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Bennet JD, Brinkman M. Lancet. 1989 Jan 21;1(8630):164. (Letter)
Abstract: JDB had continuously active, severe UC for 7 years confirmed endoscopically and histologically. The condition was refractory to standard management including steroids and sulphasalazine and every time daily prednisone dosage was reduced below 30mg severe symptoms (bloody diarrhea, cramping tenesmus, skin lesions and arthritis recurred. For the past 4 years symptoms had been controlled with 4.2gms of alpha tocopherylquinone and a low fat diet. When the tocopheryl was discontinued or reduced, symptoms returned within 1-2 days. With a protocol developed to sterilize the bowel before surgery, his flora was greatly reduced. The donor flora was introduced by large volume retention enemas. 1 wk later tocopheryls were discontinued without any recurrence of symptoms. It has now been 6 months since this implantation of normal flora and patient has been symptom free for the first time in 11 years without any medications. 3 months after the implantation, colonic biopsy revealed chronic inflammatory cells but no active inflammation.

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Clements, ML, Levine, MM, Black, RE, et al. Lactobacillus prophylaxis for diarrhea due to enterotoxigenic Escherichia coli. Antimicrob Agents Chemother 1981;20:104-108.

Clements ML, Levine MM, Ristaino PA, et al. Exogenous lactobacilli fed to man - their fate and ability to prevent diarrheal disease. Prog Food Nutr Sci 1983;7:29-37.

Coconnier MH, Lievin V, Hemery E, Servin AL. Antagonistic activity against Helicobacter infection in vitro and in vivo by the human Lactobacillus acidophilus strain LB. Appl Environ Microbiol. 1998 Nov;64(11):4573-4580.

Coconnier MH, Bernet MF, Kerneis S, Chauviere G, Fourniat J, Servin AL. Inhibition of adhesion on enteroinvasive pathogens to human intestinal Caco-2 cells by Lactobacillus acidophilus strain LB decreases bacterial invasion. FEMS Microbiol Lett 1993 Jul 1;110(3):299-306.

de dios Pozo-Olano, J, Warram, JH Jr, Gomez, RG, Cavazos, MG. Effect of a lactobacilli preparation on traveler's diarrhea. A randomized, double blind clinical trial. Gastroenterology 1978;74:829-830.

Dias, RS, Bambirra, EA, Silva, ME, Nicoli, JR. Protective effect of Saccharomyces boulardii against the cholera toxin in rats. Braz J Med Biol Res 1995;28:323-325.

Dolgushina, VF. [The immunocorrective properties of bacterial preparations (lactobacterin, bifidumbacterin) and bemitil in pregnant women with a urogenital infection.] Zh Mikrobiol Epidemiol Immunobiol 1991;4:56-58. [Article in Russian]

Ducluzeau, R, Bensaada, M. Comparative effect of a single or continuous administration of "Saccharomyces boulardii" on the establishment of various strains of "candida" in the digestive tract of gnotobiotic mice. Ann Microbiol 1982;133:491-501.

Fredricsson, B, Englund, K, Nord, CE, Weintraub, L. Could bacterial vaginosis be due to the competitive suppression of lactobacilli by aerobic microorganisms? Gynecol Obstet Invest 1992;33:119-123.

Fukushima Y, Kawata Y, Hara H, Terada A, Mitsuoka T. Effect of a probiotic formula on intestinal immunoglobulin A production in healthy children. Int J Food Microbiol 1998 Jun 30;42(1-2):39-44.
Abstract: The anti-infectious effect of probiotics has recently been reported and one mechanism may be the non-specific stimulation of immunity. This study was performed to elucidate the influence of a probiotic formula on intestinal microflora and local immunity in healthy children. A follow-up formula containing viable bifidobacteria was given to seven healthy Japanese children (15 to 31 months old) for 21 days. During intake of the formula, the administered strain was detected in feces from five subjects (71%) and total fecal bifidobacteria slightly increased. Fecal levels of total IgA and anti-poliovirus IgA during intake of the formula were significantly higher than those before intake (P < 0.05). The increase in local IgA levels resulting from ingestion of the probiotic formula may contribute to enhancement of the mucosal resistance against gastrointestinal infections.

Fuller R, Gibson GR. Modification of the intestinal microflora using probiotics and prebiotics. Scand J Gastroenterol Suppl 1997;222:28-31.
Abstract: Probiotics and prebiotics modulate the composition of the human gut microbiota. The beneficial effects may result from suppression of harmful microorganisms or stimulation of organisms which contribute in a positive way to the nutrition and health of the host. Both types of supplement represent an attempt to reconstitute the gut flora to its normal composition which has been adversely affected by dietary and environmental stresses.

