Probiyotiklerin Genel Özellikleri ve Sağlık Üzerine Etkileri

Abstract

Kelime anlamı olarak “yaşam için” anlamına gelen probiyotikler, bağırsaklardaki mikrobiyal dengeyi düzenleyen canlı mikroorganizmalardır. Tarihte probiyotikler sağlığa olan yararlı etkilerinden dolayı içeriği ve işlevi bilinmeden tüketilmiştir. Probiyotik konusunda 20. yüzyılın başlarında Elie Metchnikoff’un Bulgar halkı üzerinde yaptığı çalışma dönüm noktası olmuştur. Çalışmasında uzun yaşam süresi ile fermente süt tüketimi arasında ilişki kurmuş ve laktik asit bakterilerin varlığından bahsetmiştir. Günümüze kadar olan süreçte yapılan bilimsel çalışmalarda probiyotiklerin; enfeksiyonlar, inflamatuar bağırsak hastalıkları, laktoz intoleransı, kanser, yüksek kolesterol, diyabet ve obezite gibi sağlık sorunlarına karşı fayda sağlayabileceği gösterilmektedir. Ancak probiyotiklerin faydalı etkisinin görülmediği, hatta bazı yan etkilerinin görüldüğü çalışmalar da mevcuttur. Bu etkileri; probiyotiklerin türü, kullanılan suşu, dozu ve veriliş yoluna göre değişkenlik gösterebilmesinden dolayı genelleme yapmak oldukça güçtür. Özellikle de yapılan çalışmaların klinik ve metodolojik farklılıklar bulunması etkinlik konusunda kesinlikten söz edebilmeyi daha da zorlaştırmaktadır. Bu bakımdan probiyotiklerin tür ve kullanılan suş özelliklerine göre uygun klinik ve metodolojik yöntemler kullanılarak daha kapsamlı çalışmalara ihtiyaç olduğu düşünülmektedir. Bu derlemede; probiyotiklerin genel özellikleri ve kapsamı oldukça geniş bir alan olan sağlığa etkileriyle ilgili yapılan çalışmalar özetlenmiştir.

Keywords

• Sağlık
• beslenme
• probiyotikler

Supporting Institution

Destekleyen herhangi bir kurum/kuruluş bulunmamaktadır.

Project Number

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Thanks

Bu derlemede emeği geçen tüm yazarlara teşekkür ederiz.

General Properties of Probiotics and Effects on Health

Abstract

Probiotics, which literally means for life, are live microorganisms that regulate the microbial balance in the intestines. In history, probiotics have been consumed without knowing their content and function due to their beneficial effects on health. On the subject of probiotics, Elie Metchnikoff's work on the Bulgarian people at the early 20th century was a turning point. In his study, he established a relationship between longevity and fermented milk consumption and mentioned the presence of lactic acid bacteria. In the scientific studies carried out until today, probiotics; It has been shown that it can benefit health problems such as infections, inflammatory bowel diseases, lactose intolerance, cancer, high cholesterol, diabetes and obesity. However, there are also studies in which the beneficial effect of probiotics is not observed and even some side effects are seen. It is very difficult to generalize these effects, as probiotics can vary depending on the type, strain used, dose and route of administration. In particular, the clinical and methodological differences in the studies made make it more difficult to talk about efficacy with certainty. In this respect, it is thought that more comprehensive studies are needed by using appropriate clinical and methodological methods according to the species and strain characteristics of probiotics. In this review; Studies on the general properties of probiotics and their effects on health, which is a very wide area, are summarized.

Keywords

• health
• nutrition
• probiotics

Project Number

Herhangi bir proje numarası bulunmamaktadır.

