Unlocking Therapeutic Potential of Bengkoang (Pachyrhizus erosus) Inulin and Lactobacillus Synergies in Synbiotics for Immunomodulatory Interventions in Indonesia: A Review

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Refa Rahmaddiansyah
Rauza Sukma Rita
Sukarsi Rusti


BACKGROUND: Indonesia’s vision for 2045 encapsulates a grand aspiration for global competitiveness and resilience, with an emphasis on cultivating robust and skilled human capital. This study delves into the pivotal role of health-centric food and beverages as a fundamental component aligned with the Sustainable Development Goals 2030. The objective is to confront non-communicable diseases and preempt the anticipated surge in malnutrition-related fatalities projected for Indonesia’s population of 340 million by 2045. The findings illuminate the potential of synbiotics, specifically highlighting the synergistic relationship between Bengkoang inulin and Lactobacillus.

METHODS: Conducted through a narrative literature review method, this research meticulously synthesized articles drawn from national and international journals published within the past decade. The rigorous selection criteria honed in on themes surrounding synbiotics, Pachyrhizus erosus, immunomodulators, inulin, and Lactobacillus. The chosen articles underwent comprehensive analysis and synthesis.

RESULTS: Synbiotics exhibited promising enzymatic activities, growth enhancements, and significant immune modulation. These outcomes signal substantive implications for disease prevention and overall health enhancement. The discussion emphasizes the potential application of synbiotics as a promising therapeutic intervention for malnutrition. It is underscored by its multifaceted impact on gut health, nutrient absorption, immune modulation, and its potential therapeutic applications across diverse health domains – the pivotal role of synbiotics in averting health disparities and augmenting overall well-being. The discussion delves into the immunomodulatory potential of synbiotics, elucidating their ability to fine-tune immune responses, mitigate inflammation, and potentially enhance vaccine efficacy.

CONCLUSION: This comprehensive analysis underscores the far-reaching implications of synbiotic therapy, positioning it as a promising avenue for therapeutic innovation and holistic health interventions.


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Rahmaddiansyah R, Rita RS, Rusti S. Unlocking Therapeutic Potential of Bengkoang (Pachyrhizus erosus) Inulin and Lactobacillus Synergies in Synbiotics for Immunomodulatory Interventions in Indonesia: A Review. SEE J Immunol [Internet]. 2024 Feb. 20 [cited 2024 Jul. 19];7:43-9. Available from: https://seejim.eu/index.php/seejim/article/view/6066
Clinical Immunology


Nuraini L, Af’idah IN, Chasannudin A, Zaim Z. Education adolescent reproductive health to meet Indonesia gold 2045. Indones Berdaya. 2022;4(1):243-52. https://doi.org/10.47679/ ib.202336

Alaloul WS, Liew MS, Zawawi NA, Kennedy IB. Industrial revolution 4.0 in the construction industry: Challenges and opportunities for stakeholders. Ain Shams Eng J. 2020;11(1):225-30. https://doi.org/10.1016/j.asej.2019.08.010

Sassi M, Thakare H. Conflict and child malnutrition: A systematic review of the emerging quantitative literature. Curr Nutr Rep. 2022;11(1):1-8. https://doi.org/10.1007/ s13668-021-00386-w PMid:35094307

Fairuzzabadi, Hamat Z, Rahmawat S, Isa RM, Agussabti MS, Hanapi MS, et al. Human resources development model for the industrial revolution 4.0 Era in Aceh, Indonesia. Turk J Comput Math Educ. 2021;12(5):44-55.

Wisnumurti AA, Darma IK, Suasih NN. Government policy of Indonesia to managing demographic bonus and creating Indonesia Gold in 2045. IOSR J Humanit Soc Sci. 2018;23(1):23- 34. https://doi.org/10.9790/0837-2301072334

United Nations. Global Indicator Framework for the Sustainable Development Goals and Targets of the 2030 Agenda for Sustainable Development. Work of the Statistical Commission Pertaining to the 2030 Agenda for Sustainable Development. New York: United Nations; 2020.