Fuller, R. Probiotics in human medicine. Gut 1991 Apr;32(4):439-442. (Review).

Gismondo, MR, Lo Bue, AM, Chisari, G, et al. Competitive activity of a bacterial preparation on colonization and pathogenicity of C. pylori. A clinical study. Clin Ter 1990;134:41-46. [Article in Italian]

Guarino A, Canani RB, Spagnuolo MI, Albano F, Di Benedetto L. Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea. J Pediatr Gastroenterol Nutr 1997 Nov;25(5):516-519.
Abstract: BACKGROUND: Oral administration of live Lactobacillus casei strain GG is associated with the reduction of duration of diarrhea in children admitted to the hospital because of diarrhea. The purposes of this work were to investigate the clinical efficacy of oral administration of Lactobacillus in children with mild diarrhea who were observed as outpatients, and to see whether Lactobacillus GG can reduce the duration of rotavirus excretion. METHODS: Duration of diarrhea was recorded in 100 children seen by family pediatricians and randomly assigned to receive oral rehydration or oral rehydration followed by the administration of lyophilized Lactobacillus casei, strain GG. Rotavirus was looked for in the stools of all children and in those in whom results were positive, stools were examined again 6 days after the onset of diarrhea. RESULTS: In 61 children results were positive for rotavirus and in 39 results were negative. Duration of diarrhea was reduced from 6 to 3 days in children receiving Lactobacillus GG, with a similar pattern in rotavirus-positive and -negative children. Six days after the onset of diarrhea, stools in only 4 out of 31 children that received Lactobacillus GG were positive for rotavirus compared with positive findings in 25 out of 30 control subjects. CONCLUSIONS: Oral administration of Lactobacillus GG is effective in rotavirus-positive and rotavirus-negative ambulatory children with diarrhea. Furthermore, it reduces the duration of rotavirus excretion.

Hayatsu, H, Hayatsu, T. Suppressing effect of Lactobacillus casei administration on the urinary mutagenicity arising from ingestion of fried ground beef in the human. Cancer Lett 1993;73:173-179.

Hillier, SL, Krohn, MA, Rabe, LK, et al. The normal vaginal flora, H2O2 producing Lactobacilli and bacterial vaginosis in pregnant women. Clin Infect Dis 1993;16 Suppl 4:S273-S281.

Hilton, E, Isenberg, HD, Alperstein, P, et al. Ingestion of Lactobacilli acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 1992;116:353-357.

Holzapfel WH, Haberer P, Snel J, Schillinger U, Huis in't Veld JH. Overview of gut flora and probiotics. Int J Food Microbiol 1998 May 26;41(2):85-101. (Review)
Abstract: Scientific developments in recent years have opened new frontiers and enable a better understanding of the gastrointestinal tract (GIT) as a complex and delicately balanced ecosystem. This paper focuses on more recent information related to the microbial population of the GIT and its functional role in human physiology and health. Special attention is also given to modern approaches for improving or stabilising the intestinal system and its functioning by the deliberate application of viable microbial cultures, so-called 'probiotics', selected for special functional properties.

Isolauri, E, Juntumen, M, Rautanen, T, et al. A human Lactobacillus strain (Lactobacillus casei sp strain GG) promotes recovery from acute diarrhea in children. Pediatrics 1991;88:90-97.

Jahn, HU, Ullrich, R, Schneider, T, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion 1996;57:95-104.

Kasper H. Protection against gastrointestinal diseases--present facts and future developments. Int J Food Microbiol 1998 May 26;41(2):127-131.
Abstract: The importance of the intestinal microflora and, more specifically its composition, in physiological and pathophysiological processes in the human GIT is becoming more evident. Examples of such processes are translocation, the production and resorption of endotoxins, immune-modulation, and colonic motility. This leads to new possibilities for prevention and therapy of diseases, mainly of the gastrointestinal organs. New discoveries are specifically related to the beneficial effects of lactobacilli which have been discussed for decades. It is possible to increase the proportion of lactobacilli in the gastrointestinal microflora by consumption of fermented dairy products or by oral administration of specific non-digestible substrates such as oligofructose. Results from clinical trials and scientific studies have confirmed the preventive and therapeutic effects of selected strains of lactobacilli in viral- and bacterial-induced intestinal infections, in positively influencing immunological parameters, in normalizing the intestinal motility, and in inhibiting metabolic events in the gut lumen which promote colonic carcinogenesis. Nevertheless, there are still unresolved issues which can only be answered by well designed and well controlled clinical trials.