References

1. Ağca, G., Yalçın, E. ve Göktaş, Z. (2019). İrritabl bağırsak sendromu ve fonksiyonel dispepsi tedavisinde probiyotikler ve prebiyotikler. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(2), 178-191. https://doi.org/10.21020/husbfd.437227
2. Akal, C. ve Yetişmeyen, A. (2020). Probiyotik ve prebiyotik tüketiminin laktoz intoleransı üzerine etkileri. Gıda, 45(2), 380-389. https://doi.org/10.15237/gida.GD20016
3. Akdeniz, V., Özer, E. ve Akalın, A. S. (2018). Helicobacter pylori enfeksiyonunda probiyotiklerin rolü. Gıda, 43(6), 943-956. https://doi.org/10.15237/gida.GD18062
4. Akpınar, A., Akalın, A. S. ve Uysal, H. R. (2013). Probiyotiklerin atopik dermatit üzerine etkisi. Akademik Gıda, 11(1), 83-87.
5. Akpınar, D.D. ve Türköz, B.K. (2019). Probiyotik- insan bağışıklık sistemi etkileşimleri. Food and Health, 5(4) 265-280. https://doi.org/10.3153/FH19027
6. Allen, S. J., Martinez, E. G., Gregorio, G. V. and Dans, L. F. (2010). Probiotics for treating acute infectious diarrhoea. The Cochrane Database of Systematic Reviews, 2010(11). https://doi.org/10.1002/14651858.CD003048.pub3
7. Almeida, C. C., Lorena, S. L. S., Pavan, C. R., Akasaka, H. M. I. and Mesquita, M. A. (2012). Beneficial effects of long-term consumption of a probiotic combination of Lactobacillus casei Shirota and Bifidobacterium breve Yakult may persist after suspension of therapy in lactose-intolerant patients. Nutrition in Clinical Practice, 27(2), 247-251. https://doi.org/10.1177/0884533612440289
8. Arslan, N. (2014). İrritabl barsak sendromunda prebiyotik ve probiyotiklerin kullanımı. Kara A, Çoşkun T (Ed.), Teoriden kliniğe prebiyotikler probiyotikler içinde (ss. 257–271). İstanbul: Akademi Yayınevi.

