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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]
Experimental — accuracy not yet measuredIn 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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Redefining the Role of Intestinal Microbes in the Pathogenesis of Necrotizing Enterocolitis
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The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy
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“96 97 As the situation now stands, evidence of ef fi cacy is not convincing enough to compel paediatric organisations to recommend routine use of probiotics.”
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Self-citationEffect of Lactobacillus GG and Breast-feeding in the Prevention of Rotavirus Nosocomial Infection
Mastretta, E., Longo, P., Laccisaglia, A., Balbo, L., Russo, R., Mazzaccara, A., & Gianino, P. (2002) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-200210000-00013 · Cited by 159
Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial
Barraud, D., Blard, C., Hein, F., Marçon, O., Cravoisy, A., Nace, L., Alla, F., Bollaert, P., & Gibot, S. (2010) · Intensive Care Medicine · doi:10.1007/s00134-010-1927-0 · Cited by 154 · cited 1×
“Although probiotics show promise in reducing nosocomial infections among some populations, they are not recommended for critically ill hospitalised patients at this time.(46) 47”
BackgroundWorthley, D. L., Leu, R. K. L., Whitehall, V., Conlon, M. A., Christophersen, C. T., Belobrajdic, D. P., Mallitt, K., Hu, Y. C., Irahara, N., Ogino, S., et al. (2009) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.28106 · Cited by 149
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Self-citationProbiotics, Enteric and Diarrheal Diseases, and Global Health
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The Role of the Gastrointestinal Microbiota in Colorectal Cancer
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Szajewska, H., Wanke-Rytt, M., & Patro-Gołąb, B. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04837.x · Cited by 131
Honeycutt, T., Khashab, M. E., Wardrop, R. M., McNeal-Trice, K. A., Honeycutt, A. L. B., Christy, C. G., Mistry, K. P., Harris, B. D., Meliones, J. N., & Kocis, K. C. (2007) · Pediatric Critical Care Medicine · doi:10.1097/01.pcc.0000282176.41134.e6 · Cited by 130
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“It is noteworthy that tumour incidence and mass are greater in conventional than in germ-free rodents.(70) Taken together, these findings strongly support the concept that the microbiota play some role in CRC, but causality remains to be confirmed.”
ResultUpdating the DALYs for diarrhoeal disease
Guerrant, R. L., Kosek, M., Lima, A. A. M., Lorntz, B., & Guyatt, H. L. (2002) · Trends in Parasitology · doi:10.1016/s1471-4922(02)02253-5 · Cited by 126
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Parkes, G. C., Sanderson, J. D., & Whelan, K. (2009) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(09)70059-3 · Cited by 115
The microbiota link to irritable bowel syndrome
Jeffery, I. B., Quigley, E. M. M., Öhman, L., Simrén, M., & O’Toole, P. W. (2012) · Gut Microbes · doi:10.4161/gmic.21772 · Cited by 114
Self-citationProbiotics for treating persistent diarrhoea in children
Aponte, G. B., Mancilla, C. A. B., Carreazo, N. Y., & Galarza, R. A. R. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007401.pub3 · Cited by 108
Fermented Milks, Probiotic Cultures, and Colon Cancer
Saikali, J., Picard, C., Freitas, M., & Holt, P. R. (2004) · Nutrition and Cancer · doi:10.1207/s15327914nc4901_3 · Cited by 106
Self-citationDiet, fecal water, and colon cancer - development of a biomarker
Pearson, J. R., Gill, C. I., & Rowland, I. R. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2009.00224.x · Cited by 103
A Recombinant Probiotic for Treatment and Prevention of Cholera
Focareta, A., Paton, J. C., Morona, R., Cook, J., & Paton, A. W. (2006) · Gastroenterology · doi:10.1053/j.gastro.2006.02.005 · Cited by 101
Guidance on the scientific requirements for health claims related to gut and immune function
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Self-citationAwad, H., Mokhtar, G., Imam, S. S., Gad, G. I., Hafez, H. M., & Aboushady, N. M. (2010) · Pakistan Journal of Biological Sciences · doi:10.3923/pjbs.2010.253.262 · Cited by 81 · cited 4×
“65 A study from Egypt reported that L rhamnosus GG, or a killed preparation of the same probiotic strain, signi fi cantly reduced the incidence of NEC.”
