title: An update on the use and investigation of probiotics in health and disease.
abstract: 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.
authors.affiliation: Dairy & Food Culture Technologies, Centennial, Colorado, USA.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Sanders
authors.forename: Francisco
authors.initials: F
authors.lastname: Guarner
authors.forename: Richard
authors.initials: R
authors.lastname: Guerrant
authors.forename: Peter R
authors.initials: PR
authors.lastname: Holt
authors.forename: Eamonn M M
authors.initials: EM
authors.lastname: Quigley
authors.forename: R Balfour
authors.initials: RB
authors.lastname: Sartor
authors.forename: Philip M
authors.initials: PM
authors.lastname: Sherman
authors.forename: Emeran A
authors.initials: EA
authors.lastname: Mayer
mesh_terms: D003093:Colitis, Ulcerative / Q000188:drug therapy; D015179:Colorectal Neoplasms / Q000517:prevention & control; D003424:Crohn Disease / Q000188:drug therapy; D003428:Cross Infection / Q000517:prevention & control; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control; D019317:Evidence-Based Medicine; D005260:Female; D006304:Health Status; D006801:Humans; D006967:Hypersensitivity / Q000517:prevention & control; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D015201:Meta-Analysis as Topic; D019936:Probiotics / Q000627:therapeutic use*; D014627:Vaginitis / Q000517:prevention & control