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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]
In the citing paper
“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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Zavišić, G., Ristić, S., Petricevic, S. M., Janković, D. L., & Petković, B. B. (2024) · Foods · doi:10.3390/foods13162487 · Cited by 41
“…are effective in combating foodborne pathogens, there are challenges in characterizing and elucidating the underlying molecular mechanisms of action and in developing potential delivery strategies that could maintain the viability and functionality of the probiotic in the target organ [40].”
BackgroundWhether viable and dead probiotic are equally efficacious?
Sarkar, S. (2018) · Nutrition & Food Science · doi:10.1108/nfs-07-2017-0151 · Cited by 38
Zhai, Z., Torres‐Fuentes, C., Heeney, D. D., & Marco, M. L. (2019) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.8b06657 · Cited by 40
Živković, M., Hidalgo-Cantabrana, C., Kojić, M., Gueimonde, M., Golić, N., & Ruas‐Madiedo, P. (2015) · Food Research International · doi:10.1016/j.foodres.2015.05.012 · Cited by 39
Probiotics, Prebiotics, and Fibers in Nutritive and Functional Beverages
Raman, M., Ambalam, P. S., & Doble, M. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-816842-4.00009-5 · Cited by 40
Lu, W.-W., Chen, X., Ni, J.-L., Sheng-liang, Z., Fei, A., & Wang, X. (2021) · Annals of Palliative Medicine · doi:10.21037/apm-21-429 · Cited by 40
“Probiotics and their mechanism The World Health Organization defines probiotics as live microorganisms that can give the host health benefits (28).”
BackgroundPrato cheese as suitable carrier for Lactobacillus acidophilus La5 and Bifidobacterium Bb12
Chaves, K. S., & Gigante, M. L. (2015) · International Dairy Journal · doi:10.1016/j.idairyj.2015.08.009 · Cited by 36
Wu, Z. F., Wu, J., Cao, P., Jin, Y., Pan, D., Zeng, X., & Guo, Y. (2017) · Journal of Dairy Science · doi:10.3168/jds.2017-12640 · Cited by 36
“Lactic acid bacteria ( LAB ) have potential probiotic use as food-grade fermentation starters (Sanders et al., 2013).”
BackgroundShelf life and quality of probiotic yogurt produced with Lactobacillus acidophilus and Gobdin
Ertem, H., & Çakmakçı, S. (2017) · International Journal of Food Science & Technology · doi:10.1111/ijfs.13653 · Cited by 36
“…infections, alleviating lactose intolerance, preventing gastrointestinal diseases, lowering serum cholesterol levels, providing anticarcinogenic activity, reducing allergens and improving disease resistance (FAO/WHO, 2001; Sanders et al., 2013; NajgebauerLejko, 2014; Mishra et al., 2015).”
BackgroundEffects of temperature, diet and genotype-induced variations on the gut microbiota of abalone
Wang, X., Tang, B., Luo, X., Ke, C., Huang, M., You, W., & Wang, Y. (2020) · Aquaculture · doi:10.1016/j.aquaculture.2020.735269 · Cited by 36
Precise probiotic therapy: Advances, bottlenecks, and the road to microbiome-informed nutrition
Jiang, Y., Jiang, S., Wang, Z., Zhu, P., Zhang, J., Teng, F., & Huang, S. (2026) · Gut Microbes · doi:10.1080/19490976.2026.2623359 · Cited by 41
“4,37 The success of probiotic colonization is largely determined by the existing microbial community, which can either promote or impede the establishment and function of introduced strains.”
The Role of Intestinal Microbiota in Acute Graft-versus-Host Disease
Chen, Y., Zhao, Y., Cheng, Q., Wu, D., & Liu, H. (2015) · Journal of Immunology Research · doi:10.1155/2015/145859 · Cited by 37
“Some of the beneficial impacts of probiotics have been scientifically documented, and three main categories of probiotics contributing to host health have been described [83, 88, 89].”
BackgroundFilling the Gaps: Current Research Directions for a Rational Use of Probiotics in Preterm Infants
Aceti, A., Beghetti, I., Maggio, L., Martini, S., Faldella, G., & Corvaglia, L. (2018) · Nutrients · doi:10.3390/nu10101472 · Cited by 35
“In addition, despite a generally clear association between dysbiosis and disease, the causality and reversal of disease in response to probiotic-induced changes in gut microbiota have not yet been demonstrated [19].”
