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  • Y10S435/00—Chemistry: molecular biology and microbiology
  • Y10S435/8215—Microorganisms
  • Y10S435/822—Microorganisms using bacteria or actinomycetales
  • Y10S435/853—Lactobacillus

Definitions

• This invention relates to probiotic Bifidobacterium strains which have various applications in foodstuffs and in medicine. More particularly, the invention relates to probiotic strains of bifidobacteria which are capable of beneficially modifying and consequently alleviating observable symptoms in inflammatory disease.
• GIT gastrointestinal tract
• IBS irritable bowel syndrome
• IBD inflammatory bowel disease
• Probiotics have been defined as live microbial food supplements which beneficially affect the host by improving the intestinal microbial balance, or more broadly, as living micro-organisms, which upon ingestion in certain numbers, exert health effects beyond inherent basic nutrition.
• Criteria which have been suggested for the selection of potentially effective probiotic micro-organisms may be summarised as follows: human origin, non- pathogenic behaviour, resistance to technological processes (i.e., viability and activity in delivery vehicles), resistance to gastric acidity and bile toxicity, adhesion to gut epithelial tissue, ability to colonise the GIT, production of antimicrobial substances, ability to modulate immune responses, and the ability to influence metabolic activities (e.g., cholesterol assimilation, lactase activity, vitamin production) (Huis in't Veld J, Shortt C. Selection criteria for probiotic micro-organisms. In: Leeds, A.R., Rowland, I.R. eds. Gut Fora and Health - Past, Present and Future. London: The Royal Society of Medicine Press Ltd., 1996: 19-26).
• Bifidobacteria are one of several predominant culturable bacteria present in the colonic microflora.
• Bifidobacteria are considered to be probiotics as they are living organisms which exert healthy effects beyond basic nutrition when ingested in sufficient numbers. Numerous ingested bifidobacteria must reach the site of action in the gut in order to exert a probiotic effect. A minimum level of approximately 10 6 -10 7 viable bifidobacteria per gram intestinal contents has been suggested (Bouhnik, Y., Lait 1993: 73:241-247). There are reports in the literature which show that in vivo studies completed in adults and in infants indicate that some strains of bifidobacteria are capable of surviving passage through the gastrointestinal tract. Significant differences have been observed between the abilities of different bifidobacteria strains to tolerate acid and bile salts, indicating that survival is an important criterion for the selection of potential probiotic strains.
• Ingestion of bifidobacteria can improve gastrointestinal transit.
• Antimicrobial activity has been reported to be associated with bifidobacteria. Also, bifidobacteria have been shown to modulate various parameters of the immune system.
• Mucosal inflammation in IL-10 deficient mice has been reported to be reduced by feeding the subject animals a preparation of lactic acid bacteria (Madsen, K. et al. Gastroenterol. 1997;112:A1030.). Further studies completed in rats have demonstrated that ingestion of bifidobacteria can suppress aberrant crypt foci (early preneoplastic lesions) formation in the colon (Kulkarni, N. and Reddy, B.
• the invention provides a strain of Bifidobacterium isolated from resected and washed human gastrointestinal tract which is significantly immunomodulatory following oral consumption in humans.
• the strain of Bi dobacterium preferably effects changes in an immunological marker when introduced into a system comprising cells which interact with the immune system and cells of the immune system.
• the cells which interact with the immune system are epithelial cells.
• the immunological marker is a cytokine, especially TNF ⁇ .
• the cells which interact with the immune system and the immune system cells are of matched origin.
• the cells which interact with the immune system are of gastrointestinal, respiratory or genitourinary origin.
• the cells of the immune system are preferably of gastrointestinal, respiratory or genitourinary origin.
• the invention also provides a strain of Bi dobacterium longum mfantis isolated from resected and washed human gastrointestinal tract which is significantly immunomodulatory following oral consumption in humans.
• the strain of Bifidobacterium which has significant anti-inflammatory effect following oral consumption in humans.
• the strain of Bi ⁇ dobacte ⁇ um is preferably isolated from resected and washed human gastrointestinal tract which is capable of combating the effects of inflammatory bowel disease, said capability being maintained in the presence of physiological concentrations of human bile and human gastric juice.