Jones KD, Thitiri J, Ngari M, Berkley JA. Childhood malnutrition: Toward an understanding of infections, inflammation, and antimicrobials. Food Nutr Bull. 2014;35(2 Suppl):S64-70. https:// doi.org/10.1177/15648265140352S110 PMid:25069296

Ariati NN, Wiardani NK, Kusumajaya AA, Fetria A. Implementation of child nutrition anthropometry pocketbook for early childhood education to increase the ability of teachers to assess nutritional status of early childhood education students in Gianyar regency, Bali, Indonesia. Bali Med J. 2021;10(3):940-4. https://doi.org/10.15562/bmj.v10i3.2662

Amoroso L. Post-2015 agenda and sustainable development goals: Where are we now? Global opportunities to address malnutrition in all its forms, including hidden hunger. World Rev Nutr Diet. 2017;118:45-56. https://doi.org/10.1159/000484334 PMid:33503779

Asim M, Nawaz Y. Child malnutrition in Pakistan: Evidence from literature. Children (Basel). 2018;5(5):60. https://doi. org/10.3390/children5050060 PMid:29734703

Ibrahim MK, Zambruni M, Melby CL, Melby PC. Impact of childhood malnutrition on host defense and infection. Clin Microbiol Rev. 2017;30(4):919-71. https://doi.org/10.1128/ CMR.00119-16 PMid:28768707

Vonaesch P, Tondeur L, Breurec S, Bata P, Nguyen LB, Frank T, et al. Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA). PLoS One. 2017;12(8):e0182363. https://doi.org/10.1371/journal. pone.0182363 PMid:28796794

Gómez-Gallego C, García-Mantrana I, Martínez-Costa C, Salminen S, Isolauri E, Collado MC. The microbiota and malnutrition: Impact of nutritional status during early life. Annu Rev Nutr. 2019;39:267-90. https://doi.org/10.1146/ annurev-nutr-082117-051716 PMid:31433738

Sharma V, Sharma V, Khan A, Wassmer DJ, Schoenholtz MD, Hontecillas R, et al. Malnutrition, health and the role of machine learning in clinical setting. Front Nutr. 2020;7:44. https://doi.89/fnut.2020.00044 PMid:32351968

Nurhayati R, Utami RB, Irawan AA. Health education about stunting nutrition in mothers to weight stunting children aged 2-5 years. J Qual Public Health. 2020;4(1):38-43. https://doi.org/10.30994/jqph.v4i1.148

Decker JE, Delahanty MT, Davey A, Robson SM, Trabulsi JC. Human milk, infant formula, and other milks fed to infants and toddlers in the United States, NHANES 2007-2018. J Acad Nutr Diet. 2023;123(9):1320-8.e3. https://doi.org/10.1016/j.jand.2022.10.017 PMid:36332789

Raman AS, Gehrig JL, Venkatesh S, Chang HW, Hibberd MC, Subramanian S, et al. A sparse covarying unit that describes healthy and impaired human gut microbiota development. Science. 2019;365(6449):eaau4735. https://doi.org/10.1126/science.aau4735 PMid:31296739

Oral presentations: Dietary interventions including probiotics, prebiotics and synbiotics. Neurogastroenterol Motil. 2017;29(Suppl. 2):3-140. https://doi.org/10.1111/nmo.13180

Zhu YT, Yue SM, Li RT, Qiu SX, Xu ZY, Wu Y, et al. Prebiotics inulin metabolism by lactic acid bacteria from young rabbits. Front Vet Sci. 2021;8:719927. https://doi.org/10.3389/fvets.2021.719927 PMid:34660762

Hartono, Cut M, Indra AA. Effect of inulin compound extract of shallots (Allium Cepa Linn.) on growth probiotic bacteria Lactobacillus acidophilus. J Bionature. 2013;14(1):61-9. https://doi.org/10.35580/bionature.v14i1.1449

