Cited by 76Probiotics and Fermented FoodsGastrointestinal motility and disordersGut microbiota and health

Responders and non-responders to probiotic interventions: How can we improve the odds?

Open access
Reid, Gregor, Gaudier, Estelle, Guarner, Francisco, Huffnagle, Gary B, Macklaim, Jean M, Munoz, Alicia Murcia, Martini, Margaret, Ringel-Kulka, Tamar +4 more·2010·Gut Microbes

Abstract

As with many clinical studies, trials using probiotics have shown clearly that some patients benefit from the treatment while others do not. For example if treatment with probiotics leads to 36% cure rate of diarrhea, why did the other 64% not have the same result? The issue is important for human and indeed experimental animal studies for two main reasons: (i) Would changing the design of the study result in more subjects responding to treatment? (ii) If a subject does not respond what are the mechanistic reasons? In order to tackle the issue of responders and non-responders to therapy, a workshop was held by the International Scientific Association for Probiotics and Prebiotics (ISAPP). The outcome was four recommendations. 1. Clearly define the end goal: this could be supporting a health claim or having the highest clinical effect and impact. 2. Design the study to maximize the chance of a positive response by identifying precise parameters and defining the level of response that will be tested. 3. Base the selection of the intervention on scientific investigations: which strain(s) and/or product formulation should be used and why. 4. Carefully select the study cohort: use biological or genetic markers when available to stratify the patient population before enrollment and decide at what point intervention will provide the best outcome (for example, in acute phase of disease, or during remission, with or without use of pharmaceutical agents). By following these recommendations and selecting an appropriate primary outcome, it is hoped that clinical data will emerge in the future that expands our knowledge of which probiotics benefits which subjects and by what mechanism.

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Authors
Reid, G., Gaudier, E., Guarner, F., Huffnagle, G. B., Macklaim, J. M., Munoz, A. M., Martini, M., Ringel-Kulka, T., Sartor, B. R., Unal, R. R., Verbeke, K., & Walter, J.
Affiliations
  • Western University (CA)
  • Unilever Research and Development Vlaardingen (NL)
  • Vall d'Hebron Hospital Universitari (ES)
  • University of Michigan (US)
  • Lawson Health Research Institute (CA)
  • University of North Carolina at Chapel Hill (US)
  • KU Leuven (BE)
  • University of Nebraska–Lincoln (US)
Corresponding author
Reid, Gregor
Venue
Gut Microbes
Published
2010-05
Volume
1
Issue
3
Pages
200-204
ISSN
  • 1949-0976 (ISSN-L)
  • 1949-0984
OpenAlex
W1978007556
Cited by
76
References
32
Citations by year
2026: 9 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 11 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 4 · 2014: 3 · 2013: 10 · 2012: 3
Type
conference abstract
Language
en
Open access
Licence
cc-by-nc
Locations
  • Gut Microbes (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Lincoln (University of Nebraska) (submittedVersion)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
probiotics, treatment response variability, responders and non-responders, clinical trial design, health claims, probiotic strain selection, primary outcome definition, diarrhea
MeSH terms
Animals, Clinical Trials as Topic, Diarrhea, Humans, Treatment Outcome, Probiotics

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