Bifidobacteria and Their Health-Promoting Effects
Open accessAbstract
Bifidobacteria are members of the intestinal microbiota of mammals and other animals, and some strains are able to exert health-promoting effects. The genus Bifidobacterium belongs to the Actinobacteria phylum. Firmicutes , Bacteroidetes , and Actinobacteria constitute the most abundant phyla in the human intestinal microbiota, Firmicutes and Bacteroidetes being predominant in adults, and Actinobacteria in breast-fed infants, where bifidobacteria can reach levels higher than 90% of the total bacterial population. They are among the first microbial colonizers of the intestines of newborns, and play key roles in the development of their physiology, including maturation of the immune system and use of dietary components. Indeed, some nutrients, such as human milk oligosaccharides, are important drivers of bifidobacterial development. Some Bifidobacterium strains are considered probiotic microorganisms because of their beneficial effects, and they have been included as bioactive ingredients in functional foods, mainly dairy products, as well as in food supplements and pharma products, alone, or together with, other microbes or microbial substrates. Well-documented scientific evidence of their activities is currently available for bifidobacteria-containing preparations in some intestinal and extraintestinal pathologies. In this review, we focus on the role of bifidobacteria as members of the human intestinal microbiota and their use as probiotics in the prevention and treatment of disease.
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TL;DR
This review summarizes bifidobacteria as early colonizers of the infant gut and as probiotics, with strain-specific health effects reported in intestinal, extraintestinal, and allergic conditions. It concludes that evidence is promising but often insufficient, strain- and host-dependent, and requires better mechanistic understanding and product labeling.
Key findings
- Bifidobacteria can exceed 90% of the total bacterial population in breast-fed infants; adult fecal bifidobacterial load is estimated at close to 4%. The genus contains more than 50 species, with more than 50 complete genome sequences available, and a phylogeny based on 48 genomes identified seven phylogenetic groups.
- Clinical benefits are reported for selected strains and mixtures, including B. animalis subsp. lactis BB-12, B. breve Yakult, B. infantis 35624, and VSL#3, in antibiotic-associated diarrhea, C. difficile-associated diarrhea, IBS, ulcerative colitis, necrotizing enterocolitis, H. pylori infection, colorectal cancer, and allergic disease. A meta-analysis of 23 clinical trials (n = 4,213) found moderate evidence that probiotics are effective in preventing C. difficile-associated diarrhea; VSL#3 given for 10 days yielded an H. pylori eradication rate of 32.5% in adults; fecal microbiota transplantation showed up to 95.9% success for C. difficile infection.
- Proposed mechanisms include human milk oligosaccharide utilization, organic acid and antibacterial peptide production, quorum-sensing inhibition, immune modulation, exopolysaccharide effects, and cross-feeding with other gut bacteria. Effects are described as strain-dependent and influenced by the target population’s genetic background and gut microbiota composition.
- In a study of 16 probiotic products, only one matched its bifidobacterial label, highlighting unresolved labeling and strain-identification problems.
Methods
- Narrative review; no systematic review protocol, search strategy, inclusion criteria, or meta-analytic methods are stated.
- Synthesizes human clinical trials, meta-analyses, and in vitro/in vivo mechanistic studies; for the disease-effectivity section, the authors state they focus on clinical trials and exclude animal models and in vitro or ex vivo studies.
- Includes tables listing Bifidobacterium strains reported to show effectivity in human trials and selected meta-analyses/reviews on probiotic products containing bifidobacteria.
Limitations
- Stated: for many strains there is insufficient scientific evidence to support reported positive effects, and clear biomarkers for bifidobacterial efficacy are not yet identified. Most bifidobacterial strains were tested in combination with other microorganisms or prebiotic carbohydrates, making single-strain probiotic effects difficult to prove.
- Stated: health benefits appear strain-dependent, notably for immunomodulation, and also depend on the genetic background of the target population; further basic research is needed to clarify molecular mechanisms and define strain-specific effects. Correct identification and labeling of species/strains in foods and supplements remains an unresolved issue.