Kirchhelle, A, Fruhwein, N, Toburen, D. Treatment of persistent diarrhea with S. boulardii in returning travelers. Results of a prospective study. Fortschr Med 1996;114:136-140.

Klein, SM, Elmer, GW, McFarland, LV, et al. Recovery and elimination of the biotherapeutic agent, Saccharomyces boulardii, in healthy human volunteers. Pharm Res 1993;10:1615-1619.

Kollaritsch, H, Holst, H, Grobara, P, Wiedermann, G. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study. Fortschr Med 1993;111:152-156.

Korshunov, VM, Kafarskaia, LI, Volodin, NN, Tarabrina, NP. The correction of dysbiotic disorders of the vaginal microflora by using a preparation made from highly adhesive lactobacteria. Zh Mikrobiol Epidemiol Immunobiol 1990;7:17-19.[Article in Russian]

Korshunov, VM, Sinitsyna, NA, Ginodman, GA, Pinegin, BV. Correction of intestinal microflora in chemotherapeutic dysbacteriosis using bifidobacterial and lactobacterial autologous strains. Zh Mikrobiol Epidemiol Immunobiol 1985;9:20-25. [Article in Russian]

Kuznetsov VF, Iushchuk ND, Iurko LP, Nabokova NIu. Intestinal dysbacteriosis in yersiniosis patients and the possibility of its correction with biopreparations. Ter Arkh 1994;66:17-18. [Article in Russian]

Lankaputhra WE, Shah NP. Antimutagenic properties of probiotic bacteria and of organic acids. Mutat Res 1998 Feb 2;397(2):169-182.
Abstract: Antimutagenic activities of live and killed cells of 6 strains of Lactobacillus acidophilus and 9 strains of bifidobacteria and of organic acids usually produced by these probiotic bacteria were determined using 8 potent chemical mutagens and promutagens. The mutagens and promutagens used were N-methyl, N'-nitro, N-nitrosoguanidine; 2-nitroflourene; 4-nitro-O-phenylenediamine; 4-nitroquinoline-N-oxide; Aflatoxin-B; 2-amino-3-methyl-3H-imidazoquinoline; 2-amino-1-methyl-6-phenyl-imidazo (4,5-b) pyridine, and 2-amino-3-methyl-9H-pyrido (3,3-6) indole. The mutagenicity of these mutagens and antimutagenic activity of probiotic bacteria against the mutagens were determined according to the Ames TA-100 assay using a mutant of Salmonella typhimurium. Efficiency of bacterial cells in binding or inhibiting these mutagens was also investigated. Live cells of probiotic bacteria showed higher antimutagenic activity and their efficiency in inhibiting the mutagens was better than killed bacterial cells. Live bacterial cells bound or inhibited the mutagens permanently, whereas killed bacteria released mutagens upon extraction with dimethyl sulfoxide. Among the organic acids, butyric acid showed highest inhibition of mutagens followed by acetic acid. Lactic and pyruvic acids did not show appreciable levels of inhibition.

Larsen, B. Vaginal flora in health and disease. Clin Obstet Gynecol 1993;36:107-121.

Larvol, L, Monier, A, Besnier, P, Levecq, H. Liver abscess caused by Lactobacillus acidophilus. Gastroenterol Clin Biol 1996;20:193-195. [Article in French]

Levy J. Immunonutrition: the pediatric experience. Nutrition 1998 Jul;14(7-8):641-647.
Abstract: The health benefits of specific nutrients in the diet are reviewed as they pertain to the pediatric population and its unique needs. Secretory immunoglobulins, lysozyme, interferon, and growth factors, among others, are known to confer immunological advantages to breast milk. Inhibition of bacterial pathogens, as well as permissive growth of a protective colonic ecoflora occur as a result of various cellular and biochemical mechanisms at play. The immunomodulatory properties of minerals such as iron, zinc, and selenium, are presented and the newly recognized protective role of vitamin A and its importance in developing countries and in conditions of compromised nutrition are discussed. The review also covers the role of arginine, glutamine, and nucleotides in adaptive responses of the developing gut and in pathologic states such as necrotizing enterocolitis, short bowel syndrome, and inflammatory bowel disease. Probiotics (specific microbial feeds with potential benefits to the host), and prebiotics (dietary components such as complex carbohydrates able to change the colonic microenvironment fostering colonization with non-enteropathogens) are areas of current interest because they offer alternatives for the management of the growing problem of multiple antibiotic resistance and overwhelming infections in the hospitalized patient.

Litiaeva, LA. The effect of a combination of immune and bacterial preparations on the microbial ecology of pregnant women in a risk group. Akush Ginekol (Mosk) 1993;1:19-22. [Article in Russian].

