Probiotics and the gut microbiota in intestinal health and disease

• Published in: Nature reviews. Gastroenterology & hepatology Vol. 7; no. 9; pp. 503 - 514
• Main Authors: Sherman, Philip M, Gareau, Mélanie G, Walker, W. Allan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2010; Nature Publishing Group
• Subjects: 631/92/609; 692/698/2741/2135; 692/699/1503/1581; 692/700/459/1994; Biomedicine; Diarrhea - drug therapy; Diarrhea - prevention & control; Gastroenterology; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - prevention & control; Gastrointestinal Tract - microbiology; Health aspects; Hepatology; Host-bacteria relationships; Humans; Inflammatory Bowel Diseases - drug therapy; Inflammatory Bowel Diseases - prevention & control; Medicine; Medicine & Public Health; Microbiota (Symbiotic organisms); Physiological aspects; Physiological research; Probiotics; Probiotics - adverse effects; Probiotics - therapeutic use; review-article
• ISSN: 1759-5045; 1759-5053
• DOI: 10.1038/nrgastro.2010.117

The use of probiotics is increasing in popularity for both the prevention and treatment of a variety of diseases; however, the specific immune and physiological effects of probiotics in health and disease have not been fully elucidated. This Review considers recent advances in clinical trials of probiotics for intestinal disorders. An overview of in vitro and in vivo research related to potential mechanisms of action of various probiotic formulations is also considered. The use of probiotics is increasing in popularity for both the prevention and treatment of a variety of diseases. While a growing number of well-conducted, prospective, randomized, controlled, clinical trials are emerging and investigations of underlying mechanisms of action are being undertaken, questions remain with respect to the specific immune and physiological effects of probiotics in health and disease. This Review considers recent advances in clinical trials of probiotics for intestinal disorders in both adult and pediatric populations. An overview of recent in vitro and in vivo research related to potential mechanisms of action of various probiotic formulations is also considered. Key Points Probiotics are increasingly being used for various digestive diseases, including IBS, IBD, necrotizing enterocolitis, acute infectious diarrhea and antibiotic-associated diarrhea Not all probiotic strains are appropriate for all ailments Depending on the strain, probiotics have different underlying mechanisms of action to provide a beneficial effect In addition to live organisms, probiotic-derived products, such as surface-layer proteins and bacteriocins may provide beneficial effects Probiotics are contraindicated in certain patient populations, including those with severe immune deficiencies