Table 4.

Therapeutic potential and health benefits of probiotics, prebiotics and synbiotics.

Biotic types	Sources	Diseases	Health effects	Mechanism of action	References
Probiotics	Lactobacillus acidophilus and Bifidobacterium infantis	Intestinal infections	Inhibition of Staphylococcus aureus, Salmonella typhimurium, Yersinia enterocolitica, Clostridium perfringens and Aeromonas hydrophila	Production of organic acids, bacteriocins and other primary metabolites, such as hydrogen peroxide, carbon dioxide and diacetyl	Shahani and Chandan, 1979; Laroia and Martin, 1990; Mishra and Lambert, 1996; Van der Meer and Bovee-Oudenhoven, 1998
	L. casei, L. acidophilus and B. bifidum	Immune enhancement	Data not available	Enhancement in non-specific (e.g. phagocyte function, NK cell activity) and specific (e.g. antibody and cytokine production) host immune responses	Kaila et al., 1992; Schiffrin et al., 1995; Gill, 1998
	L. acidophilus, S. thermophilus, B. longum, L. rhamnosus GG and B. bifidum	Diarrhoeal infections	Inhibitions of Escherichia coli, Salmonella, Shigella, Clostridium difficile and rotavirus	Production of organic acids, bacteriocins, hydrogen peroxide, carbon dioxide and diacetyl	Merson et al., 1976; Barefoot and Klaenhammer, 1983; Tojo et al., 1987; Oksanen et al., 1990; Siitonen et al., 1990; Hilton et al., 1997.
	B. longum, L. casei Shirota, L. acidophilus, Bifidobaterium spp. and L. rhamnosus GG	Cancer	Inhibition of tumour formation and proliferation	Inhibition of carcinogens and procarcinogens, bacteria converting procarcinogens to carcinogens, immune system activation, and reduced faecal enzyme levels	Lidbeck et al., 1991; Reddy and Rivenson, 1993; Goldin et al., 1996; McIntosh, 1996.
	L. acidophilus	Hypercholesterolaemia	Reduction of cholesterol levels	Assimilation of cholesterol and deconjugation of bile salts	Gilliland and Speck, 1977; Buck and Gilliland, 1994.
	L. acidophilus, B. angulatum, B. breve, B. bifidum and B. longum	Lactose intolerance	Utilisation of lactose	Production of β-D-galactosidase which hydrolyzes lactose	Kilara and Shahani, 1976; Hughes and Hoover, 1995.
	L. acidophilus and Bifidobacterium spp. Production of	Reduction of peptic ulcer, gastro-oesophageal reflux, non-ulcer dyspepsia and gastric cancer	Inhibition of Helicobacter pylori	Lactic and acetic acids, bacteriocins etc	Berrada et al., 1991; Lambert and Hull, 1996; Lankaputhra et al., 1996.
	L. rhamnosus GG	Food allergy	Help to relieve intestinal inflammation and hypersensitivity reactions in infants with food allergies	Hydrolyse the complex casein to smaller peptides and amino acids and hence decrease the proliferation of mitogen-induced human lymphocytes	(Sutas et al., 1996; Majamaa and Isolauri, 1997)
Prebiotics	Inulin from chicory roots	-	-	Stimulate the growth of Bifidobacterium	Gibson et al., 1995.
	Neosugar	–	-	Metabolised by the resident microbes in the colon including bifidobacteria, Enterococcus faecalis, E. faecium, Bacteroides vulgates, etc	Desai, 2008; Guarino et al., 2020.
	Isomalto-oligosaccharides (IMO) from miso, soy sauce and honey	–	Local and systemic Th-1-like immune response and regulation of immune function, balancing the dysbiosis of gut microbiota	Bifidobacterium and the Bacteroides groups can utilise IMO	Kohmoto et al., 1988; Wang et al., 2014.
	Xylooligosaccharides (XOS) from fruits, bamboo shoots, vegetables, honey, etc.	–	-	B. adolescentis utilizes xylobiose and xylotriose, whereas L. lactis, L. rhamnosus and L. plantarum utilise oat β-glucooligosaccharides	Okazaki et al., 1990.
Synbiotics	Food products containing B. animalis and amylose cornstarch	–	-	Promote the growth of bifidobacteria	Bruno et al., 2002.
	Curd containing B. longum and fructooligosaccharide (FOS)	–	Decrease cardiovascular risk factors, metabolic syndrome prevalence and markers of insulin resistance in elderly patients	Promote the growth of B. longum	Hughes and Hoover, 1995; Linares et al., 2017; Cicero et al., 2021.
	Oral synbiotic preparation containing L. plantarum and FOS	Sepsis in early infancy	Significant reduction in sepsis and lower respiratory tract infections	Promotes growth of L. plantarum ATCC202195	Panigrahi et al., 2017.
	Synbiotics containing five probiotics (L. plantarum, L. delbrueckii spp. bulgaricus, L. acidophilus, L. rhamnosus, Bifidobacterium bifidum) and inulin	–	-	Adult subjects with NASH (non-alcoholic steatohepatitis) demonstrated a significant reduction of IHTG (intrahepatic triacylglycerol)	Wong et al., 2013.
	Synbiotic products containing L. rhamnosus, Bifidobacterium lactis, inulin and oligofructose	Hepatic conditions	-	Increased level of intestinal IgA, reduced blood cholesterol levels and lower blood pressure	Pathmakanthan et al., 2002; Perez-Conesa et al., 2006.
	L. rhamnosus CGMCC1.3724 and inulin	Obesity	Weight loss	Reduction in leptin increase in Lachnospiraceae	Sanchez et al., 2014.
	L. acidophilus, L. rhamnosus, B. bifidum, B. longum, E. faecium and FOS	Obesity	Changes in anthropometric measurements	Decrease in TC, LDL-C and total oxidative stress serum levels	Ipar et al., 2015.
	L. sporogenes and inulin	Type 2 diabetes	-	Significant reduction in serum insulin levels and homeostatic model assessment cell function	Tajadadi-Ebrahimi et al., 2014.
	L. casei, L. rhamnosus, S. thermophilus, B. breve, L. acidophilus, B. longum, L. bulgaricus and FOS	Insulin resistance syndrome	The levels of fasting blood sugar and insulin resistance improved significantly	-	Eslamparast et al., 2014.
	L. rhamnosus GG, B. lactis Bb12 and inulin	Cancer	Increase in probiotics in stools and decrease in Clostridium perfringens led to increase in the IL2 in polypectomised patients	Increased production of interferon-ϒ	Safavi et al., 2013.