Articles published in 2019

28 Novembre 2019
DOI: 10.17470/NF-019-0017

Human milk oligosaccharides and the GI microbiota: is there a rationale for the use of HMOs in autism?

Adams CA, Gutiérrez B.
The gastrointestinal (GI) microbiota plays a key role in health and disease. It also has a longdistance effect influencing the brain through the gut–brain axis. The establishment of an effective GI microbiota is associated with human milk oligosaccharides (HMOs). In animal studies there is evidence that HMOs can influence brain activity and cognitive development. This further suggests that management of the GI microbiota by dietary means could impact upon a wide range of diseases. Autism, which is the familiar name for autism spectrum disorder (ASD), comprises a group of heterogeneous neurodevelopmental disorders characterized by social deficits, repetitive and stereotypical behaviours, insistence on routines and communication impairments. GI abnormalities are a characteristic of a substantial number of children with ASD. These children possess a lower overall abundance of beneficial taxa, such as Bifidobacteria and Akkermansia, in the GI microbiota. Many children with ASD have higher counts of potentially pathogenic Clostridia than normally developing children. The underlying pathophysiology of ASD remains unknown although sub-optimal breast-feeding practices are associated with ASD. HMOs selectively promote the growth of Bifidobacteria in the GI tract, which is associated with numerous beneficial health outcomes. There are two potential benefits of HMOs in alleviating autism. Firstly, supplying HMOs to infants though breast-feeding can help establish a functional GI microbiota and thus avoid GI dysbiosis which is commonly related to the onset of autism. Secondly, administration of HMOs may alleviate the symptoms of autism through an effect on the gut–brain axis.
15 Ottobre 2019
DOI: 10.17470/NF-019-0016

Efficacy of polyketide pigment produced by Monascus purpureus and its biological activity

Gajalakshmi P, Raja A, Banu HMV.
Monascus purpureus (MTCC 1090) was obtained from the IMTECH Culture Collection Centre, Chandigarh, India. Extracellular and intracellular polyketide pigment was produced by solidstate fermentation using red rice production and pigments were extracted with methanol solvent. Maximum pigment production was found with intracellular extraction and the total yield of pigment was 41 U/g followed by 33 U/g for extracellular production by substrate fermentation. Crude pigments were separated by column chromatography and an antibacterial study revealed that the yellow pigment was most effective against all test pathogens and the red pigment was found to be a potent antioxidant. The greatest antagonistic activity was almost 91% against Trichophyton rubrum followed by 88% against Microsporum canis.
26 Settembre 2019
DOI: 10.17470/NF-019-0015

Retrospective analysis of the effects of a gum gel intended to treat signs and symptoms of teething in infants

Di Pierro F, Risso P, Bertuccioli A, Donato G.
Teething discomfort is a widespread disorder affecting a very high percentage of infants. It creates anxiety in parents, who look for help in paediatric clinics. The use of hyaluronic acid gels has been shown in the last 20 years to be an effective tool, generally devoid of side effects, in reducing oral mucosal inflammation in adults. Recently, such results have also been confirmed in infants affected by teething. From our routine practice results, we have retrospectively reported the efficacy and the safety profile of Bonjela® Soothing Teething Gel, a teething gel capable of addressing in a significant way this infant complaint, which improves all of the clinical outcomes used in these types of study to describe the clinical condition of infants.
20 Settembre 2019
DOI: 10.17470/NF-019-0014

Clinical evaluation of a hyaluronic acid-based medical device in counteracting aphthous stomatitis in adults

Di Pierro F, Giuberti R, Risso P, Bertuccioli A.
Oral mucosal ulcers are quite common in an otherwise healthy population, and can determine a real worsening of the quality of life. Conventional therapy is not appropriate since ulcers often recur and, even if not needed, therapy lasting not less than 2–3 weeks carries a high risk of serious side effects. The use of hyaluronic acid applied as an adhesive gel over the lesions seems to have potential in terms of efficacy and the avoidance of side effects. Of course, hyaluronic acid-based formulations show different effects and tolerability. In our study, we retrospectively report the results obtained using a medical device, Bloxaphte®, applied for 14 days to counteract ulcers in adults. Our data clearly demonstrate the healing capability and safety profile of the product in reducing the number and size of the ulcers within the first week of daily application.
16 Settembre 2019
DOI: 10.17470/NF-019-0013

