I came across this while examining environmental illness. There are two features that makes Lactobacillus fermentum ME-3 DSM-14241 of special interest:

• It is human sourced — thus there is a reasonable chance that it may take up residence
• It produces glutathione — very unusual

Last, it is available on Amazon.com (this specific strain)

Pub Med Literature Review

• ” L. fermentum ME-3 is a unique strain of Lactobacillus species, having at the same time the antimicrobial and physiologically effective antioxidative properties and expressing health-promoting characteristics if consumed. Tartu University has patented this strain in Estonia (priority June 2001, patent in 2006), Russia (patent in 2006) and the USA (patent in 2007).” [2009] [Full text– an interesting read]
  • ” the strains of the L. fermentum species were also found from some other Estonian children, yet not from Swedes!”
• “The consumption of Reg’Activ Cholesterol  (containing Lactobacillus fermentum ME-3) in clinically asymptomatic volunteers with borderline-high values of risk factors for cardiovascular disease (BMI, HbA1c%, LDL cholesterol) for 4 weeks had a positive effect on blood lipoprotein, oxidative stress and inflammatory profile.” [2016]
• ” this study show that probiotic L. fermentum ME-3 contains both glutathione peroxidase and glutathione reductase. We also present that L. fermentum ME-3 can transport GSH from environment and synthesize GSH. This means that it is characterized by a complete glutathione system: synthesis, uptake and redox turnover ability that makes L. fermentum ME-3 a perfect protector against oxidative stress. To our best knowledge studies on existence of the complete glutathione system in probiotic LAB strains are still absent and glutathione synthesis in them has not been demonstrated.” [2010]
• “only L. casei spp. (including L. casei 114001) and L. fermentum ME-3 revealed pronounced ability to suppress oxidation of luminol (by 43-65,8%) and microsomal lipid peroxidation (by 57,9-89,5%).” [2009]
• Available in some cheeses in Europe (Baltic area) [2004]

Histamines?

• “The gene encoding for the multi-copper oxidase was sequenced and detected also in other amine-degrading strains of Lb. fermentum, … was able to degrade all the BAs were singly used as adjunct starter for decreasing the concentration of histamine and tyramine in industrial Caciocavallo cheese.” [2016]
• “Lactobacillus fermentum (two strains) caused very low (4.2% – 8.8%) histamine release.” [2002]
• “Histamine release induced by … L. fermentum was lower (at a range of 2.4%-8.2%).” [2000]

Blood-Brain Barrier

• ” one of the  L. fermentum (LAC 42) showed activity also against Pseudomonas aeruginosa and Klebsiella pneumoniae… Our data on this antibacterial molecule suggest that it is a compound with low molecular weight and with highly hydrophilic component.” [2016] – low molecular weight is needed to cross the blood-brain barrier.
• “the current study demonstrated that probiotic consumption(Including L.F) for 12 weeks positively affects cognitive function and some metabolic statuses in the Alzheimer’s disease patients.” [2016]

From Patent Filing

• “has a high anti-microbial effect on Escherichia coli, Shigella sonnei, Staphylococcus aureus, Salmonella typhimurium, and moderate activity against Helicobacter pylori strains.”
• “Up to the present no strain of lactobacilli with an extensive anti-microbial effect against numerous pathogens and opportunistic pathogens has been described.” – this one does!!!!
• “The innate resistance of Lactobacillus fermentum ME-3 against antimicrobial preparations (TMP-SMX, ofloxacin, aztreonam, cefoxitin and metronidazole) allows to use it as a preparation accompanying antibiotic treatment in case of gastrointestinal and uroinfections”
• For making Yogurt: “Lactobacillus fermentum ME-3 pure culture in 0.15% MRS-agar is used for producing the yoghurt, additionally the pure cultures of Lactobacillus plantarum and Lactobacillus buchneri are seeded into fresh goat milk autoclaved for 20 min at 110° C. Three cultures of these strains of lactobacilli are mixed in equal proportions together with 2% of Streptococcus thermophilus and are added in 0.2% of content into autoclaved goat milk.”

Sources

• Press Release
• Reg’Activ – Amazon US – available first in 2015.

A reader forwarded me a copy of their results. As usual, I like to go thru it via a blog post. The report gives good information but in the context of CFS/IBS we may be approaching the edge of what we can do with it (i.e. no studies, etc). Here goes….