- Evident: as a narrative review, it does not systematically appraise study quality or risk of bias, and its tables are described as a selection, so conclusions may reflect selected literature rather than a comprehensive evidence synthesis.
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- Premisecitation§ ABSTRACT
Bifidobacteria are numerically dominant members of the intestinal microbial communities by the age of 3 to 4 months.
“Indeed, bifidobacteria are numerically dominant members of the intestinal microbial communities by the age of 3 to 4 months (15, 16).”
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- Premisecitation§ ABSTRACT
Bifidobacteria are among the best described gut bacteria with ability to utilize HMOs.
“Bifidobacteria are among the best described gut bacteria with ability to utilize HMOs.”
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- Interpretationnone given§ ABSTRACT
Some Bifidobacterium strains are able to exert health-promoting effects.
“Bifidobacteria are members of the intestinal microbiota of mammals and other animals, and some strains are able to exert health-promoting effects.”
Quote in the paperSubstantial claim - Premisecitation§ ABSTRACT
Bifidobacteria are among the dominant bacterial populations in the gastrointestinal tract of humans.
“Bifidobacteria are among the dominant bacterial populations in the gastrointestinal tract (GIT) of humans.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [5] Delgado S, Suárez A, Mayo B. 2006. Bifidobacterial diversity determined by culturing and by 16S rDNA sequence analysis in feces and mucosa from ten healthy Spanish adults. Dig Dis Sci 51:1878–1885. 10.1007/s10620-006-9293-z [DOI] [PubMed] [Google Scholar] source
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- Premisecitation§ ABSTRACT
Bifidobacterial exopolysaccharides have been proven to be capable of modulating gut microbiota in in vitro fecal batch cultures and in vivo mice trials.
“Bifidobacterial molecules, such as the exopolysaccharides present in the outer cell-surface layer, have been proven to be capable of modulating gut microbiota in in vitro fecal batch cultures (55) and in vivo mice trials (56), thus providing a molecular basis for gut microbiota-bifidobacteria cross talk.”
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- Interpretationnone given§ ABSTRACT
Bifidobacterium-mediated health benefits are the result of a complex dynamic interplay established among bifidobacteria, other members of the gut microbiota, and the human host.
“Bifidobacterium-mediated health benefits are the result of a complex dynamic interplay established among bifidobacteria, other members of the gut microbiota, and the human host.”
Quote in the paperSubstantial claim - Premisecitation§ ABSTRACT
Bifidobacteria numbers and diversity decrease with age.
“By using different approaches and techniques, it has been observed that bifidobacteria numbers and diversity decrease with age, although the fact that particular bifidobacterial types are more related with the elderly still remains obscure (10–12).”
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In vitro and in vivo studies have shown that modulating bifidobacterial levels through probiotic or prebiotic supplementation can change the overall composition and metabolism of the gut microbiota.
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- Premisecitation§ ABSTRACT
Bifidobacteria are members of the intestinal microbiota of mammals and other animals.
“Bifidobacteria are members of the intestinal microbiota of mammals and other animals, and some strains are able to exert health-promoting effects.”
- Also stated in: § ABSTRACT · plain
“Bifidobacteria are among the dominant bacterial populations in the gastrointestinal tract (GIT) of humans.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [5] Delgado S, Suárez A, Mayo B. 2006. Bifidobacterial diversity determined by culturing and by 16S rDNA sequence analysis in feces and mucosa from ten healthy Spanish adults. Dig Dis Sci 51:1878–1885. 10.1007/s10620-006-9293-z [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
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Not checked in the free run.
- Also stated in: § ABSTRACT · plain
- Interpretationreasoning§ ABSTRACT
The ability of B. bifidum, B. longum subsp. infantis, and B. breve to utilize HMOs explains their abundance in the breast-fed infant.
“Thus the ability of these species to utilize these otherwise indigestible carbohydrates explains their abundance in the breast-fed infant.”
Quote in the paperSubstantial claim - Premisecitation§ ABSTRACT
Breast-fed infants generally harbor a more complex and numerous Bifidobacterium microbiota than formula-fed infants.