ResultInfluentialUsing Probiotics in Gastrointestinal Disorders
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Self-citationPrevalence and management of abdominal cramping and pain: a multinational survey
Quigley, E. M. M., Locke, G. R., Mueller‐Lissner, S., Paulo, L. G., Tytgat, G. N. J., HELFRICH, I., & Schaefer, E. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.02989.x · Cited by 71
Self-citationProbiotics: From Bench to Market
Klein, M. A., Sanders, M. E., Duong, T., & Young, H. A. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2010.05839.x · Cited by 57
Self-citationProbiotic Therapy in Radiation‐Induced Intestinal Injury and Repair
Ciorba, M. A., & Stenson, W. F. (2009) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.04029.x · Cited by 52
Use of probiotics for prevention of radiation-induced diarrhea.
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“For example, one systematic review of three RCTs evaluating Bifidobacterium animalis CNCM I-3446 in 293 preterm babies reported only a trend towards prevention of NEC, suggesting that this treatment regimen may not be as effective as others.(68) Others consider available evidence sufficient to support a change in prac…”
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Probiotics for treating persistent diarrhoea in children
Aponte, G. B., Mancilla, C. A. B., Carreazo, N. Y., & Galarza, R. A. R. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007401.pub2 · Cited by 42
Pharmabiotic Manipulation of the Microbiota in Gastrointestinal Disorders, from Rationale to Reality
Shanahan, F., & Collins, S. M. (2010) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2010.08.006 · Cited by 41 · cited 2×
“Such a product would fall under the more general term, ‘pharmabiotic’, which encompasses non-viable microbes and health-promoting substances derived from micro-organisms.(48)”
BackgroundProbiotics for treating acute infectious diarrhoea
Allen, S. J., Martinez, E. G., Gregorio, G. V., & Dans, L. F. (2011) · Sao Paulo Medical Journal · doi:10.1590/s1516-31802011000300012 · Cited by 40
Movsas, B., Vikram, B., Hauer‐Jensen, M., Moulder, J. E., Basch, E., Brown, S. L., Kachnic, L. A., Dicker, A. P., Coleman, C. N., & Okunieff, P. G. (2010) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-10-1402 · Cited by 36 · cited 1×
“Incapacitating diarrhoea, dehydration and malnutrition are adverse effects of radiotherapy and chemotherapy, which can limit the amounts of therapy that can be administered, thus compromising patient management.(91) Probiotics that effectively mitigate these side effects of cancer treatment could be important therapeu…”
BackgroundThe science and regulations of probiotic food and supplement product labeling
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Probiotic and prebiotic claims in Europe: seeking a clear roadmap
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Self-citationClinical studies involving probiotics
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Fecal Microbiota Transplantation: Past, Present and Future
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Diabetes and Risk of Non-Hodgkin Lymphoma: A Case-Control Study
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Probiotics and Prebiotics in Pediatrics
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Self-citation
Cited by
Sorted by citations
Inflammation-induced cancer: Crosstalk between tumours, immune cells and microorganisms
Elinav, E., Nowarski, R., Thaiss, C. A., Hu, B., Jin, C., & Flavell, R. A. (2013) · Nature reviews. Cancer · doi:10.1038/nrc3611 · Cited by 2,000
Gut microbiota and IBD: causation or correlation?
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Gut microbes and the brain: paradigm shift in neuroscience
Mayer, E. A., Knight, R., Mazmanian, S. K., Cryan, J. F., & Tillisch, K. (2014) · The Journal of Neuroscience · doi:10.1523/jneurosci.3299-14.2014 · Cited by 1,033
“Surprisingly, there has been a paucity of studies in animals or humans with prebiotics, although specific prebiotics have been shown to increase brain BDNF levels (Savignac et al., 2013).”
BackgroundSelf-citationIntestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis
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Maldonado-Gómez, M. X., Martínez, I., Bottacini, F., O’Callaghan, A., Ventura, M., van Sinderen, D., Hillmann, B., Vangay, P., Knights, D., Hutkins, R. W., et al. (2016) · Cell Host & Microbe · doi:10.1016/j.chom.2016.09.001 · Cited by 517
“However, the degree to which clinical improvements have been causally linked to probiotic-induced microbiota changes has not been established (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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