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An update on the use and investigation of probiotics in health and disease
Open accessAbstract
Probiotics are derived from traditional fermented foods, from beneficial commensals or from the environment. They act through diverse mechanisms affecting the composition or function of the commensal microbiota and by altering host epithelial and immunological responses. Certain probiotic interventions have shown promise in selected clinical conditions where aberrant microbiota have been reported, such as atopic dermatitis, necrotising enterocolitis, pouchitis and possibly irritable bowel syndrome. However, no studies have been conducted that can causally link clinical improvements to probiotic-induced microbiota changes. Whether a disease-prone microbiota pattern can be remodelled to a more robust, resilient and disease-free state by probiotic administration remains a key unanswered question. Progress in this area will be facilitated by: optimising strain, dose and product formulations, including protective commensal species; matching these formulations with selectively responsive subpopulations; and identifying ways to manipulate diet to modify bacterial profiles and metabolism.
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“FMT introduces a complete, stable, and durable community of gut microbiota [26] , unlike probiotics, that temporarily alter the metabolic, or immunologic activity, of the native gut microbiota [27] .”
From Intestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis (2014) · cites this paper as [27]
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“the use of probiotics in preventive medicine to keep a healthy intestinal function is well documented”
From Intestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis (2014) · cites this paper as [27]
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Microbiota-gut-brain signalling in Parkinson's disease: Implications for non-motor symptoms
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Molecular mechanisms of postbiotics in colorectal cancer prevention and treatment
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“1 and Lactobacillus rhamnosus GG can exert the same antiproliferative and proapoptotic effects on cancer cells in vitro (84).”
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BackgroundTargeting gut microbiota in hepatocellular carcinoma: probiotics as a novel therapy
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“Therefore, oral administration of probiotics may be beneficial to the patients who are candidates for colorectal surgery [13, 14], however, the postoperative clinical benefit in maintaining balance of gut microbiota remains largely unexplored and unknown [15-19].”
BackgroundKandasamy, S., Vlasova, A. N., Fischer, D. D., Kumar, A., Chattha, K. S., Rauf, A., Shao, L., Langel, S. N., Rajashekara, G., & Saif, L. J. (2016) · The Journal of Immunology · doi:10.4049/jimmunol.1501705 · Cited by 113
“inflammatory diseases of the gastrointestinal (GI) tract in children (13).”
BackgroundThe biological activities of postbiotics in gastrointestinal disorders
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“…possible presence of biological and/or non-biological contaminants, and health-promoting claims (general and specific) (Aguilar-Toal a et al. 2018; Sanders et al. 2013) BB12 can prevent the development of biofilms induced by Streptococcus mutans in dental cavities to a significant extent…”
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Cheow, W. S., Kiew, T. Y., & Hadinoto, K. (2014) · Carbohydrate Polymers · doi:10.1016/j.carbpol.2014.01.036 · Cited by 107
Yan, F., Liu, L., Cao, H., Moore, D. J., Washington, M. K., Wang, B., Peek, R. M., Acra, S. A., & Polk, D. B. (2016) · Mucosal Immunology · doi:10.1038/mi.2016.43 · Cited by 106
“However, a number of metaanalyses vary in their conclusions on the effectiveness of probiotics on disease prevention and treatment.(15) Therefore, hypothesis-driven clinical trials using optimal strains, dose, and delivery and treatment protocols are needed.”
Irritable bowel syndrome symptom severity improves equally with probiotic and placebo
Lyra, A., Hillilä, M., Huttunen, T., Männikkö, S., Taalikka, M., Tennilä, J., Tarpila, A., Lahtinen, S., Ouwehand, A. C., & Veijola, L. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i48.10631 · Cited by 106
Aceti, A., Maggio, L., Beghetti, I., Gori, D., Barone, G., Callegari, M. L., Fantini, M. P., Indrio, F., Meneghin, F., Morelli, L., et al. (2017) · Nutrients · doi:10.3390/nu9080904 · Cited by 106
“Probiotics, defined as live micro-organisms that confer health benefits to the host through an interaction with gut microbiota and immune function when administered at adequate doses [9], have been proposed as potential tools to prevent NEC and LOS [10].”