“In fact it has been reported that breast-fed infants generally harbor a more complex and numerous Bifidobacterium microbiota than formula-fed infants (19, 20).”
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- Premisecitation§ ABSTRACT
Numerous in vitro studies have demonstrated that bifidobacteria can inhibit pathogens through the production of organic acids, antibacterial peptides, quorum-sensing inhibitors, or immune stimulation among other mechanisms.
“Numerous in vitro studies have demonstrated that bifidobacteria can inhibit pathogens through the production of organic acids (38), antibacterial peptides (39), quorum-sensing inhibitors (40, 41), or immune stimulation (42) among other mechanisms, providing molecular clues of their capacity to prevent certain infections.”
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- Premisecitation§ ABSTRACT
Most bifidobacterial strains were tested in combination with other microorganisms, typically LAB, or with prebiotic carbohydrates, making it difficult to prove the probiotic effect of a single strain.
“In addition, most bifidobacterial strains were tested in combination with other microorganisms, typically lactic acid bacteria (LAB), or with prebiotic carbohydrates, making it difficult to prove the probiotic effect of a single strain (88).”
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- Premisecitation§ ABSTRACT
Individuals with different gut microbiota composition appear to respond differently to Bifidobacterium supplementation.
“Further evidence of the existence of a bifidobacterial-gut microbiota cross talk has been provided by the fact that individuals with different gut microbiota composition appear to respond differently to Bifidobacterium supplementation (73).”
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- Premisecitation§ ABSTRACT
Administration of B. animalis subsp. lactis BB-12 together with Lactobacillus rhamnosus GG and inulin improved immune functions in resected colorectal cancer patients.
“In this sense, administration of B. animalis subsp. lactis BB-12 together with Lactobacillus rhamnosus GG and inulin improved the immune functions in resected CRC patients (126).”
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- Premisecitation§ ABSTRACT
A commercial product containing B. infantis reduces the incidence and severity of necrotizing enterocolitis in very-low-birth-weight infants and preterm infants.
“A commercial product containing a strain of B. infantis was able to reduce the incidence and severity of NEC in very-low-birth-weight infants (146) and in very-low-birth-weight preterm infants (147).”
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- Premisecitation§ ABSTRACT
The preparation of bifidobacterial suspensions in skimmed milk increased significantly their viability under simulated gastrointestinal transit with human stomach and duodenal fluids.
“The preparation of bifidobacterial suspensions in skimmed milk increased significantly their viability under simulated gastrointestinal transit with human stomach and duodenal fluids (98).”
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- Premisecitation§ ABSTRACT
There is moderate evidence from a meta-analysis of 23 clinical trials (n=4,213) that probiotics are effective in preventing Clostridium difficile-associated diarrhea.
“Goldenberg and coworkers (113) concluded, after an exhaustive meta-analysis (23 clinical trials, n = 4,213), that there is moderate evidence suggesting that probiotics are effective in the prevention of CDAD.”
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- Premisecitation§ ABSTRACT
B. bifidum YIT4007 reduces gastric mucosa alterations and other gastrointestinal symptoms by reducing H. pylori levels.
“This strain was able to reduce gastric mucosa alterations and other gastrointestinal symptoms due to a reduction in the levels of H. pylori (121).”
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- Premisecitation§ ABSTRACT
It has been demonstrated, in vivo, that B. animalis subsp. lactis HN019 changes its effect on the (mice) host when the strain is given in a fermented dairy format in comparison with the unfermented milk.
“In this regard, it has been demonstrated, in vivo, that B. animalis subsp. lactis HN019 changes its effect on the (mice) host when the strain is given in a fermented dairy format in comparison with the unfermented milk (89).”
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- Premisecitation§ ABSTRACT
Dairy products, and specifically fermented milks and yogurts, constitute a good matrix for the delivery of bifidobacteria.
“Dairy products, and specifically fermented milks and yogurts, constitute a good matrix for the delivery of bifidobacteria (92).”