• the capability of combating the effects of inflammatory bowel disease is measured by measuring a reversal of a wasting disease induced in severe combined immunodeficient recipient mice (SCID) which have been administered purified
• CD4 + , CD45RB high T cells CD4 + , CD45RB high T cells.
• the capability of the strain of Bi ⁇ dobacterium longum infantis to combat the effects of inflammatory bowel disease can also be measured by measuring the reduction in colonic inflammation in IL-10 deficient mice (IL-10 + 129 Svex strain) following administration of one or more of the strains of Bi ⁇ dobacte ⁇ um longum mfantis according to the invention alone or in combination with a strain of Lactobacillus saliva ⁇ us as hereinafter defined.
• Interleukin 10 is an important regulatory cytokine that supresses effector functions of macrophage/monocytes, T helper 1 (Thl) cells, and natural killer cells.
• IL-10 augments proliferation and differentiation of B cells.
• Murine models lacking the IL-10 gene spontaneously develop inflammatory bowel disease and gastrointestinal tumors. The gastrointestinal flora have been implicated in the pathogenesis of these disease states as germ free animals do not develop disease.
• the strain of Bi ⁇ dobacte ⁇ um preferably has inhibitory activity against a broad range of Gram positive and Gram negative bacteria.
• the strain of Bi ⁇ dobacte ⁇ um exhibits a broad-spectrum of activity against bacteria including Staphylococcus, Pseudomonas, Colifoim and Bacillus species.
• the invention provides strain of Bi ⁇ dobacte ⁇ um longum infantis UCC35624 or mutant or variant thereof.
• the mutant is a genetically modified mutant.
• the variant is a naturally occurring variant of Bi ⁇ dobacte ⁇ um longum infantis XJCC35624.
• the strain of Bi ⁇ dobacte ⁇ um may be in the form of viable cells.
• the strain of Bi ⁇ dobacte ⁇ um is in the form of non-viable cells.
• the invention also provides an antimicrobial agent obtained from a strain of Bi ⁇ dobacte ⁇ um of the invention which is antagonistic to the growth of other organisms.
• the invention provides a formulation which comprises a strain of Bi ⁇ dobacte ⁇ um of the invention.
• the formulation may comprise two or more strains of Bi ⁇ dobacte ⁇ um.
• the formulation may include another probiotic material.
• the formulation includes a prebiotic material.
• the formulation may which include a strain of Lactobacillus salivarius.
• the strain of Lactobacillus saliva ⁇ us may be in the form of viable cells or in the form of non- viable cells.
• the Lactobacillus saliva ⁇ us is preferably isolated from resected and washed human gastrointestinal tract, the Lactobacillus saliva ⁇ us being significantly immunomodulatory following oral consumption in humans.
• the strain of Lactobacillus saliva ⁇ us is isolated from resected and washed human gastrointestinal tract which inhibits a broad range of Gram positive and Gram negative micro-organisms.
• the strain of Lactobacillus saliva ⁇ us secretes a product having antimicrobial activity into a cell - free supernatant, said activity being produced only by growing cells and being destroyed by proteinase K and pronase E, the inhibitory properties of said strain and its secretory products being maintained in the presence of physiological concentration of human bile and human gastric juice.
• Such strains of Lactobacillus salivarius are disclosed in WO 98/35014.
• the strain of Lactobacillus saliva ⁇ us is Lactobacillus saliva ⁇ us strain UCC 118 or a mutant or variant thereof.
• the mutant is a genetically modified mutant.
• the variant may be a naturally occurring variant of Lactobacillus saliva ⁇ us.
• Lactobacillus saliva ⁇ us strain UCC 118 was made at the NCIMB on November 27, 1996 and accorded the accession number NCIMB 40829.
• the formulation includes an ingestable carrier.
• the ingestable carrier may be a pharmaceutically acceptable carrier such as a capsule, tablet or powder.
• the ingestable carrier may be a food product such as acidified milk, yoghurt, frozen yoghurt, milk powder, milk concentrate, cheese spreads, dressings or beverages.
• the formulation may comprise a protein and/ or peptide, in particular proteins and/ or peptides that are rich in glutamine/glutamate, a lipid, a carbohydrate, a vitamin, mineral and/ or trace element.
• the Bi ⁇ dobacte ⁇ um is present at more than 10° cfu per gram of delivery system.
