Interactive Web-Based Probiotics Database for Healthcare Professionals Colleen Conlon BS, BA, MS, Nicole Andreini BS, Ariel Mooney RDH, BS, Rishi Ramraj BS, John G. Thomas MS, Ph.D.

The World Health Organization reported that 30% of the global population consumes $87.5 billion worth of pre/probiotics a year[3,4].Recent advances in metagenomics have fostered greater clarity of human microbiota and the use of probiotics into two interactive/complimentary pathways: bioburden reduction and immune up-regulation/modulation[3,4]. Problem: Considerable confusion and misunderstanding exists about the value of probiotic therapy, fostered by a plethora of commercial products availability without prescriptions. This has caused a lack of uniformity in the use, regulation, and study of probiotics[1,2].Hypothesis: Studies indicate that probiotics are successful in managing a large range of diseases including infections of the gastrointestinal, urinary, integumentary, endocrine, and immune systems.

Introduction Oral - 75 Articles- Candida albicans- Dental plaque- Gingivitis- Perio pathogens- Strep. mutans - Halitosis

Breast – 2 Article- Infectious Mastitis

Gastrointestinal – 110 Articles - Antibiotic Associated Diarrhea- Acute Gastritis - Blastocytis hominis- Candida Colonization- Colon Cancer  - Celiac - Clostridium difficle - Crohn’s Disease - Constipation - Diarrhea - Helicobacter pylori- IBS- Liver Disease - Neonatal Enterocolitis - Pouchitis - Regulation of microflora 

Female reproduction – 20 Articles- Bacterial Vaginosis- Vaginal Health- Yeast infection

Cardiovascular- 25 Articles - Obesity - Cholesterol

Methods A survey was given to dental patients and oral health care providers over the course of 3 years to construct a baseline of probiotic knowledge and use in the oral health field. The most recent survey is on our website “Bac2Health survey”. Over 300 articles were selected and rated based on the type and validity of the research. Each paper was ranked on a “Strength of Article” grading scale based on the type of study performed, indicating if there was statistical significance or lack of benefit found. Each paper was then coded to correlate conditions with microbes and probiotic product. A grading system of A-F was assigned to each probiotic and bacterium based on the strength of supporting research found for each condition. A website was constructed by Rishi Ramraj, using the Remind platform. The “Bac2Health” website was created utilizing the compiled research to allow users to search for information in several fields such as probiotic, microbe, disease, and strength of evidence.

Surveys confirmed confusion and limited knowledge of use, benefits, and availability of probiotics both by consumer and professional health care providers. There was a significant reservoir of peer reviewed published literature, mostly international, that described the use, mechanism of action, and application of probiotics with lack of uniformity.

Results

Greatest dental clinical focus included caries, periodontal disease, halitosis, and Candida infection, with a growing application in nurseries and daycare centers. A computer database was constructed providing educational materials for both consumer and health providers. The algorithm-based integrated analysis matched clinical disease, conditions, strength of evidence, microbes, and probiotics highlighted by literature and survey reviews. Probiotic summaries were constructed based on observations in the literature search.

Results (cont.)

In view of CDC’s recent proclamation of the “Post Antibiotic Era”, probiotics and reconstructive microbiology are emerging from adjunctive therapy to real time intervention[3]. The emergence of oral metagenomics has catalyzed awareness of disease management via recreating a balanced eco-system for “restorative microbiology,” particularly in the fields of gastroenterology and dentistry[3,4]. Our interactive database, remaining current with reviews, comments, and federal guidelines, was constructed to meet the obvious void in both the consumer and professional knowledge emphasized by multiple, international probiotic surveys. Probiotics/symbiotic and prebiotics are a growing focus of molecular research with the development of designer probiotics and “bacterioreplacement therapy”, focusing more recently on immune up regulation and modulation[3,4]. We anticipate expansion of probiotic oral health to include endodontics and chronic wounds, given the shared pathogenicity via MMP’s, recognizing that “toothless periodontal pockets” are now considered wounds[3,4].We are actively searching for grant support to build the Bac2Health site that is integrated with industrial, Biotech, state, international, and federal opportunities.

Conclusion

References 1. Danielle Wolvers, Jean-Michel Antoine, Eveliina Myllyluoma, Juergen Schrezenmeir, Hania Szajewska, and Ger T Rijkers. “Guidance for Substantiating the Evidence for Beneficial Effects of Probiotics: Prevention and Management of Infections by Probiotics.” The Journal of Nutrition 140, No. 3 (March 2010): 698S –712S. doi:10.3945/jn.109.1137532. M.F. Zarco, T.J. Vess, G.S. Ginsburg. “The oral microbiome in health and disease and the potential impact on personalized dental medicine.” Oral Diseases (2012) 18, 109 –120. doi:10.1111/j.1601-0825.2011.01851.x3. Harpreet Singh Grover, Shailly Luthra. “'Probiotics – the nano soldiers of oral health.” JIACM 2011; 13(1): 48-54.4. John G Thomas, Khaled Seifelnasr, “Maximizing Clinical Benefits of Probiotics: Matching Metagenomics, Patient Age and Microbial Composition.” Oral Health Journal, December 2013.

Respiratory – 3 Articles - Cystic Fibrosis - Ventilator Pneumonia - Common Cold 

Neurological- 1 Article- Brain activity

Endocrine – 12 Articles- Diabetes- Gestational diabetes

Immune – 35 Articles - Immune regulation- Allergies- Allergic Rhinitis- Wound Therapy

Skin – 15 Articles- Eczema- Atopic dermatitis

Joint Health – 2 Article - Arthritis

Figure 1. Treatment of periodontal inflammation with probiotic gum.