Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/66—Microorganisms or materials therefrom
  • A61K35/74—Bacteria
  • A61K35/741—Probiotics
  • A61K35/744—Lactic acid bacteria, e.g. enterococci, pediococci, lactococci, streptococci or leuconostocs
  • A61K35/747—Lactobacilli, e.g. L. acidophilus or L. brevis
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
  • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
  • A23L33/135—Bacteria or derivatives thereof, e.g. probiotics
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
  • A23L33/20—Reducing nutritive value; Dietetic products with reduced nutritive value
  • A23L33/21—Addition of substantially indigestible substances, e.g. dietary fibres
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2200/00—Function of food ingredients
  • A23V2200/30—Foods, ingredients or supplements having a functional effect on health
  • A23V2200/32—Foods, ingredients or supplements having a functional effect on health having an effect on the health of the digestive tract
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2200/00—Function of food ingredients
  • A23V2200/30—Foods, ingredients or supplements having a functional effect on health
  • A23V2200/32—Foods, ingredients or supplements having a functional effect on health having an effect on the health of the digestive tract
  • A23V2200/3202—Prebiotics, ingredients fermented in the gastrointestinal tract by beneficial microflora
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2200/00—Function of food ingredients
  • A23V2200/30—Foods, ingredients or supplements having a functional effect on health
  • A23V2200/32—Foods, ingredients or supplements having a functional effect on health having an effect on the health of the digestive tract
  • A23V2200/3204—Probiotics, living bacteria to be ingested for action in the digestive tract
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2400/00—Lactic or propionic acid bacteria
  • A23V2400/11—Lactobacillus
  • A23V2400/165—Paracasei
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K2035/11—Medicinal preparations comprising living procariotic cells

Definitions

• the present invention relates to the use of a composition comprising bacteria in order to increase the intestinal production of butyric acid, folic acid or niacin and/or to decrease the intestinal production of succinic acid. Moreover, the present invention relates to the use of said composition for the treatment and/or prevention of an intestinal butyrate- and/or succinate- dependent pathological condition, in particular, for the treatment and/or prevention of intestinal inflammation, diarrhoea, ulcerative colitis or intestinal colopathies.
• Intestinal microbiota also known by the by now obsolete term of intestinal flora, is the whole of the microorganisms, prevalently consisting of bacteria, residing in the intestine and in symbiosis with the body of the host.
• the intestinal microbiota is a highly complex ecosystem and the condition of equilibrium among the different microorganisms making up the intestinal is fundamental in order to ensure the body's well-being and health, since the microbiota significantly conditions the development and the homeostasis of the intestinal mucosa of the host individual.
• the intestinal microbiota represents a veritable organ.
• qualitative and/or quantitative modifications in the intestinal microbiota of an individual, or so-called disbiosis or dismicrobism can result in the loss of the intestinal homeostasis, which in turn can condition the etiopathogenesis of a large number of pathologies.
• probiotics or, according to the definition of the FAO/WHO, "live microorganisms which, when administered in adequate amounts, confer a health benefit on the host".
• probiotics or, according to the definition of the FAO/WHO, "live microorganisms which, when administered in adequate amounts, confer a health benefit on the host".
• paraprobiotics for health has also been demonstrated; these are defined as “non-viable microbial cells (intact or broken) or raw cellular extracts which, when administered in adequate amounts (orally or topically), confer a health benefit on the host” (Taverniti and Guglielmetti, 2011).
• Butyric acid is a short-chain fatty acid which is physiologically formed in the colon of humans as a result of the fermentation of dietary fibre by the microbiota.
• Butyric acid is the principal source of energy for colon cells (colonocytes) and is therefore a nutrient that is essential for the human body.
• butyric acid performs various important functions, e.g.: it stimulates the turnover and physiological maturation of colonocytes; it plays a key role in maintaining the integrity of the mucosa and in processes of repairing intestinal lesions; it stimulates the reabsorption of water and sodium in the colon; and it contributes to lowering the intestinal pH, creating an environment that is unfavourable to the development of pathogenic bacteria.
• a deficiency of butyric acid can cause inflammatory colitis in humans.
• Succinic acid is likewise a short-chain organic acid, of the bicarboxylic type. It is considered ulcerogenic and can cause serious damage to the mucosa. Therefore, an increase in the amount of succinic acid (succinate) is harmful to human health.