First item, I am in general very happy with their presentation of information, as shown below.

Organic Acids Test  – Nutritional and Metabolic Profile

The following were all in the normal range:

• Glycolytic Cycle Metabolities
• Mitochondrial Markers – Krebs Cycle Metabolites
• Mitochondrial Markers – Amino Acid Metabolities
• Pyrimidine Metabolites – Folate Metabolism
• Ketone and Fatty Acid Oxidation
• Indicators of Detoxification
• Mineral Metabolism

Mitochondrial markers being normal excludes one set of hypothesis about CFS for this patient. See these PubMed articles where CFS patients were found to have mitochondrial issues.

Yeast and Fungal Markers

The following were high:

• Citramalic (~ 96%ile)
• Tartaric Acid – very high (3x high normal range)
• Arabinose – high (2x high normal range)

My read would be to take prescription  Metronidazole/Flagyl  (people responded well to it according to the surveys) or other anti-fungal medications. For herbs  Cistus Incancus is one of many choices.

• Increased number of Candida albicans in the faecal microflora of chronic fatigue syndrome patients during the acute phase of illness[2007].
• Yeast metabolic products, yeast antigens and yeasts as possible triggers for irritable bowel syndrome [2005]. ” But more research is needed before antifungal treatment can be recommended as a first line treatment for IBS.”
• Chronic intestinal candidiasis as a possible etiological factor in the chronic fatigue syndrome [1995].

In short — evidence that a subset have issues here — but a lack of followup studies.

Bacterial Markers

• Hippuric – very high 4x high normal range
  • “Hippuric acid is a normal component of urine and is typically increased with increased consumption of phenolic compounds (tea, wine, fruit juices).” [source] – other sources are exposure to high levels of toluene.
    • Mulder TP, Rietveld AG, van Amelsvoort JM.
      Consumption of both black tea and green tea results in an increase in the excretion of hippuric acid into urine. Am J Clin Nutr 2005;81:256S-260S.
    • Clifford MN, Copeland EL, Bloxsidge JP, Mitchell 10.
      LA. Hippuric acid as a major excretion product associated with black tea consumption. Xenobiotica 2000;30:317-326. Li C, Lee MJ, Sheng
• 4-Hydroxybenzoin ~ 98%ile

What I could find:

• Probiotics Blunt the Anti-Hypertensive Effect of Blueberry Feeding in Hypertensive Rats without Altering Hippuric Acid Production[2015].

Lab’s Recommendation: “High hippuric acid (Marker 10) may derive from food, GI bacterial activity, or exposure to the solvent toluene. …. Bacterial overgrowth can be treated with natural anti-bacterial agents and/or probiotics (30-50 billion cfu’s) that include Lactobacillus rhamnosus.”

Actions: None beyond the above

Clostridia Bacterial Markers

Three markers were in the normal range, only one was outside

• HPHPA – 96%ile
  • “(HPHPA) was found in higher concentrations in urine samples of children with autism compared to age and sex appropriate controls and in an adult with recurrent diarrhea due to Clostridium difficile infections… a value 300 times the median normal adult value,”[2010]  – reader value is no where need this
  • “After oral vancomycin treatment, urinary excretion of HPHPA … decreased markedly, which indicated that these compounds may also be from gut Clostridium species.”[2016]
    • If the reader was taking any Clostridium probiotics, this could account for the slightly high reading.

Lab’s Recommendations: “Treatment with Metronidazole or Vancomycin is almost 100% effective in killing parent Clostridia organisms but not their spores. At least three months of probiotic therapy is recommended after antimicrobial treatment due to spore formation by Clostridia species. Clostridia overgrowth can sometimes be controlled by supplementation with Lactobacillus rhamnosus GG (Culturelle) or Saccharomyces boulardii. Phenalalanine or tyrosine supplements should be avoided because of the possibility of conversion to HPHPA or other toxic byproducts.”

Actions: Not sufficiently high to warrant 3 months of antibiotics (which will cause other side effects)

Oxalate Metabolites

• Oxalic – 98%ile

Lab’s Recommendations: “…. are also byproducts of molds such as Aspergillus and Penicillium and probably Candida.  ….Elevated oxalate values with a concomitant increase in glycolic acid may indicate genetic hyperoxaluria (type I), whereas increased glyceric acid may indicate a genetic hyperoxaluria (type II). Elevated oxalic acid with normal levels of glyceric or glycolic metabolites rules out a genetic cause for high oxalate. However, elevated oxalates may be due to a new genetic disorder, hyperoxaluria type III.
Organic ”

Actions: Resolve the Candida/Fungal/Yeast and then get retested.

