Skip to main content
Wiley - PMC COVID-19 Collection logoLink to Wiley - PMC COVID-19 Collection
. 2008 Sep 16;61(3):91–99. doi: 10.1301/nr.2003.marr.91-99

Probiotics: Considerations for Human Health

Mary Ellen Sanders 1
PMCID: PMC7167708  PMID: 12723641

Abstract

Evidence for the role of probiotics in maintenance of health or prevention of disease is mounting and is supported in some cases by blinded, placebo‐controlled human trials. Today, in an era of antibiotic‐resistant pathogens and other looming microbial threats, the value of prevention of infection is recognized. Probiotics may play an important role in helping the body protect itself from infection, especially along the colonized mucosal surfaces of the gastrointestinal tract. Probiotic products are available in many different forms worldwide, including pills, powders, foods, and infant formula. In some cases, general health claims are made that cannot be substantiated for the specific strains and levels being used and consumers must therefore beware.

Keywords: probiotics intestinal health, gastrointestinal, tract, antibiotic‐resistant pathogens

References

  • 1. FAO/WHO. Evaluation of health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. 2001. Report of a Joint FAO/WHO Expert Consultation. Available at: http://www.fao.org/es/ESN/food/foodandfoo_probio_en.stm.
  • 2. Vollaard EJ, Clasener AL. Colonization resistance. Antimicrob Agents Chemother. 1994; 38: 409–414. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3. Marshall JC. Gastrointestinal flora and its alterations in critical illness. Curr Opin Clin Nutr Metab Care. 1999; 2: 405–411. [DOI] [PubMed] [Google Scholar]
  • 4. Lilly DM, Stillwell RH. Probiotics: growth promoting factors produced by microorganisms. Science. 1965; 147: 747–748. [DOI] [PubMed] [Google Scholar]
  • 5. Parker RB. Probiotics, the other half of the antibiotic story. Anim Nutr Health. 1974; 29: 4–8. [Google Scholar]
  • 6. Fuller R. Probiotics in man and animals. J Appl Bacteriol. 1989; 66: 365–378. [PubMed] [Google Scholar]
  • 7. Havenaar R, Huis In't Veld JMJ. Probiotics: a general view In: Wood BJB. ed. Lactic Acid Bacteria in Health and Disease. Vol 1 New York : Chapman and Hall; 1992. [Google Scholar]
  • 8. Guarner F, Schaafsma GJ. Probiotics. Int J Food Microbiol. 1998; 39: 237–238. [DOI] [PubMed] [Google Scholar]
  • 9. Salminen S, von Wright A, Morelli L, et al. Demonstration of safety of probiotics—a review. Int J Food Microbiol. 1998; 44: 93–106. [DOI] [PubMed] [Google Scholar]
  • 10. Schrezenmeir J, de Vrese M. Probiotics, prebiotics, and synbiotics—approaching a definition. Am J Clin Nutr. 2001; 73: 361S–364S. [DOI] [PubMed] [Google Scholar]
  • 11. Markowitz JE, Bengmark S. Probiotics in health and disease in the pediatric patient. Pediatr Clin North Am. 2002; 49: 127–141. [DOI] [PubMed] [Google Scholar]
  • 12. Sanders ME. Probiotics. Food Technol. 1999; 53: 67–77. [Google Scholar]
  • 13. Naidu AS, Bidlack WR, Clemens RA. Probiotic spectra of lactic acid bacteria (LAB). Crit Rev Food Sci Nutr. 1999; 38: 13–126. [DOI] [PubMed] [Google Scholar]
  • 14. Mercenier A, Pavan S, Pot B. Probiotics as bio‐therapeutic agents: present knowledge and future prospects. Current Pharmaceutical Design. 2002; 8: 99–110. [DOI] [PubMed] [Google Scholar]