Analgesic effects of RodeMyr®, a Commiphora molmol extract with a highly standardized furanodiene content

Di Pierro F, Bertuccioli A, Giuberti R.
Furanoeudesma-1,3-diene, curzerene and lindestrene are thought to be the active principles underlying the analgesic action of myrrh (Commiphora molmol) extract. Recently, a very highly standardized dry extract from myrrh has been developed (RodeMyr®) and formulated in a single active nutritional supplement (Mirra+®), notified to the Italian Health Authorities in 2018. We have therefore used such a finished product to evaluate the analgesic action of myrrh in subjects affected by chronic pain. The results of the study have shown that the use of 100 mg of dry myrrh extract, administered twice a day, is effective in reducing pain perception and functio laesa both as a sole and an add-on therapy. Tolerability, compliance and side effect evaluation demonstrated the safety profile of the extract and its usefulness in treating patients with chronic pain.
16 Settembre 2019
DOI: 10.17470/NF-019-0012

Antibiotic resistance profile and adhesion properties of Lactobacillus crispatus M247

Di Pierro F, Bertuccioli A, Sagheddu V, Cattivelli D, Soldi S, Elli M.
In an attempt to better characterize the strain M247, a strain of Lactobacillus crispatus isolated in 1989 from the faeces of a healthy newborn baby, we have further investigated its antibiotic resistance profile, evaluating also antibiotics not recommended by the EFSA, and analyzing in addition its viability in the presence of a high concentration of boric acid, a molecule commonly use to eradicate antimycotic-resistant fungi from the vagina. At the same time, we have evaluated the ability of M247 to adhere to vaginal epithelial cells to get a better understanding of its vaginal colonizing properties. According to the obtained results, M247 appears to be insensitive to metronidazole, sulfamethoxazole and boric acid. Such resistance is not transferrable due to the total absence of mobile elements inside its genome. Moreover, the M247 strain has been shown to adhere by more than 70% to vaginal epithelial cells, thereby providing a mechanistic explanation of its vaginal colonizing capabilities observed both after local and oral use.
28 Agosto 2019
DOI: 10.17470/NF-019-0011

Streptococcus salivarius K12 in pharyngotonsillitis and acute otitis media – a meta-analysis

Bertuccioli A, Rocchi M, Morganti I, Vici G, Gervasi M, Amatori S, Sisti D.
The oral administration of Streptococcus salivarius K12 represents a valid solution for the prevention of pharyngitis or pharyngotonsillitis, of bacterial or viral origin, and/or acute otitis media. In particular, this could be an interesting alternative to antibiotic prophylaxis in patients with relapse or disease recurrence. In this regard, the studies published in the scientific literature are limited, and thus, it was of interest to provide a meta-analysis in order to analyze in more detail the results obtained in this research field. For the meta-analysis, clinical studies were selected, as identified through PubMed, which examined the relationship between the use of formulations based on Streptococcus salivarius K12 and the number of cases or episodes of pharyngitis or pharyngotonsillitis, of bacterial or viral origin, and acute otitis media in children and adults. The effect size (ES) was calculated according to Cohen using the fixed effects model (fixed effects). Seven studies met the predefined inclusion criteria and they were included in the meta-analysis. ES values equal to -1.40 [-1.67; -1.13] and -1.01 [-1.19; -0.83] were obtained for the effect of Streptococcus salivarius K12 on the prevention of pharyngitis and acute otitis media, respectively. Both values were translated into a "big effect" according to Cohen's scale. Treatment based on this strain is effective for both the prevention of pharyngitis and acute otitis media. In addition, it is further revealed that the strain is more effective in the prevention of pharyngitis. It is desirable that further clinical investigation continues to expand and update the meta-analysis work and to recommend the use of the strain as a useful prophylactic tool to reduce the events of pharyngotonsillitis and acute otitis media.
24 Giugno 2019
DOI: 10.17470/NF-019-0010