BackgroundZhen, W., Shao, Y., Gong, X., Wu, Y., Geng, Y., Wang, Z., & Guo, Y. (2018) · Poultry Science · doi:10.3382/ps/pey119 · Cited by 104
Practical aspects of the use of probiotics in pig production: A review
Barba-Vidal, E., Martín-Orúe, S. M., & Castillejos, L. (2019) · Livestock Science · doi:10.1016/j.livsci.2019.02.017 · Cited by 119
The administration of probiotics and synbiotics in immune compromised adults: is it safe?
van den Nieuwboer, M., Brummer, R. J., Guarner, F., Morelli, L., Cabana, M. D., & Claassen, E. (2014) · Beneficial Microbes · doi:10.3920/bm2014.0079 · Cited by 99
“A high number of randomised trials have been conducted to prove probiotic efficacy with contradicting results (Sanders et al., 2013).”
BackgroundResultSelf-citationNeufeld, K. M., O’Mahony, S. M., Hoban, A. E., Waworuntu, R. V., Berg, B. M., Dinan, T. G., & Cryan, J. F. (2017) · Nutritional Neuroscience · doi:10.1080/1028415x.2017.1397875 · Cited by 98
The Effect of Probiotics and Gut Microbiota on Th17 Cells
Tanabe, S. (2013) · International Reviews of Immunology · doi:10.3109/08830185.2013.839665 · Cited by 102
“[14], and updated articles by other groups are also available [15, 16].”
BackgroundTLR Signaling Modulates Side Effects of Anticancer Therapy in the Small Intestine
Frank, M., Hennenberg, E. M., Eyking, A., Rünzi, M., Gerken, G., Scott, P., Parkhill, J., Walker, A. W., & Cario, E. (2015) · The Journal of Immunology · doi:10.4049/jimmunol.1402481 · Cited by 98
“Probiotic strains may constitute an alternative to reduce chemotoxicity (69); however, large-scale and randomized, placebo-controlled clinical trials are currently lacking.”
BackgroundChaikham, P. (2015) · Food Bioscience · doi:10.1016/j.fbio.2015.07.006 · Cited by 94
Sugahara, H., Yao, R., Odamaki, T., & Xiao, J. (2017) · Beneficial Microbes · doi:10.3920/bm2016.0158 · Cited by 94
Probiotics in digestive diseases: focus on Lactobacillus GG.
Pace, F., Pace, M., & Quartarone, G. (2015) · PubMed · Cited by 89
Kim, J., Hlaing, S. P., Lee, J., Saparbayeva, A., Kim, S., Hwang, D. S., Lee, E. H., Yoon, I., Yun, H., Kim, M., et al. (2021) · Carbohydrate Polymers · doi:10.1016/j.carbpol.2021.118462 · Cited by 96
Chua, L. L., Rajasuriar, R., Azanan, M. S., Abdullah, N. K., Tang, M. S., Lee, S. C., Woo, Y. L., Lim, Y. A. L., Ariffin, H., & Loke, P. (2017) · Microbiome · doi:10.1186/s40168-017-0250-1 · Cited by 94
“probiotics [73]), fecal transplantation [74] and helminth colonization [75, 76] are being investigated, which may be applicable to ALL survivors in the future.”
BackgroundDiling, C., Yang, X., Chaoqun, Z., Yang, J., Xiaocui, T., Jun, C., Shuai, O., & Yizhen, X. (2017) · Oncotarget · doi:10.18632/oncotarget.20689 · Cited by 90
“Oncotarget85845www.impactjournals.com/oncotarget Immune factors play a predominant role in the pathogenesis of IBDs.”
BackgroundInfluentialProbiotics-mediated suppression of cancer
So, S. S. Y., Wan, M. L. Y., & El-Nezami, H. S. (2016) · Current Opinion in Oncology · doi:10.1097/cco.0000000000000342 · Cited by 94
Safety of probiotics and synbiotics in children under 18 years of age
van den Nieuwboer, M., Brummer, R. J., Guarner, F., Morelli, L., Cabana, M., & Claassen, E. (2015) · Beneficial Microbes · doi:10.3920/bm2014.0157 · Cited by 83
Self-citationProbiotics and blood pressure: current insights
Sudha, R., & Upadrasta, A. (2016) · Integrated Blood Pressure Control · doi:10.2147/ibpc.s73246 · Cited by 88
“Introduction Probiotics have gained significant importance in the last few decades for their health promoting roles in the prevention and prophylaxis of various gut associated disorders, urogenital, and respiratory infections.(1) They have also been shown to positively affect the host immune system through immunoglobu…”
BackgroundAnti-influenza Activity of a Bacillus subtilis Probiotic Strain
Starosila, D., Рыбалко, С. Л., Varbanetz, L., Ivanskaya, N. V., & Sorokulova, I. B. (2017) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00539-17 · Cited by 82
“Probiotic bacteria show efficacy in the treatment and prevention of different gastrointestinal conditions, including inflammatory bowel disease, irritable bowel syndrome, necrotizing enterocolitis (7), acute diarrhea (8), and antibiotic-associated diarrhea (9, 10).”
