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Cited by 44Probiotics and Fermented FoodsGut microbiota and healthAquaculture disease management and microbiota

Accounting for the health risk of probiotics

Open access
Liu, Xiangyi, Zhao, Haiyi, Wong, Aloysius·2024·Heliyon
DOI 10.1016/j.heliyon.2024.e27908PMC PMC10950733
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Abstract

Probiotics have long been associated with a myriad of health benefits, so much so that their adverse effects whether mild or severe, are often neglected or overshadowed by the enormous volume of articles describing their beneficial effects in the current literature. Recent evidence has demonstrated several health risks of probiotics that warrant serious reconsideration of their applications and further investigations. This review aims to highlight studies that report on how probiotics might cause opportunistic systemic and local infections, detrimental immunological effects, metabolic disturbance, allergic reactions, and facilitating the spread of antimicrobial resistance. To offer a recent account of the literature, articles within the last five years were prioritized. The narration of these evidence was based on the nature of the studies in the following order of preference: clinical studies or human samples, in vivo or animal models, in situ, in vitro and/or in silico. We hope that this review will inform consumers, food scientists, and medical practitioners, on the health risks, while also encouraging research that will focus on and clarify the adverse effects of probiotics.

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  • Probiotic supplementation can prevent or cure autoimmune diseases or reduce cytokine levels.

    “However, probiotic supplementation can prevent or cure autoimmune diseases or reduce cytokine levels [87].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [87]

    In “Detrimental immunological effects,” the paper says probiotic supplementation has not been conclusively shown to prevent or treat autoimmune diseases or lower cytokine levels. It also reports studies finding no benefit or elevated cytokines, rather than establishing the claimed benefits. (LLM, conf=0.91)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Results regarding probiotic use in the scientific literature are irregular and vary significantly due to differences in probiotic types, doses, and treatment regimens across studies.

    “The bottom line is that the results regarding probiotic use described in the scientific literature are irregular and vary significantly due to differences in probiotic types, their doses, and treatment regimens across studies [87].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [87]

    The Conclusion and outlook says outcomes vary because probiotic types, amounts, and administration frequency differ across studies. But “these effects” refers specifically to reductions in complications and infections among surgical patients; the citing sentence generalizes that finding to results on probiotic use overall. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Research results on probiotics and prebiotics for prevention and treatment of allergic diseases remain inconclusive or contradictory.

    “Despite the increasing interest in probiotics and prebiotics the prevention and treatment of allergic diseases, including atopic dermatitis, asthma, rhinitis, and food allergy, research results remain inconclusive or contradictory [87].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [87]

  • Vulnerable populations including newborns, immunocompromised individuals, and critically ill individuals are at greater risk from probiotics.

    “Vulnerable populations (newborns, immunocompromised individuals, and critically ill individuals) are at greater risk; therefore, assessing regulatory compliance requires a combination of biochemical and metabolomic studies, whole genome sequencing for virulence, antibiotic resistance genes and motility mapping [63,66,87].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [87]

  • Conclusions on probiotics for metabolic disorders were not universally positive, and some studies reported unexpected side effects.

    “Conclusions were not universally positive, and some studies even reported unexpected side effects [87,108].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [87]

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Cited by

Sorted by citations

Authors
Liu, X., Zhao, H., & Wong, A.
Affiliations
Wenzhou-Kean University (CN)
Corresponding author
Wong, Aloysius
ORCID
Wong, Aloysius
Venue
Heliyon
Publisher
Elsevier BV
Published
2024-03
Volume
10
Issue
6
Pages
e27908
ISSN
2405-8440 (ISSN-L)
DOI
10.1016/j.heliyon.2024.e27908
PMC
PMC10950733
OpenAlex
W4392764930
Cited by
44
References
24
Citations by year
2026: 20 · 2025: 19 · 2024: 5
FWCI
1.64
Type
journal article
Language
en
Open access
Licence
Locations
  • Heliyon (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Wenzhou-Kean University
  • Southern Partners Fund (SpF2021002)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Life Sciences › Immunology and Microbiology › Immunology › Aquaculture disease management and microbiota
Keywords
probiotics, health risks, adverse effects, opportunistic infections, immunological effects, metabolic disorders, allergic reactions, antimicrobial resistance, systemic infection, local infection

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