BackgroundPatrone, V., Molinari, P., & Morelli, L. (2016) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2016.08.012 · Cited by 34
Bravo-Santano, N., Boll, E. J., Capern, L. C., Cieplak, T., Keleszade, E., Letek, M., & Costabile, A. (2020) · Antibiotics · doi:10.3390/antibiotics9120849 · Cited by 37
“Due to their characteristics, probiotics are good candidates for preventing and treating gastrointestinal infections and acute diarrhea [1].”
BackgroundMicrobiota Targeted Interventions of Probiotic Lactobacillus as an Anti-Ageing Approach: A Review
Ishaq, M., Khan, A., Bacha, A. S., Shah, T., Hanif, A., Ahmad, A. A., Ke, W., Li, F., Din, A. U., Ding, Z., et al. (2021) · Antioxidants · doi:10.3390/antiox10121930 · Cited by 34
Bi, Z., Cui, E., Yao, Y., Chang, X., Wang, X., Zhang, Y., Xu, G., Zhuang, H., & Hua, Z. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.927277 · Cited by 34
Four types of B ifidobacteria trigger autophagy response in intestinal epithelial cells
Lin, R., Jiang, Y., Zhao, X. Y., Guan, Y., Qian, W., Fu, X. C., Ren, H. Y., & Hou, X. H. (2014) · Journal of Digestive Diseases · doi:10.1111/1751-2980.12179 · Cited by 36
Fermented Dairy Products Modulate Citrobacter rodentium–Induced Colonic Hyperplasia
Collins, J. W., Chervaux, C., Raymond, B., Derrien, M., Brazeilles, R., Kosta, A., Chambaud, I., Crepin, V. F., & Frankel, G. M. (2014) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiu205 · Cited by 34
“ments, or medical foods [1, 3], and are defined as live microorganisms that confer a health benefit to the host, aside from general nutrition [4].”
BackgroundThe Crosstalk Between Gut Microbiota and Obesity and Related Metabolic Disorders
Xu, W., Nie, Y., Yang, Z., & Lü, N. (2016) · Future Microbiology · doi:10.2217/fmb-2015-0024 · Cited by 35
Flach, J., van der Waal, M., Kardinaal, A., Schloesser, J., Ruijschop, R., & Claassen, E. (2018) · Cogent Food & Agriculture · doi:10.1080/23311932.2018.1452839 · Cited by 37
“For instance, the consumption of certain probiotic strains is associated with a decreased risk for antibiotic-associated diarrhea (AAD) or upper respiratory infections (Hao, Lu, Dong, Huang, & Wu, 2011; Sanders et al., 2013).”
BackgroundPlavec, T. V., Kuchař, M., Benko, A., Lišková, V., Černý, J., Berlec, A., & Malý, P. (2019) · Microorganisms · doi:10.3390/microorganisms7050152 · Cited by 33
“The composition of microbiota could be influenced by food management and prebiotic supplementation [37]; alternatively, supplementation with probiotic lactic acid bacteria that belong to the phylum Firmicutes was also established as beneficial [38].”
BackgroundUpdate on Strategies of Probiotics for the Prevention and Treatment of Colorectal Cancer
Tang, G., & Zhang, L. (2020) · Nutrition and Cancer · doi:10.1080/01635581.2020.1865420 · Cited by 32
“incidence (3), and it is also the fourth most common cause of death in cancers (4).”
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Immunostimulatory Activity of Lactococcus lactis subsp. lactis CAB701 Isolated from Jeju Cabbage
Jeong, H., Kim, S., Hwang, U.-S., Choi, H.-J., & Park, Y. (2023) · Microorganisms · doi:10.3390/microorganisms11071718 · Cited by 34
“By introducing beneficial bacteria into the gastrointestinal (GI) tract, probiotics can help restore the gut microbiota balance and promote digestion and nutrient absorption [3].”
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Engineering the human gut commensal Bacteroides thetaiotaomicron with synthetic biology
Lai, Y., Hayashi, N., & Lu, T. K. (2022) · Current Opinion in Chemical Biology · doi:10.1016/j.cbpa.2022.102178 · Cited by 31
Production of a Functional Frozen Yogurt Fortified with Bifidobacterium spp.
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Gut Microbiota Alteration After Long-Term Consumption of Probiotics in the Elderly
Gao, R., Zhang, X., Huang, L., Shen, R., & Qin, H. (2018) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-018-9403-1 · Cited by 32
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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