PROBIOTIC PRODUCTS IN HORSES

Transcription

1 ISAPP Open Forum, London UK, June 26-28, 2007 Royal College of Physicians Development of Probiotic strains for Equine Application Alexander Rodriguez-Palacios,* DVM, MSc, DVSc. DipACVIM - candidate Ontario Veterinary College, University Of Guelph, Canada. *Current Address: Food Animal Health Research Program Preventive Veterinary Medicine The Ohio State University PROBIOTIC PRODUCTS IN HORSES probiotic products are widely available Lactic acid bacteria Yeast cultures Nutritional additives Manufacturers often claim health benefits help to reduce the risk of digestive colic

2 Definition of a Probiotic: Live microorganisms Adequate numbers Health benefits on the host (FAO/WHO, 2001)

3 QUALITY OF VETERINARY PRODUCTS IS QUESTIONABLE In 2002, most products scrutinized had wrong or incomplete information in labels (dose and strains) (Weese, 2002a) In 2002, microbiologic testing of 8 veterinary preparations revealed: Low microbial counts (<2% of CFU claimed, <10 7 ) Isolation of unlisted organisms (Weese, 2002b) QUALITY OF PROBIOTICS RISES CONCENRS: DOSING & EFFICACY Adequate doses are unknown for horses If a person needed per day (Isolauri, 1999, Gupta, 2000) A 500-kg horse would need more than 10 times of the same product (Weese, 2002)

4 Microorganisms used in Probiotics Oral Probiotics in Calf Diarrhea: Clinical Trials, % of studies (11/42): Single micro-organism 73.8% of studies (31/42): Mixture of micro-organisms (Rodriguez-Palacios, 2004) 9 studies: COMMERCIAL PRODUCTS Effect reported in the studies : 55% (+) 40% (No effect) 5% (-) Micro-organisms studied in 42 calf clinical trials 40%= non-specific description Mixed LAB 9 Bifidobacteria 1 Streptococci 1 Yeast 1 Mixed E.coli 1 No reported 3 L. acidophilus 23 L. plantarum 3 L. casei 3 L. gallinarum 2 L. lactis 2 L. jugarti 1 L. bulgaricus 1 S. faecium 4 S. bovis 1 S. lactis 1 S. faecalis 1 S. thermophilus 1 E. faecium 1 Bif. thermophilum 1 Bif. pseudolongum 1 Bacillus cereus 3 Bacillus subtilis 1 Bacillus tojoy 1 Ruminobacter 1 Succinilvibrio 1 Sach. cereviseae 4 (Rodriguez-Palacios, 2004)

5 Probiotics in horses: review of available literature METHODS 1. Search engines: (Last accessed June 17, 2007) - Pubmed & CABabstracts - Google Scholar 2. Criteria for inclusion: (abstract or title) -in-vitro and in vivo studies -horses and probiotics 3. Publications: No restrictions 4. RefWorks: For descriptive quantification (Rodriguez-Palacios, 2007, unpublished) >120 Abstracts reviewed RESULTS 1 - C. difficile 54 Manuscripts s s s Salmonella spp 10 - foals 7 - in vitro 3 - safety 3 - colonization 10 Randomized-blinded placebo- controlled clinical trials No suitable for Meta-analysis