• the formulation includes an adjuvant.
• the formulation may include a bacterial component.
• the formulation may alternatively or additionally include a drug entity.
• the formulation may also include a biological compound.
• the formulation may be in a form for oral immunisation.
• the invention further provides a strain of Bi ⁇ dobacte ⁇ um or a formulation thereof for use in foodstuffs.
• the invention provides a strain of Bi ⁇ dobacte ⁇ um or a formulation thereof for use as a medicament.
• the strain or formulation may be for use in the prophylaxis and/ or treatment of undesirable inflammatory activity.
• the strain or formulation may be for use in the prophylaxis and/ or treatment of undesirable gastrointestinal inflammatory activity such as inflammatory bowel disease eg. Crohns disease or ulcerative colitis, irritable bowel syndrome, pouchitis or post infection colitis.
• undesirable gastrointestinal inflammatory activity such as inflammatory bowel disease eg. Crohns disease or ulcerative colitis, irritable bowel syndrome, pouchitis or post infection colitis.
• the undesirable inflammatory activity may be due to cancer.
• strain or formulation may be for use in the prophylaxis and/ or treatment of gastrointestinal cancer(s).
• the strain or formulation may be used for the prophylaxis of cancer. Further, the strain or formulation may be for use in the prophylaxis and/or treatment of systemic disease such as rheumatoid arthritis.
• the strain or formulation may be for use in the prophylaxis and/or treatment of autoimmune disorders due to undesirable inflammatory activity.
• the strain or formulation may be for use in the prophylaxis and/or treatment of cancer due to undesirable inflammatory activity.
• the strain or formulation may be for use in the prophylaxis and/or treatment of diarrhoeal disease due undesirable inflammatory activity, such as Clostridium dif ⁇ cile associated diarrhoea, Rotavirus associated diarrhoea or post infective diarrhoea.
• Fig. 1 is a graph of cfu/ml versus time for Bi ⁇ dobacterium longum infantis strain 35612 as described in Example 2;
• Fig. 2 is a graph of cfu/ml versus time for Bi ⁇ dobacterium longum infantis strain 35624 as described in Example 2;
• Fig. 3 is a graph of percentage weight change versus time (days) for five SCID mice (1-5) administered strain UCC 35624 as described in Example 5;
• Fig. 4 is a graph of average percentage weight change versus time (days) for the SCID mice (1-5) administered strain UCC 35624 as described in Example 5;
• Fig. 5 is a graph of percentage weight change versus time (days) for mice (6-10) administered a combination of strains Lactobacillus salivarius UCC
• Fig. 6 is a graph of average percentage weight change versus time (days) for mice (6-10) administered a combination of strains UCC 118 and UCC 35624 as described in Example 5;
• Fig. 7 is a graph of percentage weight change versus time (days) for mice (11-15) administered a combination of strains UCC 118 and UCC 35624 as described in Example 5;
• Fig. 8 is a graph of average percentage weight change versus time (days) for mice (11-15) administered a combination of strains UCC 118 and UCC 35624 as described in Example 5;
• Fig. 9 is a bar chart of TNF ⁇ levels in patient and control samples in the presence of PBMCs and Bifidobacteria longum infantis as described in Example 7;
• Fig. 10 is a bar chart showing TNF ⁇ and IL-8 levels in co-cultures of epithelial cells, PBMCs and Bi ⁇ dobacterium longum infantis as described in Example 7. Controls represent co-cultures of epithelial cells and PBMCs alone;
• Fig.13 is a bar chart of TNF ⁇ levels in cell-free spent culture supernatant of Bi ⁇ dobacterium longum infantis and an MRS control as described in Example 9;
• Fig.14 is a diagrammatic representation of a SCID mouse lower intestine after treatment with Bi ⁇ dobacterium longum infantis.
• Fig.15 is a diagrammatic representation of the lower intestine of an untreated SCID mouse .
• strains of probiotic bacteria which are capable of beneficially modifying and consequently alleviating observable symptoms in inflammatory disorders.
• These strains and the formulations prepared may be used in a variety of foodstuffs and medicaments to combat the effect of inflammatory disorders.
• mice consuming Bi ⁇ dobacterium longum infantis retained solid stools while control mice suffered from diarrhoea.