BackgroundFuture for probiotic science in functional food and dietary supplement development
Neef, A., & Sanz, Y. (2013) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e328365c258 · Cited by 82
“com microbiota modulation and that a microbiota predisposing to disease can be reshaped by probiotic administration to reduce the disease incidence in humans [5].”
BackgroundEskandarzadeh, S., Effatpanah, M., Khosravi‐Darani, K., Askari, R., Hosseini, A. F., Reisian, M., & Jazayeri, S. (2019) · Nutritional Neuroscience · doi:10.1080/1028415x.2019.1598669 · Cited by 83
Our extended microbiome: The human-relevant metabolites and biology of fermented foods
Caffrey, E. B., Sonnenburg, J. L., & Devkota, S. (2024) · Cell Metabolism · doi:10.1016/j.cmet.2024.03.007 · Cited by 87
Shen, X. P., Liu, L., Peek, R. M., Acra, S. A., Moore, D. J., Wilson, K. T., He, F., Polk, D. B., & Yan, F. (2018) · Mucosal Immunology · doi:10.1038/s41385-018-0034-3 · Cited by 90
“Although probiotics are recommended for use for several diseases, such as infectious diarrhea and antibiotic-associated diarrhea in children 47, 48 , it should be noted that the effectiveness of probiotics on diseases at different ages might vary 49, 50 .”
Probiotic and synbiotic safety in infants under two years of age
van den Nieuwboer, M., Claassen, E., Morelli, L., Guarner, F., & Brummer, R. J. (2014) · Beneficial Microbes · doi:10.3920/bm2013.0046 · Cited by 78
“This might be attributable to different study populations (and power of the study) and conditions, probiotic strains, dosage and study duration (Sanders et al., 2013).”
BackgroundSelf-citationGargari, G., Taverniti, V., Balzaretti, S., Ferrario, C., Gardana, C., Simonetti, P., & Guglielmetti, S. (2016) · Applied and Environmental Microbiology · doi:10.1128/aem.01753-16 · Cited by 82
“However, although numerous studies have demonstrated the efficacy of different probiotic preparations in a number of pathological conditions (3), the potential benefits associated with probiotic consumption by the general (healthy) population remain unclear (4).”
BackgroundLinking microbiota and respiratory disease
Hauptmann, M., & Schaible, U. E. (2016) · FEBS Letters · doi:10.1002/1873-3468.12421 · Cited by 77
The Role of Bacteria, Probiotics and Diet in Irritable Bowel Syndrome
Harper, A. J., Naghibi, M., & Garcha, D. S. (2018) · Foods · doi:10.3390/foods7020013 · Cited by 82
“This may be the reason for the variable results observed in human clinical studies in IBS with probiotics to date [75].”
ResultKang, Y., Cai, Y., & Yang, Y. X. (2021) · Liver Cancer · doi:10.1159/000521358 · Cited by 78
Kemsawasd, V., Chaikham, P., & Rattanasena, P. (2016) · Food Bioscience · doi:10.1016/j.fbio.2016.09.001 · Cited by 75
King, S., Tancredi, D. J., Lenoir‐Wijnkoop, I., Gould, K. M., Vann, H., Connors, G., Sanders, M. E., Linder, J. A., Shane, A. L., & Merenstein, D. (2018) · European Journal of Public Health · doi:10.1093/eurpub/cky185 · Cited by 76
Self-citationAttenuation of Colitis by Lactobacillus casei BL23 Is Dependent on the Dairy Delivery Matrix
Lee, B., Yin, X., Griffey, S. M., & Marco, M. L. (2015) · Applied and Environmental Microbiology · doi:10.1128/aem.01360-15 · Cited by 79
Hidalgo-Cantabrana, C., Algieri, F., Rodríguez‐Nogales, A., Vezza, T., Martínez‐Camblor, P., Margollés, A., Ruas‐Madiedo, P., & Gálvez, J. (2016) · Frontiers in Microbiology · doi:10.3389/fmicb.2016.00868 · Cited by 76
“World Gastroenterology Organisation, 2011; Sanders et al., 2013).”
