| 1 | Actual concept of 'probiotics':Is it more functional to science or business?显示文摘It is our contention that the concept of a probiotic as a living bacterium providing unspecified health benefits is inhibiting the development and establishment of an evidence base for the growing field of pharmacobiotics.We believe this is due in part to the current regulatory framework,lack of a clear definition of a probiotic,the ease with which currently defined probiotics can be positioned in the market place,and the enormous profits earned for minimum investment in research.To avoid this,we believe the following two actions are mandatory:international guidelines by a forum of stakeholders made available to scientists and clinicians,patient organizations,and governments;public research funds made available to the scientific community for performing independent rigorous studies both at the preclinical and clinical levels. | Michele Caselli Francesca Cassol Girolamo Calò John Holton Giovanni Zuliani Antonio Gasbarrini | 2013 | World Journal of Gastroenterology2013，19，10： | 3 |
| 3 | Test-based exclusion diets in gastro-esophageal reflux disease patients:A randomized controlled pilot trial显示文摘AIM:To investigate the clinical response of gastroesophageal reflux disease(GERD)symptoms to exclusion diets based on food intolerance tests.METHODS:A double blind,randomized,controlled pilot trial was performed in 38 GERD patients partially or completely non-responders to proton pump inhibitors(PPI)treatment.Fasting blood samples from each patients were obtained;leukocytotoxic test was performed by incubating the blood with a panel of 60food items to be tested.The reaction of leukocytes(rounding,vacuolization,lack of movement,flattening,fragmentation or disintegration of cell wall)was then evaluated by optical microscopy and rated as follows:level 0=negative,level 1=slightly positive,level 2=moderately positive,and level 3=highly positive.A'true'diet excluding food items inducing moderatesevere reactions,and a'control'diet including them was developed for each patient.Then,twenty patients received the'true'diet and 18 the'control'diet;after one month(T1)symptoms severity was scored by the GERD impact scale(GIS).Hence,patients in the'control'group were switched to the'true'diet,and symptom severity was re-assessed after three months(T2).RESULTS:At baseline(T0)the mean GIS global score was 6.68(range:5-12)with no difference between'true'and control group(6.6±1.19 vs 6.7±1.7).All patients reacted moderately/severely to at least 1 food(range:5-19),with a significantly greater number of food substances inducing reaction in controls compared with the'true'diet group(11.6 vs 7.0,P<0.001).Food items more frequently involved were milk,lettuce,brewer’s yeast,pork,coffee,rice,sole asparagus,and tuna,followed by eggs,tomato,grain,shrimps,and chemical yeast.At T1 both groups displayed a reduction of GIS score('true'group 3.3±1.7,-50%,P=0.001;control group 4.9±2.8,-26.9%,P=0.02),although the GIS score was significantly lower in'true'vs'control'group(P=0.04).At T2,after the diet switch,the'control'group showed a further reduction in GIS score(2.7±1.9,-44.9%,P=0.01),while the'true'group did not(2.6±1.8,-21.3%,P=0.19),so that the GIS scores didn’t differ between the two groups.CONCLUSION:Our results suggest that food intolerance may play a role in GERD symptoms development,and leucocytotoxic test-based exclusion diets may be a possible therapeutic approach when PPI are not effective or indicated. | Michele Caselli Giovanni Zuliani Francesca Cassol Nadia Fusetti Elena Zeni Natalina Lo Cascio Cecilia Soavi Sergio Gullini | 2014 | World Journal of Gastroenterology2014，20，45： | 1 |
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