Neurotransmitter Metabolites

• Quinolinic / 5-HIAA Ratio — very high ( 5-HIAA was near bottom of range — hence the high ratio). 5-HIAA is a metabolite of serotonin which is typically low in CFS [2015] [2004]

Lab’s Recommendations: ” Supplementation with the precursor 5-HTP (5-hydroxytryptophan) at 50-300 mg/day may be beneficial. Supplementation with tryptophan itself may form the neurotoxic metabolite quinolinic acid, however, 5-HTP is not metabolized to quinolinic acid. Excessive tryptophan supplementation has been associated with eosinophilia myalgia syndrome. ”

Actions: Consider d-ribose — if does result in improvement of symptoms. Taking tryptophan has no improvement for CFS [2010] [2014]

Nutritional Markers

• Pantothenic (Vitamin B5) – High

Lab’s Recommendations: “High pantothenic acid (B5) (Marker 52) indicates high recent intake of pantothenic acid. Pantothenic acid is an essential B vitamin. Since some individuals may require very high doses of pantothenic acid, high values do not necessarily indicate the need to reduce pantothenic acid intake.”

Actions: None suggested

• Ascorbic (Vitamin C) – Low

Lab’s Recommendations: “Ascorbic acid (vitamin C) levels below the mean (Marker 54) may indicate a less than optimum level of the antioxidant vitamin C. Suggested supplementation is 1000 mg/day of buffered vitamin C, divided into 2-3 doses.”

Actions: Follow the labs — nothing specific for CFS is reported. However, do not get from orange juice as it may increase Hippuric levels further [2014]

Amino Acid Metabolites

Many(5) values were zero at bottom of normal range.

Lab’s Recommendations: “Low values for amino acid metabolites (Markers 62-74) indicate the absence of genetic disorders of amino acid metabolism. These markers are deamination (ammonia removed) byproducts that are very elevated only when a key enzyme has low activity; slight elevations may indicate a genetic variation or heterozygous condition which may be mitigated with diet or supplementation. Low values are not associated with inadequate protein intake and have not been proven to indicate specific amino acid deficiencies.

Actions: Consider supplementation with those listed in this post. Alternatively visit http://www.hmdb.ca/ and see what they suggest for each. For example for having zero 3-Hydroxyisovaleric acid  “Levels may also be increased from prolonged consumption of raw egg-whites (PMID: 16895887 , 9523856 , 15447901 , 9176832 )(OMIM: 210210 , 253270 , 600529 , 253260 , 246450 , 210200 , 238331 ).”

Bottom Line

Apart from address Fungal/Yeast issues – there does not seem to be any actionable items beyond the existing lab recommendations.

For other CFS patients — the results will likely vary greatly because of the variation in the microbiome shifts.

The pubmed studies cited in my last post on environmental illness or syndrome suggests addressing peroxynitrite as a course of action. This post drill into a single aspect this area. We do not have studies indicating if it is effective.

• “Peroxynitrite (sometimes called peroxonitrite) is an ion with the formula ONOO⁻. It is an unstable structural isomer of nitrate, NO−3.  Although its conjugate acid is highly reactive, peroxynitrite is stable in basic solutions.^[1][2] It is prepared by the reaction of hydrogen peroxide with nitrite:” Wikipedia

Herbs

• “The potency of scavenging activity was in the following order:
  • Apis cerana Fabricius (Propolis) >
  • Rosmarinus officinalis L (Rosemary) >
  • Pseudolarix amabilis (Nelson) Rehd. (Pine Bark PE) >
  • Echinacea Moenck. (Echinacea);
  • the remaining twenty-eight herbs performed unsatisfactorily for their scavenging activity.” [2010]
• “The potency of scavenging activity following the addition of authentic ONOO(-) was in the following order:
  • witch hazel bark > …  Hamamelitannin, the major active component of witch hazel bark, was shown to have a strong ability to scavenge ONOO(-).
  • rosemary >
  • jasmine tea >
  • sage >
  • slippery elm >
  • black walnut leaf >
  • Queen Anne’s lace >Z
  • Linden flower. [2002]
• “In the ONOO(-) assay, H. baylahuen and Buddleia globosa showed the highest activities.” [2006]

