US20140335066A1

US20140335066A1 - Lactobacillus plantarum inducia dsm 21379 as enhancer of cellular immunity, hypocholesterolemic and anti-oxidative agent and antimicrobial agent against clostridium difficile

Info

Publication number: US20140335066A1
Application number: US14/244,284
Authority: US
Inventors: Marika Mikelsaar; Epp Songisepp; Pirje Hütt; Imbi Smidt; Kai Truusalu; Merle Rätsep; Siiri Kõljalg; Jelena Stsepetova; Kalle Kilk; Mihkel Zilmer; Epp Sepp; Raik-Hiio Mikelsaar
Original assignee: Tervisliku Piima Biotehnologiate Arenduskeskus OU
Current assignee: Tervisliku Piima Biotehnologiate Arenduskeskus OU
Priority date: 2008-05-13
Filing date: 2014-04-03
Publication date: 2014-11-13
Also published as: US10272122B2; RU2010147343A; US20160296570A1; EE200800027A; RU2486234C2; EP3193895B1; EE05809B1; EE05341B1; US20110274789A1; DK3193895T3; KR20110018898A; PL2288360T3; EP2288360A1; EP2288360B1; KR101595042B1; LT3193895T; EE201800005A; DK2288360T3; WO2009138092A1; EP3193895A1

Abstract

A microorganism strain Lactobacillus plantarum Inducia DSM 21379 for use as hypocholesterolemic, antimicrobial and anti-oxidative agent and as enhancer of the natural defense potential of a subject. L. plantarum Inducia is used for reducing the level of LDL-cholesterol in blood for preventing the cholesterol metabolism disorders and cardiovascular disorders. L. plantarum Inducia enhances simultaneously the natural defense potential and cellular immunity, and as anti-oxidative agent enhances anti-oxidative activity of blood by reducing the level of oxidized low density lipoprotein (ox-LDL). The strain is also used as an antimicrobial agent for lowering risk of Clostridium difficile associated diarrhoeae (CDAD) by preventing germination of C. difficile spores and by suppressing proliferation of its vegetative cells. The compositions comprising L. plantarum Inducia decrease the levels of LDL-cholesterol and ox-LDL in blood, enhance the natural defense potential and lower risk of CDAD. The composition may further comprise xylitol.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part and claims the benefit under 35 U.S.C. §120 of U.S. application Ser. No. 12/992,862, filed Nov. 15, 2010, the entire contents of which are incorporated herein by reference, which is a 371 National Stage of International Application No. PCT/EE2009/000006, filed May 12, 2009, the entire contents of which are incorporated herein by reference, which claims priority from prior EE Application No. P200800027, filed May 13, 2008.

TECHNICAL FIELD

The present invention relates to the field of microbiology and nutrition referring to Lactobacillus plantarum Inducia DSM21379 strain which has various applications in the field of biotechnology, food industry and medicine.