9. Ayvaz, D.Ç. ve Tezcan, İ. Probiyotik-prebiyotik ve mukozal immün sistem. Kara A, Çoşkun T (Ed.), Teoriden kliniğe prebiyotikler probiyotikler içinde (ss. 88–105). İstanbul: Akademi Yayınevi.
10. Bakır, B. O. (2012). Prebiyotik, probiyotik ve sinbiyotiklere genel bakış. Beslenme ve Diyet Dergisi, 40(2), 178-182. Balkış, M. (2011). Lise öğrencilerinin beslenme alışkanlıkları, probiyotik süt ürünleri tüketim sıklıkları ve bilgilerinin belirlenmesi: Kulu örneği. Selçuk Üniversitesi Sosyal Bilimler Enstitüsü, Konya.
11. Besselink, M. G. and Van Santvoort, H. C. Buskens E., et al. (2009). Probiotic prophylaxis in predicted severe acute pancreatitis: A randomized, double-blind, placebo- controlled trial. Journal of Parenteral and Enteral Nutrition, 33(4), 444-446.
12. Borgeraas, H., Johnson, L. K., Skattebu, J., Hertel, J. K. and Hjelmesaeth, J. (2018). Effects of probiotics on body weight, body mass index, fat mass and fat percentage in subjects with overweight or obesity: A systematic review and meta-analysis of randomized controlled trials. Obesity Reviews, 19(2), 219–232. https://doi.org/10.1111/obr.12626
13. Bozkurt, H. ve Aslım, B. (2004). İmmobilizasyonun probiyotik kültürlerde kullanımı. Orlab On-Line Mikrobiyoloji Dergisi, 2(7), 1-14.
14. Cabana, M. D., McKean, M., Caughey, A. B., Fong, L., Lynch, S., Wong, A., Leong, R., Boushey, H. A. and Hilton, J. F. (2017). Early probiotic supplementation for eczema and asthma prevention: a randomized controlled trial. pediatrics, 140(3), e20163000. https://doi.org/10.1542/peds.2016-3000
15. Ceyhan, N. ve Alıç, H. (2012). Bağırsak mikroflorası ve probiyotikler. Türk Bilimsel Derlemeler Dergisi, 5(1), 107-113.
16. Chitapanarux, I., Chitapanarux, T., Traisathit, P., Kudumpee, S., Tharavichitkul, E. and Lorvidhaya, V. (2010). Randomized controlled trial of live Lactobacillus acidophilus plus Bifidobacterium bifidum in prophylaxis of diarrhea during radiotherapy in cervical cancer patients. Radiation Oncology, 5(31). https://doi.org/10.1186/1748-717X-5-31
17. Chiu, H. F., Fang, C. Y., Shen, Y. C., Venkatakrishnan, K. and Wang, C. K. (2021). Efficacy of probiotic milk formula on blood lipid and ıntestinal function in mild hypercholesterolemic volunteers: A placebo-control, randomized clinical trial. Probiotics and Antimicrobial Proteins, 13(3), 624–632. https://doi.org/10.1007/s12602-020-09728-6
18. Choi, C. H., Jo, S. Y., Park, H. J., Chang, S. K., Byeon, J. S. and Myung, S. J. (2011). A randomized, double-blind, placebo-controlled multicenter trial of Saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. Journal of Clinical Gastroenterology, 45(8), 679–683. https://doi.org/10.1097/MCG.0b013e318204593e
19. Coşkun, T. (2006). Pro-, pre- ve sinbiyotikler. Çocuk Sağlığı ve Hastalıkları Dergisi, 49(2), 128-148.
20. Çatak, J., Demirci, A. ve Yaman, M. (2021). Besin alerjileri ve mikrobiyota. Avrupa Bilim ve Teknoloji Dergisi, (27), 902-910. https://doi.org/10.31590/ejosat.932606
21. Çetin, A. R., Karabekiroğlu, S. ve Ünlü, N. (2011). Probiyotikler ve ağız sağlığına etkileri. Süleyman Demirel Üniv Diş Hek Fak Derg, 3(1), 19-29.
22. Çetinbaş, S., Kemeriz, F., Göker, G., Biçer, İ. ve Velioğlu, Y. S. (2017). İnsan mikrobiyomu: Beslenme ve sağlık üzerindeki etkileri. Akademik Gıda, 15(4), 409-415. https://doi.org/10.24323/akademik-gida.370267
23. Çevik, B. A. ve Pirinçci, E. (2017). Beslenme ve kanser. Firat Tip Dergisi, 22(1).
24. Çoşkun, T. (2014). Probiyotikler. Kara A, Çoşkun T (Ed.), Teoriden kliniğe prebiyotikler probiyotikler içinde (ss. 56–70). İstanbul: Akademi Yayınevi.
25. Dai, M., Lu, J., Wang, Y., Liu, Z. and Yuan, Z. (2012). In vitro development and transfer of resistance to chlortetracycline in Bacillus subtilis. J Microbiol, 50(5), 807-812. https://doi.org/10.1007/s12275-012-1454-5
