A Perspective on the Application of Pro-/Synbiotics in Clinical Practice

Wu, Xiangdong; Chen, Yu; Huang, Wei

doi:10.3389/fmicb.2017.00866

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Based on our previous meta-analysis, 3 we performed several subgroup analyses including supplementation (probiotics vs synbiotics), regimen (multistrain vs single-strain) supplementation dose (high dosage vs low dosage), supplementation route (oral vs enteral vs enteral or oral), supplementation time (preoperative vs postoperative vs perioperative), regions (Asia vs Europe), to explore the optimal regimen of probiotics and synbiotics. 7 We further confirmed that prophylactic probiotics in combination with antibiotics are more effective in preventing surgical site infection and other complications in patients undergoing colorectal surgery. 8 Although these analyses were post hoc, these could serve as reference for future trials design.…”

Section: A Systematic Review and Meta-analysis Of Randomized Controlledsupporting

confidence: 66%

“…Third, as the TSA indicated that, current evidence on probiotics and synbiotics in patients undergoing elective surgery are sufficient and conclusive, it is high time to dig into the details of administration of probiotics or synbiotics. Based on our previous meta-analysis, 3 we performed several subgroup analyses including supplementation (probiotics vs synbiotics), regimen (multi-strain vs single-strain) supplementation dose (high dosage vs low dosage), supplementation route (oral vs enteral vs enteral or oral), supplementation time (preoperative vs postoperative vs perioperative), regions (Asia vs Europe), to explore the optimal regimen of probiotics and synbiotics 7 . We further confirmed that prophylactic probiotics in combination with antibiotics are more effective in preventing surgical site infection and other complications in patients undergoing colorectal surgery 8 .…”

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confidence: 99%

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Comment on “Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery

Wu¹,

Wu²,

Liu

et al. 2019

Annals of Surgery

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Notably, as strengthened repeatedly in the original report, 1 findings from observational studies can only suggest associations, but cannot infer causality before being further supported by prospective and/or randomized studies. Furthermore, the underlying report 1 suggested quality metrics for lymph node examination to address stage migration and stratify patient survival at the population level, and the management of each individual case should be personalized: that is, while overall examining more lymph nodes was numerically associated with higher survival, not every PaC case necessarily benefited from examination of lymph nodes more than the determined thresholds. For clinical decisionmaking, models that can predict individualized benefits and harms from dissecting a certain number of lymph nodes may be needed in this regard. Also as highlighted in the original report, 1 the number of ELNs results from the joint efforts of both surgeons and pathologists. Based on meticulous and thorough lymph node examination, the correspondence between the number of ELNs and the extent of lymphadenectomy should be carefully determined. I would strongly agree that surgical safety, which is a very important issue in major surgery especially pancreatectomy and which can greatly impact patient survival, should always be taken into account when planning treatment for patients with PaC, and benefits and harms should be always carefully weighted when considering a specific treatment modality.

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Section: A Systematic Review and Meta-analysis Of Randomized Controlledsupporting

confidence: 66%

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confidence: 99%

Comment on “Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery

Wu¹,

Wu²,

Liu

et al. 2019

Annals of Surgery

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“…Well‐designed, properly powered RCTs are still warranted to confirm these findings and guide clinical practice before the combination of prophylactic probiotics and antibiotics can be a widely accepted and recommended. Notably, selection of optimal probiotics regimens including probiotics strains, administration duration, and supplements dose, might also be important to translate these favorable results into daily clinical practice . Besides, development of an optimal federated scenario of probiotics and antibiotics to play the greatest degree of synergistic effects, and exploration of next‐generation probiotics to reestablish the microbiota and enhance colonization resistance are also warranted.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

Liu

et al. 2018

Journal of Surgical Oncology

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This meta-analysis aimed to determine whether prophylactic probiotics in combination with antibiotics are superior to antibiotics alone in the prevention of surgical site infection (SSI) after colorectal surgery. Fourteen trials involving 1524 participants were included. Compared with antibiotics alone, prophylactic probiotics in combination with antibiotics reduced the risk of SSI as well as other complications, shortened the cumulative duration of antibiotic therapy. Current evidence suggested that probiotics in combination with antibiotics could be recommended.

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“…Initial screening of the compatibility of bioactive compounds is extremely important for the success of synergistic synbiotic production (Wu et al 2017 ). The current study aided in the identification of compatible bioactive substances, either commercial prebiotics or plant extracts for use in potential formulations of synergistic synbiotics or prophybiotics, respectively, with the six LAB studied.…”

Section: Discussionmentioning

confidence: 99%

In-vitro screening of compatible synbiotics and (introducing) “prophybiotics” as a tool to improve gut health

Wishna-Kadawarage,

Jensen,

Powałowski

et al. 2023

Int Microbiol

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Synbiotics have been intensively studied recently to improve gut health of humans and animals. The success of synergistic synbiotics depends on the compatibility of the prebiotic and probiotic components. Certain plant extracts possess both antimicrobial and prebiotic properties representing a potential use in combination with probiotics to improve the gut health. Here, we coined the term “prophybiotics” to describe this combined bioactivity. The current study aimed to select prebiotics that are preferred as an energy source and antimicrobial plant extracts which do not inhibit the growth, of six strains of lactic acid bacteria (LAB namely; Lactiplantibacillus plantarum, Lacticaseibacillus casei, Limosilactobacillus reuteri, Lacticaseibacillus rhamnosus, Leuconostoc mesenteroides, and Pediococcus pentosaceus) in-vitro to identify compatible combinations for potential synbiotic/prophybiotic use, respectively. Their growth kinetics were profiled in the presence of prebiotics: Inulin, Raffinose, and Saccharicterpenin with glucose, as the control, using carbohydrate free MRS broth media. Similarly, their growth kinetics in MRS broth supplemented with turmeric, green tea, and garlic extracts at varying concentrations were profiled. The results revealed the most compatible pairs of prebiotics and LAB. Turmeric and garlic had very little inhibitory effect on the growth of the LAB while green tea inhibited the growth of all LAB in a dose-dependent manner. Therefore, we conclude that turmeric and garlic have broad potential for use in prophybiotics, while the prebiotics studied here have limited use in synbiotics, with these LAB.

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A Perspective on the Application of Pro-/Synbiotics in Clinical Practice

Cited by 7 publications

References 38 publications

Comment on “Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery

Comment on “Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

In-vitro screening of compatible synbiotics and (introducing) “prophybiotics” as a tool to improve gut health

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