• This anti-diarrhoeal effect could be related to the anti-inflammatory activity of this invention, possibly mediated via cAMP modulation.
• non-viable cells such as killed cultures or compositions containing beneficial factors expressed by Bi ⁇ dobacterium longum infantis UCC35624.
• non-viable cells product preparation is simpler, cells may be incorporated easily into pharmaceuticals and storage requirements are much less limited than viable cells.
• Lactobacillus casei YIT 9018 offers an example of the effective use of heat killed cells as a method for the treatment and/or prevention of tumour growth as described in US Patent No. US4347240.
• agar media RCM (reinforced clostridial media) and RCM adjusted to pH 5.5 using acetic acid; TPY (trypticase, peptone and yeast extract), Chevalier, P. et al. (1990) J. Appl. Bacteriol 68, 619-624).
• MRS deMann, Rogosa and Sharpe
• ROG acetate medium (SL) of Rogosa
• LLA Liver-lactose agar of Lapiere
• BHI brain heart infusion agar
• LBS Lactobacillus selective agar
• TSAYE tryptone soya agar supplemented with 0.6% yeast extract.
• agar media was supplied by Oxoid Chemicals with the exception of TPY agar. Plates were incubated in anaerobic jars (BBL, Oxoid) using C0 2 generating kits (Anaerocult A, Merck) for 2-5 days at 37°C.
• TPY complex non-selective media
• Isolates were routinely cultivated in TPY medium unless otherwise stated at 37°C under anaerobic conditions.
• Presumptive Bifidobacteria species were stocked in 40% glycerol and stored at -20° and -80°C.
• Biochemical and physiological traits of the bacterial isolates were determined to aid identification. Nitrate reduction, indole formation and expression of ⁇ - galactosidase activity were assayed. Growth at both 15°C and 45°C and protease activity on gelatin were determined. Growth characteristics of the strains in litmus milk were also assessed.
• Antibiotic sensitivity profiles of the isolates were determined using the 'disc susceptibility' assay. Cultures were grown up in the appropriate broth medium for 24-48 h, spread-plated (lOO ⁇ l) onto agar media and discs containing known concentrations of the antibiotics were placed onto the agar. Strains were examined for antibiotic sensitivity after 1-2 days incubation at 37°C under anaerobic conditions. Strains were considered sensitive if zones of inhibition of lmm or greater were seen.
• tissue sections taken from the human G.I.T. were screened for the presence of strains belonging to the Bi ⁇ dobacterium genus. There was some variation between tissue samples as follows. Samples A (ileum) and E (appendix) had the lowest counts with approximately 10 2 cells isolated per gram of tissue. In comparison, greater than 10 3 cfu/g tissue were recovered from the other samples.
• the remaining isolates were predominantly homofermentative coccobacilli. Thirty eight strains were characterised in more detail- 13 isolates from G; 4 from F; 8 from D; 9 from C; 3 from B and 1 from E. All thirty eight isolates tested negative both for nitrate reduction and production of indole from tryptophan.
• Antibiotics of human clinical importance were used to ascertain the sensitivity profiles of selected bifidobacteria.
• the bifidobacteria tested were sensitive to ampicillin, amoxycillin ceftaxime, ceftriaxone, ciprofloxacin, cephradine, rifampicin, amikacin, gentamicin and chloramphenicol. They were also resistant to netilmicin, trimethoprim, nalidixic acid, cefuroxime, vancomycin and tetracycline.
• the first line of host defence that a micro-organism reaches following human consumption is gastric acid in the stomach.
• a key factor influencing bacteria is survival in gastric juice.
• the survival and growth of Bi ⁇ dobacterium longum infantis strains 35612 and 35624 in a low pH environment were examined.
• the strains were routinely cultured in trypticase-peptone-yeast extract (TPY) medium at 37°C under strict anaerobic conditions (BBL Gas jars using the Merck
• Anaerocult A gas pak system for 12-24h. Human gastric juice was obtained from healthy subjects by aspiration through a nasogastric tube (Mercy Hospital, Cork, Ireland). It was immediately centrigued at 13,000 g for 30 min. to remove all solid particles, sterilised through 0.45 ⁇ m filters and 0.2 ⁇ m filters and stored at 4°C. The pH and pepsin activity were measured prior to experimental use.
