Single-strain and multistrain probiotics can be beneficial for specific clinical applications.1,2 Potential advantages of multistrain probiotic supplements are a broader spectrum of health benefits (compared to intake of a single probiotic strain) and synergistic effects of the individual probiotic strains.2
Clinical trial results on a new, high colony-forming units (CFU) count combination of 8 strains of Lactobacillus and Bifidobacterium probiotics were recently published in Integrative Medicine: A Clinician’s Journal.3 The study evaluated the short-term impact of consumption of one capsule per day using standard blood panels and a health questionnaire as well as stool tests. This novel combination included the following probiotic strains:
Lactobacillus acidophilus NCFM®
Lactobacillus paracasei Lpc-37
Lactobacillus plantarum Lp-115
Lactobacillus rhamnosus HN001
Bifidobacterium animalis subspecies lactis Bi-07®
Bifidobacterium animalis subspecies lactis HN019
Bifidobacterium animalis subspecies lactis Bl-04
The main finding of the research was that the probiotic combination was well-tolerated by the study participants. More interestingly, after analyzing the stool samples of the study volunteers, the researchers found that taking the probiotic combination for 10 days was associated with increases in beneficial gut bacteria.
The gut bacteria that increased after taking the probiotic were Faecalibacterium prausnitzii and Akkermansia muciniphila, bacteria that are considered potential “keystone species” due to their potential roles in supporting the organization and diversity of the gut ecosystem.4–6 F. prausnitzii and A. muciniphila have also been described as “bioindicators of health” because low levels of these species are associated with many conditions.7,8
Low levels of F. prausnitzii have been demonstrated in patients with the following conditions:
- Irritable bowel syndrome (IBS)9
- Inflammatory bowel disease (IBD)—including Crohn’s disease and ulcerative colitis8,10
- Celiac disease in children11
- Colorectal cancer12
- Type 2 diabetes13
- Nonalcoholic fatty liver disease (NAFLD)15
- Bipolar disorder16
- Allergic disease in children17
Low levels of A. mucinphila have been described in patients with the following conditions:
- Type 2 diabetes18,19
- Allergic disease in children17
Supporting intestinal levels of F. prausnitzii and/or A. mucinphila has been proposed as a novel option to prevent or treat many of the above conditions due to the key roles these microbes have in gut and systemic health.4,8,20,21
Why is this clinically relevant?
- This study demonstrated that intake of the 8-strain probiotic combination by healthy individuals was associated with increases in F. prausnitzii and A. muciniphila, potential keystone species that are associated with health
- Despite great interest in administering F. prausnitzii and A. muciniphila as probiotics, there are technical issues limiting their availability as probiotics22
- Supporting F. prausnitzii and/or A. muciniphila levels in the gut has been proposed as novel options for preventing and treating highly prevalent inflammatory and metabolic conditions
- Ouwehand AC et al Effectiveness of multistrain versus single-strain probiotics current status and recommendations for the future. J Clin Gastroenterol. 2018;52:S35-S40.
- Chapman CMC et al. Health benefits of probiotics: are mixtures more effective than single strains? Eur J Nutr. 2011;50(1):1-17.
- Ryan JJ et al. Short-term tolerability, safety, and gut microbial composition responses to a multi-strain probiotic supplement: an open-label study in healthy adults. Integr Med. 2020;20(1).
- Miquel S, et al. Anti-nociceptive effect of Faecalibacterium prausnitzii in non-inflammatory IBS-like models. Sci Rep. 2016;6:1-8.
- Belzer C et al. Microbial metabolic networks at the mucus layer lead to diet-independent butyrate and vitamin B12 production by intestinal symbionts. MBio. 2017;8(5):1-14.
- Chia LW et al. Deciphering the trophic interaction between Akkermansia muciniphila and the butyrogenic gut commensal Anaerostipes caccae using a metatranscriptomic approach. Antonie van Leeuwenhoek, Int J Gen Mol Microbiol. 2018;111(6):859-873.
- Verhoog S et al. Dietary factors and modulation of bacteria strains of akkermansia muciniphila and faecalibacterium prausnitzii: A systematic review. Nutrients. 2019;11(7):1-20.
- Ferreira-Halder CV et al. Action and function of Faecalibacterium prausnitzii in health and disease. Best Pract Res Clin Gastroenterol. 2017;31(6):643-648.
- Liu H et al. Altered molecular signature of intestinal microbiota in irritable bowel syndrome patients compared with healthy controls: A systematic review and meta-analysis. Dig Liver Dis. 2017;49(4):331-337.
- Kostic AD et al. The microbiome in inflammatory bowel disease: Current status and the future ahead. Gastroenterology. 2014;146(6):1489-1499.
- De Palma G et al. Intestinal dysbiosis and reduced immunoglobulin-coated bacteria associated with coeliac disease in children. BMC Microbiol. 2010;10(63).
- Konstantinov SR et al. Functional genomic analyses of the gut microbiota for crc screening. Nat Rev Gastroenterol Hepatol. 2013;10(12):741-745.
- Gurung M et al. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine. 2020;51:102590.
- Yan Q et al. Alterations of the gut microbiome in hypertension. Front Cell Infect Microbiol. 2017;7:381.
- Grabherr F et al. Gut dysfunction and non-alcoholic fatty liver disease. Front Endocrinol (Lausanne). 2019;10:1-9.
- Sublette ME et al. Bipolar disorder and the gut microbiome: A systematic review. Bipolar Disord. 2021.
- Melli LCFL, et al. Intestinal microbiota and allergic diseases: A systematic review. Allergol Immunopathol (Madr). 44(2):177-188.
- Dao MC et al. Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut. 2016;65(3):426-436.
- Yassour M et al. Sub-clinical detection of gut microbial biomarkers of obesity and type 2 diabetes. Genome Med. 2016;8(1):1-14.
- Cani PD et al. Next-generation beneficial microbes: The case of Akkermansia muciniphila. Front Microbiol. 2017;8(SEP):1-8.
- Zhou JC et al. Akkermansia muciniphila: a promising target for the therapy of metabolic syndrome and related diseases. Chin J Nat Med. 2019;17(11):835-841.
- Ndongo S et al. From anaerobes to aerointolerant prokaryotes. Hum Microbiome J. 2020;15:100068.