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enters into the circulatory system within chylomicrons the development of antibiotic resistance has prompted the
and are transported to cardiac, skeletal muscle, and use of probiotics, with its long history of safety. Research
adipose tissue. There the triglyceride components are has clearly demonstrated that the proper balance of gut
hydrolyzed by lipoprotein lipase, thereby allowing the inhabitants are essential in determining health, especially
released free fatty acids to be absorbed by these tissues. 16,17 in metabolic disorders. Lactobacilli and Bifidobacterium
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HIV and several antiretroviral treatments including spp. have been globally recognized for their potential
combinations such as ritonavir and lopinavir are linked to health benefits. Spore-forming bacilli have the intrinsic
HT. Autoimmune diseases, including systemic lupus ability to produce a large number of secretory proteins,
erythematosus, multiple myeloma, and juvenile enzymes, vitamins, carotenoids, and antimicrobial
dermatomyositis, are also associated with HT. There are compounds. Furthermore, Bacillus spp. are able to endure
immunosuppressant medications which raise triglyceride and survive the hostile environment of the gastrointestinal
levels, and HT is prevalent in certain renal diseases, such tract (GIT) and have higher acid and bile salts tolerance. 36,37
as renal failure and nephrotic syndrome. 18-22 Bacillus spore formers have probiotic characteristics, and
Several recent publications have shown that either have also demonstrated to have pathogen exclusion,
fasting or non-fasting TG levels are linked to cardiovascular antimicrobial, anti-oxidant, and immunomodulatory
episodes. However, we still generally measure fasting effects. 38-40
triglycerides, even though most people exist in a post- Bacilli are considered as soil organisms though many
prandial state, with their circulatory system immersed by of them, including B. subtilis, have been found in ileal
triglyceride-rich lipoproteins. 16,23,24 Prospective studies biopsies and feces in volunteers. A study by Hong el al.
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have shown that when compared with fasting TG levels, supported the growing opinion that B. subtilis and other
non-fasting TG levels may be a better predictor of CV species had the ability to sporulate anaerobically and
events in the general population. Recent studies have produce antimicrobials, adapting to life in the human GIT,
shown that non-fasting triglycerides were associated with therefore becoming gut commensals rather than just soil
increased stroke risk. 5,16,17, 23-27 microorganisms. Pinchuck published a study showing
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The treatment of HT is essential in view of the new the anti-Helicobacter Pylori activity of a probiotic
data in a number of studies demonstrating a causal role of B. subtilis strain, which produced a secretion of
triglycerides in cardiovascular risk. Increased effort is aninocoumacin A antibiotic, and also showed antagonistic
needed in reducing elevated triglycerides in patients by activity against Shigella flexneri and E. faecium. A recent
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non-pharmacological treatment methods. In general, diet, study by Ripert demonstrated that the probiotic B. clausii
physical activity, and weight reduction are part of HT protected cells from the cytotoxic effect of Clostridium
treatment. Currently, treatment for HT includes Niacin, difficile and B. cereus toxins. A publication by Joseph
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which is not as effective as fibrates in lowering confirmed the antimicrobial activity of B. subtilis against
triglycerides. 28,29 Recent randomized clinical trials using foot ulcer bacterial pathogens, with the highest recorded
extended release niacin or placebo failed to show any against Klebsiella spp. 44
benefits of niacin on CVD outcomes. 30,31 Probiotic Bacillus strains ameliorate the dysbiosis and
Clinicians should review the medications patients are gut inflammation by reestablishing the gut microbiome
taking that could elevate triglycerides, such as estrogens toward beneficial microbial population and help the
and retinoic acid products. Optimum control in patients intestinal mucosa to recover from injuries due to illness.
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with diabetes, thyroid disease, and alcohol consumption The beneficial effects on gut metabolism of B. coagulans
are added important points as these contribute to HT. was shown by the suppressed production of bile acid,
In patients with HT, pharmacological management improved intestinal permeability, and decreased
alone is insufficient to lower triglyceride levels, and should bactericidal effect of bile acid, supporting the growth of
not be the first line of treatment. These new data beneficial microbiota in the intestine. 45
4
regarding a causal role for triglycerides in increasing Probiotic strains of Bacilli are currently being used for
cardiovascular risk should prompt us today to redouble their therapeutic effects on several systemic clinical
our efforts to reduce hypertriglyceridemia in our patients syndromes, including metabolic syndrome. In a study by
using non-pharmacological approaches. As this Ghoneim, the therapeutic effects of B. subtilis showed the
randomized, double-blind, placebo-controlled trial reduction of blood glucose and troponin, as well as on
demonstrates, probiotics consisting of five spore forming total serum cholesterol, LDL, and VLDL47. Another study
bacilli effectively lowers triglyceride levels. on diabetic rats showed that B. subtilis promoted HDL
Probiotics, a term coined by the Russian Nobel cholesterol and delayed the absorption of LDL cholesterol
laureate Dr. Ilya Metchnikoff over a hundred years ago, is and triglycerides, in effect demonstrating anti-lipemic
synonymous with beneficial microbes. Probiotics are live effects. Probiotic B. clausii consumption was shown to
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microorganisms that can confer health benefits to the host have multiple beneficial effects in a study on human
when given in adequate amounts. The search for safe and subjects using DNA microarray technique. The genes
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cost-effective therapy and the concern in medicine over involved in inflammation, immune response, intestinal

Campbell—Spore Forming Bacilli Supplementation for HT Integrative Medicine • Vol. 19, No. 2 • April 2020 23