26. Déchelotte, P., Breton, J., Trotin-Picolo, C., Grube, B., Erlenbeck, C., Bothe, G., Fetissov, S. O. and Lambert, G. (2021). The probiotic strain H. alvei HA4597® ımproves weight loss in overweight subjects under moderate hypocaloric diet: a proof-of-concept, multicenter randomized, double-blind placebo-controlled study. Nutrients, 13(6), 1902. https://doi.org/10.3390/nu13061902
27. Depommier, C., Everard, A., Druart, C., Plovier, H., Van Hul, M., Vieira-Silva, S., Falony, G., Raes, J., Maiter, D., Delzenne, N. M., de Barsy, M., Loumaye, A., Hermans, M. P., Thissen, J. P., de Vos, W. M. and Cani, P. D. (2019). Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study. Nature Medicine, 25(7), 1096–1103. https://doi.org/10.1038/s41591-019-0495-2
28. Derin, D. Ö. ve Keskin, S. (2013). Gıda mühendisliği öğrencilerinin probiyotik ürün tüketim durumlarının belirlenmesi: Ege Üniversitesi Örneği. Gıda, 38(4), 215-222.
29. Dhillon, P., Singh, K. and Kaur, K. (2020). The benefits of probiotic interventions in maternal-fetal health: An appraise review. PharmaNutrition, 13. 10.1016/j.phanu.2020.100211
30. Drago, L., Iemoli, E., Rodighiero, V., Nicola, L., De Vecchi, E. and Piconi, S. (2011). Effects of Lactobacillus salivarius LS01 (DSM 22775) treatment on adult atopic dermatitis: A randomized placebo-controlled study. Int. J. Immunopathol. Pharrnacol, 24(4), 1037-1048. https://doi.org/10.1177/039463201102400421
31. Ejtahed, H. S., Mohtadi-Nia, J., Homayouni-Rad, A., Niafar, M., Asghari-Jafarabadi, M. and Mofid, V. (2012). Probiotic yogurt improves antioxidant status in type 2 diabetic patients. Nutrition, 28(5), 539–543. https://doi.org/10.1016/j.nut.2011.08.013 Feizollahzadeh, S., Ghiasvand, R., Rezaei, A., Khanahmad, H., Sadeghi, A. and Hariri, M. (2017). Effect of probiotic soy milk on serum levels of adiponectin, ınflammatory mediators, lipid profile, and fasting blood glucose among patients with type II diabetes mellitus. Probiotics and Antimicrobial Proteins, 9(1), 41–47. https://doi.org/10.1007/s12602-016-9233-y
32. Feyisetan, O., Tracey, C. and Hellawell, G. O. (2012). Probiotics, dendritic cells and bladder cancer. BJU International, 109(11), 1594–1597. https://doi.org/10.1111/j.1464-410X.2011.10749.x
33. Fırıncıoğulları, B. ve Öner, Z. (2022). Kolesterol düşürücü etkilere sahip Lactobacillus spp. suşlarının peynirde başlatıcı kültür olarak kullanımı. GIDA, 47(2), 266-276. https://doi.org/10.15237/gida.GD21141
34. Ganguli, K., Collado, M. C., Rautava, J., Lu, L., Satokari, R., von Ossowski, I., Reunanen, J., de Vos, W. M., Palva, A., Isolauri, E., Salminen, S., Walker, W. A. and Rautava, S. (2015). Lactobacillus rhamnosus GG and its SpaC pilus adhesin modulate inflammatory responsiveness and TLR-related gene expression in the fetal human gut. Pediatric Research, 77(4), 528–535. https://doi.org/10.1038/pr.2015.5
35. Gibson, G., Scott, K., Rastall, R., Tuohy, K., Hotchkiss, A., Dubert-Ferrandon, A., Gareau, M., Murphy, E., Saulnier, D., Loh, G., Macfarlane, S., Delzenne, N., Ringel, Y., Kozianowski, G., Dickmann, R., Lenoir-Wijnkoop, I., Walker, C. and Buddington, R. (2010). Dietary prebiotics: Current status and new definition. Food Science and Technology Bulletin: Functional Foods, 7, 1–19. https://doi.org/10.1616/1476-2137.15880
36. Giovannini, M., Agostoni, C., Riva, E., Salvini, F., Ruscitto, A., Zuccotti, G. V. and Radaelli, G. A. (2007). Randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis. Pediatric Research, 62(2), 215-220. https://doi.org/10.1203/pdr.0b013e3180a76d94