Supplements

• ALA – “Superoxide production and peroxynitrite (ONOO-) formation were reduced with alpha-linolenic acid supplement” [2013]
• Grape Seed Extract – “grape seed extract counteracted the inhibitory effect of peroxynitrite on human plasma clotting” [2012]
• NOT: Coenzyme Q(10), vitamin E, selenium, and methionine “confirmed  increased antiviral cytokine and peroxynitrite plasma levels.”
• “creatine displayed a significant ability to remove ABTS+, O(*-)(2), and OONO- when compared with controls.” [2002] creatine is low in CFS.

Probiotics

VSL#3 has been studied [2014] with undesired results, “increased expression of NADPH oxidase subunits, angiotensin converting enzyme, AT1 receptors and angiotensin II, and formation of ROS and peroxynitrite were observed.”

Lactobacillus fermentum ME-3 (DSM14241, LfME-3) reports a reduction [2015]. This is available on Amazon. This probiotic produces Glutathione and is human sourced. I will be doing a post on it in a few days.

I include the following under environment sensitivity

• multiple chemical sensitivity (MCS)
• electromagnetic sensitivity (EMF)
• noise sensitivity (Misopbonia, hyperacusis, diplacousis, and polyacousis.)
• light sensitivity (Photophobia) which can trigger sleep reversal
  • ” the most common conditions associated with photophobia are migraine, blepharospasm, and traumatic brain injury.” [2016]
  • “Their most common ocular condition was dry eyes,”[2012]
    • “Certainly there have been no major randomized controlled trials of treatment of photophobia. Most of the literature consists of case-reports and a few studies with small numbers of subjects.”

With CFS (and by themselves), if you have one of these, you are much more likely to have another of them. In other words, they may all be different manifestation of the same root issues with variations of symptoms due to DNA, epigenetic (DNA being activated by environmental factors), and microbiome.

• “About one fourth of the general population report environmental intolerance (EI) to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs), and/or sounds.” [2016]
  • “All four EI groups, compared to the referents, reported significantly poorer sleep quality, more non-restorative sleep, more daytime sleepiness, more obstructive breathing and higher prevalence of nocturnal insomnia than the referents.”
• “In population-based surveys, the prevalence of EHS has ranged from 1.5% in Sweden to 13.3% in Taiwan. Provocation studies on EMF have yielded different results, ranging from where people with EHS cannot discriminate between an active RF signal and placebo, to objectively observed changes following exposure in reactions of the pupil, changes in heart rhythm, damage to erythrocytes, and disturbed glucose metabolism in the brain.” [2015]
• “As inflammation appears to be a key process resulting from electromagnetic field (EMF) and/ or chemical effects on tissues, and histamine release is potentially a major mediator of inflammation, we systematically measured histamine in the blood of patients. Near 40% had a increase in histaminemia (especially when both conditions were present), indicating a chronic inflammatory response can be detected in these patients.” [2015]
  • “Nitrotyrosin, a marker of both peroxynitrite (ONOO°-) production and opening of the blood-brain barrier (BBB), was increased in 28% the cases.”
  • “Protein S100B, another marker of BBB opening was increased in 15%.”
  • “Circulating autoantibodies against O-myelin were detected in 23%, indicating EHS and MCS may be associated with autoimmune response.”
  • “increased Hsp27 and/or Hsp70 in 33% of the patients.”

“For the first time, auditory-related perceptual disorders were studied in MCS. A strong association between Weinstein’s Noise Sensitivity Questionnaire (WNS) , Khalfa’s Hyperacusis Questionnaire (HQ). results and MCS symptoms severity has been highlighted. These findings suggest that decreased sound tolerance and noise sensitivity could be considered as possible new aspects of this syndrome, contributing to its peculiar phenotype.” [2016]