BACKGROUND ART

During the past decades lactobacilli have widely been used as probiotics in functional foods. Food can be regarded as functional, if beyond adequate nutritional components it contains some natural additives (pre- or probiotics), which beneficially affect one or more target functions in the body, either improving the state of health and well-being and/or reducing disease risk. Probiotics are live microorganisms, which, when administered in adequate scientifically proven amounts, confer a health benefit on the host. Probiotic products may be conventional foods or dietary supplements. Currently a probiotic product is a strain-specific preparation targeting several host functions (anti-infectious, morphologic, immunologic, metabolic) in order to improve health by either supporting host physiologic activity or by reducing the risk of disease.
Probiotics are often used for enhancement of organisms' defense capability.
Enhancement of organisms' natural immunity has become essential in connection with the ageing of population and diseases connected with immunodeficiency (HIV infection, tissue transplantation induced immunosuppression). The cause of all of mentioned diseases is the decrease of the capability of several physiological functions of the organism (Timiras, P. S. Physiology of aging: standards for age-related functional competence In: Comprehensive Human Physiology. Greger, R (edt)/Windhorst, U (eds) Springer Verlag, 1996; pp 2391-2405).
The permeability of the intestinal mucosa frequently increases on the background of chronic inflammation. Microbial metabolites play essential role in the integrity of mucosa, e.g. short chain fatty acids (SCFA), produced by lactic acid bacteria in the colon in the case of fiber (substances of plant origin) rich diet (Roy C C, Kien C L, Bouthillier L., Levy E. Short chain fatty acids: ready for prime time? Nutr. Clin. Pract., 2006; 21:351-366).
For enhancement of mucosal barrier besides short chain fatty acids also polyamines are essential. Polyamines are linear aliphatic compound, in which amino acids are situated along the structure. Putrescine, spermidine and spermine belong to polyamines (Larque, M., Sabater-Molina, S. Zamora E. Biological significance of dietary polyamines. Nutrition 2007; 23(1): 87-95). Polyamines are produced by decarboxylation from amino acids ornithine and arginine. Putrescine is produced straight from ornithine; arginine, is primarily converted into agmantine which is then converted into putrescine (Halaris A, Plietz, Agmatine: metabolic pathway and spectrum of activity in brain. CNS Drugs, 2007; 21: 885-90).
The physiological impact of polyamines is targeted to cell growth and differentiation, regulation of immune cells and inflammatory response, and several other effects. Polyamines possess the ability to induce apoptosis, avoiding the hyperproliferation of epithelium and destruction of primary cancer cells (Moinard C, Cynober L, De Bandt J P Polyamines: metabolism and implications in human disease. Clin Nutr. 2005; 24: 184-197). Polyamines are produced endogenously or they are obtained actively from food.
In the case of the damage of epithelial cells, the production of polyamines by the intestinal microflora is considered one of the compensatory mechanisms for modification of immune response and apoptosis regulation. Lactobacilli comprise majority of microflora of the proximal colon. Lactobacilli produce polyamines through decarboxylation of amino acids, particularly at the high pH of the intestinal content (Lonvaud-Funel A, Biogenic amines in wine: role of lactic acid bacteria. FEMS Microbiol. Letters, 2001: 199: 9-13). On the other hand, strains of Lactobacillus acidophilus utilize putrescine and reduce odour of faces (WO 2008/019887, BASF AG).
Probi AB Estonian patent EE03597 discloses pharmaceutical composition that contains L. plantarum strains 299 and 299v together with arginine for prevention translocation of intestinal microbes during liver injury. Also in this patent no information is available concerning the end products of arginine utilization (putrescine, cadaverine, tyramine, enhancement of NO or antioxidativity) by L. plantarum, which are responsible for aforementioned effect. In close relationship with previous patent another Probi AB patent EE04097 does not disclose the polyamines or NO production ability of mentioned L. plantarum strains.
It has been demonstrated, that Lactobacillus rhamnosus GG could enhance NO production in the epithelial cells of the intestine or by proinflammatory cytokines and it has been indicated, that beneficial effects of Lactobacillus rhamnosus GG could be due to the production of NO by macrophages and epithelial cells (Korhonen K, Reijonen T M, Remes K, Malmstrom K, Klaukka T, Korppi M. Reasons for and costs of hospitalization for paediatric asthma: A prospective 1-year follow-up in a population-based setting. Pediatr Allergy Immunol 2001: 12:331-338). It has been demonstrated, that NO protects mucosa for damages and excessive permeability, arising after reperfusion (Payne D, Kubes P. Nitric oxide donors reduce the rise in reperfusion-induced intestinal mucosal permeability. Am J Physiol. 1993: 265 (1 Pt 1):G189-G195).
USA patent application US20060078595 (Friesland Brands B.V.) discloses method to avoid the excessive permeability of the intestinal barrier in newborns by glutamate and its precursors as well as by polyamines spermidine, spermine, putrescine in the case of different syndromes (malnutrition, allergy, sepsis, translocation of microbes, endotoxemia, viral diarrhoea). Lactobacillus Reuteri (BIOGAIA) served as glutamate source.
Polyamine spermidine has inflammation-lowering property. It has been demonstrated that spermidine, when added to human monocytes stimulated with lipopolysaccharides, inhibits effectively the synthesis of TNF, IL-1, IL-6 and other proinflammatory cytokines (Zang M, Caragine T. Wong H et al. Spermine inhibits proinflammatory cytokine synthesis in human mononuclear cells: a counter regulatory mechanism, that restrains the immune response. J. Exp. Med., 1997, 185: 1759-1768). Matsumoto with co-authors described the suppression of proinflammatory cytokine synthesis (Matsumoto M, Ohisshi H, Benno Y Impact of LKM512 yoghurt on improvement of intestinal environment of the elderly. FEMS immunol. Medical Microbiol, 2001; 31:181-186). Bifidobacterium lactis LKM512 comprising yoghurt administration to elderly decreased the glukoprotein haptoglobuline caused inflammatory acute phase response due to IL-1, 11-6 and TNF-alfa, but the probiotic administration was also accompanied by decrease of mutagenicity of the intestinal epithelial cells. At the same time it is evident, that different lactic acid bacteria incl. lactobacilli species and strains differ by their ability to induce pro- and anti-inflammatory cytokines and non-specific cellular immune response. Up to now, no lactobacillus species/strain has been described, which would be able to produce physiologically relevant amounts of polyamines, which could be detected in urine after the consumption of this particular strain comprising composition and which promote simultaneously the adaptive activation of immunocytes due to interleukin IL-6.
Proinflammatory cytokine IL-6 synthesis has been described after 24 h of stimulation with different strains of Bifidobacterium animalis and Lactobacillus rhamnosus (Miettinen M., Vuopio-Varkila J, Varkila K. Synthesis of human tumour necrosis factor alpha, interleukin-6 and interleukin-10 is induced by lactic acid bacteria. Infection and Immunity, 1996, 64:5403-5408). It is important to observe inflammation markers like counts of leucocytes (WBC) and amount of CRP in sera on the induction of IL-6 (Kiecolt-Glaser J K, Preacher K J, MacCallum R C et al. Chronic stress and age-related increases in the proinflammatory cytokine IL-6, PNAS, 2003; 100:9090-9095) to avoid the overproduction of IL-6. Aforementioned is associated with cardio-vascular diseases, arthritis, type II diabetes, cancer, periodontal diseases, cachexy and decrease of organisms functions (Rose-John S., J. Scheller, G. Elson, and S. A. Jones. Interleukin-6 biology is coordinated by membrane-bound and soluble receptors: role in inflammation and cancer J. Leukoc. Biol., Aug. 1, 2006; 80 (2): 227-236).
Lactobacillus plantarum is a widely spread representative of the genus Lactobacillus. Aforementioned lactobacillus species is present on fermented plants (sauerkraut, pickles, and silage), fermented dairy/meat products (cheese, salami) as well as in human gastrointestinal tract. Lactobacillus plantarum is able to reorganize its metabolism according to environmental conditions.
Probiotic Lactobacillus plantarum is available in probiotic foods as well as in food supplements (e.g. Lactobacillus plantarum 299v DSM 9843, Probi AB, Sweden, Skånemejeriers' ProViva probiotic brand in Sweden or as one of the components in bacterial composition VSL#3 (VSL Pharmaceuticals, Inc. USA). WO2007/108764 (Probac AB) discloses the action mechanisms of Lactobacillus plantarum strains, which are able to enhance immunotolerance in the case on autoimmune coeliac disease.
Cheese as a probiotic carrier has several controversial aspects. Incorporation lactobacilli of human origin into a food product different from other milk-based products and having a long ripening period could be complicated. At the same time fat and protein-rich cheese matrix protects a probiotic microbial strain throughout the passage of gastrointestinal tract better than other milk products (yoghurt, kefir). Antimicrobial and antioxidative probiotic cheese has been produced by using Lactobacillus fermentum ME-3 (DSM 14241) (Estonian patent EE04580, Russian patent RU2284354, USA patent U.S. Pat. No. 6,190,879). European patent EP1064857B1 (Snow Brand Milk Products Co Ltd., 2004) discloses methods for production substances incl. putrescine with lactobacilli, bifidobacteria and propionibacteria from Gouda cheese milk ultrafiltration. These methods are either polymerization reactions for incorporating putrescine into casein or vice versa—purification of these compounds by ultrafiltration, that have already been produced into milk, methods are different from this one described in present invention, where putrescine, that has been produced by lactobacilli into milk is still present in cheese after 30 days of ripening. Various non-starter lactobacilli have been described (Lactobacillus paracasei, Lactobacillus curvatus), which are able to gain energy for proliferation from ornithine (ornithine is released from milk casein arginine) after depletion of carbohydrates (Laht T.-M., Kask S., Elias P., Adamberg K., Paalme T. Role of arginine in the development of secondary microflora in Swiss-type cheese. Int. Dairy Journal, 2002, 12: 831-840).
Till now no lactobacillus species/strain have been described, the culture of which produces NO and additionally physiologically relevant amounts of polyamines in food product, whereas the latter could be detectable in urine after the consumption of this strain comprising food product (cheese) or composition and that is able to regulate through polyamines the apoptosis of intestinal epithelium and increase the count of the mucosal lymphfollicles and blood monocytes, regulating the condition of mucosa by NO and antioxidative compounds and to enhance the activation of immune cells particularly the activation of macrophages by central interleukine.
One of the factors leading to cardiovascular disease (CVD) is abnormally elevated cholesterol level. Recently, the view of high cholesterol as damaging agent has been reverted to abnormality of its particles, particularly low density lipoprotein-cholesterol (LDL-c). LDL-c accounts 60-70% of total cholesterol. LDL-c particles carry cholesterol, triglycerides, fat-soluble vitamins and antioxidants. The LDL-cholesterol is an important modulator for prevention of atherosclerosis and maintenance of cardiovascular health. Thus, the LDL-c is widely recognized as an established cardiovascular risk marker. The close relation between mucosal epithelial cells of host gut and microbiota is of utmost importance for health. Among indigenous microbiota of gastrointestinal tract (GIT) the lactic acid bacteria assimilate cholesterol from dietary products (Gilliland, S. E., Nelson, C. R., Maxwell, C., Assimilation of cholesterol by Lactobacillus acidophilus. Appl Environ Microbiol 1985; 49, 377-381). In patent of Cuñé Castellana, 2009 (EP2485743B1; AB Probiotics S.A.) Lactobacillus plantarum strains CECT 7528, CECT 7526 and CECT 7529 as single or in composition demonstrated both in vitro and in vivo the cholesterol lowering ability. These strains have bile salt hydrolases (BHS) activity, also the antagonistic activity to inhibit the growth of pathogenic strains (Salmonella enterica Enteritidis, Salmonella enterica Typhimurium, Yersinia pseudotuberculosis, Clostridium perfringens, Clostridium ramnosus, Enterococcus faecalis) and can be used as probiotic bacteria.
Pereira et al. (Pereira, D. I., McCartney, A. L., Gibson, G. R., An in vitro study of the probiotic potential of a bile-salt-hydrolyzing Lactobacillus fermentum strain, and determination of its cholesterol-lowering properties. Appl Environ Microbiol. 2003; 69, 4743-4752) have demonstrated the role of short-chain fatty acid concentrations, specifically the molar proportion of propionate and/or bile salt deconjugation as the major mechanism involved in the purported cholesterol-lowering properties of L. fermentum.
However, the effect of Lactobacillus spp strains on levels of serum cholesterol (and cholesterol fractions) is strain-specific and dependant on the origin and properties of a certain strain (Tanaka, H., K. Doesburg, T. Iwasaki and I. Mireau, Screening of lactic acid bacteria for bile salt hydrolase activity. J. Dairy Sci. 1999; 82: 2530-2535).
Disturbed Microbial Ecology of Gut
The colonic microbiota is well stabilised and due to mucosal microbiota it does not change easily. But it is well known that the application of broad-spectrum antimicrobial preparations for treatment of infections and inflammatory complications may cause profound imbalance among GI microbiota.
Clostridium difficile Infection
Clostridium difficile was identified in the 1970's as the causative agent of antibiotic associated diarrhoeae. The anaerobic spore-forming intestinal pathogen Clostridium difficile is spread in hospitals and elderly homes (Britton, R. A., Young, V. B. Interaction between the intestinal microbiota and host in Clostridium difficile colonization resistance. Trends Microbiol. 2012; 20, 313-319). C. difficile infection is initiated by infection with C. difficile spores. Endospore production is vital for the spread of Clostridium difficile infection. In order to cause disease, these spores must germinate and return to vegetative cell growth (Burns D. A, Heap J. T. Minton N. P. Clostridium difficile spore germination: an update. Res Microbiol. 2010; 161(9):730-4). C. difficile elicits disease through the actions of secreted toxins, which are produced by vegetative cells, not by spores.
In a quarter of patients (25%) infected with C. difficile develop serious sequela such as pseudomembraneous colitis (PMC). C. difficile-associated diarrhea (CDAD) increases mortality rates, lengthens hospitalization and dramatically increases overall health care costs. Clostridium difficile infection recurs in about 20% of patients, and increases to 40% and 60% with subsequent recurrences (Kelly, C. P., LaMont, J. T. Clostridium difficile-more difficult than ever. N Engl J Med. 2008; 359, 1932-1940). Antimicrobial treatment disrupts the complex balance of diverse microorganisms and is a key factor in the pathogenesis of C. difficile colonization and disease. Preservation and restoration of the microbial diversity could represent novel strategies. The crucial moment in prevention and treatment of this disease is to find the possibility to reconstitute the alteration of intestinal microbiota during and after antibiotic therapy with various regimens incl. administration of probiotics. Most probiotics colonize the gut temporarily, produce bactericidal acids and peptides and promote “competition” among microbes by competing for nutrients and epithelial adhesion. These effects appear to reduce the favourability of the environment for C. difficile. Previous studies suggest that probiotics for prevention of CDI include combination L. acidophilus and L. casei, S. boulardii, or L. rhamnosus. In addition, a dosage of >10⁹cfu/day is more effective than lower doses.
The antimicrobial activity of probiotic strains is one of the suggested mechanisms for competition with C. difficile. Lactic acid bacteria produce short chain fatty acids that lower the pH of the local gut environment as well as prevent the adhesion of C. difficile (McFarland, L. V., Beneda, H. W., Clarridge, J. E., Raugi, G. J. Implications of the changing face of C. difficile disease for health care practitioners. Am J Infect Control. 2007; 35, 237-253). Next, the possibility for intestinal barrier protection with probiotics may result in interfering with the binding of C. difficile toxins A and B to colonic epithelial cells thus stabilizing gut permeability and inhibiting development of pseudomembranes on epithelia of gut.
Strain-specificity of lactobacilli is an important factor to take into consideration when looking for potential probiotics in the prevention of C. difficile infection or binding the C. difficile toxins (Tejero-Sarinena S., Barlow J., Costabile A, Gibson G. R., I. Rowland Antipathogenic activity of probiotics against Salmonella Typhimurium and Clostridium difficile in anaerobic batch culture systems: Is it due to synergies in probiotic mixtures or the specificity of single strains? Anaerobe 2013: 24; 60-65).
Furthermore, some clinical trials could not reach statistical evidence to demonstrate the effect for the prevention of Clostridium difficile associated diarrhea (CDAD) of certain probiotics. The authors of a large, randomized trial including 2941 elderly adults with antibiotic exposure noted that those who received probiotics (a multistrain preparation of Lactobacillus acidophilus and Bifidobacterium bifidum) did not show a risk reduction for CDI (RR 0.71; 95% CI 0.34-1.47; p=0.35) (Allen, S. J., Wareham, K., Wang, D., Bradley, C., Hutchings, H., Harris, W., Dhar, A., Brown, H., Foden, A., Gravenor, M. B., Mack, D. Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older inpatients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet, 2013: 382, 1249-1257). After years of trials with different probiotics for treatment of CDI the strain, dose, and duration of probiotics are still under discussion (Naaber, P., Mikelsaar, M., Interactions between Lactobacilli and antibiotic-associated diarrhea. Adv Appl Microbiol, 2004: 54, 231-260).
Xylitol Application
Xylitol is a 5-C sugar alcohol, e.g. pentitol, and is found in plants, fungi and algae. Xylitol is an important intermediate product in mammalian carbohydrate metabolism; i.e. human blood contains up to 8×10⁻⁵M of xylitol. Consumed xylitol is not absorbed completely and the unabsorbed part can be used as a dietary fibre for bacterial fermentation to convert xylitol to short fatty acid chains utilized in energy pathways. Xylitol influences the growth of some species of gut microbiota in the large intestines stimulating the growth and activities of indigenous microbiota. One gram of xylitol contains 2.4 kcal as compared to one gram of glucose which has 3.87 kcal. Xylitol is advertised as “safe” for diabetics and individuals with hyperglycaemia (Talbot J. M., K. P. Fisher The Need for Special Foods and Sugar Substitutes by Individuals with Diabetes Mellitus. Diabetes Care 1978: 1; 231-240).
In our previous studies on Caco-2 cell lines we have discovered that 1% xylitol prevented the adhesion of vegetative cells of C. difficile reference strain VPI 10463, seemingly blocking the receptors on cells. In an applied hamster model (Naaber, P., Lehto, E., Salminen, S., Mikelsaar, M Inhibition of adhesion of Clostridium difficile to Caco-2 cells. FEMS Immunol Med Microbiol. 1996: 14, 205-209) 1 ml of 20% xylitol solution together with Lactobacillus rhamnosus GG significantly protected animals from development of severe enterocolitis (Naaber, P., Lehto, E., Salminen, S., Mikelsaar, M., 1996. Inhibition of adhesion of Clostridium difficile to Caco-2 cells. FEMS Immunol Med Microbiol, 14, 205-209). In these experimental studies with xylitol in combination with probiotic L. rhamnosus GG the vegetative cells of Clostridium difficile, precultivated in laboratory anaerobic environment, have applied for inoculation of cell cultures or hamsters.
In opposite, in clinical practice or elderly home the infection develops from inoculation with C. difficile extremely resistant spores surviving in the aerobic environment of these facilities. The spores start to germinate inside the intestine of host.
Some authors have postulated that in the animal model some of sugars similarly to glucose could block the expression of toxins A and B of C. difficile (Karlsson, S., Burman, L. G., Akerlund, T. Induction of toxins in Clostridium difficile is associated with dramatic changes of its metabolism. Microbiology, 2008: 154, 3430-3436).
There is still a need for probiotic strains effective in enhancing of cellular immunity, decreasing LDL-cholesterol as well as in lowering the risk of Clostridium difficile infection.