37. Goldenberg, J. Z., Ma, S. S. Y., Saxton, J. D., Martzen, M. R., Vandvik, P. O., Thorlund, K., Guyatt, G. H. and Johnston, B. C. (2013). Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews, (5), 1-101. https://doi.org/10.1002/14651858.cd006095.pub3
38. Guslandi, M., Giollo, P. and Testoni, P. A. (2003). A pilot trial of Saccharomyces boulardii in ulcerative colitis. Eur J Gastroenterol Hepatol, 15 (6), 697-698. https://doi.org/10.1097/00042737-200306000-00017
39. Guslandi, M., Mezzi, G., Sorghi, M. and Testoni, P. A. (2000). Saccharomyces boulardii in maintenance treatment of Crohn’s disease. Digestive Diseases and Sciences, 45(7), 1462-1464. https://doi.org/10.1023/a:1005588911207 Gülbandilar, A., Okur, M. ve Dönmez, M. (2017). Fonksiyonel gıda olarak kullanılan probiyotikler ve özellikleri. Türk Bilimsel Derlemeler Dergisi, 10(1), 44-47.
40. Hakyemez, İ.N., Şimşek F., Yıldırmak T., Yöntem, B., Aksu, A. (2012). Antibiyotik ilişkili ishal olgularının değerlendirilmesi. Abant Tıp Dergisi, 1(1), 16-17.
41. Hajare, S. T. and Bekele, G. (2017). Effect of probiotic strain Lactobacillus acidophilus (LBKV-3) on fecal residual lactase activity in undernourished children below 10 years. Journal of Immunoassay & Immunochemistry, 38(6), 620–628. https://doi.org/10.1080/15321819.2017.1372475
42. Hamilton-Miller, J. M. (2004). Probiotics and prebiotics in the elderly. Postgraduate Medical Journal, 80(946), 447–451. https://doi.org/10.1136/pgmj.2003.015339
43. Hatakka, K., Ahola, A. J., Yli-Knuuttila, H., Richardson, M., Poussa, T., Meurman, J. H. and Korpela, R. (2007). Probiotics reduce the prevalence of oral Candida in the elderly a randomized controlled trial. J Dent Res, 86(2), 125-130. https://doi.org/10.1177/154405910708600204
44. Hatakka, K., Mutanen, M., Holma, R., Saxelin, M. and Korpela, R. (2008). Lactobacillus rhamnosus LC705 together with Propionibacterium freudenreichii ssp shermanii JS administered in capsules is ineffective in lowering serum lipids. Journal of the American College of Nutrition, 27(4), 441–447. https://doi.org/10.1080/07315724.2008.10719723
45. Hong, K. S., Kang, H. W., Im, J. P., Ji, G. E., Kim, S. G., Jung, H. C., Song, I. S. and Kim, J. S. (2009). Effect of probiotics on symptoms in korean adults with irritable bowel syndrome. Gut and Liver, 3(2), 101–107. https://doi.org/10.5009/gnl.2009.3.2.101
46. Ishikawa, H., Akedo, I., Otani, T., Suzuki, T., Nakamura, T., Takeyama, I., Ishiguro, S., Miyaoka, E., Sobue, T. and Kakizoe, T. (2005). Randomized trial of dietary fiber and Lactobacillus casei administration for prevention of colorectal tumors. Int. J. Cancer, 116(5), 762-767. https://doi.org/10.1002/ijc.21115
47. Ishikawa, H., Akedo, I., Otani, T., Umesaki, Y., Tanaka, R. and Imaoka, A. (2003). Randomized controlled trial of the effect of Bifidobacteria-fermented milk on Ulcerative Colitis. Journal of the American College of Nutrition, 22(1), 56-63. https://doi.org/10.1080/07315724.2003.10719276
48. Iwamoto, T., Suzuki, N., Tanabe, K., Takeshita, T. and Hirofuji, T. (2010). Effects of probiotic Lactobacillus salivarius WB21 on halitosis and oral health: An open-label pilot trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 110(2), 201-208. https://doi.org/10.1016/j.tripleo.2010.03.032
49. İmamlı, H. ve Akça, F. (2018). Probiyotik kullanımının sağlığa ve sportif performansa etkileri. Spormetre, 16(2), 196-208. https://doi.org/10.1501/Sporm_0000000365
50. İnanç, N., Şahin, H. ve Çiçek, B. (2005). Probiyotik ve prebiyotiklerin sağlık üzerine etkileri. Erciyes Tip Dergisi, 27(3), 122-127.
51. Kadooka, Y., Sato, M., Imaizumi, K., Ogawa, A., Ikuyama, K., Akai, Y., Okano, M., Kagoshima, M. and Tsuchida, T. (2010). Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial. Eur J Clin Nutr, 64(6), 636-643. https://doi.org/10.1038/ejcn.2010.19 Kamarlı, H. (2019). Pre-probiyotikler ve diyabet. Beslenme ve Diyet Dergisi, 47, 92-101.
