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Can probiotics modulate human disease by impacting intestinal barrier function?
Open accessAbstract
Intestinal barrier integrity is a prerequisite for homeostasis of mucosal function, which is balanced to maximise absorptive capacity, while maintaining efficient defensive reactions against chemical and microbial challenges. Evidence is mounting that disruption of epithelial barrier integrity is one of the major aetiological factors associated with several gastrointestinal diseases, including infection by pathogens, obesity and diabetes, necrotising enterocolitis, irritable bowel syndrome and inflammatory bowel disease. The notion that specific probiotic bacterial strains can affect barrier integrity fuelled research in which in vitro cell lines, animal models and clinical trials are used to assess whether probiotics can revert the diseased state back to homeostasis and health. This review catalogues and categorises the lines of evidence available in literature for the role of probiotics in epithelial integrity and, consequently, their beneficial effect for the reduction of gastrointestinal disease symptoms.
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“There is substantial evidence that probiotics can strengthen the intestinal barrier, regulate mucosal immune function, and produce metabolites beneficial to the host to maintain health, as illustrated in Figure 1 [22,23].”
From Probiotics Regulate Gut Microbiota: An Effective Method to Improve Immunity (2021) · cites this paper as [22]
In the citing paper
“a variety of studies do suggest that probiotics are able to improve mucosal barrier function (Bron et al., 2017).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Bron et al., 2017
In the citing paper
“There is compelling evidence that probiotics are able to support the intestinal barrier (Bron et al., 2017), which may act to dampen the increased inflammatory tone seen in aging and enhance the immune response to viral infections and vaccinations.”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Bron et al., 2017
In the citing paper
“The GI microbiome is thought to be a key player in this process as it is essential for the proper maintenance of the intestinal barrier through various mechanisms, e.g., production of SCFA (Bron et al., 2017) as well as tryptophan metabolites (Rothhammer and Quintana, 2019).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Bron et al., 2017
In the citing paper
“Similar as the endogenous microbiota, probiotics may improve mucosal barrier function, limiting the ability of viral particles to cross this physical barrier and maintain this barrier during viral disease (Bron et al., 2017).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Bron et al., 2017
In the citing paper
“Numerous pre-clinical studies have shown that oral probiotics are capable of positively influencing gut barrier function and systemic immunity, and thus, in the case of pneumonia, may enhance the host’s ability to suppress and clear reproducing lung pathogens as they emerge (Bron et al., 2017) (Forsythe, 2014).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Bron et al., 2017
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Gut Microbiota and Autoimmune Diseases: A Charming Real World Together with Probiotics
Piccioni, A., Cicchinelli, S., Valletta, F., Luca, G. D., Longhitano, Y., Candelli, M., Ojetti, V., Sardeo, F., Navarra, S. M., Covino, M., et al. (2021) · Current Medicinal Chemistry · doi:10.2174/0929867328666210922161913 · Cited by 36
Bu, Y., Liu, Y., Liu, Y., Cao, J., Zhang, Z., & Yi, H. (2023) · Nutrients · doi:10.3390/nu15163518 · Cited by 38
“With the increasing researches on probiotics and intestinal health, several functions of probiotics have been proven to be correlated with their role of regulating the intestinal barrier [6].”
BackgroundPotential Ability of Probiotics in the Prevention and Treatment of Colorectal Cancer
Zhao, J., Liao, Y., Wei, C., Ma, Y., Wang, F., Chen, Y., Zhao, B., Ji, H., Wang, D., & Tang, D. (2023) · Clinical Medicine Insights Oncology · doi:10.1177/11795549231188225 · Cited by 44
Xu, H., Zhao, C., Li, Y., Liu, R., Ao, M., Li, F., Yao, Y., Tao, Z., & Yu, L. (2019) · Food & Function · doi:10.1039/c9fo01599j · Cited by 36
Zang, J., Xiao, L., Shi, Y., Kou, Y., Ma, K., Zhang, C., Rui, X., Lin, T., & Li, W. (2026) · Comprehensive Reviews in Food Science and Food Safety · doi:10.1111/1541-4337.70383 · Cited by 46
Biological strategies for the prevention of periodontal disease: Probiotics and vaccines
Myneni, S. R., Brocavich, K., & Wang, H. H. (2020) · Periodontology 2000 · doi:10.1111/prd.12343 · Cited by 34
Lactobacillus casei Zhang exerts probiotic effects to antibiotic-treated rats
Yao, G., Cao, C., Zhang, M., Kwok, L., Zhang, H., & Zhang, W. (2021) · Computational and Structural Biotechnology Journal · doi:10.1016/j.csbj.2021.10.026 · Cited by 34
“, by competing with pathogenic microbes for available nutrients and epithelial binding sites, strengthening the gut barrier structure and function, enhancing host immunity, and modulating the stability, expression, and composition of host-microbiota either directly or indirectly [6].”