• “The brain responses at the recognition threshold (fecal odor) and normal perceived levels (sweet and fecal odors) were stronger in patients with MCS than in controls.” [2016]
• ” chemical sensitivity clearly does exist (pulse rate differences between positive responses and placebo)” [1991]
• “heightened sensitivity to noise (hyperacusis) and touch (hyperaesthesia)… the serology showed an apparent infective pre-cursor to the illness with evidence of possible autoimmune serology.” [2012]
• “These patients were taken off all medication and not fed until the leg pain and swelling disappeared, which was four to seven days… The five-year follow-up in the group showed two 48-hour episodes of phlebitis cleared by home bed rest and food abstenance. In contrast, the control group had more than 60 episodes of phlebitis at home and 41 episodes in the hospital.” – 101 vs 2….[1981]
  • Ten randomly selected patients with recurrent non-traumatic thrombophlebitis of unknown etiology were studied using a comprehensive environmental control method. All cleared their phlebitis without medications. Using withdrawal and challenge of incitants, eight of 10 patients had their phlebitis reproduced. The numerous single triggering agents were common-place inhaled and ingested foods and chemicals. [1976] ” Multiple incitants were found in each patient.” [1977]
  • Thrombophlebitis – vein inflammation
• “Twelve highly selected patients with non-arteriosclerotic cardiac arrhythmias and/or chest pain refractory to medication and having symptoms related to smooth muscle sensitization were studied in a rigidly controlled, relatively fume- and particle-free environment. The majority of signs and symptoms cleared in 10 patients without medication while under environmental control, and in 10 of the 12 patients all arrhythmias were reproduced with controlled, repeated individual-blind and double-blind incitant challenges.” [1978]

Treatment of any of these sensitivity have generally been unsuccessful for most patients. The following is a review of recent pubmed articles in this area (and a few classic ones)

• Trigeminal neurons detect cellphone radiation: Thermal or nonthermal is not the question[2016]. see  trigeminal nerve. The nerve changes  were not the result of heat from the cell phone.
• ” Based on our current understanding, a treatment approach that minimizes the adverse effects of peroxynitrite – as has been increasingly used in the treatment of multisystem illnesses – works best.” [2015]
• “The biopsies taken from skin lesions of patients with EHS indicated on infiltration of the skin layers of the epidermis with mastocytes and their degranulation, as well as on release anaphylactic reaction mediators such as histamine, chymase and tryptase. The number of people suffering from EHS in the world is growing describing themselves as severely dysfunctional, showing multi organ non-specific symptoms upon exposure to low doses of electromagnetic radiation, often associated with hypersensitivity to many chemical agents (Multiple Chemical Sensitivity-MCS) and/or other environmental intolerances (Sensitivity Related Illness-SRI).” [2015]
• History of chemical sensitivity and diagnosis[2016]:
  • “. In our experience, 80% of the EMF-sensitive patients had chemicalsensitivity when studied under less-polluted conditions for particulates, controlled natural gas, pesticides, and chemicals like formaldehyde.”
• Characterization of air freshener emission: the potential health effects. [2015]
  • “The use of these products may be associated with an increase in the measured level of terpene, such as xylene and other volatile air freshener components,”
  • “The constituents of air fresheners can react with ozone to produce secondary pollutants such as formaldehyde…..including benzene, phthalate, and limonene,”
  • “this work shows that use of some consumer cleaning agents can yield high levels of volatile organic compounds, including glycol ethers–which are regulated toxic air contaminants–and terpenes that can react with ozone to form a variety of secondary pollutants including formaldehyde and ultrafine particles.” [2006]
• Triggers for MCS can include [2015]:
  • formaldehyde, (less than 0.2 ppm [1981])
  • pesticide, (less than 0.0134 ppm [1981])
  • cigarette smoke,
  • ethanol,
  • petroleum alcohol (less than 0.5 ppm [1981])
  • phenol, (less than 0.0024 ppm [1981])
  • chlorine, (less than 0.33 ppm [1981])
  •  perfume
  • volatile organic compounds (VOCs) including:
    • formaldehyde,
    • orris root,
    • newsprint,
    • terpenes,
    • terpenoids.
  • ” Terpenes and terpenoids are a diverse class of organic compounds produced by a variety of plants, particularly conifers…Often patients cannot clear their symptoms from exposure to chemicals unless terpenes and terpenoids are avoided and neutralized along with chemical avoidance and treatment.”
    • Comment: There may be an interaction with allergies to conifers here..
      7% of the allergic population are allergic to conifers [1970] a.k.a. Christmas Tree Allergy.
    • “Terpenes are biogenic volatile organic compounds (VOCs) that are also contained in many consumer products.” [2013]
  • “Results suggest that traffic emission sources of OCpri and quasi-ultrafine particles lead to increased systemic inflammation and platelet activation and decreased antioxidant enzyme activity in elderly people with CAD.” [2008]

Bottom Line

Environmental illness seems to be a consequence of modern life. From the electronics waves passing thru us each day, the chemical additives in foods and ongoing level of stress and uncertainty. Genetics and epigenetics play a role — some people are resistant (think of George Burns — who smoked cigars until he was 100 with no cancer) and others are very susceptible.