DISCLOSURE OF THE INVENTION

The purpose of the present invention is to provide a strain Lactobacillus plantarum Inducia DSM 21379 for use as hypocholesterolemic agent for decreasing the level of LDL-cholesterol in blood for preventing the cholesterol metabolism disorders and consecutive cardiovascular disorders.
Another purpose of the instant invention is to provide the aforesaid strain for use as an antimicrobial agent for lowering risk of Clostridium difficile associated diarrhoeae (CDAD) by preventing germination of Clostridium difficile spores and by suppressing proliferation of Clostridium difficile vegetative cells.
The next purpose of this invention is to provide Lactobacillus plantarum Inducia DSM 21379 for use as anti-oxidative agent for enhancing anti-oxidative activity of blood by reducing the level of oxidized low density lipoprotein (ox-LDL) and by enhancing the total anti-oxidative activity (TAA) of a composition comprising said strain.
The current invention also relates to the compositions comprising L. plantarum Inducia DSM 21379 for decreasing the levels of LDL-cholesterol and ox-LDL in blood, lowering risk of CDAD and for enhancing the natural defense potential and cellular immunity of a human.
Due to the fact that L. plantarum Inducia DSM 21379 produces polyamines from ornithine and glutamate, nitric mono-oxide (NO), the composition comprising said strain possesses antioxidative activity and improves the intestinal barrier function, increases the number of immunocytes in blood and induces cytokine synthesis for enhancement of organisms' natural defense. Lactobacillus plantarum Inducia DSM 21379 is used as enhancer of the natural defense potential and cellular immunity of a subject, and simultaneously as anti-oxidative agent as well as hypocholesterolemic agent.
The composition may further comprise xylitol. The composition can be used for the production of food products, food supplements or pharmaceutical or veterinary products. The food product can be dairy product (fermented milk, cheese) or meat product, sweets, etc. The food supplement may be may be used in powder (capsules, lozenges, tablets, powder sachets etc.) or liquid (ampoules) form. The strain may be used in compositions in freeze-dried form.
The fact that the microbial strain originates from the intestinal tract of a healthy child proves its GRAS (generally recognized as safe) status i.e. that this strain of microorganism is harmless for human organism and is suitable for oral application compositions.

Antimicrobial Activity

Lactobacillus plantarum Inducia DSM 21379 expresses in vitro on MRS agar medium antagonistic activity against several enteric pathogens (Table 1).

Functional Properties

TABLE 1

Lactobacillus plantarum Inducia DSM 21379 antimicrobial
activity against pathogens and non-starter
lactobacilli on modified MRS agar medium
(pathogen growth inhibition zone, mm)

Pathogen	Growth inhibition zone (mm)

Non-starter lactobacilli (NSLAB)	2.67 ± 3.4
Listeria monocytogenes	22.7 ± 2.4
Yersinia enterocolitica	11.2 ± 2.7
Salmonella enteritidis	22.1 ± 1.9
S. typhimurium	20.8 ± 2.8
Shigella sonnei	24.0 ± 0.1
Escherichia coli	23.0 ± 1.4
Enterobacter sakazakii	18.1 ± 1.8
Campylobacter jejuni	12.0 ± 7.6

Lactobacillus plantarum Inducia DSM 21379 antimicrobial activity in vitro in streak-line procedure (antimicrobial effect of metabolites) was highest against E. coli, followed by growth inhibition of Salmonella sp., Shigella and Listeria. The lowest antimicrobial activity was detected against other lactobacilli (NSLAB).
Total Antioxidative Activity of Lactobacillus plantarum Inducia DSM 21379
Method. For the detection of TAA and TAS of the microbial cells, the strain L. plantarum Inducia was incubated in MRS broth (Oxoid, U.K.) for 24 h at 37° C. Microbial cells were harvested by centrifugation (1500 RPM, during 10 min) at 4° C. and the pellet was washed with isotonic saline (4° C.) and suspended in 1.15% KCl (Sigma, USA). The density of the suspension was OD₆₀₀of 1.1×10⁹bacterial cells ml⁻¹). Total antioxidative activity (TAA) was assessed by using the linolenic acid test (LA-test). (Kullisaar, T, Songisepp, Mikelsaar M, Zilmer, K, Vihalemm, T, Zilmer, M. British J of Nutrition. Antioxidant probiotic fermented milk decreases oxidative stress-mediated atherogenicity in human. 2003: 90, 2, 449-456) and total antioxidative status (TAS) was measured by commercial kit (TAS, Randox Laboratories Ltd., UK).

TABLE 2

Total antioxidative activity (TAA) and total antioxidative
status (TAS) of Lactobacillus plantarum Inducia DSM 21379

Strain	TAA (%)	TAS (mmol/l)

L. plantarum Inducia DSM 21379	26 ± 1.2	0.13 ± 0.04
L. plantarum DSM 21380	22 ± 5	0.05 ± 0.02

Production of nitrogen mono-oxide (NO)

Method. Nitrogen mono-oxide production measurements were carried out with 24 h old intact cells in 500μ of MRS broth with Apollo 4000 free radical analyzer (WPI, Berlin, Germany) and electrodes of type. ISO-NOP electrode signals were registered during 5-7 minutes. Mean signal strength was calculated. Each experimental point was measured in 4 independent parallels and each parallel was measured twice. NO concentration was calculated according to the standard curves correlation with the strength of the electrodes signal.

TABLE 3

NO concentration (μM) produced by Lactobacillus
plantarum DSM 21379

	Strain number	NO concentrations (μM)

	L. plantarum DSM 21379	2.7 ± 1.2
	L. plantarum DSM 21380	2.6 ± 0.8
	L. coprophilus	2.1 ± 1.1
	L. plantarum	2.1 ± 0.9
	L. paracasei ssp paracasei strain no 1	1.3 ± 0.8
	L. paracasei ssp paracasei strain no 2	1.8 ± 0.9
	L. paracasei ssp paracasei strain no 3	2.8 ± 1.6
	L. buchneri	2.0 ± 1.1

	In vitro polyamines production of Lactobacillus plantarum Inducia DSM 21379

Method. Microbial strains were suspended in physiological saline according to McFarlandi turbidity standard (10⁹CFU/ml) and 0.5 ml of each strain suspension was seeded into decarboxylation medium (a 4.5 ml) and incubated at 37° C. for 4 days (Bover-Cid and Holzapfel W. H. Improved screening procedure for biogenic amine production by lactic acid bacteria. Int J food Microbiol 1999; 53, (1); 33-41(9)).
For detection of BA 200 μl of medium was derivatized for GC analyze by modified method of Nakovich (Nakovich, L. Analysis of biogenic amines by GC/FID and GC/MS. Thesis, Virginia polytechnic institute, USA. 2003).
GC analysis were carried out by gas chromatograph HP 6890 Series GC System, with capillary colonna HP-5 19091J-413 (30 m×0.32 mm; 0.25 μm) with 160° C. 1 min, 20° C./min 280° C. 15 min; and detector (FID) 300° C.

TABLE 4

Production of polyamines in vitro in the decarboxylation
medium (Arena, M. E. and Manca de Nadra, M. C. Biogenic amine
production by Lactobacillus. J Appl Microbiol, 2001; 90; 158-162)

Polyamines (μg/ml) and biogenic amines

Arginine

Glutamine

Lysine

Ornithine

Histi-dine

	Putres-	Cadav-	Putres-	Cadav-	Putres-	Cadav-	Putres-	Cadav-	Cadav-
Sample	cine	erine	cine	erine	cine	erine	cine	erine	erine

L. plantarum	0	0.4	1.2	0.5	0	0.4	1.9	0	0
Inducia DSM
21379
L. plantarum	0	0	0	0	0	0.3	0.5	0.6	0
DSM
2137980

Lactobacillus plantarum strain Inducia DSM 21379 is able to produce cadaverine from arginine, putrescine both from glutamine as well as from ornithine. But the control strain was able to produce putrescine in low amounts only from ornithine (FIG. 1). Traces of cadaverine were detected both in control strain as well as in Lactobacillus plantarum Inducia DSM 21379. No histamine production was detected (Table 4).

DESCRIPTION OF THE DRAWINGS

FIG. 1. Production of polyamines by L. plantarum DSM 21379 in vitro in the decarboxylation medium (Arena, M. E. and Manca de Nadra, M. C. Biogenic amine production by Lactobacillus. J Appl Microbiol, 2001; 90; 158-162) (a) from ornithine (b) from glutamine.

FIG. 2 a, 2 b, 2 c. Lactobacillus species by Pearson UPMAG cluster analyses in L. plantarum Inducia DSM 21379 group.

Subjects no 3, 6, 9, 11, 14, 15, 19, 20, 22, 23, 24 and 25.

Four samples: at the recruitment (1), after consumption of probiotic cheese (2), after wash-out period (3) and after consumption of control cheese (4).

FIG. 3. The pH values of in L. plantarum Inducia DSM 21379 in xylitol containing and control modified MRS media in microaerobic and anaerobic environment.

FIG. 4. Presence of toxA and B genes in C. difficile VPI 10643 by reverse transcription (RT) and real-time PCR amplification (qPCR).

FIG. 5. Presence of toxB gene in liver and small intestine of a hamster treated with ampicillin and C. difficile by reverse transcription (RT) and real-time PCR amplification (qPCR).

FIG. 6. a) Normal mucosa of large intestine after probiotic administration and b) mucosa with C. difficile infection.

FIG. 7. Morphological changes in experimental CDAD infection. Moderate hyperaemia in a) small intestine and b) large intestine and intense hyperaemia in c) pancreas and d) spleen. Pseudomembrane in e) small intestine and PMN infiltration with pseudomembrane f) in large intestine.

DESCRIPTION OF THE EMBODIMENTS

Example 1

Obtaining Needed (Optimal) Viable Counts of Lactobacillus plantarum Inducia DSM 21379 in Food Product

Test with Estonia Cheese
Method. Microorganism Lactobacillus plantarum Inducia DSM 21379 was added to the cheese milk of Dairy Cooperative E-Piim, (inoculation dose 3×10⁸CFU/vat) and the milk was renneted (25 min). The curds were cut (25 min), heated (34° C. 15 min), dried (25 min), pressed, drained (1 h), salted in brine (12° C.; 20% NaCl; pH 4.7) 20 h, drained and dried (8 h), backed into plastic and ripened at 12° C. for at least 4 weeks.

TABLE 5

Dynamics of microflora in Lactobacillus plantarum
Inducia DSM 21379 comprising cheese.

	L. plantarum Inducia DSM	Control
	21379 comprising cheese	cheese

Sample

Day

14	Day 21	Day 30	Day 14	Day 21	Day 30

total counts	8 × 10⁸	4 × 10⁸	10¹⁰	2 × 10⁸	3 × 10⁸	2 × 10⁸
Lactobacillus	5 × 10⁸	2 × 10⁸	10¹⁰	10⁵	—	3 × 10³
sp
L. plantarum	5 × 10⁸	2 × 10⁸	10¹⁰	—	—	3 × 10³
cocci	3 × 10⁸	2 × 10⁸	10⁹	2 × 10⁸	3 × 10⁸	10⁸
spore-forming	—	—	10³	—	10⁷	10⁸
microbes
L. casei	—	—	—	10⁵	.	—

I. Lactobacillus plantarum Inducia DSM 21379 for Enhancing Cellular Immunity

Example 2

Production of Polyamines in Food Product by Lactobacillus plantarum Inducia DSM 21379

Method. Cheese samples were extracted (20 ml 50% methanol solution was added to 10 g of cheese and incubated at 45° C. for 1 h, cooled to 30° C. and centrifuged) and 200 μl of upper layer was derivatized for GC analyze by modified method of Nakovich (Nakovich, L. 2003 Analysis of biogenic amines by GC/FID and GC/MS).
GC analysis were carried out by gas chromatograph HP 6890 Series GC System, with capillary colonna HP-5 19091J-413 (30 m×0.32 mm; 0.25 μm). The column temperature program 160° C. 1 min, 20° C./min 280° C. 15 min; and detector (FID) 350° C.
The production of putrescine and tyramine was related to that: in different lots in comparison with control-cheese putrescine content increased 3-11 times and tyramine content accordingly 2-5 times.
Lactobacillus plantarum Inducia DSM 21379 belongs to the facultatively heterofermentative group of lactobacilli and therefore the content of tyramine in cheeses was significantly lower than that of strains of OHEL group. On the other hand, the content of putrescine was higher.

