunomodulatory activity by increasing IL-10 synthesis and secretion in macrophages and T-cells derived from the inflamed colon. This may provide a mechanism through which probiotic bacteria ameliorate inappropriate inflammation and induce tolerance. (4)

Current evidence supports the concept that oral administration of probiotic Lactobacilli may be therapeutic in preventing antibiotic-associated diarrhea in children and in re-establishing normal flora in the gastrointestinal tract. Children with human immunodeficiency virus (HIV) infections may have episodes of diarrhea and frequently experience malabsorption associated with possible bacterial overgrowth; together these may interact to produce the growth abnormalities characteristic of this group. The overall objective of this investigation has been to determine whether oral administration of the probiotic Lactobacillus plantarum 299v could improve nutrient status and promote growth in children congenitally exposed to HIV. In addition, the possible beneficial effect of Lactobacillus plantarum 299v in modulating immune response was evaluated. In preliminary results, it is reported that Lactobacillus plantarum 299v has the ability to colonize children with HIV and promote a specific immune response after oral supplementation. (14)

We have studied the effect of the probiotic strain Lactobacillus plantarum 299v on the functions of immunity. Immunoglobulin levels (IgA and IgM) and E. coli-specific antibodies were measured in serum. Subjects given L. plantarum 299v in addition to E. coli showed lower counts of E. coli in the small intestine 1 week after colonization compared with the group colonized with E. coli alone. Subjects colonized with L. plantarum 299v and E. coli had significantly higher total serum IgA levels and marginally higher IgM and IgA antibody levels against E. coli than those colonized with E. coli alone. The results indicate that L. plantarum 299v colonization competes with E. coli for intestinal colonization and can influence intestinal and systemic immunity. (15)

Probiotic agents, live microorganisms with beneficial effects for the host, may offer an alternative to conventional antimicrobials in the treatment and prevention of enteric infections. The probiotic agent Lactobacillus plantarum 299v quantitatively inhibited the adherence of an attaching and effacing pathogenic Escherichia coli to intestinal cells. Intestinal cells were grown under conditions that induced high levels of intestinal mucins that line the digestive tract and prevent bacterial infection. Incubation of L. plantarum 299v with human intestinal cells increased mucin levels. From these studies, it is proposed that the ability of probiotic agents to inhibit adherence of attaching and effacing organisms to intestinal epithelial cells is mediated through their ability to increase expression of intestinal mucins. (16)

Infection is the commonest cause of death in acute pancreatitis. Early reduction of commensal flora (particularly Lactobacillus species) and, at the same time, overgrowth of Enterobacteriaceae, especially Escherichia coli, have recently been described during acute pancreatitis. Lactobacillus plantarum 299v has been shown to be effective in reducing the egress of endotoxin and microbial translocation (the movement of bacteria within an organ or environment) in several experimental models such as chemically induced hepatitis and ulcerative colitis (a common digestive disorder). The aim of this study was to investigate whether L. plantarum 299v (Lp 299v) is capable of effectively reducing microbial translocation in experimental pancreatitis. The results showed that Lp 299v is effective in reducing microbial translocation in experimental pancreatitis. This study concluded that treatment with probiotic bacteria seems to be a promising alternative to antibiotic therapy. (13)

Small bowel bacterial overgrowth is a common complication of short bowel syndrome, and although it is often controlled with antimicrobial therapy, it has been suggested that the use of probiotic supplements may also be beneficial. This study recruited six patients with bacterial overgrowth, who did not respond to antimicrobial therapy and therefore required alternative means to control this condition. Bacterial overgrowth was shown to be successfully treated with periodic small bowel irrigation with a balanced hypertonic electrolyte solution, encouraging frequent stooling, or probiotic therapy with Lactobacillus plantarum 299v. Inadequate or incomplete response to antibiotic therapy is common in this condition, and therefore L.plantarum 299v could offer an alternative treatment.
(18)

The purpose of this work was to investigate whether a probiotic bacterium, Lactobacillus plantarum 299v, could affect intestinal permeability induced by Escherichia coli. The results showed that one week of pretreatment with L. plantarum 299v in the drinking water abolished the E. coli-induced increase in permeability. These data demonstrate that pretreatment with L. plantarum 299v, which is a probiotic bacterium, protects against E. coli-induced increase in intestinal permeability. Thus, this study supports the concept that probiotics may exert beneficial effects in the gastrointestinal tract. (20)