52. Kang, E. J., Kim, S. Y., Hwang, I. H. and Ji, Y. J. (2013). The effect of probiotics on prevention of common cold: a meta-analysis of randomized controlled trial studies. Korean Journal of Family Medicine, 34(1), 2–10. https://doi.org/10.4082/kjfm.2013.34.1.2
53. Kara, A. (2014). Antibiyotik İlişkili İshal. Kara A, Çoşkun T (Ed.), Teoriden kliniğe prebiyotikler probiyotikler içinde (ss. 161–165). İstanbul: Akademi Yayınevi.
54. Karatay, E. (2019). Mikrobiyota, probiyotik ve prebiyotikler. Anadolu Güncel Tıp Derg, 1(3), 68-71. https://doi.org/10.38053/agtd.529392
55. Kılıç, K. ve Özdoğan, Y. (2022). Obezite paradoksu. Gazi Sağlık Bilimleri Dergisi, 7(1), 164-172. https://doi.org/10.52881/gsbdergi.972930
56. Kondo, S., Xiao, J. Z., Satoh, T., Odamaki, T., Takahashi, S., Sugahara, H., Yaeshima, T., Iwatsuki, K., Kamei, A. and Abe, K. (2010). Antiobesity effects of Bifidobacterium breve strain B-3 supplementation in a mouse model with high-fat diet-induced obesity. Bioscience, Biotechnology, and Biochemistry, 74(8), 1656–1661. https://doi.org/10.1271/bbb.100267
57. Külcü, A. and Önal, Ö. (2022). Microbiota Awareness Scale Validity and Reliability Study. SDÜ Tıp Fakültesi Dergisi, 29(2), 205–212. https://doi.org/10.17343/sdutfd.1031515
58. Land, M. H., Rouster-Stevens, K., Woods, C. R., Cannon, M. L., Cnota, J. and Shetty, A. K. (2005). Lactobacillus sepsis associated with probiotic therapy. Pediatrics, 115(1), 178-181. https://doi.org/10.1542/peds.2004-2137
59. Li, C., Li, X., Han, H., Cui, H., Peng, M., Wang, G. and Wang, Z. (2016). Effect of probiotics on metabolic profiles in type 2 diabetes mellitus: A meta-analysis of randomized, controlled trials. Medicine, 95(26), e4088. https://doi.org/10.1097/MD.0000000000004088
60. Lucas, N., Legrand, R., Deroissart, C., Dominique, M., Azhar, S., Le Solliec, M. A., Léon, F., do Rego, J. C., Déchelotte, P., Fetissov, S. O. and Lambert, G. (2019). Hafnia alvei HA4597 strain reduces food ıntake and body weight gain and ımproves body composition, glucose, and lipid metabolism in a mouse model of hyperphagic obesity. microorganisms, 8(1), 35. https://doi.org/10.3390/microorganisms8010035
61. Maden, E. A. ve Altun, C. (2012). Probiyotikler ve ağız sağlığı. Atatürk Üniv. Diş Hek. Fak. Derg, 22(3), 334-339. Maroof, H., Hassan, Z. M., Mobarez, A. M. and Mohamadabadi, M. A. (2012). Lactobacillus acidophilus could modulate the immune response against breast cancer in murine model. Journal of Clinical Immunology, 32(6), 1353–1359. https://doi.org/10.1007/s10875-012-9708-x
62. Martin, F. P., Wang, Y., Sprenger, N., Yap, I. K., Lundstedt, T., Lek, P., Rezzi, S., Ramadan, Z., van Bladeren, P., Fay, L. B., Kochhar, S., Lindon, J. C., Holmes, E. and Nicholson, J. K. (2008). Probiotic modulation of symbiotic gut microbial-host metabolic interactions in a humanized microbiome mouse model. Molecular Systems Biology, 4(157). https://doi.org/10.1038/msb4100190
63. Martínez-Martínez, M. I., Calabuig-Tolsá, R. and Cauli, O. (2017). The effect of probiotics as a treatment for constipation in elderly people: A systematic review. Arch Gerontol Geriatr, 71, 142-149. https://doi.org/10.1016/j.archger.2017.04.004
64. Marttinen, A., Haukioja, A., Karjalainen, S., Nylund, L., Satokari, R., Öhman, C., Holgerson, P., Twetman, S. and Söderling, E. (2012). Short-term consumption of probiotic lactobacilli has no effect on acid production of supragingival plaque. Clinical Oral Investigations, 16(3), 797–803. https://doi.org/10.1007/s00784-011-0584-1
