Strong MIYARISAN® Probiotics, 90 tablets

Strong MIYARISAN® helps maintain gastrointestinal balance for

immune, digestive and bowel movement health.

Accordingly, it has established a role in:

·        Managing constipation

·        Managing diarrhoea

·        Preventing antibiotic-associated diarrhoea

·        Managing Irritable Bowel Disease (IBD)

·        Ameliorating GI effects of H pylori eradication therapy

Rich Heritage of More Than 80 Years!

It provides the Clostridium butyricum Miyairi® 588 (CBM588®) strain which was first isolated by Dr Chikaji Miyairi in Japan’s Chiba Medical University in 1933.

Once commercial production began in 1940, it was quickly adopted for use in various Asian countries (Japan, Korea, and China) for managing diarrhoea and constipation for more than 80 years now.

The safety of the CBM588® strain of Clostridium butyricum is well established. It is naturally found in the human gut, and it does not carry any genes encoding any toxins and virulence factors associated with Clostridium or other intestinal pathogens.

It is granted GRAS (Generally Regarded as Safe) status for use in US and as a novel food ingredient in EU. ¹

Mode of Actions

CBM588® is resistant to stomach acid, heat, and antibiotics, allowing it to reach the intestines undenatured to proliferate.

During the process of proliferation, CBM588® produces butyric acid which brings about various beneficial effects:

1.     It increases the abundance of Bifidobacterium, Lactobacillus, and Lactococcus species to improve the gut microbiome balance.^2,5

2.     Short-chain fatty acids such as butyric acid produced by CBM588® is used as an energy source for the intestinal lining’s epithelial cells and contribute towards strengthening the gastrointestinal barrier.²

3.     It modulates inflammatory processes and the intestinal immune response, helping to maintain a stable intestinal environment.²

Application: to prevent antibiotic-associated diarrhoea

CBM588® has been used to prevent antibiotic-associated diarrhoea in adults and children ³ as it plays an important role in controlling antibiotic-induced dysbiosis.

Specifically, was found to protect the gut mucin layer from the effects of antibiotic-induced dysbiosis. ⁴

And it promotes mucin production by modulating the gut microbiota. ⁵

As intestinal epithelial cells under the mucin layer contain absorptive epithelial cells, a dysfunction of these cells leads to diarrhoea induced by incomplete absorption of water in faeces. ⁶

The investigation of the immunological and metabolic interaction between our body and gut microbiome under antibiotic-induced dysbiosis revealed two novel protective mechanisms of epithelial cells in the colon under CBM588® treatment:

1.     Inducing innate immune cells activity in the colonic lamina propria, thus enhancing gut epithelial barrier function.⁷ 

2.     Upregulating anti-inflammatory lipid metabolites such as palmitoleic acid, 15d-prostaglandin J2, and protectin D1 and reducing expression of inflammatory cytokines. ⁷

Diagram: Clostridium butyricum CBM588 promotes the thickness of the mucous layer and the integrity of the tight junctions thanks to the stimulation of the release of IL-17 exerted on the intraepithelial T cells, with a reduced permeability of pathogens and lipopolysaccharide. (↑ Increased, ↓ Decreased).

Application: Managing IBD

The gut immune system interacts with the gut microbiota and maintains intestinal homeostasis.

Accumulating evidence supports the idea that imbalance in this complicated network between the immune system and the microbiota is involved in the pathogenesis of gut inflammatory diseases, including IBD. ⁸

Interleukin 10 (IL-10) is a cytokine with potent anti-inflammatory properties that plays a central role in limiting host immune response, thereby preventing damage to the host and maintaining normal tissue homeostasis. 

CBM588® ability to induce IL-10-producing immunoregulatory macrophages is being studied for its potential as an immunomodulatory probiotic for both maintenance and induction of remission in IBD, by targeting intestinal macrophages. ^9,10

Application: Ameliorate GI Effects of H pylori Eradication Therapy

H pylori is deeply involved in gastroduodenal ulcer disease and H pylori-positive patients are generally treated using Triple Therapy with a proton pump inhibitor and two antibiotics selected from among the following three: amoxicillin, clarithromycin and metronidazole.

This therapy can achieve a bacterial eradication rate of about 80-90%.

But it also results in a high incidence of gastrointestinal side effects like diarrhoea and loose stools.

Studies have shown that concomitant supplement with CBM588® during therapy reduced the change in intestinal flora and prevented gastrointestinal side effects.^11,12