Diarrhoea:

Enteropathogenic E.coli (EPEC) is a Gram-negative bacillus that causes diarrhea and secretory responses of intestinal epithelial cells can be seen after EPEC infection. Probiotics, which are live bacteria that have proven benefit to the host, play a role in the treatment and prevention of the different enteric pathogens. The aims of this study were to determine whether the probiotic agent Lactobacillus plantarum 299v (Lp299v) alters the secretory changes seen in EPEC infection and, if so, what underlying mechanism is possible. EPEC infection caused an increase in short circuit current that was reduced by preincubation with Lp299v. Lp 299v can play an important role in reducing the secretory change in response to EPEC infection, possibly through inhibition of its binding. However, it is suggested that the use of Lp229v for this purpose would be more effective as a preventive therapy. (17)

Other Uses - Heart Disease:

The short-chain fatty acids formed in the human colon by the bacterial fermentation of fiber may have an antiinflammatory effect, may reduce insulin production, and may improve lipid metabolism. We previously showed in hypercholesterolemic patients that supplementation with the probiotic bacteria Lactobacillus plantarum 299v significantly lowers concentrations of LDL cholesterol and fibrinogen (a protein involved in the clotting cascade). We determined the influence of a functional food product containing L. plantarum 299v on lipid profiles, inflammatory markers, and monocyte function in heavy smokers. Thirty-six healthy volunteers(18 women and 18 men) aged 35-45 y participated in a controlled, randomized, double-blind trial. The experiment lasted 6 weeks and entailed no changes in lifestyle. Significant decreases in systolic blood pressure, leptin, and fibrinogen were recorded in the experimental group. No such changes were observed in the control group. L. plantarum 299v administration was shown in this study to lead to a reduction in cardiovascular disease risk factors and therefore could be useful as a protective agent in the primary prevention of heart disease. (12)

Other Uses - Intestinal Maintenance:

Radiation therapy for the treatment of colon cancer is associated with several complications, including diarrhea, impaired colonic healing and mucosal membrane deterioration. Oral administration of lactobacilli has been demonstrated to be effective in stimulating intestinal mucosal growth and reduce mucosal inflammation. The objective of this study was to examine the effects of Lactobacillus plantarum 299v administration on external radiation injury in colon anastomotic healing at different time points. The results of this study were positive. It therefore seems that administration of Lactobacillus plantarum 299v reduces the intestinal injury and inflammation following external radiation and improves colonic healing.
(19)


STABILITY

Gastric Survival:

To be effective, a probiotic must survive the passage of the stomach and small intestine and be viable on arrival at the large intestine. In vitro tests have demonstrated the resistance of Lp299v to gastric acidity and biliary salts, corresponding to the two critical stages for survival of micro-organisms. (22)

Another study investigated the capacity of Lp299v to reach and colonise the human colon. In a randomized, double-blind study on healthy adult volunteers, the first group of 26 received a preparation containing the strain Lp299v for 21 days, while a second group of 22 received a placebo preparation. The strain was found in the stools of the first group during the treatment period and was still present 8 days after the end of treatment in 5 out of 26 patients which demonstrates effective colonization of the large intestine. (23)

The presence of friendly bacteria in the faeces is direct evidence that the probiotic has survived the harsh acidic environment of the stomach. The aim of this study was to investigate the onset and duration of a possible effect of a fermented oatmeal drink containing Lactobacillus plantarum 299v on the composition of the faecal flora of healthy volunteers in a placebo-controlled, double-blind study. Twenty-two participants consumed a fermented oatmeal drink with or without L. plantarum 299v for 4 weeks. L. plantarum 299v significantly increased the number of lactobacilli in the faecal flora within 1 week, and therefore proved that this strain of bacteria was highly resistant to stomach acid. (21)


ADHESION PROPERTIES

Barrier Effect:

During investigation of adhesive properties of lactic acid bacteria it was found that 11 strains adhered to buccal intestinal and vaginal epithelium of humans. L. plantarum 299v expressed high adhesive activity to buccal epithelium. Monosaccharide composition of glycocalix of 6 strains of lactic acid bacteria was studied to understand the adhesion mechanism. It was shown that surface structures of this microorganism interact with plant lectins, specific to certain monosaccharides. (1)