Sarkar R, Bhowmik A, Kundu A, Dutta A, Nain L, Chawla G, et al. Inulin from Pachyrhizus erosus root and its production intensification using evolutionary algorithm approach and response surface methodology. Carbohydr Polym. 2021;251:117042. https://doi.org/10.1016/j.carbpol.2020.117042 PMid:33142600

Crespo I, Arindra A, Lualdi JT, Rimba PA, Putra AB, Rahardja R. Inulin from several tubers available in Indonesia and the growth of gut microbiota. Indones J Life Sci. 2020;2(1):16-22. https://doi.org/10.54250/ijls.v2i1.33

Bhanja A, Paikra SK, Sutar PP, Mishra M. Characterization and identification of inulin from Pachyrhizus erosus and evaluation of its antioxidant and in-vitro prebiotic efficacy. J Food Sci Technol. 2023;60(1):328-39. https://doi.org/10.1007/s13197-022-05619-6 PMid:36618034

Azad MAK, Sarker M, Li T, Yin J. Probiotic species in the modulation of gut microbiota: An Overview. Biomed Res Int. 2018;2018:9478630. https://doi.org/10.1155/2018/9478630 PMid:29854813

Helmizar H, Surono IS. Characteristics of amino acid, micronutrient and probiotic isolated from dadih and their benefits for pregnant mothers and outcomes in West Sumatra, Indonesia. Glob J Health Sci. 2019;12(1):116. https://doi.org/10.5539/gjhs.v12n1p116

Arnold M, Rajagukguk YV, Gramza-Michałowska A. Characterization of dadih: Traditional fermented buffalo milk of Minangkabau. Beverages. 2021;7(3):60. https://doi.org./10.3390/beverages7030060

Pulbutr P, Phaluek S, Sinsang P, Rattanakiat SR. Investigation of the prebiotic properties of the yam bean (Pachyrhizus erosus (l.) urban) tuber extract. Trop J Nat Prod Res. 2021;5(7):1250-4. https://doi.org/10.26538/tjnpr/v5i7.15

Santoso P, Maliza R, Rahayu R, Astrina Y, Syukri F, Maharani S. Extracted yam bean (Pachyrhizus erosus (L.) Urb.) fiber counteracts adiposity, insulin resistance, and inflammation while modulating gut microbiota composition in mice fed with a high-fat diet. Res Pharm Sci. 2022;17(5):558-71. https://doi.org/10.4103/1735-5362.355213 PMid:36386490

Oladejo TC, Olaniyi OO, Ayodeji AO, Akinyele BJ. Protease produced by Lactobacillus brevis enhanced nutritional values of African yam beans and demonstrated improvement in the growth and blood indices of albino rats. Heliyon. 2020;6(10):e05123. https://doi.org/10.1016/j.heliyon.2020.e05123 PMid:33134572

Liu Y, Zhong X, Lin S, Xu H, Liang X, Wang Y, et al. Limosilactobacillus reuteri and caffeoylquinic acid synergistically promote adipose browning and ameliorate obesity-associated disorders. Microbiome. 2022;10(1):226. https://doi.org/10.1186/s40168-022-01430-9 PMid:36517893

Azad MA, Sarker M, Wan D. Immunomodulatory effects of probiotics on cytokine profiles. Biomed Res Int. 2018;2018:8063647. https://doi.org/10.1155/2018/8063647 PMid:30426014

Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: From biology to the clinic. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-16. https://doi.org/10.1038/s41575-019-0173 PMid:31296969

Valdes AM, Walter J, Segal E, Spector TD. Role of the gut microbiota in nutrition and health. BMJ. 2018;361:k2179. https://doi.org/10.1136/bmj.k2179 PMid:29899036

Stower H. A microbiome aid for malnutrition. Nat Med. 2019;25(8):1189. https://doi.org/10.1038/s41591-019-0553-9 PMid:31388177

Rowland I, Gibson G, Heinken A, Scott K, Swann J, Thiele I, et al. Gut microbiota functions: Metabolism of nutrients and other food components. Eur J Nutr. 2018;57(1):1-24. https://doi.org/10.1007/s00394-017-1445-8 PMid:28393285

