Turkiye Klinikleri Pediatric Sciences - Special Topics

Beslenme ve Metabolizma Hastalıkları Özel Sayısı
Pro-, Pre- ve Sinbiyotikler
PRO-, PRE- AND SYNBIOTICS
Turgay COŞKUNa
aÇocuk Sağlığı ve Hastalıkları ABD, Hacettepe Üniversitesi Tıp Fakültesi, ANKARA
Turkiye Klinikleri J Pediatr Sci. 2007;3(6):82-98
Article Language: TR
ÖZET
Probiyotikler, konakçının bağırsak florasını düzenleyerek ve immün sistemini uyararak sağlığını olumlu yönde etkileyen canlı mikroorganizma desteği olarak tanımlanabilir. Organizmalar, besinlerin saklanmasında ve alkol üretiminde fermentasyon amaçlı olarak uzun yıllar kullanılmasına karşın, ancak son yıllarda bilim adamlarının ilgisini çekmeye başlamıştır. Probiyotik olarak kullanılan mikroorganizmalar çoğunlukla Laktobasil ve Bifidobakteri grubundandır. Probiyotiklerin sağlığımız üzerindeki olumlu etkileri arasında rotavirus ishallerinin süresinin kısaltılması, laktoz intoleransı semptom ve bulgularının hafifletilmesi, atopik bünyeli bireylerde allerji riskinin azaltılması, çeşitli organ kanserlerinin önlenmesi, serum kolesterol düzeylerinin düşürülmesi, ürogenital enfeksiyonların önlenmesi, bazı besin ögelerinin biyolojik yararlılığının arttırılması ve vücutta sentezlenmesi sayılabilir. Probiyotik mikroorganizmalar bu yararlı etkilerini ortaya koyabilmek için bağırsak duvarına tutunma ve lümende bulunan besin maddelerinin tüketimi için patojen mikroorganizmalar ile yarışır (yarışmacı dışlama), antimikrobiyal özellikte maddeler üretir ve bağırsak mukozası ile ilişkili immün işlevleri düzenler. Probiyotiklerin vücudun değişik kısımlarındaki olumlu etkileri bakteri suşuna özgü olduğundan, hangi bakterinin hangi organ hastalığında etkili olduğunun belirlenmesine gereksinim vardır. Prebiyotikler ise bağırsaklarda sınırlı sayıda yararlı mikroorganizmanın çoğalma veya aktivitesini arttıran ve sindirilmeyen oligosakkaritlerdir. İyi bilinen prebiyotik moleküller arasında frukto-oligosakkaritler, galakto-oligosakkaritler, inülin, oligofruktoz, ksilo-oligosakkaritler, asidik oligosakkaritler ve sindirime dirençli nişasta sayılabilir. Kalın bağırsaklarda prebiyotiklerin flora bakterileri enzimlerince fermentasyonu sonucu kısa zincirli yağ asitleri (asetat, bütirat ve propiyonat) açığa çıkar. Kısa zincirli yağ asitleri bağırsak bütünlüğünün korunması, işlevleri, bağırsak ilişkili immün sistemin düzenlenmesi, bağırsaklardan kalsiyum ve magnezyum emilimi ve normal serum kolesterol düzeylerinin sürdürülmesi için gereklidir. Fermentasyon reaksiyonu ürünleri hem yararlı mikroorganizmalar ve hem de bağırsak epitel hücreleri tarafından enerji kaynağı olarak da kullanılır. Sinbiyotikler, probiyotik ve prebiyotikleri birlikte bulunduran besin desteğidir. Prebiyotikler, vücuda yararlı mikroorganizmalar için enerji kaynağı olduğundan, prebiyotik ve probiyotikleri birlikte bulunduran ürünler alındığında probiyotiklerin daha uzun süre canlı kalacağı, additif ve hatta sinerjistik etki ortaya çıkabileceği varsayılmaktadır.

Anahtar Kelimeler: Probiyotikler; prebiyotikler; sinbiyotikler;bağırsak florası, sağlık, allerji, immünite, ishal, kanser, ürogenital sistem enfeksiyonları, serum kolesterol düzeyi, inflamatuvar bağırsak hastalıkları
ABSTRACT
Probiotics can be defined as live microbial food supplements which beneficially affect the health of the host by maintaining a balanced intestinal flora and stimulating its immune system. Although microbes have been used for many decades for food and alcoholic fermentation but only recently they have drawn the attention of the scientific community. Probiotic microorganisms are mostly from the Lactobacillus and Bifidobacterium family. They may contribute to our health in many different ways. Beneficial health effects attributed to probiotics are shortening of the duration of rotavirus diarrhea, relief of signs and symptoms of lactose intolerance, decreasing risk of allergy in atopic individuals, cancer prevention, lowering serum cholesterol levels, prevention of urogenital infections, and synthesizing and enhancing the bioavailability of nutrients. Probiotic bacteria may compete with pathogens for nutrients and mucosal adherence, produce antimicrobial substances, and modulate mucosal immune functions. The beneficial effects of probiotics are strain-specific, therefore there is need for the definition which probiotics ( as a single strain or a combination) are most effective in specific diseases. Prebiotics are indigestible oligosaccharides that promote the growth or activity of a limited number of beneficial bacteria in the gut. Some of the typical prebiotics include fructo-oligosaccharides, galacto-oligosaccharides, inulin, oligofructose, xylo-oligosaccharides, acidic oligosaccharides, and resistant starch. The breakdown of prebiotic molecules by bacterial enzymes in the large bowel yields lactate and short-chain fatty acids (acetate, butyrate, and propionate) as end-products. Short-chain fatty acids are crucial to gut integrity and function, modulation of the immune system, calcium and magnesium absorption, maintenance of normal serum cholesterol levels. The end products of this fermentation are consumed by both these bacteria and intestinal epithelium as fuel. Synbiotics refer to nutritional supplements which contain probiotics and prebiotics in combination. Since it has been hypothesized that prebiotics ensure the survivability of some beneficial bacteria, their effects might be additive or even synergistic.

Keywords: Probiotics, prebiotics, synbiotics, intestinal flora, health, allergy, immunity, diarrhea, cancer, urogenital infections, serum cholesterol, inflammatory bowel disease

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30.03.2014

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