Comprehensive review of the impact of modification on the properties of jackfruit seed starch and its applications

Kushwaha R, Singh V, Kaur D.
Jackfruit belongs to the family Moraceae and is used as a novel source of starch. In the native stage, starch granules are generally insoluble at room temperature, extremely resistant to enzymatic hydrolysis and display an inability to endure processing conditions related to pH, temperature, shear rate and freeze–thawing. Modification can be carried out using chemical, physical or enzymatic methods, or a combination of these. To solve this problem, modification of starches is usually conducted to alter pasting, gelatinization and retrogradation behavior. Modified starches have been recognized as a multifunctional excipient in various industries. This review covers a wide array of topics relating to starch, including: methods of modification; the impact of modification on morphology, crystallinity, viscosity and functionality; and the application of modified starch.
21 Giugno 2019
DOI: 10.17470/NF-019-0009

Efficacy of an oral supplement containing hyaluronic acid, collagen, glucosamine sulfate, chondroitin sulfate, alpha-lipoic acid, methylsulfonylmethane and vitamins on vaginal dryness in young women

Angelucci M, Frascani F, Garo ML.
This study evaluated the oral administration of a new supplement containing a combination of bioactive agents (hyaluronic acid, glucosamine sulfate, chondroitin sulfate, alpha-lipoic acid, methylsulfonylmethane and vitamins A, C and E). The objective of the study was to demonstrate that the oral administration of this product combats vulvovaginal atrophy in young women. This observational study recruited 32 women of fertile age with vaginal dryness, post-coital cystitis and/or dyspareunia (painful intercourse). Patients were evaluated using the VHI scale and the FSFI at baseline and at each follow-up. All patients took one tablet of the supplement twice daily (morning and evening) for two months. After two months, 28 patients (87%) showed an improvement in symptoms and reported complete remission. At the first follow-up at three months, that is, one month after stopping treatment, no substantial changes were reported. At the second follow-up at four months, that is, two months after stopping treatment, vaginal dryness had recurred, and patients were asked to re-start the therapy. We can conclude that this product is highly effective in young women suffering from vaginal dryness and sexual dysfunction caused by oxidative stress.
17 Giugno 2019
DOI: 10.17470/NF-019-0008

Probiotics – a final countdown for caries

Janczarek M.
The development of contemporary knowledge in the field of oral microbiology and probiotics was commenced by Elie Metchnikoff's report on Lactobacillus bulgaricus in 1907. Since then, multiple indications for the use of probiotics have been established, following the WHO definition: "probiotics are live microorganisms, which when applied in adequate amount may benefit the host health status". In accordance with a general classification, several types of bacteria and fungi have been distinguished and, moreover, their mechanisms of action run parallel in both the gut and oral cavity. The possible use of probiotics in dentistry is a relatively new idea. Until now, three species prevailed in available research: Bifidobacterium, Lactobacillus rhamnosus GG and Lactobacillus reuteri. Current research focuses on the application of probiotics and the natural displacement of cariogenic bacteria within the oral cavity, and the subsequent alteration of health status in both adults and children. Carioblis BLIS M18 probiotic, which contains freeze-dried cultures of Streptococcus salivarius M18, was introduced to the market as a supplement indicated for patients with a high caries rate. The aim of this study was to investigate the influence of the BLIS M18 strain on oral cavity microflora and estimate possible health outcomes.
28 Maggio 2019
DOI: 10.17470/NF-019-0007

Food neophobia status in Ardabil children

Mohajeri M, Barzegar A, Nemati A.
Food neophobia means not accepting a new food, which seems to be a protective mechanism against new foods. The aim of this study was to assess the food neophobia status in Ardabil children. The present study was a cross-sectional study to assess the situation of children's disgust at two to six years of age in households in Ardabil. A questionnaire relating to five main food groups was used to assess the type of food that was hated. A questionnaire containing four questions was completed to check the factors affecting food neophobia. The results of the study showed that 52.5% (95% confidence interval) of the children were suffering from food neophobia. The children in the study felt more disgusted about dairy products and vegetables. Parents have stated that their children refuse to eat fruit and vegetables. More than half of the children were suffering from food neophobia and the socioeconomic status of parents, parental employment and the type of child feeding before the age of two were among the factors influencing the disgust of children in the study.
24 Maggio 2019
DOI: 10.17470/NF-019-0006