What to do?

• Reduce EMF exposure — that can be hard and expensive to do.
  • My family have made some progress here. Moving to a 10 hectares (25 acres lot) in a rural area — we have no over-the-air TV signals, no neighbor WiFi signals. All of our computer are hard-wired to the internet. When I am in the city, I often seen 30-60 wifi sources appear on my phone. Mobile phones are placed in Aircraft mode if we are at home (phone calls will go to our PCs instead because we are using Google FI service)
• Eliminate chemical additives – this means preparing food from scratch. Scents and fragrences are much harder to address.
  • We remove residue chemicals  from our clothes, with a outdoor shed (with ozonators) that we put our street clothes into as soon as we get home

The above mitigates a worsening of symptoms — reversal is another challenge. The chemical  FeTMPyP appears effective against peroxynitrite but there are no human studies for environmental illness. In a future post, I will dive into possible ways of dealing with peroxynitrite.

My last post looked at faecal calprotectin and which probiotics can lowere it.  This caused me to look explicitly at TNF-alpha(or tumor necrosis factor-α) and probiotics. We saw that one strain of Lactobacillus Acidophilus increases TNF-alpha.  TNF-Alpha is high in CFS patients (and most autoimmune patients)[2016] and should not be raised higher.

” is a cell signaling protein (cytokine) involved in systemic inflammation and is one of the cytokines that make up the acute phase reaction. It is produced chiefly by activated macrophages, although it can be produced by many other cell types such as CD4+ lymphocytes, NK cells, neutrophils, mast cells, eosinophils, and neurons.^{[3]” [Wikipedia]}

TNF-Alpha reducing probiotics

• DECREASE : Bacillus coagulans..significant decrease in the production of pro-inflammatory cytokines, such as TNF-α [2016]
• DECREASES: Clostridium butyricum (CB) capsules. [2016]
• DECREASE: Saccharomyces cerevisiae RC016 [2016]
• DECREASE: Lactococcus chungangensis CAU 28(T)…reduced the release of β-hexosaminidase and histamine in human mast cell cells..  suppressed the production of … tumor necrosis factor-α [2016]
• DECREASE: B. lactis HN019 … a significant decrease in tumor necrosis factor-α [2016]
• DECREASE: clostridium butyricum CGMCC0313.1… reduced tumor necrosis factor (TNF)-α level [2016]
• DECREASE: Bifidobacterium breve, Lactobacillus casei, Lactobacillus bulgaricus and Lactobacillus acidophilus [2016]
• DECREASE: Lactobacillus plantarum HM218749 [2016]
• DECREASE: “Pseudomonas bacteria demonstrated that probiotic therapy inhibited septicemic accumulation of the pathogen in remote organs. In addition, probiotic therapy successfully suppressed the infection-dependent induction of TNF-α and interleukins 6 and 10 in the liver.” [2016]
• DECREASE: “a probiotic mixture, including Lactobacillus and Bifidobacterium species,” [2016]
• DECREASES: B. bifidum, L. acidophilus and Ba. coagulans [2016]
• DECREASES: Clostridium leptum [2016]
• DECREASES: VSL#3 [2016]
• DECREASES: Lactobacillus plantarum WLPL04 [2016]
• NONE:  Lactobacillus planetarum A7 [2016]
• INCREASES: Pediococcus pentosaceus [2017]
• INCREASES: Bacillus cereus [2016]
• INCREASES:  Lactobacillus plantarum BF-LP284 (H-Lp) [2016]
• INCREASES: Lactobacillus rhamnosus GG [2016]
• INCREASES: Lactobacillus delbrueckii subsp. lactis CIDCA 133 “The production of TNF-α (a protective cytokine in B. cereus infections) by dendritic cells was increased in the presence of lactobacilli[2016].

Available Probiotics

• Mutaflor… expression of the pro-inflammatory cytokines IL-6 and TNF-α was higher [2012]