Bourassa MW, Alim I, Bultman SJ, Ratan RR. Butyrate, neuroepigenetics and the gut microbiome: Can a high fiber diet improve brain health? Neurosci Lett. 2016;625:56-63. https://doi.org/10.1016/j.neulet.2016.02.009 PMid:26868600

ChenDC.Gutmicrobiotaandintestinaldecolonizationofpathogenic microorganisms. Chin Med J (Engl). 2016;129(14):1639-42. https://doi.org/10.4103/0366-6999.185872 PMid:27411449

Cruchet S, Furnes R, Maruy A, Hebel E, Palacios J, Medina F, et al. The use of probiotics in pediatric gastroenterology: A review of the literature and recommendations by Latin- American experts. Paediatr Drugs. 2015;17(3):199-216. https://doi.org/10.1007/s40272-015-0124-6 PMid:25799959

Nicolucci AC, Reimer RA. Prebiotics as a modulator of gut microbiota in paediatric obesity. Pediatr Obes. 2017;12(4):265- 73. https://doi.org/10.1111/ijpo.12140 PMid:27072327

Peterson CT. Dysfunction of the microbiota-gut-brain axis in neurodegenerative disease: The promise of therapeutic modulation with prebiotics, medicinal herbs, probiotics, and synbiotics. J Evid Based Integr Med. 2020;25. https://doi.org/10.1177/2515690X20957225 PMid:33092396

Tuncil YE, Nakatsu CH, Kazem AE, Arioglu-Tuncil S, Reuhs B, Martens EC, et al. Delayed utilization of some fast-fermenting soluble dietary fibers by human gut microbiota when presented

in a mixture. J Funct Foods. 2017;32:347-57. https://doi.org/10.1016/j.jff.2017.03.001

Rusli R, Amalia F, Dwyana Z. Potential Lactobacillus bacteria acidophilus as an antidiarrheal and immunomodulator. Bioma J Biol Makassar. 2018;3(2):25-30. https://doi.org/10.20956/bioma.v3i2.5814

Farzad R, Kuhn DD, Smith SA, O’Keefe SF, Hines IS, Bushman TJ, et al. Effects of selenium-enriched prebiotic on the growth performance, innate immune response, oxidative enzyme activity and microbiome of rainbow trout (Oncorhynchus mykiss). Aquaculture. 2021;531(2):735980. https://doi.org/10.1016/j.aquaculture.2020.735980

Markowiak P, Śliżewska K. Effects of probiotics, prebiotics, and synbiotics on human health. Nutrients. 2017;9(9):1021. https://doi.org/10.3390/nu9091021 PMid:28914794

Shinde T, Perera AP, Vemuri R, Gondalia SV, Karpe AV, Beale DJ, et al. Synbiotic supplementation containing whole plant sugar cane fibre and probiotic spores potentiates protective synergistic effects in mouse model of IBD. Nutrients. 2019;11(4):818. https://doi.org/10.3390/nu11040818 PMid:30979002

Li X, Hu S, Yin J, Peng X, King L, Li L, et al. Effect of synbiotic supplementation on immune parameters and gut microbiota in healthy adults: A double-blind randomized controlled trial. Gut Microbes. 2023;15(2):2247025. https://doi.org/10.1080/19490976.2023.2247025 PMid:37614109

KalyuzhinOV.ProbioticstrainsofLactobacilliasimmunomodulators: Focus on Lactobacillus rhamnosus GG. Med Counc. 2017;(9):108- 15. https://doi.org/10.21518/2079-701X-2017-9-108-115

Adebo OA, Gabriela Medina-Meza I. Impact of fermentation on the phenolic compounds and antioxidant activity of whole cereal grains: A mini review. Molecules. 2020;25(4):927. https://doi.org/10.3390/molecules25040927 PMid:32093014