The cardiometabolic risk: a new concept for old diseases

Derosa G, Maffioli P.
Among the most important risk factors for cardiometabolic disease, hypertension, hypercholesterolaemia and diabetes mellitus play a main role; these chronic diseases are involved in creating huge health expenditure, with respect to both clinical–instrumental analysis and from a pharmacological point of view. An earlier stage of these diseases is the pre-risk (Fig. 1), a condition that, if not properly recognized and treated, can progress to the documented risk. We will talk about pre-hypertension, hypercholesterolaemia in primary prevention and dysglycaemia.
21 Maggio 2019
DOI: 10.17470/NF-019-0005

Bioavailability of menaquinone-7 in milk formulation. Comparison of different solubilization techniques

Cirilli I, Orlando P, Silvestri S, Marcheggiani F, Tiano L.
Menaquinone-7 (MK-7) is a type of vitamin K of fermentative origin that plays a key role in cardiovascular and bone health as a cofactor of gamma-glutamyl carboxylase enabling the activation of several vitamin K-dependent proteins, particularly at the extrahepatic level. Despite its proven biological efficacy and outstanding bioavailability over other dietary menaquinones, its presence in food is marginal, especially in the Western diet. Dairy products are a major dietary source of menaquinones of minor biological relevance for human health and constitute optimal carriers due to their lipid content. Dairy fortification with MK-7 represents an attractive formulative strategy, also for the high calcium and vitamin D content that may act synergistically in promoting vitamin K-dependent functions. However, limited solubility of MK-7 in aqueous solution may limit its use and affect its bioavailability in vivo. The present study compares the bioavailability of MK-7 in enriched 1%-fat milk either as a direct powder solution or a pre-emulsified dispersion. Bioavailability data show that formulation strategies strongly affect the bioavailability of MK-7 and that the results are greatly improved when it is prepared as an oil–water emulsion.
16 Maggio 2019
DOI: 10.17470/NF-019-0004

A comparison of in-field fat mass evaluation techniques: a practical perspective

Bertuccioli A, Vici G, Ceci R, Cesanelli L, Belli L, Polzonetti V.
Nutritional status assessment of the individual is a key aspect in the monitoring of health status. In this context, body composition evaluation results are of fundamental importance. Several body composition techniques can be used depending on the information needed and the examined categories, and all the techniques are characterized by advantages and disadvantages. In this regard, this study aims to evaluate and compare the most commonly used techniques to evaluate body fat mass percentages in different situations. Fifty subjects took part in the study. Anthropometric data were collected and the percentage of fat mass was estimated using three different techniques: circumference, skinfold and ultrasound. Correlation strength among techniques was evaluated and the level of agreement among techniques was determined. Inferential analysis was performed and the percentage error of each technique for each individual was calculated. Correlation analysis revealed a stronger coefficient between skinfold and ultrasounds than between skinfold and circumferences (respectively, r=0.932 and r=0.686). Delta fat mass percentages were similar, approximately 5%, both when considering skinfold–ultrasound and skinfold–circumference. Stratifying the population by gender, it was observed that the correlation is worse in women than in men. In the case of stratification by BMI, in the ‘Obese’ grouping, the correlation coefficient was small, independent of the technique. Comparing these techniques has highlighted some critical features of single methods, especially considering specific target populations. This highlights the importance of the use of coupled techniques or the inadequacy of one with respect to another for particular categories.
16 Maggio 2019
DOI: 10.17470/NF-019-0003

Enterococcus as probiotics: what is the advantage?