• Folic acid (vitamin B9, or M or folacin) is a very important vitamin for the whole population, in particular in adults over 50 years of age and in women of a fertile age, because it intervenes (directly or, most of the time, by decreasing the plasma levels of homocysteine) in many vital processes such as DNA synthesis, repair and methylation.
• a deficiency of folic acid can lead to macrocytic anaemia, which may be accompanied by leukopaenia and thrombocytopaenia, skin and mucosa alterations and gastrointestinal disorders (malabsorption and diarrhoea).
• Niacin or vitamin PP or vitamin B3
• nicotinic acid and nicotinamide is important because, among other things, it is the essential component of the coenzymes NAD and NADH and a deficiency thereof causes a pathology known as pellagra.
• this pathology begins with problems in the gastrointestinal system, which are then compounded by a photosensitizing dermatitis, mental disorders with fatigue, depression and memory disorders.
• the present invention responds to the needs of the prior art described above with a composition comprising microorganisms, preferably bacteria of the genus Lactobacillus species paracasei, capable of (directly and/or indirectly) increasing, in an individual that takes it, the intestinal production of butyric acid, folic acid, niacin and/or salts thereof.
• microorganisms preferably bacteria of the genus Lactobacillus species paracasei, capable of (directly and/or indirectly) increasing, in an individual that takes it, the intestinal production of butyric acid, folic acid, niacin and/or salts thereof.
• compositions comprising microorganisms, preferably of the genus Lactobacillus species paracasei, is capable of (directly and/or indirectly) decreasing the intestinal production of succinic acid and/or salts thereof. Therefore, the composition of the present invention is particularly advantageous for the treatment and/or prevention of intestinal butyrate- and/or succinate-dependent pathological conditions.
• FIG. 1.1 shows the result of the statistical analysis demonstrating the increase in the population of bacteria of the genus Coprococcus before and after treatment with the composition of the present invention (A) and the decrease thereof, in contrast, before and after treatment with the placebo (B);
• FIG. 1.2 shows the result of the statistical analysis demonstrating the decrease in the population of bacteria of the genus Blautia before and after treatment with the composition of the present invention (A) and the increase thereof, in contrast, before and after treatment with the placebo (B);
• FIG. 2.2 shows the percentage increase in the population of bacteria of the genus Coprococcus (dark grey) and the percentage decrease in the population of bacteria of the genus Blautia (light grey) before and after treatment with the composition of the present invention (A) and the percentage decrease in the population of bacteria of the genus Coprococcus (dark grey) and the percentage increase in the population of bacteria of the genus Blautia (light grey) before and after treatment with the placebo (B);
• - Figure 3 shows the result of the statistical analysis which demonstrates the increase in the metabolism of nicotinic acid before and after treatment with the composition of the present invention and the decrease thereof before and after treatment with the placebo
• - Figure 4 shows the result of the statistical analysis which demonstrates the increase in the biosynthesis of folic acid before and after treatment with the composition of the present invention and an absence of any modifications, in contrast, before and after treatment with the placebo.
• the present invention relates to the use of a composition comprising microorganisms, preferably at least one bacterium of the genus Lactobacillus species paracasei, to increase the direct and/or indirect intestinal production of butyric acid and/or salts thereof, and/or folic acid and/or salts thereof, and/or niacin and/or salts thereof and/or to decrease the direct and/or indirect intestinal production of succinic acid and/or salts thereof.
• microorganisms preferably at least one bacterium of the genus Lactobacillus species paracasei
• intestinal production means the release, into the environment, of any molecule produced by primary or secondary metabolism by any intestinal microorganism in any region of the intestine.
• composition of the present invention can also be used to reduce the intestinal proliferation of pathogenic microorganisms, and/or to promote the integrity of the intestinal mucosa, and/or to promote the processes of repair of intestinal lesions, preferably by increasing the direct and/or indirect intestinal production of butyric acid and/or salts thereof and/or by decreasing the direct and/or indirect intestinal production of succinic acid and/or salts thereof.
• Some pathogenic microorganisms particularly sensitive to the composition of the present invention are, for example, enterohaemorrhagic Escherichia coli, Listeria monocytogenes, Clostridium difficile, Pseudomonas aeruginosa and Salmonella spp.
• composition of the present invention uses of the composition of the present invention are intended both for a healthy individual and an individual with a pathological intestinal condition.