BackgroundSaviano, A., Brigida, M., Migneco, A., Gunawardena, G., Zanza, C., Candelli, M., Franceschi, F., & Ojetti, V. (2021) · Medicina · doi:10.3390/medicina57070643 · Cited by 73
“Emerging evidence showed that probiotic activities and effects are strain and dose related [53,54].”
BackgroundYang, J., Peng, M., Tan, S., Ge, S., Li, X., Zhou, T., Liu, W., Zhang, K., Zhang, Z., Liu, J., et al. (2023) · ACS Central Science · doi:10.1021/acscentsci.3c00227 · Cited by 73
Kim, H. K., Rutten, N. B. M. M., der Vaart, I. B.-V., Niers, L. E. M., Choi, Y. H., Rijkers, G. T., & van Hemert, S. (2015) · Beneficial Microbes · doi:10.3920/bm2015.0056 · Cited by 75
“…shown to be effective in the prevention and/or management of disorders such as necrotising enterocolitis, acute infectious diarrhoea, antibiotic-associated diarrhoea, inflammatory bowel disease (pouchitis and ulcerative colitis) and lactose maldigestion (Floch et al. , 2011; Sanders et al. , 2013).”
Impact of genomics on the field of probiotic research: historical perspectives to modern paradigms
Johnson, B. R., & Klaenhammer, T. R. (2014) · Antonie van Leeuwenhoek · doi:10.1007/s10482-014-0171-y · Cited by 79
“This systematic analysis reflects a notable caveat that must be made in probiotic research; namely, that probiotic activities are strain-specific (Hungin et al. 2013; Sanders et al. 2013).”
BackgroundInfluentialZhao, J., Ling, Y., Zhang, R., Ke, C., & Hong, G. (2018) · Aquaculture · doi:10.1016/j.aquaculture.2018.05.011 · Cited by 72
Review: Are we using probiotics correctly in post-weaning piglets?
Barba-Vidal, E., Martín-Orúe, S. M., & Castillejos, L. (2018) · animal · doi:10.1017/s1751731118000873 · Cited by 72
“In addition, we will eventually be able to identify the most appropriate strain (or strains) to use as specific probiotic treatments for a particular situation depending on the targeted microbial ecosystem (Sanders et al., 2013).”
Metadata
- Authors
- Sanders, M. E., Guarner, F., Guerrant, R., Holt, P. R., Quigley, E. M., Sartor, R. B., Sherman, P. M., & Mayer, E. A.
- Affiliations
- Dairy & Food Culture Technologies, Centennial, Colorado, USA
- Vall d'Hebron Hospital Universitari (ES)
- University of Virginia (US)
- Rockefeller University (US)
- Houston Methodist (US)
- University of North Carolina at Chapel Hill (US)
- University of Toronto (CA)
- University of California, Los Angeles (US)
- Corresponding author
- Mayer, Emeran A
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2013-03-08
- Volume
- 62
- Issue
- 5
- Pages
- 787-796
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC4351195
- OpenAlex
- W2148017101
- Cited by
- 503
- References
- 134
- Citations by year
- 2026: 18 · 2025: 23 · 2024: 20 · 2023: 29 · 2022: 29 · 2021: 34 · 2020: 37 · 2019: 29 · 2018: 44 · 2017: 46 · 2016: 52 · 2015: 58 · 2014: 61 · 2013: 22
- FWCI
- 8.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Gut (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion, cc-by-nc)
- PubMed Central (acceptedVersion, cc-by-nc)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- UNC Libraries
- Funders
- Procter and Gamble
- Mead Johnson Nutrition
- Danone
- Ironwood Pharmaceuticals, Incorporated
- Alimentary Health
- Instituto Danone
- Norgine
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK048351, U01DK082370)
- 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
- probiotics, gut microbiota, commensal microbiota, atopic dermatitis, necrotizing enterocolitis, pouchitis, irritable bowel syndrome, host immune response, diet and microbiome, microbiota resilience
- MeSH terms
- Colitis, Ulcerative, Crohn Disease, Cross Infection, Diarrhea, Female, Health Status, Humans, Hypersensitivity, Vaginitis, Colorectal Neoplasms, Meta-Analysis as Topic, Evidence-Based Medicine, Probiotics, Enterocolitis, Necrotizing, Irritable Bowel Syndrome
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