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- Premisecitation§ ABSTRACT
In colorectal cancer patients, microbiota composition is one factor favoring carcinogenic lesions, notably through genotoxic bacteria such as Fusobacterium nucleatum or colibactin-producing Escherichia coli.
“In CRC patients, it is known that the composition of the microbiota is one of the factors favoring the development of carcinogenic lesions, notably by the presence of genotoxic bacteria such as Fusobacterium nucleatum or colibactin-producing Escherichia coli (124, 125).”
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- Premisecitation§ ABSTRACT
The probiotic efficacy of bifidobacteria showing positive effects on gastrointestinal functions after human intervention trials has only been studied for a few strains, most of them belonging to the species B. animalis subsp. lactis, B. breve, B. longum, and B. bifidum.
“However, the probiotic efficacy of bifidobacteria showing positive effects on gastrointestinal functions after human intervention trials has only been studied for a few strains, normally supported by multinational food companies, most of them belonging to the species B. animalis subsp. lactis, B. breve, B. longum, and B. bifidum (75).”
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- Interpretationreasoning§ ABSTRACT
Beneficial effects resulting from the consumption of bifidobacteria on human health have mainly been associated with the prevention and treatment of intestinal diseases and immunological disorders.
“Beneficial effects resulting from the consumption of bifidobacteria on human health have mainly been associated with the prevention and treatment of intestinal diseases and immunological disorders (Tables 1 and Table 2).”
Quote in the paperSubstantial claim - Premisecitation§ ABSTRACT
Supplementation of the gut microbiota obtained from a cohort of systemic lupus erythematosus patients with a B. bifidum strain partially corrected the altered immune response characteristic of lupus, using a dendritic cell/naive T-cell model.
“In this regard, supplementation of the gut microbiota obtained from a cohort of systemic lupus erythematosus patients with a B. bifidum strain partially corrected the altered immune response characteristic of lupus, using a dendritic cell/naive T-cell model (105).”
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- Premisecitation§ ABSTRACT
A phase 3 clinical trial of B. breve BBG-001 found no evidence of benefit for very preterm infants.
“For instance, a phase 3 clinical trial aimed at testing the effectiveness of the probiotic B. breve BBG-001 concluded that there is no evidence of benefit for very preterm infants (149).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [149] Costeloe K, Hardy P, Juszczak E, Wilks M, Millar MR, Probiotics in Preterm Infants Study Collaborative Group. 2016. Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial. Lancet 387:649–660. 10.1016/S0140-6736(15)01027-2 [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- May combine two claims. 10
- Classified as probably not a substantial claim. 1
May combine two claims.
Premisecitation§ ABSTRACTNumerous studies have demonstrated the capability of prebiotics to promote bifidobacterial presence within the microbiota, correlating with other changes in the overall microbiota composition and metabolism.
“On the other hand, numerous studies have demonstrated the capability of prebiotics to promote bifidobacterial presence within the microbiota, correlating with other changes in the overall microbiota composition and metabolism.”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [52] Monteagudo-Mera A, Arthur JC, Jobin C, Keku T, Bruno-Barcena JM, Azcarate-Peril MA. 2016. High purity galacto-oligosaccharides enhance specific Bifidobacterium species and their metabolic activity in the mouse gut microbiome. Benef Microbes 7:247–264. 10.3920/BM2015.0114 [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [60] Jung TH, Jeon WM, Han KS. 2015. In vitro effects of dietary inulin on human fecal microbiota and butyrate production. J Microbiol Biotechnol 25:1555–1558. 10.4014/jmb.1505.05078 [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [61] Kato T, Fukuda S, Fujiwara A, Suda W, Hattori M, Kikuchi J, Ohno H. 2014. Multiple omics uncovers host-gut microbial mutualism during prebiotic fructooligosaccharide supplementation. DNA Res 21:469–480. 10.1093/dnares/dsu013 [DOI] [PMC free article] [PubMed] [Google Scholar] source
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- cites [62] Neyrinck AM, Possemiers S, Druart C, Van de Wiele T, De Backer F, Cani PD, Larondelle Y, Delzenne NM. 2011. Prebiotic effects of wheat arabinoxylan related to the increase in bifidobacteria, Roseburia and Bacteroides/Prevotella in diet-induced obese mice. PLoS One 6:e20944. 10.1371/journal.pone.0020944 [DOI] [PMC free article] [PubMed] [Google Scholar] source
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May combine two claims.
