Pro- und Präbiotika

Zusammenfassung

Die Darmmikrobiota ist von großer Bedeutung für die Gesundheit und spielt bei zahlreichen Erkrankungen eine Rolle. Aufgrund dieser Tatsache sind die potenziellen Einsatzmöglichkeiten von Pro- und Präbiotika für Prävention und Therapie von Erkrankungen in den vergangenen Jahren zunehmend ins Interesse der Wissenschaft gerückt. Zahlreiche probiotische und – in geringerem Umfang – auch präbiotische Lebensmittel, Nahrungsergänzungsmittel und Arzneimittel sind heute erhältlich. Probiotika sind lebende Mikroorganismen, die dem Wirt einen gesundheitlichen Nutzen bringen können. Dabei handelt es sich vielfach um Stämme der Gattungen Laktobazillen und Bifidobakterien. Inzwischen gilt die Wirkung von Probiotika bei der Therapie akuter infektiöser Diarrhö, dem Reizdarmsyndrom, der Remissionserhaltung bei Colitis ulcerosa und Pouchitis sowie bei der Prävention von antibiotikaassoziierter Diarrhö und nekrotisierender Enterokolitis als gesichert. Bei einigen anderen Erkrankungen gibt es gewisse Hinweise auf einen Effekt von Probiotika, die sich jedoch in weiteren wissenschaftlichen Studien bestätigen müssen. Im primärpräventiven Bereich sind probiotische Wirkungen weniger klar belegt. Zur Erzielung einer Wirkung sind beim Einsatz von Probiotika mehrere Faktoren zu berücksichtigen, allen voran ihre Stammspezifität. Präbiotika sind selektiv fermentierte Substanzen wie Inulin und Oligofruktose, die bestimmte Spezies der gastrointestinalen Mikrobiota und so die Gesundheit des Wirts fördern können. Die Wirkmechanismen und -bereiche sind weniger gut untersucht als die der Probiotika.

Abstract

The intestinal microbiota is of relevant importance for health and plays a role in numerous diseases. Due to this, the potential application fields of pro- and prebiotics for prevention and therapy of diseases are more and more propelled into the focus of scientific research during the last years. Numerous probiotic, and in a smaller scale also prebiotic, food, nutritional supplements, and pharmaceuticals are available today. Probiotics are living microorganisms, which can improve the health of the host. The most frequent probiotic microorganisms are strains of lactobacilli and bifidobacteria. Today, the effects of probiotics in the therapy of acute infectious diarrhea, irritable bowel syndrome, maintenance of remission of pouchitis and ulcerative colitis as well as the prevention of antibiotic associated diarrhea and necrotizing enterocolitis are regarded as evidenced. For some other diseases there is more or less strong evidence for an effect of probiotics, which has to be proven in further scientific studies. There are some factors that have to be considered when using probiotics, especially the strain specifity. Prebiotics are selectively fermented substances like inulin or oligofructose that beneficially affect the gastrointestinal microbiota and with this the host health. The mechanisms and fields of application are less good investigated than those of probiotics.

Schlüsselwörter

Probiotika - Präbiotika - Darmmikrobiota - darmassoziiertes Immunsystem

Keywords

probiotics - prebiotics - intestinal microbiota - gut associated immune system

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