益生菌与牙周健康 Probiotics and periodontal health

益生菌（ Probiotics ） 定义 (definition) 通过摄取适当的量, 对食用者的身体健康能发挥有效作 用的活菌 (FAO & WHO, 2001) 。 living microbes, or as food ingredients containing living microbes, that beneficially influence the health of the host when used in adequate numbers.

临床应用 (Clinical application) 防治胃肠道感染性疾病 增强人体免疫力 婴儿的泌尿系统及呼吸道的感染； 缓解过敏反应； 降低血清胆固醇； 预防癌症和抑制肿瘤生长 预防儿童艾滋病及糖尿病

Present findings Laboratory studies During the fermentation process in milk, Lactobacillus helveticus produces short peptides that act on osteoblasts and increase their activity in bone formation. These bioactive peptides could thereby contribute to reducing the bone resorption associated with periodontitis. Narva M,. Life Sci. 2004;75(14):

Present findings Clinical Trials Patients with various periodontal diseases, gingivitis, periodontitis, and pregnancy gingivitis, were locally treated with a culture supernatant of a L. acidophilus strain. Significant recovery was reported for almost every patient. Kragen H. Zahnarztl Welt.1954;9:

Present findings Clinical Trials Krasse and colleagues assessed the beneficial effect of L. reuteri against gingivitis. After 14 days of ingesting the probiotic incorporated into chewing gum, the oral cavity of patients with a moderate to severe form of gingivitis had been colonized by L. reuteri and the plaque index had been reduced. Krasse P, et al. Swed Dent J. 2006;30(2):55-60.

Present findings Clinical Trials another similar experiment showed that the use of probiotic chewing gum containin L. reuteri ATCC and ATCC PTA 5289, not only improved the gingival health, but also decreased GCF volume and the levels of pro-inflammatory cytokines in GCF. Twetman S, et al. Acta Odontol Scand 2009;67:19-24.

Present findings Clinical Trials Riccia studied the anti-inflammatory effects of Lactobacillus brevis in a group of patients with chronic periodontitis. The treatment, which involved sucking on lozenges containing L. brevis over a period of 4 days, led to improvements in the targeted clinical parameters and a significant reduction in salivary levels of prostaglandinE2 (PGE2) and matrix metalloproteinases (MMPs) was also observed. Riccia DN, et al. Oral Dis. 2007;13(4):

Clinical Trials Shimauchi H and Mayanagi G evaluated the effect of probiotic with Lactobacillus salivarius WB21 on the periodontal condition of volunteers without severe periodontitis. The results indicated that, oral administration of probiotic lactobacilli reduced the numerical sum of periodontopathic bacteria, improved periodontal clinical parameters and decreased slivary Lf level of smokers. Shimauchi H, et al. J Clin Periodontol.2008; 35: 897–905. Mayanagi G, et al. J Clin Periodontol. 2009; 36: 506–513.

more studies are needed · long-term clinical trials · unravel the mechanisms of possible probiotic action

Testa MM evaluated possible antagonistic interactions among Fusobacterium nucleatum and Prevotella intermedia and Lactobacillus casei, L. salivarius, L. rhamnosus and L. plantarum with three Different tests. The results indicated none of the species of lactobacilli studied inhibited the growth of P. intermedia or F. nucleatum. Testa MM, et al. Res Microbiol Dec;154(10):669-75

probiotic strains L. acidophilus, L. reuteri strains, L. brevis (CD2), Lactobacillus salivarius WB21, L. casei Shirota, L. salivarius WB21, Bacillus subtilis, Lactobacillus gasseri, L. fermentum, Lactobacillus helveticus

LDR0723 and CRL1528 led to a sustained increment in production of IL-12 and IFN-gamma and to a decrease in release of IL-4 and IL-5, while BNL1059 and RGS1746 favoured Th2 response, leading to a decrease in Th1/Th2 ratio with respect to unstimulated cells. Drago L. Strain-dependent release of cytokines modulated by Lactobacillus salivarius human isolates in an in vitro model. BMC Res Notes Feb 25;3:44.

A careful evaluation of anti-inflammatory properties of lactobacilli should be performed on single strain, before any consideration on potential probiotic use.

Colonization