Premisecitation§ ABSTRACTIn a recent study performed with 16 probiotic products, using DNA-based methods as well as culturing techniques, only one matched its bifidobacterial label; thus, most of them differ from the ingredient list.
“Indeed, in a recent study performed with 16 probiotic products, using DNA-based methods as well as culturing techniques, only one matched its bifidobacterial label; thus, most of them differ from the ingredient list (101).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [101] Lewis ZT, Shani G, Masarweh CF, Popovic M, Frese SA, Sela DA, Underwood MA, Mills DA. 2016. Validating bifidobacterial species and subspecies identity in commercial probiotic products. Pediatr Res 79:445–452. 10.1038/pr.2015.244 [DOI] [PMC free article] [PubMed] [Google Scholar] source
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May combine two claims.
Premisecitation§ ABSTRACTBifidobacterium is one of the main genera of commensal bacteria present in the human GIT and its presence has been related to health benefits in several studies.
“Bifidobacterium is one of the main genera of commensal bacteria present in the human GIT and its presence has been related to health benefits in several studies (83).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [83] EFSA, European Food Safety Authority. 2015. Statement on the update of the list of QPS-recommended biological agents intentionally added to food or feed as notified to EFSA. 2: Suitability of taxonomic units notified to EFSA until March 2015. EFSA J 13:4138. [Google Scholar] source
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May combine two claims.
Premisecitation§ ABSTRACTThe probiotic mixture VSL#3 reduces ulcerative colitis symptoms in adults and induces remission in children.
“In IBD, the probiotic mixture VSL#3, which contains bifidobacteria of different species, was able to reduce the UC symptoms in adults (144, 145) as well as the remission of the disease in children (84).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [144] Sood A, Midha V, Makharia GK, Ahuja V, Singal D, Goswami P, Tandon RK. 2009. The probiotic preparation, VSL#3 induces remission in patients with mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol 7:1202–1209.e1. 10.1016/j.cgh.2009.07.016 [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [145] Tursi A, Brandimarte G, Papa A, Giglio A, Elisei W, Giorgetti GM, Forti G, Morini S, Hassan C, Pistoia MA, Modeo ME, Rodino’ S, D’Amico T, Sebkova L, Sacca’ N, Di Giulio E, Luzza F, Imeneo M, Larussa T, Di Rosa S, Annese V, Danese S, Gasbarrini A. 2010. Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: a double-blind, randomized, placebo-controlled study. Am J Gastroenterol 105:2218–2227. 10.1038/ajg.2010.218 [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [84] Miele E, Pascarella F, Giannetti E, Quaglietta L, Baldassano RN, Staiano A. 2009. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 104:437–443. 10.1038/ajg.2008.118 [PubMed] [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
May combine two claims.
Premisecitation§ ABSTRACTFecal microbiota transplantation is the best methodology to reduce C. difficile-associated diarrhea and eradicate the pathogen, with up to 95.9% success including recalcitrant and severe cases.
“Regarding C. difficile infection, the best methodology to reduce the associated diarrhea and to eradicate this pathogen is the fecal microbiota transplantation, which has shown up to 95.9% success, including recalcitrant and severe cases (114).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [114] Agrawal M, Aroniadis OC, Brandt LJ, Kelly C, Freeman S, Surawicz C, Broussard E, Stollman N, Giovanelli A, Smith B, Yen E, Trivedi A, Hubble L, Kao D, Borody T, Finlayson S, Ray A, Smith R. 2016. The long-term efficacy and safety of fecal microbiota transplant for recurrent, severe, and complicated Clostridium difficile infection in 146 elderly individuals. J Clin Gastroenterol 50:403–407. [PubMed] [DOI] [PubMed] [Google Scholar] source
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May combine two claims.