• Pepsin activity was measured using the quantitative haemoglobin assay (Guantam, S. and R.S. de la Motte. 1989. Proteolytic enzymes, a practical approach. Chapter 3. R.J. Beynon and J.S. Bond(eds.), IRL Press, Oxford University Press; Dawson, R.M. 1969. pH and buffers. In Data for Biochemical Research p 138. R.M. Dawson, D.C. Elliot and K.M. Jones(eds.), Clarendon
• Fresh overnight cultures were harvested, washed twice in buffer (pH 6.5) and resuspended in human gastric juice to a final concentration of 10 6 cfu/ml.
• Human bile was obtained from several human gall bladders and sterilised at 80°C for 10 min.
• the bile acid composition of human bile was determined using reverse phase High Performance Liquid Chromatography (HPLC) in combination with a pulsed amperometric detector according to the method of Dekker, R.R. et al., Chromatographia, 1991, 31 (11/12), 255-256.
• Human bile was added at a concentration of 0.3% (v/v). Freshly streaked cultures were examined for growth after 24 and 48 h.
• Strain 35624 was capable of growth in the presence of physiologically relevant human bile (0.3% (v/v)).
• strains studied grew on agar medium supplemented with 5 mM GCA and GCDCA and on agar medium supplemented with 1 mM GDCA as shown in Table 4.
• Strain 35624 was resistant to concentrations of 5 mM LCA (data not shown) and strains 35612 and 35624 were capable of growth at concentrations of 5 mM CA as shown in Table 5. No growth was observed in the presence of 1 mM CDCA (data not shown) .
• GCDCA glycochenodeoxycholic acid
• GDCA glycodeoxycholic acid
• CGA glycocholic acid
• Bi ⁇ dobacterium species exert inhibitory effects on other bacteria by excluding long term colonisation by invasive pathogens. Their antagonistic activity is due to the production of acetic and lactic acid though fermentation (Scardovi, V. (1986) Bi ⁇ dobacterium in Bergey's Manual of systemic bacteriology, Vol. 2. Eds. Sheath,
• mice have recently been generated by either genetic or immunological means to study the mechanisms of IBD.
• One of these models involves the transfer of spleen or lymph node-derived CD4 + T lymphocytes from normal mice into severe combined immunodeficient recipient mice (SCID). It has been demonstrated that mice who receive purified CD4 + , CD45RB hlgh T cells develop a wasting disease characterised by chronic intestinal inflammation which is more severe in the colon.
• SCID mice a control group of SCID mice was injected with CD4 + CD45RB hlgh and the mice developed a progressive wasting disease including hunched over appearance, piloerection of the coat, diarrhoea, weight loss and macro and microscopic colon damage.
• a feeding trail was set up administering UCC 118 and strain 35624 (also referred to herein as UCC 35624) to determine if the symptoms of IBD could be modified in this model.
• Lactobacillus salivarius subsp. Salivarius UCC 118 and Bi ⁇ dobacterium longum infantis UCC 35624 were isolated from the ileal-caecal region of an adult human as described in Example 1.
• spontaneous rifampicin and streptomycin resistant derivatives of the strains were generated by plating cells, previously grown overnight and subsequently washed in quarter strength Ringer's solution on MRS and TPY agar containing 50 ⁇ g/ml rifampicin (Sigma) respectively and MRS containing 400 ⁇ g/ml streptomycin (Sigma). Plates were incubated for 2 days at 37°C anaerobically. The resulting antibiotic resistant derivatives were determined to be otherwise phenotypically similar to the parent strain. This selectable trait enabled the strains to be readily enumerated following gut transit.
• Donor mice C57BL/6 x BALB/c FI were purchased from Simosen Laboratories (Gilroy, CA) and maintained at the University of California - Los Angeles vivarium in ventilated cage racks (Thoren caging systems, Hazel ton, PA) under specific pathogen free (SPF) conditions.
• CB-17 SCID mice were bred in ventilated cage racks originally obtained from the University of California - Los Angeles SCID core facility. The mice were reduced flora (RF) mice rather than germ free and acting as the recipient mice (Aranda R. et al. J. of Immunol. 1997; 158(7), 3464-3473).