TABLE 6

Biogenic amines and polyamines in Lactobacillus plantarum
Inducia DSM 21379 comprising
test-cheeses from industrial test-trials

	Viable counts
	of strain				Viable
	incorporated				count of L.

into cheese

Amines (mg/kg)

Planta-rum

	(CFU/g) at	Tyra-	Putre-	Cadav-	Tensia DSM
Sample	day 3-4 after	mine	scine	erine	21379 in

L. plantarum	3 × 10⁸	4.83	20.28	0	2 × 10⁷
Inducia
DSM 21379,
1. Batch
Control cheese	—	2.31	1.82	0	—
1. Batch
L. plantarum	3.3 × 10⁷	13.57	24.67	0	2 × 10⁶
Inducia
DSM
21379,
2. Batch
Control cheese	—	2.63	6.64	0	—
2. Batch

Permitted concentration of tyramine in food e.g. in cheese is 200 mg/kg (Karovicova and Kohajdova. Biogenic amines in food. Chem pap. 2005; 59 (1); 70-79; Larque, M., Sabater-Molina, S. Zamora E. Biological significance of dietary polyamines. Nutrition 2007; 23(1): 87-95). Tyramine is considered toxic in concentrations of 1000-8000 mg/kg.
Putrescine is considered toxic if detected in organism in concentration of 2000 mg/kg per body weight and total toxicity of polyamines is >300 mg/kg per food product (Larque, M., Sabater-Molina, S. Zamora E. Biological significance of dietary polyamines. Nutrition 2007; 23(1): 87-95).
By consumption of 100 g Lactobacillus plantarum Inducia DSM 21379 comprising cheese the subject gets ca 3 mg of putrescine. Thus, in the case of person of 70 kg the concentration is up to 50 μg per kg, which does not express toxic effect.

Example 3

Enhancement of Defense Capability of Intestinal Mucosa with Lactobacillus plantarum Inducia DSM 21379 Comprising Food

In the experimental model with NIH mice 3 groups of mice consumed different cheeses during 30 days (control cheese with no additives, Lactobacillus plantarum strain Inducia DSM 21379 2×10⁸cfu/g comprising cheese).
Cheese was administered to mice at night (normal awake time for mice) 4.4 g/per mouse, daily ad libitum regular commercial diet. Consumed amount of cheese was 3.5-4.2 g/per night.
Mice stayed in good condition, no changes in fur and digestion was detected. Cheese administration caused increase of body weight: body weight at the beginning of the trial was 22.9-29.8 g and at the end of the trial a weight gain was 2-6.1 g. The mice were sacrificed by cervical dislocation at day 30. No translocation of lactobacilli or other bacteria of the microflora to blood or organs was detected at the autopsy.

TABLE 7

Total counts of lactobatsilli in faeces, ileum and colon

Sample

	Control group (cheese	Test group (cheese
	without L. plantarum	comprising L. plantarum
Faecal	Inducia DSM 21379	Inducia DSM 21379
samples	was administered)	was administered)

Day 0	6.7	7.6
Day 10	8.0	8.3
Day 15	7.0	8.0
ileum	3.0-7.1/5.95*	6.3-7.7/6.95*
colon	4.4-7.3/6.65*	6.9-7.8/7.45*

*Student t-test p = 0.001

With seeding from ileum and colon from the mice administered with Lactobacillus plantarum Inducia DSM 21379 total counts of lactobacilli were found to be increased significantly both in ileum and colon.
Tissue samples from the liver, spleen, ileum and colon were fixed in formalin and embedded in paraffin. Microtome-cut tissue samples were stained with hematoxyline-eosine.
No morphological shifts were found in organs (liver and spleen), which proves the safety of Lactobacillus plantarum Inducia DSM 21379.
In the ileum quantity and shape of intestinal mucosa, count of goblet and Paneth cells was evaluated and formation of follicles and diffuse multiple deposits by lymphocytes.
In the colon attention was paid to the numerously goblet cells containing surface epithelium and to the characteristics of lymphatic tissue in connective tissue of mucosa.

TABLE 8

Patomorphological evaluation of mice organs after administration of
Lactobacillus plantarum Inducia DSM 21379 comprising cheese.

Mice group	Liver	Spleen	Ileum	Colon

L. plantarum	Hyperaemia	ii	Lymph	Lymph
Inducia
	6/10*		follicles	follicles
DSM 21379			6/10*	8/10*
comprising cheese
consumed animals
Control cheese	Hyperaemia	Hyperaemia	Lymph	Lymph
consumed animals	3/10*	1/10	follicles	follicles
			3/10*	4/10*

*p < 0.05

Administration of Lactobacillus plantarum Inducia DSM 21379 comprising cheese during 1 month enhanced liver hyperemia and raised significantly lymphatic follicles (immunocytes) of mice ileum and colon in comparison with control mice. These results refer to enhancement of the defense capability of intestinal mucosa and liver functions.

Example 4

Examination of Clinical Blood Indices of Healthy Volunteers Consumed Lactobacillus plantarum DSM 21379 Comprising Food and the Increase of Lactobacillus plantarum Percentage in the Intestinal Microflora

The double-blind placebo-controlled (DBPC) cross-over exploratory trial (International registration number ISRCTN38739209) was conducted according to the guidelines of Declaration of Helsinki. The trial was approved by the Ethics Review Committee on Human Research of the University of Tartu, Estonia (approval number 158/10, 26.03.2007). All participants signed their written informed consent at the enrollment and were given the possibility to withdraw from the study any time.
The clinical trial with healthy volunteers evaluated the impact of putrescine, NO and antioxidative compounds producing Lactobacillus plantarum Inducia DSM 21379 comprising food consumption on (Estonian cheese) 1) safety for the consumer; 2) humoral and cell immunity parameters of blood; 3) effect on intestinal microflora; 4) and urine metabolites, to detect possible health-promoting effects.
The study group consisted of healthy volunteers, both male and female (M/F 4/8) aged 20-48 years. For exclusion criteria diabetes, glucose and glycohemoglobin HbA1c from blood sera were detected. The trial was randomized double-blind cross-over study. Trial started with 3-week consumption of test cheese. Volunteers consumed the test cheese for 3 weeks. After a 2-week washout period, volunteers were crossed over to another 3 weeks of control cheese administration.
Lactobacillus plantarum Inducia DSM 21379 content in 30 old test cheeses was 6×10⁷cfu/g.
Before consumption the test cheese was incubated with Lactobacillus plantarum Inducia DSM 21379 for 30 days at 12° C. Regular Estonian cheese of Edam type without Lactobacillus plantarum Inducia DSM 21379 served as a control.
The trial was a randomized blinded cross-over placebo controlled trial. Trial started with 3-week consumption of test cheese, followed by 2 week washout period, after which the control cheese was consumed for 3 weeks. Dose 50 g/day.
Results
1) Safety
No discomfort, abdominal pain or other negative symptoms were reported by trial participants. After cheese trial with volunteers, the values of systemic inflammation markers (U-CRP, ultrasensitive CRP, and leucocytes) were not changed and were within the normal range.
The consumption of probiotic Lactobacillus plantarum Inducia DSM 21379 cheese did not cause changes in WBC counts (leucogram) (Table 9). No change was also detected in the values of essential allergy marker IgE in comparison with pre-trial period.
Consumption of Lactobacillus plantarum Inducia DSM 21379 comprising cheese had no negative impact on organisms' kidney and liver function nor affected according parameters (ASAT, ALAT albumine, blood sera creatinine).
Thus in healthy subjects the consumption of Lactobacillus plantarum DSM 21379 comprising cheese does not cause systemic inflammation, allergic sensibilisation or causes harm to essential organs.
2) Intestinal Microflora
Method. Microbial DNA was isolated from cheese by QIAamp DNA Mini Kit (QIAGEN) and amplified with primers Uni-515-GC-rev (ATCGTATTACCGCGGCTGCTGGCA-GC), Lab-159-f (GGAAACAGA/GTGCTAATACCG) (Heilig H G, Zoetendal E G, Vaughan E E, Marteau P, Akkermans, A D L, de Vos W M, /et al./ Molecular diversity of /Lactobacillus/ ssp. and other lactic acid bacteria in the human intestine as determined by specific amplification of 16S ribosomal DNA. /Appl Envir Microbiol /2002; 68: 114-123). Subsequently, the PCR product was separated by DGGE electrophoresis in 30-60% acrylamide containing gel with Dcode™ System technique. (Bio-Rad, Hercules, Calif.). Gels were analyzed by BioNumerics 2.5 (Applied Maths, Belgium) software according to Peasoni correlation (Fromin, N.; Hamelin, J.; Tarnawski, S.; Roesti, D.; Jourdain-Miserez, K.; Forestier, N.; Teyssier-Cuvelle, S.; Gillet, F.; Aragno, M.; Rossi, P. Statistical analysis of denaturing gel electrophoresis (DGE) fingerprinting patterns Environmental Microbiology 2002; 4 (11), 634-643) (FIG. 2 a, 2 b, 2 c).
Results
Consumption of Lactobacillus plantarum Inducia DSM 21379 comprising cheese changed lactobacilli pattern profile in feces in 5 persons of 12. These changes remained stable in 3 persons of 5 even 2 weeks after completing the trial.
Thus, consumption of Lactobacillus plantarum Inducia DSM 21379 comprising cheese affects the composition of human intestinal lactoflora.
3) Humoral and Cellular Parameters of Blood Sera
It appeared that Lactobacillus plantarum Inducia DSM 21379 comprising cheese induces the raise of cytokine IL-6, in volunteers, which indicates the stimulation of cellular immunity. This finding was confirmed by the increase of blood monocytes at the end of the trial (p=0.015), whereas indices of blood cells were within the normal range.
Positive correlation after completing the cheese consumption appeared between IL-6 and blood monocytes (r=0.653, p=0.029, n=11). The linear regression model confirmed the correlation (R²=0.405, R²adj=0.338, =0.035)
Enhancement of parameters of cellular immunity is in accordance with results on animal model described above; where the administration of Lactobacillus plantarum Inducia DSM 21379 induced significantly Peyer's patches i.e. lymph follicles in the intestine. In these follicles interaction of the components of the immune system occurs. Proinflammatory cytokines incl. induction of IL-6 play important role in activation of TH1 type lymphocytes against bacteria through which macrophages i.e. blood monocytes are retroactive activated. Thereupon blood monocytes produce also IL-6.
The increase of the share of cellular immunity is explainable also by the suppression of humoral response e.g. somewhat decreased production of antibodies (IgA, IgG), which however remained within the normal range.