Two Lactobacillus plantarum strains of human intestinal origin, strains 299 and 299v, have proved to be efficient colonizers of the human intestine under experimental conditions. These strains and 17 other L. plantarum strains were tested for the ability to adhere to cells of the human colon called HT-29. L. plantarum 299 and 299v and nine other L. plantarum strains, including all six strains that belong to the same genetic subgroup as L. plantarum 299 and 299v, adhered to HT-29 cells in a manner that could be inhibited by methyl-alpha-D-mannoside. L. plantarum 299 and 299v adhered to freshly isolated human colonic and ileal enterocytes, but the binding was not significantly inhibited by methyl-alpha-D-mannoside.(In this respect, although all L.Plantarum strains in this study showed adherence to the lining of the intestine, only strains 299 and 299v resistant to inhibition of this adhesion and are therefore more effective). Thus, a mannose-specific adhesion has been identified in L. plantarum and this adhesion could be involved in the ability to colonize the intestine. (11)

This study investigated the adhesion properties of 19 different strains of lactobacilli. Lp299v was one of 5 strains isolated on biopsies of the mucosa of the jejunum and the rectum one day after the end of treatment and even on the 11th day after the end of treatment. Among these five strains, Lp299v was one of the most frequently occurring strains in the biopsies. (25)


SAFETY

Probiotic lactobacilli, including L.plantarum, have been used in probiotic and dietary supplements for decades with a compelling record for safe consumption.(8+9)

Quest Nutritionists recommend the use of Lp299v supplements that contain at least 1 billion viable micro-organisms per capsule. Quest Lp299v is guaranteed to contain 1 billion bacteria at the end of its two year shelf life but contains up to 5 billion bacteria on the date of manufacture.

Quest Lp299v is safe to use during pregnancy and lactation.


CONTRA-INDICATIONS and INTERACTIONS

Levels of Lactobacillus plantarum decrease during administration of antibiotics. Therefore supplementation should be considered during antibiotic use, but antibiotics and probiotics should be taken at least two hours apart.

REFERENCES

1. Mikrobiol Z. 2004 Jul-Aug;66(4):62-8.

2. J Gen Appl Microbiol. 2004 Jun;50(3):149-57.

3. J Clin Gastroenterol. 2004 Jul;38(6 Suppl):S104-6.

4. J Gastroenterol Hepatol. 2004 Feb;19(2):166-73

5. Curr Treat Options Gastroenterol. 2002 Aug;5(4):267-278.

6. Eur J Gastroenterol Hepatol. 2001 Oct;13(10):1143-7.

7. Am J Gastroenterol. 2000 May;95(5):1231-8.

8. Martinaue P. Safety of probiotic products. Scand J Nutr 2001; 45:22-24

9. Reid G. Lactobacillus safety as probiotic agents. Clin Infect Dis 2002; 35:
349-350

10. Am J Clin Nutr. 2001 Feb;73(2 Suppl):380S-385S.

11. Appl Environ Microbiol. 1996 Jul;62(7):2244-51.

12. Am J Clin Nutr. 2002 Dec;76(6):1249-55.

13. Dig Surg. 2001;18(1):47-50.

14. Am J Gastroenterol. 2000 Jan;95(1 Suppl):S22-5

15. Clin Exp Immunol. 1999 May;116(2):283-90

16. Am J Physiol. 1999 Apr;276(4 Pt 1):G941-50

17. J Pediatr Gastroenterol Nutr. 2002 Sep;35(3):350-5

18. J Pediatr Gastroenterol Nutr. 1998 Aug;27(2):155-60

19. Colorectal Dis. 2001 Jul;3(4):245-52

20. Dig Dis Sci. 2002 Mar;47(3):511-6

21. Aliment Pharmacol Ther. 2003 Sep 1;18(5):495-505

22. Appl. And Environment. Microbial; 65;4949-4956

23. Int J Food Microbiol 1998, 42:29-38

24. Probiotics for Crohn's and Colitis, Peter Cartwright 2003: ISBN 0-9544438-0-2

25. Appl Environ Microbiol; 59(1):15-20

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