BackgroundFermented foods and cardiometabolic health: Definitions, current evidence, and future perspectives
Li, K. J., Burton-Pimentel, K. J., Vergères, G., Feskens, E. J. M., & Brouwer-Brolsma, E. M. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.976020 · Cited by 42
Li, Y., Wu, Y., Wu, L., Qin, L., & Liu, T. (2022) · Journal of Translational Medicine · doi:10.1186/s12967-022-03695-y · Cited by 32
“can stimulate MUC3 expression and MUC2 production and secretion [54, 55].”
BackgroundMiknevicius, P., Žulpaitė, R., Leber, B., Strupas, K., Stiegler, P., & Schemmer, P. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22179347 · Cited by 33
“Generally, CTx causes a decrease in Lactobacillus, Bifidobacterium, and other protective bacteria and an increase in specific pathogenic species [49].”
BackgroundThe Microbiota in Systemic Lupus Erythematosus: An Update on the Potential Function of Probiotics
Guo, X., Yang, X., Li, Q., Shen, X., Zhong, H., & Yang, Y. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.759095 · Cited by 34
“Probiotics can affect immune homeostasis by keeping a healthy microbial balance, and can also adjust mucus secretion through intestinal epithelial cells, thereby contributing to maintaining the stability of the mucus barrier and providing resistance to pathogen colonization (Bron et al., 2017; de Oliveira et al., 2017…”
BackgroundVelayati, A., Kareem, I., Sedaghat, M., Sohrab, G., Nikpayam, O., Hedayati, M., Abhari, K., & Hejazi, E. (2021) · Archives of Physiology and Biochemistry · doi:10.1080/13813455.2021.1928225 · Cited by 32
“Also, modification of the gut microbial flora by using probiotics and prebiotics is effective in reducing endo-tox-emia and pro-inflammatory cytokines by maintaining intestinal mucosal integrity and reducing intestinal permeability (Bron et al .”
BackgroundChen, Y., Pu, W., Maswikiti, E. P., Tao, P., Li, X., Wang, D., Gu, B., Yu, Y., Gao, L., Zhao, C., et al. (2021) · Bioscience Reports · doi:10.1042/bsr20211560 · Cited by 34
Wong‐Chew, R. M., de Castro, J.-A. A., Morelli, L., Perez, M. I., & Özen, M. (2022) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2022.2085559 · Cited by 35
Anti-inflammatory effect of Bifidobacterium animalis subsp. lactis A6 on DSS-induced colitis in mice
Wang, H., Fan, C., Zhao, Z., Zhai, Z., & Hao, Y. (2022) · Journal of Applied Microbiology · doi:10.1111/jam.15681 · Cited by 32
“Intestinal barrier integrity is a prerequisite for homeostasis of mucosal function, and loss of epithelial integrity was considered to be one pathogenic factor for IBD, which was mainly due to an increased mucosal permeability (Bron et al., 2017).”
BackgroundSanders, M. E., Goh, Y. J., & Klaenhammer, T. R. (2019) · ASM Press eBooks · doi:10.1128/9781555819972.ch32 · Cited by 32
Mahboobi, S., Ghasvarian, M., Ghaem, H., Alipour, H., Alipour, S., & Eftekhari, M. H. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.1018357 · Cited by 31
“Probiotic strains have the potential to enhance epithelial barrier integrity through modulating gene expression of adhesion proteins (47, 66) and production of health promoting molecules and anti-microbial peptides which prevent pathogen growth (67, 68).”
