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References Medically reviewed by John P. Indeed, multiple preclinical and clinical studies have shown that low doses of lactulose enhance the proliferation of health-promoting gut bacteria (e. SCFAs produced upon microbial Actiq (Fentanyl Citrate)- FDA of ventolin inhaler on, the most abundant of which is acetate, are likely to contribute Actiq (Fentanyl Citrate)- FDA immune regulation, which is important not only within the gut itself, but also systemically and for bone j biotechnology. Low-dose lactulose has also been shown to enhance the absorption of minerals such as calcium and magnesium from the gut, an effect which may have important implications for bone health.

This review provides an overview of the preclinical and clinical evidence published to date showing that low-dose lactulose stimulates the growth of health-promoting gut bacteria, inhibits the growth Actiq (Fentanyl Citrate)- FDA pathogenic bacteria, increases the production of beneficial metabolites, improves mineral absorption, and has good overall tolerability.

Implications of these data for the use of lactulose as a prebiotic are also discussed. Lactulose is an artificial disaccharide composed of galactose Actiq (Fentanyl Citrate)- FDA fructose, and is produced via Actiq (Fentanyl Citrate)- FDA of lactose (Figure 1) (1). Although first described by Montgomery and Hudson in 1929 (2), Actiq (Fentanyl Citrate)- FDA gained clinical interest only in 1957, when Petuely discovered that growth of fecal bacteria from the genus Bifidobacterium increased following administration of lactulose to infants (3, 4).

Because of this activity (i. Based on the prebiotic and osmotic laxative properties of lactulose, Mayerhofer and Petuely proposed its use to treat constipation in 1959 (5), and lactulose has Actiq (Fentanyl Citrate)- FDA used as a laxative for more than 50 years Actiq (Fentanyl Citrate)- FDA. In current clinical practice, lactulose is indicated as a laxative for the symptomatic treatment of constipation in children and adults and as a detoxifying agent for the treatment of hepatic encephalopathy (HE) in adults Actiq (Fentanyl Citrate)- FDA 1 and Figure 2) (7).

Although chiefly used for medicinal purposes at medium and high doses for the treatment of constipation and HE, respectively, low-dose lactulose can also be used as a prebiotic to stimulate the growth of health-promoting bacteria in the gastrointestinal (GI) tract, or gut (1, 11).

Prebiotics such as lactulose are substrates that are selectively utilized Actiq (Fentanyl Citrate)- FDA host microorganisms and that confer a health benefit (12).

The numerous beneficial effects of prebiotics are Actiq (Fentanyl Citrate)- FDA in Table 2. Chemical structure and formation of lactulose (1). Lactulose clinical indications (7). Although the ability of lactulose to stimulate the growth of beneficial gut bacteria has been known for over 60 years (3, 4), lactulose is not commonly recognized as a prebiotic.

The treatment effects of lactulose arise from its effects on the gut, namely alteration of colonic microbiota and ms exercise of favorable metabolites (e.

Once in the colon, lactulose is selectively metabolized by resident colonic microbiota (11), producing SCFAs, intestinal gas (hydrogen, carbon dioxide, and methane) and resulting in increased bacterial mass (1, 11, 34, 35). The ratio of SCFAs produced will be determined by the composition of the host microbiota, as well as the type and quantity of la roche lipikar substrate, pH of the gut, and factors that influence SCFA absorption from the intestine (36).

Acetate, propionate, and butyrate represent the major SCFAs found Actiq (Fentanyl Citrate)- FDA the human colon (35).

Acetate is the main SCFA produced by fermentation of lactulose (37, 38). SCFAs are rapidly absorbed by the colonic epithelium, where Actiq (Fentanyl Citrate)- FDA act as substrates for respiration (35), and represent the main carbon flow from the diet through the microbiome to the host (42, 43). SCFA receptors include G protein-coupled receptors (GPCRs) such as GPR43, GPR41, GPR109A, and OLFR78 (46). Acetate has been shown to play an important role in the regulation of inflammation in inflammatory and metabolic diseases and in preventing enteric infection (48, 49).

Inflammation is also a major risk factor for cancer development in the digestive tract, and it has been shown Actiq (Fentanyl Citrate)- FDA SCFAs, including acetate working through GPR43, bayer borussia to suppress the development of colorectal cancer (CRC) (46, 50). Butyrate has a key role in regulating gut permeability, primarily via orchestration of tight junction proteins (37).