65. Mayanagi, G., Kimura, M., Nakaya, S., Hirata, H., Sakamoto, M., Benno, Y. and Shimauchi, H. (2009). Probiotic effects of orally administered Lactobacillus salivarius WB21-containing tablets on periodontopathic bacteria: a double-blinded, placebo-controlled, randomized clinical trial. Journal of Clinical Periodontology, 36(6), 506–513. https://doi.org/10.1111/j.1600-051X.2009.01392.x
66. Michaylova, M., Minkova, S., Kimura, K., Sasaki, T. and Isawa, K. (2007). Isolation and characterization of Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus from plants in Bulgaria. FEMS Microbiology Letters, 269(1), 160–169. https://doi.org/10.1111/j.1574-6968.2007.00631.x Mirghafourvand, M., Homayouni Rad, A., Mohammad Alizadeh Charandabi, S., Fardiazar, Z. and Shokri, K. (2016). The effect of probiotic yogurt on constipation in pregnant women: a randomized controlled clinical trial. Iran Red Crescent Med J, 18(11), 1-12. https://doi.org/10.5812/ircmj.39870
67. Moreira, TR., Leonhardt, D. and Conde, S. R. (2017). Influence of drınkıng a probıotıc fermented mılk beverage contaınıng Bıfıdobacterıum anımalıs on the symptoms of constıpatıon. Arq Gastroenterol, 54(3),206-210. https://doi.org/10.1590/s0004-2803.201700000-27
68. Nabizadehasl, L. (2018). Prebiyotik, probiyotik ve sinbiyotiklerin, kısa ve uzun dönemde tokluk ve besin tüketim üzerine etkisi. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
69. Namkin, K., Zardast, M. and Basirinejad, F. (2016). Saccharomyces boulardii in Helicobacter pylori eradication in children: A randomized trial from Iran. Iranian Journal of Pediatrics, 26(1), e3768. https://doi.org/10.5812/ijp.3768 Näse, L., Hatakka, K., Savilahti, E., Saxelin, M., Pönkä, A., Poussa, T., Korpela, R. and Meurman, J. H. (2001). Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Research, 35(6), 412–420. https://doi.org/10.1159/000047484
70. O’Mahony, L., Mccarthy, J., Kelly, P., Hurley, G., Luo, F., Chen, K., O’Sullivan, G. C., Kıely, B., Collıns, J. K., Shanahan, F. and Quıgley, E. M. M. (2005). Lactobacillus and Bifidobacterium in irritable bowel syndrome: Symptom responses and relationship to cytokine profiles. Gastroenterology, 128(3), 541-551. https://doi.org/10.1053/j.gastro.2004.11.050
71. Oktay, E. (2001). İnflamatuar barsak hastalıkları: Etyopatogenez, semptomatoloji, tanı ve komplikasyonlar. Gastrointestinal Sistem Hastalıkları Sempozyumu, 11-12 Ocak 2001, İstanbul, Türkiye içinde (s. 199-206). İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri.
72. Opekun, A. R., Gonzales, S. A., Al-Saadi, M. A. and Graham, D. Y. (2018). Brief report: Lactobacillus bulgaricus GLB44 (Proviotic™ ) plus esomeprazole for Helicobacter pylori eradication: A pilot study. Helicobacter, 23(2), e12476. https://doi.org/10.1111/hel.12476
73. Ostadrahimi, A., Taghizadeh, A., Mobasseri, M., Farrin, N., Payahoo, L., Beyramalipoor Gheshlaghi, Z. and Vahedjabbari, M. (2015). Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Iranian Journal of Public Health, 44(2), 228–237.
74. Osterlund, P., Ruotsalainen, T., Korpela, R., Saxelin, M., Ollus, A., Valta, P., Kouri, M., Elomaa, I. and Joensuu, H. (2007). Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. British Journal of Cancer, 97(8), 1028–1034. https://doi.org/10.1038/sj.bjc.6603990
75. Ozen, M., Kocabas Sandal, G. and Dinleyici, E. C. (2014). Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review. Expert Opinion on Biological Therapy, 15(1), 9–20. https://doi.org/10.1517/14712598.2015.980233
76. Özkan, T. B. (2003). İnflamatuar Barsak Hastalıkları. Güncel Pediatri, 1(1) , 79-91.
77. Pakdaman, M. N., Udani, J. K., Molina, J. P. and Shahani, M. (2016). The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance- a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutrition Journal, 15(1), 56. https://doi.org/10.1186/s12937-016-0172-y