• the composition of the invention performs in that individual, following intake, an action of maintaining the homeostasis of the microbiota and/or of preventing an alteration thereof, and is thus also definable as a probiotic composition (or probiotic).
• a further aspect of the present invention relates to the medical use of the composition comprising microorganisms, preferably at least one bacterium of the genus Lactobacillus species paracasei, for the treatment and/or prevention of an intestinal butyrate- and/or succinate-dependent pathological condition.
• intestinal butyrate- and/or succinate-dependent pathological condition means a pathological condition that is sensitive to treatment with butyric acid and/or salts thereof and/or treatment with succinic acid and/or salts thereof.
• pathologies are: diarrhoea, intestinal inflammation, ulcerative colitis, gastric atrophy, intestinal diverticula, stenosis, obstructions and diabetic neuropathy.
• the composition comprises the bacterial strain Lactobacillus paracasei DG.
• the bacterial strain Lactobacillus paracasei DG was deposited by SOFAR S.p.A. with the National Collection of Microorganism Cultures of the Pasteur Institute in Paris on 05/20171995, with the deposit number CNCM I- 1572. Initially, the name of the deposited strain was Lactobacillus casei DG sub.casei.
• the direct and/or indirect increase in the intestinal production of butyric acid and/or salts thereof, and/or of folic acid and/or salts thereof, and/or of niacin and/or salts thereof and/or the direct and/or indirect decrease in the intestinal production of succinic acid is ascribable to the intestinal microbiota, preferably bacteria of the genus Coprococcus and/or Blautia.
• the direct and/or indirect increase in the intestinal production of butyric acid and/or salts thereof is ascribable to bacteria of the genus Coprococcus, and/or the direct and/or indirect decrease in the intestinal production of succinic acid is ascribable to bacteria of the genus Blautia.
• the composition comprising microorganisms, preferably at least one bacterium of the genus Lactobacillus species paracasei, more preferably the bacterial strain Lactobacillus paracasei DG, can also be used to modify the density of the bacterial population of the genus Coprococcus and/or Blautia in the intestinal microbiota, preferably so as to induce an increase in the bacterial population of the genus Coprococcus and/or a decrease in the bacterial population of the genus Blautia.
• intake of the composition of the present invention modifies the amount of bacteria of the genus Coprococcus and/or Blautia within the intestinal microbiota.
• the bacteria of the genus Coprococcus increase and/or the bacteria of the genus Blautia decrease following intake of said composition.
• composition used in the present invention comprises said microorganism, preferably said at least one bacterium of the genus Lactobacillus species paracasei, in live or dead form, as a lysate or extract.
• the composition comprises about 15- 30 billion colony forming units (CFU) of bacteria, preferably 20-25 billion CFU of bacteria.
• CFU colony forming units
• the composition is formulated for oral administration.
• the composition is formulated in solid form, preferably in the form of pills, capsules, tablets, granular powder, hard capsules, water- soluble granules, sachets or pellets.
• composition of the invention is formulated in liquid form, for example as a syrup or beverage, or is added to a food, for example to a yogurt, cheese or fruit juice.
• composition of the invention is formulated in a form capable of exerting an action topically, for example as an enema.
• the composition further comprises excipients generally accepted for the production of probiotic and/or pharmaceutical products.
• the composition of the invention can be enriched with vitamins, trace elements such as zinc and selenium, enzymes, prebiotic substances such as fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), inulin, guar gum or combinations thereof.
• FOS fructo-oligosaccharides
• GOS galacto-oligosaccharides
• inulin guar gum or combinations thereof.
• the composition is taken once a day, more preferably upon awakening.
• - exclusion criteria antibiotic treatment in the month preceding the first examination; episodes of viral or bacterial enteritis in the 2 months preceding the first examination; gastric or duodenal ulcers in the 5 years preceding the first examination; pregnancy or breastfeeding; recent or presumed cases of alcoholism and drug intake; other conditions of non-compliance with the study protocol.
• Metagenomlc analysis of faecal microbiota In the pre-enrolment phase (4 weeks) the volunteers followed their usual diet, without consuming probiotic fermented milk products (traditional yogurt was thus permitted), probiotic dietary supplements, or prebiotic dietary supplements.
• the volunteers were randomized to receive one capsule per day of a probiotic or placebo for 4 weeks.