6 1. Randomized-blinded placebo clinical trials: Ref. Objective n/ group Age Length Product Strains Dose Conclusion Art, 1994 Exercise Cardiorespiratory 5 X 2 THB 2-3y 12 weeks BioRacing Daily Increased respiratory coefficients Only during training Parraga, 1997 Salmonella after colic surgery ~46 X 4 >2y Hospital 10d Gel & Paste L. plantarum L. casei L. acidophilus S. faecium /d/3x q/ 48h No effect; Proportional hazard model 20% Salmonella L. acidophilus S. faecium B. thermophilum B. longum Abd-El, 1998 BW Safety 5 X 4 7-8mo 30d lactobacilli 5, 10, 15 g/d 10g/d (pos+) Kim, 2001 Salmonella in all colics ~48 X y Hospital ~7d Gel L. lactis 10 9 E. faecium 10 9 Yeast ml/d/5d 1-9d; median 3d No effect 9% Salmonella Weese, 2003 Colonization Safety 7 X 3 7 X 2 Adult <3d 15d capsules L rham GG / /5d Adults: limited Foals: Adequate Randomized-blinded placebo clinical trials: Ref. Objective n/ group Age Length Preparation Strains dose Conclusion Yuyama, 2004 Diarrhea BW ShortFA 11 X 2 23 X 2 1y foals 14d L equi and 1 novel L. crispatus strain L. Johnsoni L. reuteri L. salivarius (+) for all outcomes Ward, 2004 Salmonella following routine admission ~42 X 2 >6m Hospital 7d gel L. planatrum L. casei L. acidophilus E. faecium 10 8 /d/3x q/48h Claimed reduced RR (Power=0.25) 4% Salmonella CultureLAB= >10 5 Weese, 2005 Neonatal diarrhea ~75 X 2 <2d 14d Freezedried L.pentosus WE7 7d More diarrhea/disease Deroches, 2005 Treatment of enterocolitis 4 safety 7 X 2 Hospital 7d S. cerevisiae subtype boulardii Safe Reduce severity Boensma, 2006, unpub. MCPC Transport N:L, cortisol 6 crossove Pony 14d B. longum Before a.m. B. bifidum meal L. rhamnosus L. salivarius L. plantarum /d/5d before transport No Probiotic detected in feces Intra-individual variability of MCPC

7 LAB overrepresented in the RBPCCTrials But Yeasts are very popular and available Extract Yeast Cultures or Live organisms Quality of produtcs: 1 Product had 10 5 instead 10 7 (Weese, 2003) >10 studies assessing one strain Studies on Yeasts in horses Initially studies supported unlimited digestibility benefits: CLASSICAL INDICATIONS: Increase BW of foals from supplemented mares (Glade, 1991a, Glade, 1991b) Fermentative benefits in vitro (Medina, 2002) BENEFITS only if given with low-quality forage (Morgan, 2007) No studies on therapeutics effects

8 S. cerevisae boulardii Study on hospitalized horses: multiple confounding factors which reduces power Multi-factorial analysis is advised in future studies. Is the oral administration of yeast safe in horses with impaired gastrointestinal mucosa? Common risk factors for systemic or pulmonary mycosis in horses: enteritis and antimicrobial therapy (Tunev 1999, Carrasco 1997, Sweeney, 1999) In humans, the administration of S. boulardii-based probiotics have been associated with cases and outbreaks of fatal fungemia in ICU patients (Lestin, 2003; Munoz, 2005)

9 Direct-fed Microbials, Guaranteed analysis: Microbial Amount Per 10 ml, min. Amount Per 80 ml Tube, min. Aspergillus oryzae 1.41 x 10 5 CFU 1.13 x 10 6 CFU Bacillus subtilus 3.72 x 10 5 CFU 2.98 x 10 6 CFU Mixed Lactic acid bacteria 1.12 x 10 7 CFU 8.96 x 10 7 CFU Saccharomyces cerevisiae 3.56 x 10 6 CFU 2.85 x 10 7 CFU Each tube contains 42.8 grams glucomannans (GM) and mannanoligosaccharides (MOS). Size, milliliters/grams 80 ml / 100 gm Suggested Retail Price CONCLUSIONS Probiotics in horses Most veterinary products may have inacurate labels Microbiologic quality of commercial preparations is of concern 90% (9/10) of RBPCCT have been conducted with commercial preparations mixed untested bacteria A horse-derived promising strain (LP WE7) was associated with a higher risk of neonatal foal diarrhea when tested in 156 foals.

10 CONCLUSIONS Probiotics in horses RBPCCT have proven that commercial preparations did not make significant difference (i.e., Salmonella shedding), or they did not prove that the effect was due to the strains S. cerevisiae might be a promising strain for prevention of grain overload complications, but clinical trials are needed. The lack of scientific evidence is encouraging to conduct more research RECOMMENDATIONS for development of strains in horses SELECTION OF STRAINS: Test strains already in the market Conduct screening studies (including relevant criteria for horses, i.e., diet, risk of laminitis/vasoactive amines) Identify potential associations between LAB and disease/diarrhea and select for it. INDUSTRY-ACADEMIA (Patent issues may be limiting) RPCT with single strains on specific populations and situations Colonization, dosing, safety studies needed Further in vitro characterization Do not conduct more studies using commercial preparations, many confounding factors

11 Thank you!