Sodium alginate 225mg/dose / Magnesium alginate 87.5mg/dose oral powder sachets sugar free

Phage therapy has enormous potential in combating bacterial resistance in food animals. However, its application via the oral route remains limited due to challenges associated with the gastrointestinal tract (GIT) environment and a lack of rigorous clinical trial evidence. Therefore, we systematically searched in Google Scholar, PubMed, Scopus, and Web of Science databases following PRISMA guidelines and finally identified 111 articles on oral phage therapy in food animals from where we summarized the key physiological and chemical factors of the gut environment hindering the effectiveness of oral phage therapy (OPT), examined the methods used to evaluate phage stability in the GI environment, and highlighted potential strategies to mitigate these challenges. In addition, we performed quantitative analysis to visualize in vitro pH and thermal stability patterns of phages targeting bacteria isolated from food animals and variability in buffer and incubation period across stability studies. The GIT consists of several anatomically and functionally distinct segments, where complex interactions occur among digestive enzymes, gastric acids, electrolytes, commensal microbiota, and mucosal immune components. The acidic pH of the stomach is a major barrier to successful oral phage delivery. According to our analysis of pH stability testing data from the reviewed studies, most phages targeting antimicrobial-resistant bacteria in food animals remained stable at pH 5-9 and inactivated under highly acidic (pH ≤ 2) or highly alkaline (pH ≥ 11) conditions. In addition, phages are susceptible to high temperatures (above 60 °C), digestive enzymes (e.g., pepsin, trypsin, lipases), bile salts, and host immune responses. Several in vitro laboratory techniques are available to assess phage stability under simulated GI conditions, but variations occur in the assessment protocols. Microencapsulation using alginate and chitosan has been used to protect phages from the adverse GI environment. Additionally, enteric-coated capsules, antacids, co-encapsulation with acid-neutralizing agents, consumption of alkaline water, and daily phage administration are suggested to improve phage survival and efficacy. For the successful clinical implementation of OPT in food animals, future research should focus on elucidating the molecular and physicochemical determinants of phage stability, understanding the humoral immune response to OPT, standardizing laboratory protocol for assessing phage viability, improving the scalability of encapsulation methods, and exploring other potential delivery techniques.

Abstract licence: CC BY

IntroductionCurrent Belgian guidelines state that chronic proton pump inhibitor (PPI) therapy is indicated for oesophagitis grade C and D, Barrett's oesophagus, Zollinger-Ellison syndrome, or to prevent bleeding ulcers with chronic non-steroidal anti-inflammatory drugs (NSAID) intake in patients at risk. Guidelines justify empiric short-term PPI therapy in other cases to control symptoms. Yet, there is insufficient PPI down-titration and/or cessation. As such, concerns have risen related to the impact of PPIs on the healthcare budget and increasing number of risks and side effects. This study aims to provide evidence to determine which strategy provides the most effective approach for stopping chronic intake of PPIs in patients in whom there is no firm medical indication for their continued use.Methods and analysisThis is a multicentre, pragmatic, randomised clinical trial. General practitioners will randomise 609 to one of three PPI deprescription strategies. Patients on a high-dose PPI are allowed to participate after down-titrating their dose to a maintenance dose for 1 month before being randomised. Patients unable to decrease the high-dose PPI are not to be randomised. Following randomisation, patients will be requested to adapt their PPI intake for 1 month to the allocated deprescription scheme: (a) on-demand PPI intake, (b) replace PPI to alginate intake and (c) intermittent PPI intake with a fixed scheme. After successfully following the deprescription strategy, patients are requested to completely stop their use of PPI. Patients are followed up for 1 year. The primary endpoint of the study is the percentage of patients achieving a successful therapeutic outcome, defined as limited PPI intake and willingness to continue the therapy, at the end of the follow-up period. Data will be collected using a study-specific online platform and analysed using the intention-to-treat approach.Ethics and disseminationThis trial was approved through the platform for Clinical Trials in the European Union by a Belgian ethics committee (CTIS reference: 2022-502375-37-00). Study results will be disseminated via open-access, peer-reviewed publications and conference presentations. Trial registration number NCT05629143.Trial registration numberNCT05629143, clinicaltrial.gov.

Abstract licence: CC BY-NC

Macroalgae have been used for nutritional and medicinal purposes in many cultures throughout history and they are an important part of traditional diets, especially in Asian countries. This narrative review provides an integrative overview of the effects of bioactive compounds present in brown macroalgae (Phaeophyceae) on nutrition and health. Brown macroalgae are rich in various bioactive compounds such as fucoxanthin, phlorotannin, fucoidan, alginate, and laminarin. These bioactive compounds have antioxidant, anti-inflammatory, antidiabetic, anticancer, and antihypertensive effects and may also exhibit immunoregulating or neuroprotective properties. Macroalgae contain high amounts of protein and polyunsaturated fatty acids, dietary fiber, vitamins, and minerals. Their nutrient contents vary depending on factors such as species, environmental conditions, and harvest time. Pigment and polyphenol derivatives, especially fucoxanthin and phlorotannins, have protective effects against chronic diseases associated with oxidative stress by reducing the effects of free radicals. However, there are very few studies on the bioavailability and mechanisms of the nutrients, phenolics, and flavonoids in macroalgae. Since the metabolic transformations of these metabolites in humans are overlooked, their effects on health are also unclear. More in vivo and clinical studies are needed on the potential use of brown macroalgae in the field of health. Overall, the findings summarized in this narrative review suggest that brown macroalgae represent promising, sustainable, and natural sources of bioactive compounds for future nutritional and health-related applications.

Abstract licence: CC BY