BackgroundKommers, M. J., Rodrigues, R. A. S., Miyajima, F., Zavala, A. A. Z., Ultramari, V. R. L. M., Fett, W. C. R., Balogun, S. O., de Oliveira, R. G., & Fett, C. A. (2019) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2019.0134 · Cited by 32
Oral Probiotics Alleviate Intestinal Dysbacteriosis for People Receiving Bowel Preparation
Deng, X., Tian, H., Yang, R., Han, Y., Wei, K., Zheng, C., Liu, Z., & Chen, T. (2020) · Frontiers in Medicine · doi:10.3389/fmed.2020.00073 · Cited by 31
“Probiotics are “living microorganisms that can have beneficial effects on the host when ingesting sufficient doses” (7), previous studies indicate that probiotics play an active role in a variety of human diseases, including irritable bowel syndrome, inflammatory bowel disease, and colon cancer (8, 9).”
BackgroundImpact of intestinal dysbiosis on breast cancer metastasis and progression
Zhang, J., Xie, Q., Huo, X., Liu, Z., Da, M., Yuan, M., Zhao, Y. D., & Shen, G. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.1037831 · Cited by 31
“Gut microbes break down non-digestible compounds through anaerobic fermentation to produce compounds of short-chain fatty acids (SCFAs), which have good anti-inflammatory and chemopreventive properties and act as barrier protectors (28, 29) and are considered as tumor suppressors (30).”
BackgroundJin, X., Hu, Y., Lin, T., Gao, F., Xu, Z., Hou, X., Yin, Y., Kan, S., Zhu, H., & Chen, D. (2023) · Food & Function · doi:10.1039/d2fo03408e · Cited by 31
Ghelardi, E., Mazzantini, D., Celandroni, F., Calvigioni, M., Panattoni, A., Lupetti, A., Fer, B. B. D., & Perez, M. I. (2023) · Frontiers in Microbiology · doi:10.3389/fmicb.2023.1127321 · Cited by 29
“Studies have highlighted the ability of probiotics to improve the gut-barrier function, modulate gut microbiota, enhance host immune response, exert antimicrobial activities, and possibly reduce risk, duration, or severity of diseases (Bron et al., 2017; Hu et al., 2017).”
BackgroundYang, N., Ma, T., Xie, Y., Li, Q., Li, Y., Zheng, L., Li, Y., Xiao, Q., Sun, Z., Zuo, K., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-51094-2 · Cited by 29
“Theyhavebeenusedtomanagediarrhea,alleviate symptoms through reducing in fl ammation, restoring gut microbiota balance, and enhancing intestinal mucosal barrier function 15 .”
Najafi, M. B. H., Fatemizadeh, S. S., & Tavakoli, M. (2018) · International Journal of Peptide Research and Therapeutics · doi:10.1007/s10989-018-9679-8 · Cited by 28
“2005), prevention of intestinal infection by producing organic acids and antibacterial agents (Bron et al. 2017), and enhancement of the immune system (de Morais 2016).”
BackgroundHan, J., Ren, Y., Zhang, P., Fang, C., Yang, L., Zhou, S., & Ji, Z. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-03788-0 · Cited by 47
“Second, probiotics interact with the intestinal epithelial cells, promoting mucin production, modulating pro-inflammatory markers, and reinforcing tight junctions to prevent apoptosis [19].”
Intestinal Microbiota in Sepsis
Sun, T., Wang, L., & Zhang, H. (2022) · Intensive Care Research · doi:10.1007/s44231-022-00001-8 · Cited by 26
“However, Lactobacillus spp could stimulate mucin3 and mucin2 production and secretion [19, 20], Akkermansia muciniphila could restore mucus growth and increase the number of goblet cells [21].”
BackgroundNew Nutritional and Therapeutical Strategies of NEC
Capriati, T., Diamanti, A., & Jean, D. V. D. G. (2019) · Current Pediatric Reviews · doi:10.2174/1573396315666190313164753 · Cited by 26
Hwang, S.-B., Chelliah, R., Kang, J. E., Rubab, M., Daliri, E. B., Elahi, F., & Oh, D. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.614963 · Cited by 27
Peng, C., Zhang, X., Chen, Y., & Wang, L. (2023) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2023.115685 · Cited by 25
Evivie, S. E., Abdelazez, A., Li, B., Lu, S., Liu, F., & Huo, G. (2020) · Frontiers in Microbiology · doi:10.3389/fmicb.2020.583070 · Cited by 25
“There is a growing body of in vitro and in vivo evidence that probiotics could be useful in lowering incidences of FBDs by modulating the gut microbiome (Bron et al., 2017; Evivie et al., 2017).”