78. Parkes, G. C. (2007). An overview probiotics and prebiotics. Nurs Stand, 21(20), 43-47. 10.7748/ns2007.01.21.20.43.c4510
79. Polat, H. ve Ekici, L. (2019). Akkermansia muciniphila: Obezite ve diyabetten korunmada yeni bir alternatif olabilir mi?. Avrupa Bilim ve Teknoloji Dergisi, (16), 533-543. https://doi.org/10.31590/ejosat.563713
80. Rodríguez, G., Ruiz, B., Faleiros, S., Vistoso, A., Marró, M. L., Sánchez, J., Urzúa, I. and Cabello, R. (2016). Probiotic compared with standard milk for high-caries children: A cluster randomized trial. Journal of Dental Research, 95(4), 402–407. https://doi.org/10.1177/0022034515623935
81. Sezer, E. ve Saka, M. (2014). İrritabl bağırsak sendromunun tedavisinde prebiyotik ve probiyotik kullanımı. Güncel Gastroenteroloji Dergisi, 18(2), 174-179.
82. Shahraki, T., Shahraki, M., Shafıghı, S. E. and Mohammadi, M. (2017). No significant impact of Lactobacillus reuteri on eradication of Helicobacter pylori in children (double-blind randomized clinical trial). Iran Red Crescent Med J, 19(3), e42101. https://doi.org/10.5812/ircmj.42101
83. Simons, L. A., Amansec, S. G. and Conway, P. (2006). Effect of Lactobacillus fermentum on serum lipids in subjects with elevated serum cholesterol. Nutrition, Metabolism, and Cardiovascular Diseases, 16(8), 531–535. https://doi.org/10.1016/j.numecd.2005.10.009
84. Tabbers, M. M., Chmielewska, A., Roseboom, M. G., Crastes, N., Perrin, C., Reitsma, J. B., Norbruis, O., Szajewska, H. and Benninga, M. A. (2011). Fermented milk containing Bifidobacterium lactis DN-173 010 in childhood constipation: A randomized, double-blind, controlled trial. Pediatrics, 127(6), 1392-1399. https://doi.org/10.1542/peds.2010-2590
85. Tapan, T. K. (2021). Covid-19 ve beslenme. Başkent Üniversitesi Sağlık Bilimleri Fakültesi Dergisi-BÜSBİD, 6. Taşdemir, A. (2017). Probiyotikler, prebiyotikler, sinbiyotikler. Kastamonu Sağlık Akademisi, 2(1), 71-88. https://doi.org/10.25279/sak.300045
86. Turck, D., Bohn, T., Castenmiller, J., De Henauw, S., Hirsch-Ernst, K. I., Maciuk, A., Mangelsdorf, I., McArdle, H. J., Naska, A., Pelaez, C., Pentieva, K., Siani, A., Thies, F., Tsabouri, S., Vinceti, M., Cubadda, F., Frenzel, T., Heinonen, M., Marchelli, R., et al. (2021). Safety of pasteurised Akkermansia muciniphila as a novel food pursuant to Regulation (EU) 2015/2283. EFSA Journal, 19(9), [e06780]. https://doi.org/10.2903/j.efsa.2021.6780
87. Turhan, E. U., Erginkaya, Z., Uney, M. H. and Ozer, E. A. (2017). Inactivation effect of probiotic biofilms on growth of Listeria monocytogenes. Kafkas Üniversitesi Veteriner Fakültesi Dergisi, 23(4). http://doi.org/10.9775/kvfd.2016.17253
88. Uçak, S. ve Kızıltan, G. (2021). Akdeniz diyeti ve kanser. Başkent Üniversitesi Sağlık Bilimleri Fakültesi Dergisi-BÜSBİD, 6(2).
89. Usta, M. ve Urgancı, N. (2014). Çocukluk çağında probiyotik kullanımı. Güncel Pediatri, 12(2), 88-94. https://doi.org/10.4274/jcp.25744
90. Uymaz, B. (2010). Probiyotikler ve kullanım alanları. Pamukkale Üniversitesi Mühendislik Bilimleri Dergisi, 16(1), 95-104.
91. Vinot, N., Baghtchedjian, E., Picolo, C. and Lambert, G. (2022). The potential of precision probiotic Hafnia alvei HA4597 to support weight loss. In (Ed.), weight management - challenges and opportunities [Working Title]. IntechOpen. https://doi.org/10.5772/intechopen.103723
92. Wallace, B. (2009). Clinical use of probiotics in the pediatric population. Nutr Clin Pract, 24 (1), 50-59. https://doi.org/10.1177/0884533608329298
93. Yasar, R. K. ve Aytekin, Ö. Ü. (2021). COVID-19 ve beslenme arasındaki ilişkiye güncel bir bakış. Akademik Gıda, 19(1), 108-115. https://doi.org/10.24323/akademik-gida.927735