Premisecitation§ ABSTRACTA meta-analysis of clinical trials showed that probiotics could be as effective as pharmacological approaches for H. pylori treatment and were the best treatment in terms of patient tolerance.
“Li and coworkers (117) published a meta-analysis that compiled the clinical trial studies involving H. pylori treatment, and they showed that the use of probiotics could be as effective as pharmacological approaches. In addition, probiotics were revealed in the same analysis as the best treatment in terms of tolerance for the patient.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [117] Li BZ, Threapleton DE, Wang JY, Xu JM, Yuan JQ, Zhang C, Li P, Ye QL, Guo B, Mao C, Ye DQ. 2015. Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis. BMJ 351:h4052. 10.1136/bmj.h4052 [DOI] [PMC free article] [PubMed] [Google Scholar] source
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May combine two claims.
Interpretationcitation§ CONCLUSIONSThe health benefits of bifidobacteria appear to be strain dependent, especially for immunomodulation, and also depend on the genetic background of the target population.
“It is noteworthy that the health benefits exerted by bifidobacteria seem to be strain dependent, notably at the level of immunomodulation, but they are also dependent on the genetic background of the target population (77).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [77] Food and Agriculture Organization. 2006. Probiotics in food: health and nutritional properties and guidelines for evaluation. FAO Food and Nutrition Paper 85. ISSN 0254-4725. [Google Scholar]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ ABSTRACTWAO guidelines concluded there is currently no evidence that probiotic supplementation reduces allergy incidence in children, but there is likely a net benefit for eczema prevention.
“These guidelines concluded that currently there is no evidence supporting probiotic supplementation for reducing the risk of allergy incidence in children. However, there is likely to be a net benefit using probiotics for eczema prevention, which requires further clinical trials to increase the sample size and the reliability of the results.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [166] Fiocchi A, Pawankar R, Cuello-Garcia C, Ahn K, Al-Hammadi S, Agarwal A, Beyer K, Burks W, Canonica GW, Ebisawa M, Gandhi S, Kamenwa R, Lee BW, Li H, Prescott S, Riva JJ, Rosenwasser L, Sampson H, Spigler M, Terracciano L, Vereda-Ortiz A, Waserman S, Yepes-Nuñez JJ, Brożek JL, Schünemann HJ. 2015. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): probiotics. World Allergy Organ J 8:4. 10.1186/s40413-015-0055-2 [DOI] [PMC free article] [PubMed] [Google Scholar] source
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May combine two claims.
Premisecitation§ ABSTRACTEach Bifidobacterium species appeared to elicit different immune effects on the host, noteworthy being the ability of B. bifidum to expand the T-regulatory response, which may be relevant for its use in chronic inflammatory diseases.
“Each Bifidobacterium species appeared to elicit different immune effects on the host, noteworthy being the ability of B. bifidum to expand the T-regulatory response, which may be relevant for its use in chronic inflammatory diseases (104).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [104] López P, González-Rodríguez I, Sánchez B, Gueimonde M, Margolles A, Suárez A. 2012. Treg-inducing membrane vesicles from Bifidobacterium bifidum LMG13195 as potential adjuvants in immunotherapy. Vaccine 30:825–829. 10.1016/j.vaccine.2011.11.115 [DOI] [PubMed] [Google Scholar] source
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May combine two claims.
Interpretationreasoning§ ABSTRACTIn many cases, there is insufficient scientific evidence to support the positive effects reported for the strains, since clear biomarkers for bifidobacterial efficacy are, as yet, not identified.
“In many cases, there is insufficient scientific evidence to support the positive effects reported for the strains, since clear biomarkers for bifidobacterial efficacy are, as yet, not identified (Fig. 1).”
Quote in the paperSubstantial claim
The paper relies on this without support.
Antibiotic treatments for H. pylori decreased in effectiveness over years of antibiotherapy, leading to antibiotic resistance in H. pylori strains.
“Although very successful in the beginning, antibiotic treatments decreased in effectiveness after years of antibiotherapy, which resulted in the emergence of antibiotic resistance in H. pylori strains.”
The paper relies on this without support.