TABLE 9

Immunological parameters of blood after consumption of probiotic
Lactobacillus plantarum Inducia DSM 21379 comprising cheese

Immunity	At the	End of the	P	Normal range
parameters	recruitment	trial	values	and units

Ultrasensitive	1.9 ± 1.6	3.3 ± 2.7	1.0	<5	mg/L
CRP

Leukocyte	6.3 ± 1.7	6.9 ± 1.6	0.116	4-10 × 10⁹/L
counts × 10⁹
Lymphocytes	2.3 ± 0.5	2.2 ± 0.4	0.878	0.8-2.9 × 10⁹/L
Monocytes	0.55 ± 0.17	0.64 ± 0.15	0.032	0.15-0.75 × 10⁹/L

Cytokine IL-6	2.7 ± 1.0	3.8 ± 1.7	0.020	<3.4	ng/L
IgA antibodies	2.5 ± 0.9	2.3 ± 0.8	0.009	0.7-4.0	g/L
IgM antibodies	1.3 ± 0.5	1.3 ± 0.5	0.776	0.4-2.3	g/L
IgG antibodies	12.9 ± 3.2	12.4 ± 3.0	0.017	7.0-16	g/L
IgE antibodies	19.6 ± 21.2	21.4 ± 25.9	0.232	<85	kU/L

4) The Urine Metabolites
For the evaluation of the content biogenic amines before the consumption of the probiotic and the efficiency of the stabilization period, the morning urine and gas chromatography method were used.
Method: urine samples were derivatized with propylchlorophormate for GC analyze by modified method of Uglandi (Ugland H G; Krough M, Rasmussen K E: Aqueous alkylchloroformate derivatization and solid-phase microextraction: determination of amphetamines in urine by capillary gas chromatography. J Chromatography B Biomed Sci Appl 1997; 701:29-38).
GC analysis were carried out by gas chromatograph HP 6890 Series GC System (Hewlett Packard, Avondale, Pa., USA), with capillar colonne HP-5 19091J-433 (30 m×0.25 mm; 0.25 μm) The column temperature program 150° C. 1 min, 20° C./min 280° C. for 5 min; and detector (FID) 250° C. The biogenic amines concentration was calculated according to nmol/mol creatinine

TABLE 10

Polyamines and biogenic amines content in the morning
urine (nmol/mol creatinine) of probiotic cheese consumers

		Control cheese (without
	Probiotic cheese comprising L.	Lactobacillus plantarum
	plantarum Inducia DSM 21379	Inducia DSM 21379)

	BL1	PRO	BL2	PL	P values
	mean ± stdev	mean ± stdev	mean ± stdev	mean ± stdev	paired t-test
	range	range	range	range	BL1 vs PRO/
	(median)	(median)	(median)	(median)	BL2 vs PL

Put	0.064 ± 0.072	0.082 ± 0.058	0.043 ± 0.044	0.044 ± 0.060	0.432/0.432
	0-0.191	0-0.191	0-0.126	0-0.216
	(0.030)	(0.077)	(0.033)	(0.031)
acPut	0.606 ± 0.559	1.087 ± 1.451	0.796 ± 0.689	0.635 ± 0.291	0.021/0.850
	0.151-2.104	0.307-5.049	0.068-2.167	0.154-1.219
	(0.435)	(0.447)	(0.600)	(0.594)
DAP	0.079 ± 0.092	0.059 ± 0.089	0.056 ± 0.089	0.117 ± 0.142	0.411/0.195
	0-0.249	0-0.216	0-0.253	0-0.418
	(0.055)	(0)	(0)	(0.055)
acSpd	0.251 ± 0.227	0.384 ± 0.198	0.354 ± 0.210	0.425 ± 0.260	0.089/0.464
	0-0.813	0.043-0.686	0.085-0.668	0.065-0.831
	(0.232)	(0.384)	(0.304)	(0.396)
Cad	0.066 ± 0.123	0.069 ± 0.162	0.067 ± 0.093	0.044 ± 0.085	1.0/0.540
	0-0.364	0-0.569	0-0.293	0-0.228
	(0)	(0)	(0.016)	(0)
His	0.231 ± 0.226	0.387 ± 0.524	0.211 ± 0.364	0.478 ± 0.684	0.910/0.250
	0-0.595	0-1.401	0-1.229	0-2.093
	(0.156)	(0.122)	(0)	(0.235)
Tyr	0.153 ± 0.161	0.101 ± 0.132	0.093 ± 0.096	0.212 ± 0.285	0.167/0.149]
	0-0.476	0-0.427	0-0.257	0-1.035
	(0.102)	(0.050)	(0.093)	(0.179)

Put—putrescine,
acPut—N-acetylputrescine,
DAP—1.3-diaminopropane,
acSpd—N 8-acetylspermidine,
Cad—cadaverine;
His—histamine,
Tyr—tyramine

The content of polyamines (putrescine, acetylputrescine and acetylspermidine) in urine increased after consumption of L. plantarum Inducia DSM 21379 comprising probiotic cheese. A significant correlation (R=0.383 p<0.01, n=48) appeared between the contents of acetylputrescine and acetylspermidine in the urine of volunteers.
At the same time the content of all polyamines incl. putrescine, acetylspermidine and acetylspermine as well as biogenic amines remained within the normal range in the urine.
Lactobacillus plantarum strain Inducia DSM 21379 is able to produce putrescine in vitro as well as in cheese. Consumption of probiotic Lactobacillus plantarum Inducia DSM 21379 cheese elevated the content of acetylputrescine in urine of trial participants.
Acetylputrescine represents a detoxified compound, elevated content of which proves putrescine production by Lactobacillus plantarum Inducia DSM 21379 in gastrointestinal tract of volunteers or absorption and metabolism of additional amounts of putrescine, consumed with cheese. On the other hand, this indicates the successful adaptational reaction of organism to deal with superfluous amounts of putrescine by excreting it with urine in acetylated form.
The immunostimulative effect of putrescine produced by Lactobacillus plantarum Inducia DSM 21379 was confirmed by the correlation between blood cytokine IL-6 and the quantity of macrophages (monocytes), which in this case could be considered activated macrophages. The finding mentioned together with H₂O₂is essential for the organisms' defense against foreign cells (microbes, cancer cells).
Physiological doses of putrescine occurring in the gut due to Lactobacillus plantarum Inducia DSM 21379 could theoretically enhance the regeneration of the epithelium of intestinal mucosa and apoptosis of old cells, thus avoiding the hyperproliferation of epithelium. These mechanisms ensure the barrier function of intestinal mucosa and protects against penetration of allergens.
Consumption of Lactobacillus plantarum Inducia DSM 21379 cheese regulates the amount and activity of blood monocytes through IL-6 which finding together with lymph follicles (increase of carriers of cellular immunity) demonstrated in experimental animals improves the barrier function of intestinal mucosa and supports organisms' immunological defense functions.

Example 5

Examination of the Clinical Blood Parameters of the Volunteers Consuming Lactobacillus plantarum Inducia DSM 21379 Containing Yoghurt

The double-blind placebo-controlled (DBPC) cross-over exploratory trial (International registration number ISRCTN68198472) was conducted according to the guidelines of Declaration of Helsinki. The trial was approved by the Ethics Review Committee on Human Research of the University of Tartu, Estonia (approval number 178/T-13 19.01.2009). All participants signed their written informed consent at the enrollment and were given the possibility to withdraw from the study any time.
The objective of the clinical trial (randomised cross-over placebo controlled double-blind clinical trial, was to assess the safety and effect on the intestinal microflora of healthy volunteers of the Lactobacillus plantarum Inducia DSM 21379 containing yoghurt.
Subjects and Methods.
The participants were 27 voluntary healthy persons of both sexes (M/F 10/17, 29.2±9.3 yrs). For exclusion latent diabetes, glucose, and glycohemoglobione (HbA1c) were measured form blood serum. Test-yogurt contained Lactobacillus plantarum strain Inducia DSM 21379 (5×10⁶-10⁷cfu/ml). Yoghurt without probiotic additive served as control. The trial started 3 week consumption of test-yoghurt, followed by a two-week washout period, after that the participants consumed the control yoghurt for 3 weeks. The daily dose was 10⁸-5×10⁹cfu).
Serum Humoral and Cellular Immunity Parameters
It was found that yogurt containing Lactobacillus plantarum Inducia DSM 21379 induced chemoattractant protein (MCP, p=0.016) in the serum of volunteers, referring the stimulation of humoral part of the immune system. This finding was positively correlated with the increase of IL 10 (r=0.583; p=0.009).
The increase of the parameters of humnoral immunity was in accordance with the results obtained in the three weeks of administration of cheese comprising Lactobacillus plantarum DSM 21379 Inducia as described above.

TABLE 11

Content (pg/ml) of cytocines in the blood seerum of volunteers during the trial

Probiotic yoghurt

Control yoghurt

P valus

	BL1	PRO	BL2	PL	BL1 vs PRO/BL2 vs PL

INFγ	2.9 ± 4.3	3.8 ± 4.2	3.7 ± 3.6	1.9 ± 1.8	0.084/0.107
TNFα	4.6 ± 3.2	5.0 ± 2.6	4.0 ± 1.4	3.8 ± 1.2	0.225/0.376
VEGF	158.8 ± 15.8	157 ± 120.4	152.2 ± 106.8	163.0 ± 157.7	0.465/0.841
MCP	218.4 ± 98.1	251.3 ± 145.1	256.2 ± 142.2	230.8 ± 116.7	0.016/0.156
EGF	54.8 ± 57.6	53.4 ± 38.4	53.2 ± 56.5	52.0 ± 45.1	0.679/0.353

VEGF—vascular endothelial growth factor
MCP—monocyte chemoattractant protein
EGF—epidermal growth factor

Thus, administration of L. plantarum Inducia containing yoghurt activated the monocyte chemoattractant protein, which demonstrates the increased immune activity.
After the administration of Lactobacillus plantarum Inducia containing yoghurt, the content of acetylated putrescine increased in the morning urine of patients.
The content of acetylated putrescine was correlated to (r=0.439 p=0.037) the increase of the amount of spermidine in the morning urine of patients.
These results are consistent with the results of the clinical trial of probiotic cheese. At the same time, the concentration of both polyamines incl. putrescine and acetylated putrescine as well as biogenic amines in the morning urine remained within normal limits.

TABLE 12

Content of polyamines and biogenic amines in the morning
urine of the subjects consuming probiotic yoghurt (nmol/mol creatinine)

Probiotic yoghurt

Control yoghurt

P values

	BL1	PRO	BL2	PL	BL1 vs PRO/BL2 vs PL

Put	0.084 ± 0.170	0.032 ± 0.060	0.033 ± 0.039	0.029 ± 0.036	0.069/0.776
acPut	0.275 ± 0.231	1.015 ± 1.816	0.349 ± 0.240	0.538 ± 0.719	0.002/0.160
DAP	0	0.038 ± 0.109	0.005 ± 0.017	0.064 ± 0.200	0.181/0.059
Spd	0.168 ± 0.081	0.221 ± 0.147	0.188 ± 0.117	0.64 ± 0.269	0.218/0.377
Cad	0	0	0 ± 0.001	0.001 ± 0.005	NA/1.0
Tyr	0		0	0	NA

Put—putrescine,
acPut—N-acetylputrescine,
DAP—1.3-diaminopropane,
acSpd—N 8-acetylspermidine,
Cad—cadaverine;
Tyr—tyramine.