BackgroundHuang, X., Ni, B., Li, Q., Liu, M., Zhao, M., Zhang, Y., Shi, X., & Wang, W. (2024) · Combinatorial Chemistry & High Throughput Screening · doi:10.2174/0113862073262645231121025911 · Cited by 26
Kwon, H., Nam, E. H., Kim, H., Jo, H.-N., Bang, W. Y., Lee, M., Shin, H., Kim, D., Kim, J. H., Kim, H.-J., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-72887-x · Cited by 32
Garcı́a, G., Carlin, M. R., & Cano, R. J. (2025) · Microorganisms · doi:10.3390/microorganisms13030514 · Cited by 26
“Additionally, probiotics modulate immune responses by promoting anti-inflammatory cytokines (e.g., IL-10) while suppressing pro-inflammatory cytokines (e.g., IL-6 and TNF-α ) [93,94].”
Zhao, L., Xie, Q., Evivie, S. E., Yue, Y., Yang, H. M., Lv, X., Liu, F., Li, B., & Huo, G. (2022) · Journal of Functional Foods · doi:10.1016/j.jff.2022.105030 · Cited by 24
Modulating gut microbiota by paraprobiotics: Mechanisms, advantages, and challenges
Yolmeh, M., Xavier-Santos, D., & Sant’Ana, A. S. (2024) · Food Bioscience · doi:10.1016/j.fbio.2024.104305 · Cited by 28
Mathipa-Mdakane, M. G., Thantsha, M. S., & Bhunia, A. K. (2019) · Microbial Biotechnology · doi:10.1111/1751-7915.13407 · Cited by 24
“monocytogenes translocation, which could be attributed to probiotic-induced physical hindrance and maintenance of tight junction integrity thus preventing pathogen passage (Pagnini et al., 2010; Bron et al., 2017).”
BackgroundUllah, H., Товчига, О. В., Daglia, M., & Khan, H. Z. (2021) · Current Neuropharmacology · doi:10.2174/1570159x19666210217084827 · Cited by 25
Probiotics and Functional Gastrointestinal Disorders in Pediatric Age: A Narrative Review
Capozza, M., Laforgia, N., Rizzo, V., Salvatore, S., Guandalini, S., & Baldassarre, M. (2022) · Frontiers in Pediatrics · doi:10.3389/fped.2022.805466 · Cited by 24
Metadata
- Authors
- Bron, P. A., Kleerebezem, M., Brummer, R.-J., Cani, P. D., Mercenier, A., MacDonald, T. T., Garcia-Ródenas, C. L., & Wells, J. M.
- Affiliations
- Nederlands Instituut Voor Zuivel Oonderzoek (NL)
- Wageningen University & Research (NL)
- Örebro University (SE)
- Walloon Excellence in Lifesciences and Biotechnology (BE)
- Nestlé (Switzerland) (CH)
- Queen Mary University of London (GB)
- Corresponding author
- Bron, Peter A.
- ORCID
- Venue
- British Journal Of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-01-14
- Volume
- 117
- Issue
- 1
- Pages
- 93-107
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- PMC
- PMC5297585
- OpenAlex
- W2573938105
- Cited by
- 499
- References
- 232
- Citations by year
- 2026: 54 · 2025: 47 · 2024: 55 · 2023: 52 · 2022: 64 · 2021: 67 · 2020: 54 · 2019: 43 · 2018: 42 · 2017: 19
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal Of Nutrition (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion, cc-by-nc-nd)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by-nc-nd)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by-nc-nd)
- Funders
- Fonds De La Recherche Scientifique - FNRS (WELBIO-CR-2012S-02R)
- Walloon excellence in life sciences and biotechnology
- FP7 Ideas: European Research Council (336452)
- 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
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- probiotics, intestinal barrier function, epithelial barrier integrity, mucosal homeostasis, gastrointestinal diseases, irritable bowel syndrome, inflammatory bowel disease, necrotizing enterocolitis, obesity, diabetes mellitus, pathogen infection
- MeSH terms
- Animals, Humans, Intestinal Diseases, Intestines, Probiotics
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