• mice Eight week old, female CB-17 (SCID) mice were housed in pairs in filter top cages in ventilated racks. The mice were divided into four groups Group A: consumed 10% skim milk, control; Group B: consumed Lactobacillus salivarius UCC 118, Group C: consumed Lactobacillus salivarius UCC 118 and Bi ⁇ dobacterium longum UCC 35624 9 (1: 1 ratio); Group D: consumed Bi ⁇ dobacterium longum
• UCC 35624 UCC 118 and UCC 35624 which were grown overnight in MRS broth and MRS broth supplemented with 0.05% cysteine (Sigma) respectively, were washed in PBS, resuspended in skim milk (10% (v/v)) and administered in the otherwise sterile drinking water (PBS).
• the mice in each respective group received 2.55X10 8 cfu/ml of UCC 118 and 2.35xl0 8 cfu/ml of UCC 35624 daily for the duration of the feeding period.
• Control mice received sterile milk diluted in sterile phosphate buffered saline (PBS) and were maintained under identical conditions as the test group.
• mice All CB-17 mice were administered their respective feed according to their grouping for 2 days prior to injection with the CD4 + CD45RB high cells.
• the sorted donor lymphocytes (3-4 x 10 5 ) were represented in 200 ⁇ l of sterile PBS and injected i.p. into the recipient CB-17 SCID mice. All mice were weighed initially, then twice weekly thereafter. They were observed for clinical signs of illness: hunched over appearance, piloerection of the coat and diarrhoea.
• the selective media used were; de Mann Rogosa & Sharpe (MRS) agar; MRS agar supplemented with 0.2% lithium chloride (BDH), 0.3% sodium propionate (Fluke chemie), 0.5% cysteine hydrochloride (Sigma), and 5% sheep's blood; Slanetz and Bartley agar; Wilkins and Chalgren agar supplemented with anaerobic supplement SR 108 and 5% horse blood; and Violet Red Bile Agar. (All Oxoid unless otherwise stated).
• VRBA and Slanetz and Bartley plates were incubated aerobically for 24 and 45 h respectively. All other plates were incubated anaerobically for 48 h at 37°C. Enumeration of culturable indigenous flora from specific segments of the CB.17 SCID murine G.I.T.
• mice After the feeding period all mice were sacrificed and dissected. Segments of the ileal-caecal region, small intestine, and the large intestine were removed. A peripheral lymph node (PLN), mesenteric lymph node (MLN) and a piece of the spleen were also taken. All tissues were weighed before being resuspended in 10 ml of PBS. Samples were then homogenised and serially diluted in PBS and either spread plated or pour plated in appropriate dilutions on appropriate media in duplicate. The bacterial groups were enumerated the same as those enumerated in the faecal analysis and samples were incubated as described previously.
• PPN peripheral lymph node
• MN mesenteric lymph node
• the isolation of the mucosal lymphocytes was carried out according to the method of Aranda, R. etal(( ⁇ 991) supra).
• Tissue samples were taken from the small intestine, large intestine, and ileal caecal region and fixed in 10% formalin. The procedure was as described in Aranda, R. etal. ((1997) supra).
• mice reconstituted with CD4 + CD45RB hig T lymphocytes and consuming skim milk alone developed a progressive wasting disease, identified by their significant weight loss. Disease became apparent at about 2 and a half to three weeks and the sick mice characteristically manifested a hunched over appearance, piloerection of their coat, and loose stool.
• One of the mice in the control group (mouse 4) died after 25 days and mice 1, 2, 3 and 5 showed a -20%, 25%, 21% and -35% percentage weight change respectively as depicted in Figs. 3 and 4.
• mice consuming UCC 118 alone gave a similar result as the controls with the characteristic weight loss.
• Mouse 3 died after 14 days, and mice 4, 5 and 6 showed a -15%, -25% and -28% percentage weight change respectively (data not shown).
• the mice consuming a combination of UCC 118 and UCC 35624 were found to have a marked improvement on the control mice. These mice did not lose as much weight as the control mice over the feeding period. Even after 35 days three of the mice in this group showed little percentage weight change. (Figs. 5 and 6). Two of the mice in this group showed a weight loss only after about 30 days whereas control mice showed weight loss at 14 days (Figs. 3 and 4).