Feces from a healthy person likely contain between 1 and 4% bifidobacteria.
“Because it is likely that the feces from a healthy person contain between 1 and 4% bifidobacteria, it remains to be elucidated whether increasing the number of bifidobacteria by appropriate donor selection, or by targeted enrichment of this population before transplantation, could be useful, not only in CDAD, but also in other diseases through fecal microbiota transplantation.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A. muciniphila can produce secretory IgA and antibacterial peptides by immunological rejection to resist pathogen damage to the intestines, and has anti-inflammatory, barrier-improving properties; it can also regulate intestinal microbial balance, and improve the situation of PD, aging, pediatric autism, MS and ALS.
“For probiotics strains, A. muciniphila can produce secretory immunoglobulin A (IgA) and antibacterial peptides by immunological rejection to resist pathogen damage to the intestines, and has anti-inflammatory, barrier-improving properties. It can also regulate intestinal microbial balance, and improve the situation of PD, aging, pediatric autism, MS and ALS (Derrien et al. 2017; Hidalgo-Cantabrana”
From Therapeutic effect of GLP-1 engineered strain on mice model of Alzheimer’s disease and Parkinson’s disease (2020) · cites this paper as Hidalgo-Cantabrana et al. 2017
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Cited chemotherapy patients described as having CRC
MinorThe text describes the patients in reference 132 as having colorectal cancer, while that reference is titled as a study of patients undergoing chemotherapy for pediatric malignancies.
“Wada and coworkers (132) showed that the administration of B. breve strain Yakult improved the intestinal environment through the production of small-chain fatty acids favoring cross-feeding relationships among the microorganism communities inhabiting the gut of CRC patients receiving chemotherapy.”
“132.Wada M, Nagata S, Saito M, Shimizu T, Yamashiro Y, Matsuki T, Asahara T, Nomoto K. 2010. Effects of the enteral administration of Bifidobacterium breve on patients undergoing chemotherapy for pediatric malignancies.”
Different references given for the B. breve BB99 IBS mixture
MinorTable 1 assigns reference 142 to the B. breve BB99 mixture, whereas the text assigns it reference 140. The reference list identifies 142 as a VSL#3 study.
“• B. breve BB99 + Lb. rhamnosus (GG + LC705) + P. freudenreichii subsp. shermanii JS 142”
“The administration of other Bifidobacterium strains has also been efficient in alleviating IBS symptoms, such as a probiotic mixture containing B. breve BB99 (140)”
Different Bifidobacterium species given for NEC study 147
MinorTable 1 identifies the Bifidobacterium strain associated with reference 147 as B. bifidum NCDO 1453. The text instead says the product in that study contained B. infantis.
“• Prevent necrotizing enterocolitis in preterm infants • B. bifidum NCDO 1453 + Lb. acidophilus NCDO1748 147”
“A commercial product containing a strain of B. infantis was able to reduce the incidence and severity of NEC in very-low-birth-weight infants (146) and in very-low-birth-weight preterm infants (147).”
Different references given for VSL#3 in ulcerative colitis
MinorTable 1 cites references 140 and 141 for reducing ulcerative colitis symptoms, while the text cites 144 and 145. The reference list describes 140 and 141 as publications about irritable bowel syndrome.
“• Reduce symptoms of patients with UC • VSL#3 140 , 141”
“In IBD, the probiotic mixture VSL#3, which contains bifidobacteria of different species, was able to reduce the UC symptoms in adults (144, 145)”
Mouse trials described by a cited rat study
MinorThe text calls the in vivo trials cited as reference 56 mouse trials, but the title of reference 56 says the strains were administered to Wistar rats.
“in vivo mice trials (56)”
“56.Salazar N, Binetti A, Gueimonde M, Alonso A, Garrido P, González del Rey C, González C, Ruas-Madiedo P, de los Reyes-Gavilán CG. 2011. Safety and intestinal microbiota modulation by the exopolysaccharide-producing strains Bifidobacterium animalis IPLA R1 and Bifidobacterium longum IPLA E44 orally administered to Wistar rats.”
