Probiotics

As the importance of the intestinal microbiota in health and disease is increasingly recognized, interest in interventions that can modulate the microbiota and its interactions with its host has soared. Apart from diet, probiotics represent the most commonly used substances taken in an effort to sustain a healthy microbiome or restore balance when it is thought that bacterial homeostasis has been disturbed, as in disease. Although a considerable volume of basic science research attests to the ability of various probiotic strains to beneficially influence host immune responses, metabolic processes, and neuro-endocrine pathways, the evidence base from human studies is notable for the shortage of high-quality studies. This translational gap owes much to the manner in which this sector is regulated; as a consequence of which, many products marketed as probiotics have not adequately addressed some of the most fundamental aspects of quality control, such as strain characterization and viability, as well as optimal product formulation and safety. Similarly, claims are seldom supported by evidence from high-quality clinical trials. Many challenges continue to confront the investigator who seeks to explore microbiota modulation in either healthy populations or those who suffer from common digestive ailments. Nevertheless, some positive signals have emerged and probiotics do show promise in the prevention and management of a number of GI disorders.