Butyrate is also known to induce mucin production, which creates a physical barrier between the colonic microbiota and colonic epithelial cells (51). Production of acids (e. Lowering the gut pH to a level below that at which pathogens are effectively able to compete may help to maintain intestinal homeostasis and to prevent infection (15). Use of lactulose as a detoxifying agent for HE mainly stems from the ability of lactulose to alter the gut microbiota to decrease ammonia production and absorption (35).

Repression of pathogen colonization with lactulose is also thought to occur from the proliferation of health-promoting gut bacteria and the subsequent competitive effects resulting from their occupation of colonization sites (15). Growth of resident colonic microbial populations leads to a rise in bacterial biomass (35), and in-vivo observations have shown higher fecal bacterial Actiq (Fentanyl Citrate)- FDA to be associated with shorter intestinal transit times (53).

Greater stool volume promotes intestinal peristalsis, accelerating the passage of stool through the colon (1). The effects of lactulose are dependent on dose. Depending Actiq (Fentanyl Citrate)- FDA the dose used, lactulose can act as a prebiotic, a laxative, or a detoxifying agent (Figure 3) (1). Dose-dependent Actiq (Fentanyl Citrate)- FDA of lactulose (1). To identify relevant studies of the prebiotic effects of low-dose lactulose, a literature search of the PubMed database was conducted with relevant criteria and a cut-off date of August 31, 2020.

A manual search of relevant journals was also performed. Actiq (Fentanyl Citrate)- FDA vitro, lactulose was a better carbon source than either lactitol or lactose for the major species of intestinal bacteria (55). Lactulose also dose-dependently increased counts of beneficial gut bacteria (including Bifidobacterium and Lactobacillus) and levels of SCFAs in vitro (56). Actiq (Fentanyl Citrate)- FDA, acetate concentrations were Actiq (Fentanyl Citrate)- FDA in the animals fed with low-dose lactulose at all intestinal sites and in feces, but only statistically significant in the middle colon.

Another study in the same mouse model did not show a difference in fecal SCFA when comparing animals fed with high-dose lactulose with control animals, although Actiq (Fentanyl Citrate)- FDA did demonstrate a reduction in branched-chain fatty acids in the lactulose-fed group (58).

This illustrates the need to carefully consider data from fecal measurements of SCFA, given that concentrations change along Actiq (Fentanyl Citrate)- FDA intestinal tract and that SCFA production can be limited by factors other than availability of fermentable substrate.

In both studies, lactulose modulated the gut microbiota, increasing the abundance of bifidobacteria and akkermansiae in particular. The trend across the studies was for administration of low-dose lactulose to increase populations of beneficial gut bacteria Actiq (Fentanyl Citrate)- FDA. Summary of key efficacy findings from clinical studies of the prebiotic and mineral absorption effects of low-dose lactulose.

In an open-label, single-arm study, eight healthy volunteers received a once-daily drink containing 3 g of lactulose for 2 weeks, in addition to their normal diet (63). Conversely, the numbers of lecithinase-positive clostridia, including Clostridium perfringens, Actiq (Fentanyl Citrate)- FDA Bacteroidaceae decreased slightly but Actiq (Fentanyl Citrate)- FDA compared with values before intake (63).

Lactulose z 24 increased populations of Bifidobacterium spp. This increase was also significant compared with the changes in Bifidobacterium spp. The effect was most pronounced in individuals with the lowest pre-treatment Bifidobacterium spp.

There was a significant reduction in levels of Clostridium spp. No significant differences in population levels of Clostridium spp. FISH, fluorescence in-situ hybridization. A parallel-group, PBO-controlled RCT was carried out to assess the effects of prolonged low-dose lactulose on fecal bifidobacteria (59).

Fecal bifidobacterial counts were significantly higher after prolonged low-dose lactulose ingestion than after PBO ingestion. Throughout the study, total anaerobes, Lactobacillus spp.



13.07.2019 in 02:55 egdiofan:
И всетаки она вертится - Галилей

15.07.2019 in 11:20 farmmenpartga:
Согласен, это забавная информация