II. Use of L. plantarum Inducia DSM 21379 as Hypocholesterolemic Agent by Decreasing LDL-Cholesterol in Blood

Example 6

Bile Salt Hydrolase Activity of L. plantarum Inducia DSM 21379

Methods. Assessing the Bile Salt Hydrolase (BSH) activity L. plantarum Inducia DSM 21379 was performed according to Cuñé Castellana, 2009 (EP 2 485743 B1; AB Probiotics S.A.)
Three Lactobacillus spp strains were cultured overnight on MRS agar in microaerobic conditions at 37° C. After incubation, cultures were standardised to McFarland 3.0. The single-strain cultures were assayed for BSH activity. Cultures were impregnated around the sterilized paper disks on MRS agar plates supplemented with 4% (w/v) sodium salt of taurodeoxycholic acid (TDCA, Sigma, USA) and 0.37 g/1 CaCl₂. Plates were anaerobically incubated at 37° C. for 72 h, and the diameter of the precipitation zones around the disks were measured. BSH activity was then calculated by subtracting the disc diameter (DD, mm) from the inhibition zone diameter (IZD, mm) and dividing this difference by two following the formula BSH activity=(IZD-DD)/2 (Table 13).

TABLE 13

Bile salt hydrolase (BSH) activity of
L. plantarum Inducia DSM 21379

		BSH activity (mm)

	L. plantarum Inducia DSM 21379	1.7
	L. plantarum BAA 793	1.5
	L. gasseri DSM 23882	0.75

BSH activity of L. plantarum Inducia DSM 21379 was higher than reference L. plantarum strain BAA793 and L. gasseri DSM 23882 (Table 13).

Example 8

LDL-Cholesterol Decreasing Ability of L. plantarum Inducia DSM 21379

The purpose of the human intervention trial ISRCTN79645828 “Effect of probiotic yoghurt on blood indices and intestinal microflora of healthy volunteers” was to assess the short term (3 weeks) LDL-cholesterol decreasing ability of L. plantarum Inducia DSM 21379 in volunteers blood when consumed with yoghurt comprising said strain.
Yoghurt preparation. The probiotic yoghurt was developed from adjusted and pasteurized (+92 . . . +95° C. 5 min) cow milk using L. plantarum Inducia DSM 21379 (2×10¹¹cfu/g) as an adjunct starter (inoculation dose 1 g/t). Shortly, the pasteurized milk was cooled to +35 . . . +43° C. before mixing with starter cultures and the probiotic strain. The milk was fermented until a pH 4.2 . . . 4.5 was reached and cooled to +23 . . . +27° C. The yoghurt was sweetened with 5% of sugar, packaged in plastic cups and cooled to +2 . . . +6° C. A yoghurt without probiotic adjunct served as a control.
Design of human volunteer trial. The double-blind placebo-controlled.
(DBPC) cross-over exploratory trial was conducted according to the guidelines of Declaration of Helsinki. The trial was approved by the Ethics Review Committee on Human Research of the University of Tartu, Estonia (approval number 190T-11, 2010). All participants signed their written informed consent at the enrollment and were given the possibility to withdraw from the study any time. The study was performed to investigate the effect of yoghurt comprising L. plantarum Inducia DSM 21379 on health biomarkers in healthy adults (n=49). Within one month prior to study participants were asked to continue their normal diet, and to avoid probiotic products (e.g. food supplements, yoghurts, cheese, kefir etc).
Two groups of participants started simultaneously with 3-week consumption of 150 g daily of test-yoghurt i.e. yoghurt comprising L. plantarum Inducia DSM 21379 (4×10⁷cfu/g) or control yoghurt. The daily dose of the probiotic L. plantarum Inducia was 6×10⁹cfu. After a two-week washout period, the volunteers were crossed over to another three weeks period of consumption of the probiotic yoghurt or control yoghurt.
Clinical Investigations
The subjects were clinically investigated and blood plasma samples were collected after an overnight fast and abstinence from any medications, tobacco, alcohol and tea or coffee. Each participant was evaluated for anthropometrical indices. Body mass index (BMI) was calculated as the weight (kg) divided by squared height (m²). BMI was used to classify normal weight range (18.5-24.9 kg/m²), overweight (≧25.0 kg/m²) and obesity (≧30.0 kg/m²) in healthy volunteers (WHO. The International Task Force. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. Geneva, Switzerland. WHO/Nut/NCD/98. 1998; 1).
The samples of fasting blood were collected four times: at recruitment, after administration of either the L. plantarum Inducia DSM 21379 comprising product or control product, after wash-out period, and after the administration of the control or probiotic product at the end of the trial.
Haematological indices: plasma lipids: total cholesterol, LDL-cholesterol (LDL), HDL-cholesterol (HDL) and triglycerides were determined by standard laboratory methods using certified assays in the local clinical laboratory (United Laboratories of Tartu University Clinics, Estonia). Intervals for routine laboratory tests proposed by Nordic Reference Interval Project (NORIP, Rustard P., Felding P., Franszon L., Kairisto V., Lahti A., Martensson A., Hyltoft Petersen P., Simonsson P., Steensland H., Uldall A. (2004) The Nordic Reference Interval Project 2000: recommended reference intervals for 25 common biochemical properties. Scand J Clin Lab Invest 64: 271-284) were used as reference.
Change in oxidized LDL (oxLDL, pmol/L) was measured by using the enzyme-linked immunosorbent assay (ELISA) kit (Mercodia, Sweden, Cat No 10-1143-01).
Statistical Analysis
Statistical analysis was performed by using R 2.10.1 (http://www.r-project.org Retrieved 25.03.2014) and GraphPad Prism version 4.00 for Windows (GraphPad Software, San Diego, Calif.). All data were expressed as mean and standard deviation (means±SD). Baseline and intervention data were compared by paired t-test or Wilcoxon rank sum test according to the distribution of data.
Differences were considered statistically significant if the value was p<0.05.
The two groups of healthy volunteers of the cross-over trial did not differ in their clinical data (Table 14).

TABLE 14

Baseline values of healthy volunteers

	Group 1 n = 25	Group 2 n = 24	P value

Age	35.8 ± 12.0	38.0 ± 12.7	0.617
	19.0-58.0	19.0-62.0
	(34.0)	(36.5)
Sex F/M) ^§	18/7	18/6	1.0
HbA1c *	5.5 ± 0.2	5.5 ± 0.3	0.976
BMI	23.8 ± 4.3	25.2 ± 5.2	0.297
	18.1-34.6	18.6-43.4
	(22.7)	(25.3)
Waist//hip	0.78 ± 0.06	0.79 ± 0.07	0.434
	0.68-0.97	0.68-0.94
	(0.77)	(0.79)
Systolic blood	118.3 ± 10	121.6 ± 15.5	0.660
pressure	101.0-144.5	98.5-158.0
	(118.0)	(117.8)
Diastolic blood	77.5 ± 7.4	78.6 ± 8.8	0.719
pressure	63.5-92.5	65.5-98.5
	(76.7)	(79.3)
Cholesterol	5.1 ± 1.1	5.2 ± 0.9	0.952
LDL-cholesterol	3.4 ± 1.0	3.4 ± 1.2	0.873
HDL-cholesterol	1.7 ± 0.4	1.7 ± 0.5	0.719
Triglycerides	1.2 ± 1.0	1.1 ± 0.3	0.298
Glucose	4.9 ± 0.5	4.9 ± 0.4	0.560

* glucohaemoglobin,
^§ Fisher exact test

TABLE 15

Metabolic indices of blood sera during the trial

					P values
					*BL1 vs PRO/

Probiotic yoghurt

Control yoghurt

BL2 vs PL

	Probiotic		Placebo	(BL1 vs BL2,
Baseline 1	period	Baseline	2	period	PRO vs PL)

Cholesterol	5.2 ± 1.0	5.1 ± 0.9	5.1 ± 0.9	5.1 ± 0.9	0.081/1.0
total	3.0-8.1	3.2-7.1	3.2-7.5	3.5-7.7	(0.588, 0.172)
	(5.1)	(5.0)	(4.9)	(5.0)
LDL-	3.3 ± 1.0	3.0 ± 0.9	3.3 ± 1.1	3.1 ± 1.0	<0.001/0.099
cholesterol	1.3-6.2	1.2-5.0	1.1-6.1	0.9-5.6	(0.358, 0.329)
total	(3.3)	(2.9)	(3.2)	(2.9)
HDL-	1.7 ± 0.5	1.7 ± 0.5	1.7 ± 0.5	1.7 ± 0.5	0.569/0.402
cholesterol	0.8-3.1	1.0-3.3	0.9-3.0	0.9-3.1	(0.896, 0.788)
total	(1.8)	(1.7)	(1.8)	(1.7)
Triglycerides	1.1 ± 0.8	1.1 ± 0.6	1.1 ± 0.6	1.1 ± 0.6	0.694/0.456
total	0.4-4.4	0.3-3.9	0.5-4.0	0.5-4.1	(0.834, 0.412)
	(0.9)	(0.9)	(1.0)	(1.0)

*BL1: baseline 1; PRO: probiotic period, BL2: baseline 2; PL: placebo period

Change in oxidized LDL (oxLDL, pmol/L) value during the trial: at the start 52.7±16.2 49.0±15.3 vs at the end of the 3-week probiotic treatment, p=0.001)
The main changes after L. plantarum Inducia DSM 21379 consumption were revealed in the content of LDL-cholesterol particles. The LDL-cholesterol content was decreased after consumption of L. plantarum Inducia DSM 21379 comprising yoghurt (Table 15).
Thus, the consumption of L. plantarum Inducia DSM 21379 yoghurt during 3 weeks reduced the LDL-cholesterol level for 9.1% and the oxidized LDL level for 7% in blood.
III. Use of L. plantarum Inducia DSM 21379 as antimicrobial agent by preventing germination of spores of C. difficile

Example 9

Antagonistic Activity of L. plantarum Inducia DSM 21379 Against Vegetative Cells of C difficile Reference Strains in Anaerobic Environment In Vitro

The purpose of the study was to assess the antagonistic activity of L. plantarum Inducia DSM 21379 against C difficile reference strains in anaerobic environment.
Methods. The tested strains were: L. plantarum Inducia DSM 21379 and C. difficile VPI 10463 (ATCC 43255), M 13042 hypervirulent strain.
Strains were seeded on solid media and incubated in an anaerobic environment. The suspension of bacteria in PBS was adjusted according to MacFarlandi standard (3 for 10⁸cfu/ml). Suspension (0.2 ml) in the 200 ml BHI media was inoculated for reaching the concentration 10⁵cfu/ml.
On different timescale the bacteriological seedings for growth were performed (0.1 ml) to MRS and LAB160 media. The plates were incubated in anaerobic and microaerobic conditions. The growth was checked after 2-5 days and the results were expressed as log₁₀CFU/ml.

TABLE 16

Inhibition of growth of C. difficile reference strains after co-cultivation
with L. plantarum Inducia DSM 21379 in BHI media after 0, 24, and 48 h

Growth (log CFU/ml)

	0 h	24 h	48 h

Growth of strains as single in BHI
L. plantarum Inducia	5.3	8.0	6.3
C. difficile VPI 10463 reference strain	5.8	4.6	7.5
M 13042 clinical reference strain	5.3	5.3	7.5
Growth of L. plantarum Inducia and C. difficile
strains after co-cultivation in BHI
L. plantarum Inducia with C. difficile VPI	5.8	8.8	7.3
L. plantarum Inducia with M reference strain	5.6	8.5	6.0
C. difficile VPI10463 strain with L. plantarum	5.5	0	0
Inducia
C. difficile M 13042 strain with L. plantarum	5.3	0	0
Inducia

Complete suppression of C. difficile vegetative cells by L. plantarum Inducia DSM 21379 was discovered after co-cultivation in BHI medium further seeded on selective MRS and CD LAB180 media after 48 h incubation L. plantarum Inducia DSM 21379 showed the highest values at 24 h in the BHI medium. After 48 h the growth yield of L. plantarum Inducia DSM 21379 was modestly suppressed equally in single culture (6.3 log cfu/g) or if combined with C. difficile strains (7.3 and 6.0 log cfu/g).