Different references given for VSL#3 in children with IBS
MinorTable 1 assigns reference 144 to this result, whereas the text assigns reference 142. The reference list identifies 142 as the study of VSL#3 in children with IBS.
“• Ameliorate symptoms of IBS in children • VSL#3 144”
“Another example was the administration of VSL#3 for 6 weeks, which resulted in the reduction of IBS symptoms and the improvement of the quality of life in children (142).”
IBS review has conflicting reference numbers
MinorTable 2 cites reference 145 for a review about probiotics and the gut microbiota in IBS, but the text identifies that review as reference 143. Reference 145 is listed as a clinical study of ulcerative colitis.
“• Probiotics and gut microbiota role in IBS 145”
“Further reading on the use of probiotics in IBS and the gut microbiota role can be obtained in the review by Distrutti and coworkers (143).”
Allergy-study strain number differs between table and text
MinorTable 1 names strain NCC2828 for reference 157, whereas both the text and the title of reference 157 name NCC2818.
“• Reduce allergic symptoms, reducing Th2 cytokines • B. animalis subsp. lactis NCC2828 157”
“The immune modulatory effect exerted by B. animalis subsp. lactis NCC2818, which reduced allergic symptoms, was mediated by a reduction in the production of Th2 cytokines (157).”
IBS mixture contains fewer Lactobacillus strains than stated
MinorThe text says the B. longum 101 mixture contains two Lactobacillus strains, but the corresponding Table 1 entry lists only one Lactobacillus strain; its other listed organisms are Lactococcus lactis and Streptococcus thermophilus.
“Another probiotic mixture that reduced IBS symptoms contains the strain B. longum 101, together with two strains of the genus Lactobacillus (141).”
“• B. longum 101 + Lb. acidophilus 102 + Lactococcus lactis 103 + S. thermophilus 104 143 , 170”
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“In IBD, the probiotic mixture VSL#3, which contains bifidobacteria of different species, was able to reduce the UC symptoms in adults (144, 145) as well as the remission of the disease in children (84).”
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- Authors
- Hidalgo-Cantabrana, C., Delgado, S., Ruiz, L., Ruas-Madiedo, P., Sánchez, B., & Margolles, A.
- Affiliations
- Consejo Superior de Investigaciones Científicas (ES)
- Department of Microbiology and Biochemistry of Dairy Products, Dairy Research Institute of Asturias, Spanish National Research Council (IPLA-CSIC), Paseo Río Linares s/n 33300, Villaviciosa, Asturias, Spain
- Venue
- Microbiology Spectrum
- Publisher
- American Society for Microbiology
- Published
- 2017-05-19
- Volume
- 5
- Issue
- 3
- ISSN
- 2165-0497 (ISSN-L)
- PMC
- PMC11687494
- OpenAlex
- W2690365708
- Semantic Scholar
- 4d9e18abf6255a3774d8924a2af1b160a90aad7b
- Cited by
- 490
- References
- 170
- Citations by year
- 2026: 45 · 2025: 73 · 2024: 98 · 2023: 83 · 2022: 51 · 2021: 51 · 2020: 45 · 2019: 24 · 2018: 15 · 2017: 4 · 2014: 1
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Microbiology Spectrum (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
- Funders
- Ministerio de Economía y Competitividad
- 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 › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- Bifidobacterium, human gut microbiome, probiotics, health-promoting properties, infant gut colonization, human milk oligosaccharides, immune system maturation, functional foods, dairy products, disease prevention and treatment, actinobacteria
- MeSH terms
- Gastrointestinal Microbiome, Adult, Age Factors, Anti-Bacterial Agents, Bifidobacterium, Dairy Products, Diarrhea, Drug Therapy, Gastrointestinal Diseases, Humans, Infant, Infant, Newborn, Intestines, Colorectal Neoplasms, Inflammatory Bowel Diseases, Clostridioides difficile, Helicobacter pylori, Helicobacter Infections, Probiotics, Enterocolitis, Necrotizing, Gastrointestinal Tract, Irritable Bowel Syndrome, Microbial Interactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.
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