Suvorov AN, Ermolenko EI, Alechina G, Chernysh A, Karaseva A, Di Pierro F.
Enterococcus is a genus of lactic acid bacteria which normally colonize the intestines of mammals including humans [1]. Enterococci are among the first bacterial colonizers after birth and are able to proliferate in both the large and the small intestine. Enterococcus faecium and Enterococcus faecalis are the most common species of enterococcus found in human feces. However, enterococci can also cause serious infection including sepsis, pneumonia, ophthalmitis, nephritis and osteomyelitis, mainly as complications of various chronic conditions associated with intestinal dysbiosis such as cancer, AIDS or chronic renal failure [2]. Most clinical strains of enterococci belong to the two species E. faecium and E. faecalis, with vancomycin-resistant enterococcal strains (VRE) being the most common cause of lethal infection. Several virulence genes have been discovered in enterococci, allowing the identification of potentially hazardous strains [3]. At the same time, enterococci have a long history, being used as starters for making fermented food products from meat, milk or vegetables [4]. Many enterococcal strains (SF68, M74, LX, etc.) from that group of probiotic strains have been used for a long time as clinically effective probiotics. The current paper summarizes the probiotic effects of one Enterococcus faecium strain—E. faecium L3. This strain was originally isolated from starter culture used in the Russian food industry. The strain was fully characterized microbiologically and genetically and tested for the absence of virulence genes, safety in laboratory animals and it immunomodulatory features. E. faecium L3 has been used in Russia in several probiotic products such as Laminolakt and Bakfir for the last 20 years. The benefits of the strain have been shown in several randomized clinical studies, including some where it was used for the treatment of gastrointestinal diseases such as chronic gastritis, gastric ulcers, irritable bowel syndrome, pancreatitis and chronic hepatitis [5– 7]. In addition to other clinical effects such as anti-cancer properties, a significant cholesterol-lowering activity was also shown [8].
9 Maggio 2019
DOI: 10.17470/NF-019-0002

Association of socioeconomic gradients with obesity in children

Mohajeri M, Barzegar A, Nemati A.
The objective of this study was to determine the influence of socioeconomic status on the body mass index (BMI) of primary school children. A cross-sectional study was conducted with a sample of 280 children aged 6 to 11 years allocated to three groups based on BMI: underweight, ideal weight and overweight/obesity. Socioeconomic status was determined based on the responses of parents/caregivers to a specific form. Data analysis involved the employment of the Kruskal–Wallis, Mann–Whitney U and chi-square tests as well as simple and multiple linear regression analyses. In the final multiple regression model, BMI was influenced by monthly household income (coef=0.223; CI: 1.014 to 1.503). Children from families with a higher monthly income had a higher BMI.
9 Maggio 2019
DOI: 10.17470/NF-019-0001

The protective effect of Enterococcus faecium L-3 in experimental allergic encephalomyelitis in rats is dose-dependent

Abdurasulova IN, Matsulevich AV, Kirik OV, Tarasova EA, Ermolenko EI, Korzevskii DE, Klimenko VM, Di Pierro F, Suvorov AN.
Recent data demonstrate that disruption of the intestinal microbiocoenosis might be the cause of several neurological diseases, including multiple sclerosis (MS). MS is a chronic disease of the central nervous system, where the nervous tissue is damaged by the individual's own immune system. The autoimmune character of MS is largely supported by the positive effects of treatment aimed at suppressing the activity of aggressive immune cells. Since probiotics have an immunomodulatory effect, they can not only correct dysbiosis, but also provide a complex immunomodulatory effect on MS. Enterococcus faecium L-3 is one of the probiotic strains which has been shown to have a protective effect on the course of the disease induced in the animal model of MS (known as experimental allergic encephalomyelitis; EAE). The purpose of this study was to compare the effects of different doses of E. faecium L-3 on the course of EAE in rats. EAE was induced by a single subcutaneous injection of a homologous spinal cord emulsified into complete Freund's adjuvant. It is shown that the extent of the protective action of E. faecium L-3 depends on the dose used, with the greatest effect on reducing the severity of EAE observed with a dose of 8.0 lg CFU/ml. Amelioration of the course of EAE in rats receiving the probiotic was accompanied by decreased inflammation and reduced damage to neurons in the spinal cord. Research shows that the use of E. faecium L-3 at an optimum concentration of bacteria may be beneficial for patients with MS.