• Table 8 is a summary of experimental data for the study on the treatment of CD45RB colitis induced CB17 and SCID mice with a cocktail of UCC 118 and
• mice were successfully reconstituted with lymphocytes and lymphocytes having been derived from the donor model (data not shown).
• Table 8 It was found in the studies that the mice were successfully reconstituted with lymphocytes and lymphocytes having been derived from the donor model (data not shown).
• Lactobacillus salivarius UCC 118 and Bifidobacteria Lactobacillus salivarius UCC 118 and Bifidobacteria.
• PBMCs peripheral blood mononuclear cells
• TNF ⁇ proinflammatory cytokine tumour necrosis factor ⁇
• PBMC compartment Co-culture of epithelial cells, PBMCs and Bi ⁇ dobacterium longum infantis resulted in significant suppression of TNF ⁇ and IL-8 production
• Bi ⁇ dobacterium longum infantis (1x10° cells per day) was consumed by 18 healthy humans in a fermented milk (yoghurt) product for three weeks. Serum was collected for cytokine analysis pre and post consumption of this probiotic strain. Faecal samples were obtained for microbiological analysis.
• No alteration in serum TNF ⁇ and Inter leukin-1 receptor antagonist (IL-IRA) levels were observed (Figure 12).
• Bi ⁇ dobacterium longum infantis was detected at approximately lxlO 5 colony forming units per gram of faecal matter over the course of this feeding study.
• Bi ⁇ dobacterium longum infantis has demonstrable immunomodulating properties in vitro. Following consumption by SCID mice and human volunteers, significant modification of systemic immune parameters was noted. Thus, the use of Bi ⁇ dobacterium longum infantis as a biotherapeutic agent in the treatment of immune mediated diseases is warranted.
• Bi ⁇ dobacterium longum infantis UCC35624 secretes a factor that antagonises TNF ⁇ activity. Production of this factor by Bi ⁇ dobacterium longum infantis at the surface of the gastrointestinal tract, in vivo, would significantly restrict the host inflammatory response.
• Inflammation is the term used to describe the local accumulation of fluid, plasma proteins and white blood cells at a site that has sustained physical damage, infection or where there is an ongoing immune response. Control of the inflammatory response is exerted on a number of levels (for review see Henderson B., and Wilson M. 1998. In “Bacteria-Cytokine interactions in health and disease. Portland Press, 79-130).
• the controlling factors include cytokines, hormones (e.g. hydrocortisone), prostaglandins, reactive intermediates and leukotrienes. Cytokines are low molecular weight biologically active proteins that are involved in the generation and control of immunological and inflammatory responses, while also regulating development, tissue repair and haematopoiesis.
• TNF ⁇ is a pivotal proinflammatory cytokine as it initiates a cascade of cytokines and biological effects resulting in the inflammatory state. Therefore, agents which inhibit TNF ⁇ are currently being used for the treatment of inflammatory diseases, e.g. infliximab.
• Pro-inflammatory cytokines are thought to play a major role in the pathogenesis of many inflammatory diseases, including inflammatory bowel disease (IBD).
• IBD inflammatory bowel disease
• Current therapies for treating IBD are aimed at reducing the levels of these pro- inflammatory cytokines, including IL-8 and TNF ⁇ . It has been suggested that such therapies may also play a significant role in the treatment of systemic inflammatory diseases such as rheumatoid arthritis.
• Humans fed with yoghurt containing Bi ⁇ dobacterium longum infantis UCC35624 have shown marked decreases in their systemic levels of IL-8. This strain may therefore have potential application in the treatment of a range of inflammatory diseases, particularly if used in combination with current anti-inflammatory therapies, such as non-steroid anti-inflammatory drugs (NSAIDs) or Infliximab.
• NSAIDs non-steroid anti-inflammatory drugs
• Infliximab Infliximab.
• the barrier function of the intestinal epithelium can be diminished during nervous (acetylcholine) and immune (histamine) mediated secretion.
• Certain bacterial toxins may also induce Ca2+ and PKC dependent secretion and thereby can disturb the epithelial barrier (Ganguly NK and Kaur T. Indian J Med Res 1996;104:28-37, Groot JA. Vet Q 1998;20(S3):45-9).