Example 4

Effect of Supernatant of Lactobacillus plantarum Inducia DSM 21379 on Vegetative Cells of Clostridium difficile Reference and Clinical Strains In Vitro

The purpose of the following in vitro experiment was to determine the antimicrobial effect of L. plantarum Inducia DSM 21379 vegetative cells of on reference and clinical C. difficile strains. The distinction between the suppressive effect of natural (acidic) and neutralised supernatant (inhibitory substances e.g. peptides) of L. plantarum Inducia DSM 21379 helps to discriminate between two mechanisms—either impact of organic acids or presence of bacteriocins.
Material (Strains) (Table 17)
L. plantarum Inducia DSM 21379
Clostridium difficile Reference Strains VPI 10463 and M 13042
Clostridium difficile Clinical Strains (11 Strains)
Methods. Antimicrobial activity of L. plantarum Inducia DSM 21379 supernatant was determined against reference and clinical C. difficile strains by a microtitre plate (MTP) assay.
The L. plantarum Inducia DSM 21379 was maintained at −80° C. in microtubes on glass-beads and was activated trice in MRS broth with 0.15% agar, incubated under microaerobic conditions (10% CO₂) at 37° C. for 24 h. Overnight L. plantarum Inducia DSM 21379 culture was used to inoculate BHI broth 1% v/v and was incubated in microaerobic conditions for 24 h. For detection of antimicrobial activity of L. plantarum Inducia DSM 21379, the extracellular cell free supernatant (CFS) was collected by centrifugation from a 24 h old BHI broth cultures. The pH of cell free supernatant was measured and divided in half. The on half was left acidic and the other half was neutralized with 6N NaOH to pH 6.0, the both supernatants were filter sterilized.
C. difficile strains were maintained at −80° C. in microtubes on glass-beads and were activated trice on Fastidious Anaerobe Agar (FAA) with horse blood supplement for 24 h in anaerobic milieu (Anaerobic glove box, gases 90% N:5% CO₂:5% H₂). Overnight C. difficile cultures were used for the suspension with density according to MacFarland 3.0. For evaluating the antimicrobial activity of L. plantarum Inducia DSM 21379, 20 μl of C. difficile cell suspension was added to 180 μl: (1) BHI broth (as control), (2) cell free BHI supernatant, (3) cell free neutralized BHI supernatant, (4) diluted cell free supernatant (1:1 in sterile BHI broth) and (5) diluted neutralized cell free supernatant (1:1 in sterile BHI broth).
Growth of C. difficile (change in optical density values) was measured after 48 h at OD_620nmusing an MTP reader and the growth rates were calculated.
The suppressive activity of L. plantarum Inducia DSM 21379 was tested with Kruskal-Wallis test, where the growth density (OD_620nm) of C. difficile control was compared with the data of C. difficile growth density in natural and neutralised and in supernatants dilutions. The statistical analysis of data was performed using PAST Statistics Web provided program.

TABLE 17

Antimicrobial activity L. plantarum Inducia DSM 21379
supernatant neutral (acidic) and neutralised cell free
supernatant and supernatant dilution against clinical
and reference strains of C. difficile after 48 h of cultivation.

			The density of
		The density of	C. difficile in
		C. difficile in	L. plantarum
		L. plantarum	Inducia supernatant
	The density	Inducia	dilution 1:1
	of C.	supernatant	(supernatant:BHI)
	difficile	(natural or	(natural or
C. difficile	in BHI	neutralized)	neutralized)

strains	(control)	natural	neutralized	natural	neutralized

CDE	0.259	0.023	0.150	0.113	0.395
CDP1	0.478	0.007	0.305	−0.007	0.294
CDP2	0.510	0.001	0.550	0.193	0.651
CDP3	0.493	0.009	0.363	0.114	0.334
CDP4	0.386	0.004	0.247	0.084	0.343
CDP5	0.311	0.003	0.192	0.097	0.369
CDP6	0.503	0.003	0.208	0.107	0.264
CDP7	0.402	0.091	0.315	0.126	0.325
CDP8	0.110	0.002	0.170	0.019	0.316
CDP9	0.090	0.032	0.170	0.103	0.334
CDP10	0.209	0.023	0.050	0.093	0.331
VPI 10643	0.420	0.044	0.076	0.329	0.290
M 13042	0.402	0.005	0.249	0.083	0.304
Mean ± SD	0.352 ±	0.019 ±	0.234 ±	0.112 ±	0.350 ±
	0.15^a;b;c	0.03^a;d;e;f	0.13^b;d	0.08^c;e	0.10^f

^ap < 0.0001;
^bp < 0.05;
^cp < 0.01,
^dp < 0.001;
^ep < 0.01;
^fp < 0.001

Legend: vegetative cells of clinical strains: C. difficile CDE, CDP 1-9; reference strains: C. difficile VPI 10463 (ATCC 43255) and C. difficile M13042 (epidemic strain from Canada belonging to ribotype 027).
Thus, the strain L. plantarum Inducia DSM 21379 possess antimicrobial activity against C. difficile relying both on acid production in natural product (pH lowering) and in a smaller extent also on some antimicrobial protein-like substance still active after neutralisation of the supernatant (neutralized product) (Table 17).

Example 11

Testing of Growth and pH Values of L. plantarum Inducia DSM 21379 in the Media with Xylitol

The purpose of the study was to find if xylitol influences the antagonistic activity of L. plantarum Inducia DSM 21379 against C. difficile.
Inducia (10⁵cfu/ml) was incubated in MRS media where glucose was substituted for 5% xylitol or used without sugar in microaerobic and anaerobic environment. The count of lactobacilli was registered as cfu/ml of media. We tested at 2, 6, 24, and 48 h if L. plantarum Inducia DSM 21379 uses xylitol for growth in vitro in microaerobic and anaerobic conditions.
At 24 h there was no difference in growth of L. plantarum Inducia DSM 21379 using media provided with xylitol or without it, at 24 h the growth in 5% of xylitole media was the best in microaerobic environment but a 2 log lower in anaerobic environment than that with glucose (Table 6).

TABLE 18

Counts of L. plantarum Inducia DSM 21379 (log cfu/ml)
after growth in anaerobic and microaerobic conditions in
modified MRS medium with 5% of xylitol or glucose

	Sugar	The count of L. plantarum (log cfu/ml)
Growth	in the	after different time of incubation

conditions	medium	0	2 h	6 h	24 h	48 h

Microaerobic	xylitol	5.6	5.60	6.24	8.0	7.2
	glucose	5.41	5.48	6.94	8.8	9.0
Anaerobic	xylitol	5.6	5.70	6.00	7.4	7.15
	glucose	5.41	5.70	6.96	9.1	9.1

This experiment proved that L. plantarum Inducia DSM 21379 did not effectively metabolise xylitol in MRS media. The change of pH after growth of L. plantarum Inducia DSM 21379 in 5% xylitol containing modified MRS media was tested.
The lowest pH values by production of organic acids were seen in control media with glucose incubated in anaerobic environment. In xylitol containing media still a pH drop from pH 6.2 to pH 5.0 was seen both in microaerobic and anaerobic conditions, still substantially different from pH of control media with glucose from pH 7.5 to pH=3.2 (FIG. 3).
Use of Xylitol in Metabolism of L. plantarum Inducia DSM 21379
The purpose of the study was to measure the use of xylitol by L. plantarum Inducia DSM 21379 in microaerobic and anaerobic environments.
Methods: Double experiments were performed by cultivation of L. plantarum Inducia DSM 21379 in in MRS medium with 5% xylitol in microaerobic and anaerobic environments for 2 to 120 h. Xylitol was detected with mass spectrometry QTRAP 3200 (Applied Biosystems, USA). The samples were centrifuged 3 min 10000 g, diluted 100 folds and 50 μl was mixed with 50 μl internal standard (5 mM D4-succinic acid in acetonitrile, 50 μl). 5 μl of dilutions were injected into mass spectrometry using 50% acetonitril/water eluent. The substrates were identified by multiple reaction monitoring (MRM) ionpairs 151/101 (xylitol) and 121/77 (internal standard). Concentration was calculated from a calibration curve made from solutions with known concentrations of commercial xylitol (Sigma-Aldrich, Germany).
In the repeated experiments Inducia used xylitol in very low amounts as the content of the sugar was sustained at Basal value ±up to 0-0.6 mM of change (Table 19).

TABLE 19

Xylitol content (mM) after cultivation of L. plantarum
Inducia DSM 21379 in 5% xylitol media
microaerobically and anaerobically during 120 h

	Re-
	peated
Xylitol 1 (mM)	tests	0 h	2 h	6 h	24 h	48 h	120 h

5% xylitol	I	3.1	ND	3.2	2.5	3.2	ND
microaerobic	II	3.4	3.4	3.3	3.2	3.3	3.3
5% xylitol	I	3.1	ND	2.8	3.2	2.5	ND
anaerobic	II	3.4	3.4	3.2	3.2	3.3	3.5

ND—not determined

Thus, we confirmed by mass spectrometry that L. plantarum Inducia metabolises xylitol in very low amounts.
Growth of C difficile Reference Strains in Environment Containing Xylitol and Ampicillin
The purpose of the study was to mimic in vitro the gut environment similar to elaborated C. difficile infection model in Syrian hamsters.
In vitro the impact of xylitol and ampicillin on growth of L. plantarum Inducia DSM 21379 and reference strains of C. difficile (VPI 10463 and the hypertoxic Ribotype 027 strain M13042) in Brain Heart medium (BHI) was tested.

TABLE 20

Impact of different concentrations of xylitol (0.1-5%)
and ampicillin (0.75 μl/ml) on 48 h growth of Clostridium
difficile and L. plantarum Inducia DSM
21379 as single in anaerobic milieu and BHI medium

	L. plantarum	C. difficile	C.difficile M strain
Experimental	Inducia log cfu/g	VPI log cfu/g	log cfu/g

modulators	0 h	48 h	0 h	48	0 h	48 h

BHI control	5.9	9.8	5.3	7.2	4.9	7.1
0.1% xylitol	5.3	8.0	4.7	6.4	5.0	6.9
1% xylitol	5.0	8.0	5.5	7.3	4.8	6.7
2.5% xylitol	5.5	8.3	5.0	6.7	5.0	6.0
5% xylitol	5.5	7.8	5.0	7.1	5.0	6.7
Ampicillin	5.3	7.1	5.8	7.0	4.7	7.0
0.75 μl/ml

The L. plantarum Inducia DSM 21379 and the two reference strains of C. difficile increased the number of CFU nearly for 2 to 4 logarithms after 48 h of cultivation in the control media of BHI. No changes were seen after influencing C. difficile strains with xylitol and ampicillin (Table 20).
Growth of strain L. plantarum Inducia DSM 21379 was suppressed for ˜2 logarithms both under 5% of xylitol and 0.75 μl/ml of ampicillin. Thus, in gut microenvironment with administered antibiotic ampicillin and up to 5% xylitole the survival of L. plantarum Inducia is granted.