• Enterolactis Plus was used as the probiotic to be administered; it consists in 420 mg capsules containing 24 billion CFU
• the placebo consisted in capsules identical in appearance to the probiotic ones, obviously devoid of the probiotic agent.
• flavour and colour of the active substance i.e. the probiotic
• placebo placebo
• the product was taken in the morning on an empty stomach, at least ten minutes before breakfast or, if forgotten, in the evening before going to bed and in any case at least two hours after the last meal.
• Treatment 1 the individuals underwent treatment A or treatment B.
• Treatment 2 the individuals underwent treatment B or treatment A.
• Treatments A and B can be the composition of the present invention, in the specific example Enterolactis plus, or else the placebo.
• At the start of the treatment it was not known what the individual was taking; only at the end of the treatment, when the blind was broken, was the intake sequence known.
• the faecal samples were stored at room temperature and delivered to the laboratory within 24 hours.
• the volunteer was given the probiotic product (or placebo) to be taken during the next 4 weeks.
• sample T1 Another faecal sample collected during the previous 24 hours.
• the volunteer completed a questionnaire on the possible effects, both positive and undesirable ones, deriving from consumption of the product.
• the volunteer was then instructed about the next 4 weeks, during which he or she again did not take the previously mentioned products.
• the volunteer went to the fourth meeting with a faecal sample (sample T2) and received the probiotic product (or placebo) to be taken during the next 4 weeks.
• the volunteer went to the fifth meeting to deliver the last faecal sample (sample T3).
• the volunteer has completed a questionnaire analogous to the one received during the third meeting.
• All the faecal samples collected were stored at -20°C for no more than 7 days before being subjected to analysis of the microbiota.
• the faecal microbiota was evaluated by analyzing the nucleotide sequence of portions of the gene encoding the 16S rRNA bacterial ribosomal subunit. More specifically, a metagenomic strategy was adopted; it consists in short in the following steps:
• Step 2 of amplifying the V3 region of the 16S ribosomal RNA genes was performed by means of the DNA amplification technique known as PCR, using Probio_Uni 5'-CCTACGGGRSGCAGCAG-3' (SEQ ID NO: 1) and Probio_Rev 5'-ATTACCGCGGCTGCT-3' (SEQ ID NO: 2) as oligonucleotides (primers).
• the pair of primers SEQ ID NO: 1 and 2 2 amplifies the V3 region of the 16S rRNA gene.
• Step 4 can be performed with the techniques known in the art for this purpose, for example techniques based on the Sanger method, pyrosequencing or the Ion Torrent Fusion Primers sequencing method used in the specific example of the present invention according to the protocol described in the materials and methods section of the scientific article by Milani et al. (2013).
• the primers are designed and synthesized in such a way as to include, at the 5' end, one of the two adaptor sequences used in this specific DNA sequencing technique.
• the adaptor sequences were SEQ ID NO: 1 and 2.
• the conditions under which the PCR was performed are the following:
• Step 5 of the method, necessary for characterizing the microbial communities can be carried out with numerous techniques presently known for this purpose. More specifically, use was made of: hierarchical clustering, taxonomic analysis and construction of phylogenetic dendrograms with heat maps according to the protocol described in the materials and methods section of the scientific article by Milani et al. (2013); more specifically, the analysis of sequence data was conducted using QIIME software.
• treatment A is the active treatment, containing Lactobacillus paracasei DG
• treatment B is the placebo, identical on the exterior to the active treatment, but devoid of lactobacilli.
• Coprococci are among the main producers of butyrate at the intestinal level.
• Butyrate is a fundamental compound at the intestinal level, since on the one hand it contributes to restoring the functional integrity of the intestinal mucosa and maintaining it over time, and on the other hand it has important anti-inflammatory effects, so much so that it is used as an adjuvant to dietary treatments for intestinal colopathies (e.g. chronic inflammatory intestinal diseases).
• Succinate is considered an ulcerogenic factor, capable, therefore, of exacerbating the condition of individuals with ulcerative colitis, since it is probably to blame for the mucosal damage present above all in the active phases of the disease.
• Vitamin B9 represents a nutritional factor of primary importance, a deficiency of which, especially in specific physiological conditions such as pregnancy, can lead to serious health consequences. Treatment with the probiotic used in this study could therefore favor the ability of intestinal microbiota to produce folic acid (vitamin B9), with a consequent nutritional benefit for the human host.

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