Tierney BT, Van den Abbeele P, Al-Ghalith GA, Verstrepen L, Ghyselinck J, Calatayud M, et al. Capacity of a microbial synbiotic to rescue the in vitro metabolic activity of the gut microbiome following perturbation with alcohol or antibiotics. Appl Environ Microbiol. 2023;89(3):e0188022. https://doi.org/10.1128/aem.01880-22 PMid:36840551

Gunawan DC, Juffrie M, Helmyati S, Rahayu ES. Synbiotic (L. Plantarum dad-13 and Fructo-Oligosaccharide) powder on gut microbiota (L. Plantarum, Bifidobacterium and Enterobacteriaceae) on stunting children in Yogyakarta, Indonesia. Curr Res Nutr Food Sci. 2022;10(1):371-83. https://doi.org/10.12944/CRNFSJ.10.1.31

Ramezani M, Sajadi Hezaveh Z. The effect of synbiotic supplementation on thyroid hormones, blood pressure, depression and quality of life in hypothyroid patients: A study protocol for a randomized double-blind placebo controlled clinical trial. Clin Nutr ESPEN. 2022;48:472-8. https://doi.org/10.1016/j.clnesp.2022.01.003 PMid:35331531

Hardy H, Harris J, Lyon E, Beal J, Foey AD. Probiotics, prebiotics and immunomodulation of gut mucosal defences: Homeostasis and immunopathology. Nutrients. 2013;5(6):1869-912. https://doi.org/10.3390/nu5061869 PMid:23760057

Cruz CS, Ricci MF, Vieira AT. Gut microbiota modulation as a potential target for the treatment of lung infections. Front Pharmacol. 2021;12:724033. https://doi.org/10.3389/fphar.2021.724033 PMid:34557097

Liu Y, Wang J, Wu C. Modulation of gut microbiota and immune system by probiotics, pre-biotics, and post-biotics. Front Nutr. 2021;8:634897. https://doi.org/10.3389/fnut.2021.634897 PMid:35047537

Kumar S, Pattanaik AK, Jadhav SE. Potent health-promoting effects of a synbiotic formulation prepared from Lactobacillus acidophilus NCDC15 fermented milk and Cichorium intybus root powder in Labrador dogs. Curr Res Biotechnol. 2021;3:209-14. https://doi.org/10.1016/j.crbiot.2021.06.001

Ciabattini A, Olivieri R, Lazzeri E, Medaglini D. Role of the microbiota in the modulation of vaccine immune responses. Front Microbiol. 2019;10:1305. https://doi.org/10.3389/fmicb.2019.01305 PMid:31333592

Yeh TL, Shih PC, Liu SJ, Lin CH, Liu JM, Lei WT, et al. The influence of prebiotic or probiotic supplementation on antibody titers after influenza vaccination: A systematic review and meta- analysis of randomized controlled trials. Drug Des Devel Ther. 2018;12:217-30. https://doi.org/10.2147/DDDT.S155110 PMid:29416317

Rodiño-Janeiro BK, Vicario M, Alonso-Cotoner C, Pascua- García R, Santos J. A review of microbiota and irritable bowel syndrome: Future in therapies. Adv Ther. 2018;35(3):289-310. https://doi.org/10.1007/s12325-018-0673-5 PMid:29498019

Aindelis G, Chlichlia K. Modulation of anti-tumour immune responses by probiotic bacteria. Vaccines (Basel). 2020;8(2):329. https://doi.org/10.3390/vaccines8020329 PMid:32575876

Shinde T, Vemuri R, Shastri S, Perera AP, Gondalia SV, Beale DJ, et al. Modulating the microbiome and immune responses using whole plant fibre in synbiotic combination with fibre-digesting probiotic attenuates chronic colonic inflammation in spontaneous colitic mice model of IBD. Nutrients. 2020;12(8):2380. https://doi.org/10.3390/nu12082380 PMid:32784883

Behera KK, Bist R, Mohanty S, Bhattacharya M. Prebiotics, Probiotics and Nutraceuticals. Berlin: Springer Nature; 2022.