• Several studies have examined the prevention and treatment of diarrhoea using probiotic bacteria.
• Figs. 14 and 15 illustrate the lower intestine of treated and untreated SCID mice.
• the lower intestine shown includes the caecum 2, intestine 3 and anus 5.
• Fig. 14 the mice were treated with Bi ⁇ dobacterium longum infantis UCC 35624 and it is apparent that solid stools 4 have been retained in the intestine.
• Fig. 15 shows the untreated mouse intestine 3, characteristically inflamed. No water absorption has occurred so that no solid stools are retained resulting in diarrhoea.
• the anti-diarrhoeal effect observed may be related to the anti-inflammatory activity, possibly mediated via cAMP modulation.
• Cyclic AMP-dependent Cl- secretion is the major secretory pathway in the human intestine (Brzuszczak IM, et al., J. Gastroenterol. Hepatol. 1996;11(9):804-10). It can be inferred that the anti-diarrhoeal effect of Bi ⁇ dobacterium longum infantis UCC 35624 is not restricted just to diarrhoea resulting from gastrointestinal inflammation, but can be applied to the general treatment of diarrhoeal disease.
• the immune system has a large repertoire of specificities expressed by B and T cells. Some of these specificities will be directed to self-components. Self- recognition is normally controlled by clonal deletion and inactivation of self- reactive lymphocytes. However, there is a constant background of autoimmunity with antibodies to many proteins being found in serum. A breakdown in the self- nonself recognition system results in autoimmunity. When autoimmune disease does occur, the resulting immune response damages the tissue bearing the offending antigen. Immune complex deposition, type II hypersensitivity and cell- mediated reactions are the most important mechanisms by which immunopathological damage occurs.
• autoimmune diseases include, but are not limited to, systemic lupus erythematosus, rheumatoid arthritis, insulin dependent diabetes mellitus, myasthenia gravis and pernicious anaemia.
• Bi ⁇ dobacterium longum infantis and Lactobacillus salivarius subsp. salivarius are immunomodulatory bacteria. Thus, consumption either as single components or in combination of these bacteria by patients suffering from autoimmune disease may restrict organ damage and help restore normal body homeostasis.
• intestinal bacteria can produce, from dietary compounds, substances with genotoxic, carcinogenic and tumour- promoting activity and gut bacteria can activate pro-carcinogens to DNA reactive agents (Rowland I.R. (1995). Toxicology of the colon: role of the intestinal microflora. In: Gibson G.R. (ed). Human colonic bacteria: role in nutrition, physiology and pathology, pp 155-174. Boca Raton CRC Press).
• species of Bi ⁇ dobacteria and Lactobacillus have low activities of xenobiotic metabolising enzymes compared to other populations within the gut such as bacteroides, eubacteria and clostridia (Saito Y., et al., Microb. Ecol. Health Dis., 1992;5, 105-110). Therefore, increasing the number of lactic acid bacteria in the gut could beneficially modify the levels of these enzymes.
• probiotic organisms The introduction of probiotic organisms is accomplished by the ingestion of the microorganism in a suitable carrier. It would be advantageous to provide a medium that would promote the growth of these probiotic strains in the large bowel.
• the addition of one or more oligosaccharides, polysaccharides, or other prebiotics enhances the growth of lactic acid bacteria in the gastrointestinal tract (Gibson, GR. Br. J. Nutr. 1998;80 (4):S209-12).
• Prebiotics refers to any non- viable food component that is specifically fermented in the colon by indigenous bacteria thought to be of positive value, e.g. bifidobacteria, lactobaciUi.
• Types of prebiotics may include those which contain fructose, xylose, soya, galactose, glucose and mannose.
• the combined administration of a probiotic strain with one or more prebiotic compounds may enhance the growth of the administered probiotic in vivo resulting in a more pronounced health benefit, and is termed synbiotic.
• the Bi ⁇ dobacterium may be administered prophylactically or as a method of treatment either on its own or with other probiotic and/or prebiotic materials as described above.
• the bacteria may be used as part of a prophylactic or treatment regime using other active materials such as those used for treating inflammation or other disorders, especially those of the gastrointestinal tract.
• Such combinations may be administered in a single formulation or as separate formulations administered at the same or different times and using the same or different routes of administration.

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