Lodinova-Zadnikova R, Sonnenborn U, Tlaskalova H. Probiotics and E. coli infections in man. Vet Q 1998;20(3 Suppl 3):S78-S81.
Abstract: After oral administration of live oral vaccines COLINFANT and MUTAFLOR prepared from non-enteropathogenic E.coli strains, both strains colonized effectively the intestine in full-term and preterm infants and remained for many weeks showing, that they were capable to establish themselves as a resident strain in the infant's gut. The presence of E.coli stimulated significantly antibody production in gut, saliva and serum of colonized infants. An early induction of secretory IgA production is important particularly in formula-fed infants, where it partly replaces the lacking immunoglobulin supplied with mother milk. In full-term and premature infants the early presence of non-pathogenic E.coli strains in the intestine decreased significantly the presence of pathogenic bacterial strains in the intestine but also other mucosal surfaces of the body. The COLINFANT strain decreased the number of nosocomial infections, mortality rate in connection with infection, and the need for antibiotics. Both strains replaced successfully pathogenic strains in carriers after treatment with antibiotics.

Loizeau E. [Can antibiotic-associated diarrhea be prevented]? Ann Gastroenterol Hepatol (Paris). 1993 Jan; 29(1): 15-18. [Article in French] (Review)

Lykova, EA, Bondarenko, VM, Izachik, IuA, et al. [The probiotic correction of microecological and immune disorders in gastroduodenal pathology in children]. Zh Mikrobiol Epidemiol Immunobiol 1996;2:88-91. [Article in Russian]

Majamaa H, et al. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol. 1997 Feb; 99(2): 179-185.

Malin, M, Suomalainen, H, Saxelin, M, Isolauri, E. Promotion of IgA immune response in patients with Crohn's disease by oral bacteriotherapy with Lactobacillus GG. Ann Nutr Metab 1996;40:137-145.

Masycheva VI, Danilenko ED, Pustoshilova NM, Beliavskaia VA. [Design of stimulating agents of non-specific resistance system]. Vestn Ross Akad Med Nauk 1998;4:13-17. [Article in Russian] (Review)
Abstract: The paper briefly reviews a study on the design of drugs enhancing the body's nonspecific resistance to pathogenic agents. To examine the potential regulatory effects on cytokine function was a main trend. The interferon inductor ridostin, dsRNA of microbiological origin, cytokines, as well as the recombinant probiotic strain yielding interferon alpha-2 synthesis were used as a pharmacological agent. This was shown by using a wide range of experimental models wherein these preparations activated the components of the non-specific resistance system resulting in the host's increased capacity to eliminate invasive agents and transformed cells.

McFarland, LV, Elmer GW. Biotherapeutic agents: past, present and future. Microecology Ther 1995;23:46-73.

Mohan, JC, Arora, R, Khalilullah, M. Preliminary observations on effect of Lactobacillus sporogenes on serum lipid levels in hypercholesterolemic patients. Indian J Med Res 1990;92:431-432.

Monterisi,A, Dain, AA, Suarez de Basnec, MC, et al. Native-valve endocarditis produced by Lactobacillus casei sub. rhamnosus refractory to antimicrobial therapy. Medicina (B Aires) 1996;56:284-286. [Article in Spanish]

Okasanen, PJ. Prevention of traveler's diarrhea by Lactobacillus GG. Ann Med 1990;22(1):53-56.

Pant, AR, Graham, SM, Allen, SJ, et al. Lactobacillus GG and acute diarrhoea in young children in the tropics. J Trop Pediatr 1996;42:162-165.

Parent, D, Bossens, M, Bayot, D, et al. Therapy of bacterial vaginosis using exogenously-applied Lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneimittelforschung 1996;46:68-73.

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Reid, G, Bruce, AW, McGroarty, JA, et al. Is there a role for Lactobacilli in prevention of urogenital and intestinal infections? Clin Microbiol Rev 1990;3:335-344.

Reid, G, Bruce, AW, Taylor, M. Influence of three-day antimicrobial therapy and lactobacillus vaginal suppositories on recurrence of urinary tract infections. Clin Ther 1992;14:11-16.

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Shirodkar, NV, Sankholkar, PC, Ghosh, S, Nulkar, SM. Multi-centre clinical assessment myconip vaginal tablets in non-specific vaginitis. Indian Pract 1980;33:207-210.

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Witsell, DL, Garrett, CG, Yarbrough, WG, et al. Effect of Lactobacillus acidophilus on antibiotic-associated gastrointestinal morbidity: a prospective randomized trial. J Otolaryngol 1995;24:230-233.

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