Example 12

Growth of L. plantarum Inducia DSM 21379 and C. difficile Reference Strains by Co-Cultivation at Different Concentrations of Xylitol and Ampicillin

The purpose of the study was to assess the growth of L. plantarum Inducia DSM 21379 and C. difficile reference strains by co-cultivation at different concentrations of xylitol and ampicillin.
The BHI media supplemented with 5% xylitol and 0.75 μl/ml ampicillin were applied for co-cultivation of L. plantarum Inducia DSM 21379 and C. difficile reference strains in anaerobic environment (workstation Concept 400, UK) for 24 and 48 h.
The viability of L. plantarum Inducia DSM 21379, C. difficile VPI and M reference strains after cocultivation were tested as single in BHI media with ampicillin and xylitol 5% (1, 2a, 2b). After ten-fold serial dilutions for determining the count of L. plantarum Inducia in MRS broth was cultivated in CO₂environment and for C. difficile on LAB 160 media in anaerobic milieu.

TABLE 21

Inhibition of C. difficile reference strains with growth of L. plantarum
Inducia DSM 21379 after co-cultivation in BHI with 5% xylitol and
0.75 μl/ml ampicillin after 0, 24, 48 h in anaerobic environment

Growth (log, CFU/ml)

Strains/co-cultivation	0 h	24 h	48 h

1. L. plantarum Inducia	5.7	8.5	7.3
2. a. C. difficile VPI	5.0	7.7	7.2
2. b. C. difficile M reference strain	5.0	7.3	7.3

3. L. plantarum Inducia	C. difficile VPI	6.0	8.3	7.0
	M reference strain	5.5	8.5	8.0
4. C. difficile VPI	L. plantarum	5.0	0	0
5. M reference strain	Inducia	5.0	5.0	2.0

During in vitro co-cultivation of L. plantarum Inducia DSM 21379 (3) and reference strains of C. difficile (4, 5) in the BHI medium with xylitol and ampicillin (mimicking the hamster model) the growth of vegetative cells of both C. difficile strains was suppressed. Full suppression was detectable for VPI strain and substantial reduction for 5 logarithms (from 5.0 to 2.0 log cfu/ml) was detected in the case of C. difficile strain M.
Thus, the in vitro experiments mimicking the gut environment of experimental hamster model after antibiotic treatment showed either full or high suppression of C. difficile growth with L. plantarum Inducia DSM 21379 alone (Table 5) or combined it with xylitol (Table 21).

Example 13

Animal Experiment

The purpose of the study was to assess the influence of L. plantarum Inducia DSM 21379 on Clostridium difficile reference strain VPI 10463 caused infection in the intestinal tract of C. difficile spores challenged hamsters.
Syrian hamsters (Mesocricetus auratus) provide a well-characterized model of Clostridium difficile infection. The colonic microbiota of hamsters treated with antibiotics is disrupted and if afterwards exposed to C. difficile spores, the animals develop C. difficile associated diarrhea (CDAD) in less than 48 h with 100% of mortality. We tested if mortality of C. difficile challenged hamsters can be decreased by administration of L. plantarum Inducia DSM 21379 according to our in vitro results.
First, we pre-feeded hamsters daily with L. plantarum Inducia DSM 21379 in the concentration of 10¹⁰cfu/ml by gastric gavage with/without 1 ml 20% xylitol for 5 consecutive days before administration of ampicillin (30 mg/kg). The administration of L. plantarum Inducia DSM 21379 in the aforementioned concentration was continued during the whole experiment. On Day 7 the hamsters were infected with 10-30 spores of C. difficile VPI 104631. For next 5 days the health of hamsters was followed and in case of symptoms indicating CDAD: wet tail—the C. difficile A/B toxin test was performed (X/pect Remel test). The group of hamsters infected with C. difficile VPI strain served as a control group.

TABLE 22

Survival of C. difficile challenged hamsters (n = 15) pretreated
with L. plantarum Inducia DSM 21379 and/or xylitol

	Number of survived hamsters	Toxin test	% of
Test	after challenge with C. difficile	result/number	survival

groups	Day 1	Day 2	Day 3	Day 4	Day 5	of animals in group	on Day 5

C. difficile VPI	15	6	4	2	2	2 negative/	2/15
10463I (n = 15)						15	13%
C. difficile VPI +	5	2	2	1	0	0 negative/	0/5
Inducia (n = 5)						5	0%
C. difficile VPI +	9	9	9	5	5	4 negative/	5/9
xylitol (n = 9)						9	56%
C. difficile VPI +	9	7	7	7	7	7 negative/	7/9
xylitol + Inducia						9	78%
(n = 9)

Thus, the highest survival was found in case of combining L. plantarum Inducia DSM 21379 with xylitol solution pre-feeding prior to challenge with C. difficile spores (Table 22). In this case the toxin tests were all negative in the survived hamsters (7/9), i.e. that the germination of spores C. difficile was suppressed. If xylitol alone was applied, the toxin tests of 4 out of 5 surviving animals were negative and only in one surviving animal the toxin test was positive.
Thus, the combination of xylitol with L. plantarum Inducia DSM 21379 works through suppression of germination of spores into vegetative cells of C. difficile able of toxin producing.
We tested if the growth of C. difficile was still present after the intervention with Inducia and xylitol and if the A and B toxins of C. difficile were found (Table 23). In survived hamsters prefeeded with combination of L. plantarum Inducia DSM 21379 and xylitol the C. difficile vegetative cells were not found 6/7 cases (only in one case the C. difficile growth was seen) in jejunum and ileum. Both the counts of anaerobes and L. plantarum Inducia substituting indigenous lactobacilli in jejunum and ileum were high showing the reconstruction and stabilisation of intestinal microbiota after administration of ampicillin, challenge with C. difficile spores and usage of the treatment with L. plantarum Inducia DSM 21379 and xylitol.

TABLE 23

Total counts of anaerobes, lactobacilli, L. plantarum Inducia DSM
21379 and C. difficile in jejunum and ileum of survived
hamster prefeeded with xylitol and L. plantarum Inducia DSM 21379

Cd

Treat-		tox	jejunum	ileum
ment	Hamster	A/B	(CFU log 10/g)	(CFU log 10/g)

groups	ID	test	AN	LB	Inducia	C.d	AN	LB	Inducia	C.d

C.	T2-1	Neg	6.48	0	4.00	0.00	7.48	0	6.70	0.00
difficile	T2-2	Neg	5.20	0	4.30	0.00	7.04	0	7.00	0.00
VPI +	T2-3	Neg	7.48	0	4.30	0.00	7.30	0	6.70	0.00
xylitol +	T2-4	Neg	8.70	0	6.00	5.00	8.11	0	7.60	7.00
Inducia	T2-5	Neg	4.48	0	0.00	0.00	7.30	0	6.00	0.00
(n = 7)	T2-7	Neg	7.18	7.08	5.00	0.00	8.11	8.08	6.78	0.00
	T2-8	Neg	8.34	6.70	6.00	0.00	8.43	7.65	6.00	0.00
C.	Xyl-1	Neg	5.30	3.00	ND	2.00	8.43	6.30	ND	0.00
difficile	Xyl-2	Neg	7.11	5.54	ND	0.00	8.30	5.00	ND	0.00
VPI +	Xyl-3	Pos	7.60	4.00	ND	5.00	8.38	5.00	ND	7.60
xylitol	24-1	Neg	7.35	7.6	ND	0	7.0	7.78	ND	0
(n = 5)	24-2	Neg	7.15	7.0	ND	0	7.8	7.78	ND	0
Pre-
feeded

AN—anaerobes, LB—lactobacilli; C.d—Clostridium difficile

The survival rate of hamsters was 22% higher due to L. plantarum Inducia DSM 21379 (Table 22). This was proved also by absence of toxin from intestinal content of large intestine (Table 23).
The growth of L. plantarum Inducia was high in jejunum (range 0-6.0, median 4.0 CFU log 10/g and in ileum 6.0-7.6, median 6.7). L. plantarum Inducia DSM 21379 acted seemingly via its acid production through its SCFAs profile.
Morphological Evaluation of the C. difficile Infected Hamsters
The typical CDAD infection was modelled in hamster model as in C. difficile infection the toxin damage of organs is the leading pathogenetic modulator.
In our study the C. difficile VPI 10643 strain possessed both toxins A and B, and these were also present in liver and small intestine (FIGS. 4 and 5).
In hamsters surviving the C. difficile infection and examined during autopsy no extensive damage of mucosa, no pseudomembranes and severe infiltration with polymorphonuclear cells was seen (FIG. 6 a).
Some hours before death the characteristic morphological finding of damaged with C. difficile infection hamsters was the inflammation with polymorphonuclear infiltration in mucosa and presence of pseudomembranes.
The severe enterocolitis developed the infiltration with red blood cells and polymorphonuclear leukocytes into gut mucosa, liver and spleen resulted in death of animals. In organs the hyperemia was present (FIG. 7 a-f).

Claims

What is claimed is:

1. A composition comprising the probiotic microorganism Lactobacillus plantarum Inducia DSM 21379

for enhancing the natural defense potential and cellular immunity of a subject, and simultaneously for use in preventing the cholesterol metabolism disorders and consecutive cardiovascular disorders by decreasing the level of LDL-cholesterol in blood, and simultaneously

for enhancing anti-oxidative activity of blood by reducing the level of oxidized low density lipoprotein (ox-LDL).

2. The composition of claim 1, which is selected from the group consisting a pharmaceutical composition, a food composition, a food supplement composition and a veterinary composition.

3. A food product comprising the composition of claim 1.

4. The food product according to claim 3, wherein the food product is a dairy product.

5. The food product according to claim 4, wherein the food product is a fermented milk product.

6. The food product according to claim 5, wherein the food product is cheese.

7. The food product according to claim 5, wherein the food product is yoghurt.

8. The composition comprising the probiotic microorganism Lactobacillus plantarum Inducia DSM 21379 for use in lowering risk of Clostridium difficile associated diarrhoeae (CDAD) by preventing germination of Clostridium difficile spores and suppressing proliferation of Clostridium difficile vegetative cells.

9. The composition of claim 8, which is selected from the group consisting a pharmaceutical composition, a food composition, a food supplement composition and a veterinary composition.

10. The composition of claim 9 further comprising xylitol.

11. The food product comprising the composition of claim 10.

12. The food product of claim 11, wherein the food product is a dairy product.

13. The food product of claim 12, wherein the food product is a fermented milk product.

14. The food product according to claim 12, wherein the food product is cheese.

15. The food product according to claim 12, wherein the food product is yoghurt.

16. Lactobacillus plantarum Inducia DSM 21379 for use as hypocholesterolemic agent by decreasing the level of LDL-cholesterol in blood for preventing cholesterol metabolism disorders and consecutive cardiovascular disorders, and simultaneously for use as anti-oxidative agent for enhancing anti-oxidative activity of blood by reducing the level of oxidized low density lipoprotein (ox-LDL) and by enhancing the total anti-oxidative activity (TAA) of a composition comprising said strain, and simultaneously for use as enhancer of the natural defense potential and cellular immunity of a subject.

17. Lactobacillus plantarum Inducia DSM 21379 for use as antimicrobial agent by preventing germination of Clostridium difficile spores and suppressing proliferation of Clostridium difficile vegetative cells for lowering risk of Clostridium difficile associated diarrhoeae (CDAD).

18. Lactobacillus plantarum Inducia DSM 21379 for use according to claim 17 together with xylitol.