Probiotics: immunomodulation and evaluation of safety and efficacy.
The intake of probiotics has been associated with beneficial effects on the immune system, such as improved disease resistance and diminished risk of allergies. This review gives an overview of the immunomodulatory effects of probiotics investigated with in vitro assays, experimental animal models, and clinical trials, and explores possible mechanisms underlying the immunomodulatory effects. Immunomodulation, however, is not always beneficial and might induce detrimental effects; therefore, a scheme is proposed for benefit-risk assessment of immunomodulation by probiotics. Within this scheme, expert judgment based on data derived from a panel of in vitro assays, animal models, and clinical trials should lead to conclusions on efficacy and safety aspects of probiotics.
Ezendam
Janine
J
National Institute of Public Health and the Environment, Laboratory for Toxicology, Pathology and Genetics, Bilthoven, The Netherlands. Janine.Ezendam@rivm.nl
van Loveren
Henk
H
D000818:Animals; D003257:Consumer Product Safety; D004195:Disease Models, Animal; D019317:Evidence-Based Medicine; D006801:Humans; D007107:Immune System / Q000276:immunology* / Q000382:microbiology; D007154:Immune System Diseases / Q000628:therapy*; D018928:Immunity, Mucosal / Q000187:drug effects; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D019936:Probiotics / Q000008:administration & dosage* / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016896:Treatment Outcome
D007155:Immunologic Factors