  • 15. Isolauri E, Rautava S, Kalliomäki M, Kirjavainen P, Salminen S. Role of probiotics in food hypersensi‐tivity. Curr Opin Allergy Clin Immunol. 2002; 2: 263–271. [DOI] [PubMed] [Google Scholar]
  • 16. Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomized placebo‐controlled trial. Lancet. 2001; 357: 1076–1079. [DOI] [PubMed] [Google Scholar]
  • 17. Malin M, Verronen P, Mykkänen H, Salminen S, Isolauri E. Increased bacteria urease activity in faeces in juvenile chronic arthritis: evidence of altered intestinal microflora Br J Rheumatol. 1996; 35: 689–694. [DOI] [PubMed] [Google Scholar]
  • 18. Matricardi PM. Probiotics against allergy: data, doubts, and perspectives. Allergy. 2002; 57: 185–187. [DOI] [PubMed] [Google Scholar]
  • 19. Nase L, Hatakka K, Savilahti E, et al. Effect of long‐term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res 2001; 35: 412–420. [DOI] [PubMed] [Google Scholar]
  • 20. Wollowski I, Rechkemmer G, Pool‐Zobel BL. Protective role of probiotics and prebiotics in colon cancer. Am J Clin Nutr. 2001; 73: 451S–455S. [DOI] [PubMed] [Google Scholar]
  • 21. Rafter J. Lactic acid bacteria and cancer: mechanistic perspective. Br J Nutr 2002; 88: S89–S94. [DOI] [PubMed] [Google Scholar]
  • 22. de Roos NM, Katan MB. Effects of probiotic bacteria on diarrhea, lipid metabolism, and carcinogene‐sis: a review of papers published between 1988 and 1998. Am J Clin Nutr. 2000; 71: 405–411. [DOI] [PubMed] [Google Scholar]
  • 23. Marteau P, Seksik P, Jian R. Probiotics and intestinal disease: a clinical perspective. Br J Nutr. 2002; 88: S51–S57. [DOI] [PubMed] [Google Scholar]
  • 24. Nanji AA, Khettry U, Hossein Sadrazadeh SM. Lactobacillus feeding reduces endotoxemia and severity of experimental alcoholic liver (disease). Proc Soc Exp Biol Med. 1994; 205: 243–247. [DOI] [PubMed] [Google Scholar]
  • 25. Saran S, Gopalan S, Krishna P. Use of fermented foods to combat stunting and failure to thrive. Appl Nutr Invest. 2002; 18: 393–396. [DOI] [PubMed] [Google Scholar]
  • 26. Felley CP, Corthesy‐Theulaz I, Rivero JLB, et al. Favourable effect of an acidified milk (LC‐1) on Helicobacter pylori gastritis in man. Eur J Gastroen-terol Hepatol. 2001; 13: 25–29. [DOI] [PubMed] [Google Scholar]
  • 27. Hata Y, Yamamoto M, Ohni M, et al. A placebo‐controlled study of the effect of sour milk on blood pressure in hypertensive subjects. Am J Clin Nutr. 1996; 64: 767–771. [DOI] [PubMed] [Google Scholar]
  • 28. Isolauri E, Sütas Y, Kankaanpää P, Arvilommi H, Salminen S. Probiotics: effects on immunity. Am J Clin Nutr. 2001; 73: 444S–450S. [DOI] [PubMed] [Google Scholar]
  • 29. Madden JAJ, Hunter JO. A review of the role of the gut microflora in irritable bowel syndrome and the effects of probiotics. Br J Nutr. 2002; 88: S67–S72. [DOI] [PubMed] [Google Scholar]
  • 30. Shanahan F. Probiotics and inflammatory bowel disease: from fads and fancy to facts and future. Br J Nutr. 2002; 88: S5–S9. [DOI] [PubMed] [Google Scholar]
  • 31. Campieri C, Campieri M, Bertuzzi B, et al. Reduction of axaluria after an oral course of lactic acid bacteria at high concentration. Kidney Int. 2001; 60: 1097–1105. [DOI] [PubMed] [Google Scholar]
  • 32. de Vrese M, Stegelmann A, Richter B, Fenselau S, Laue C, Schrezenmeir J. Probiotics—compensation for lactase insufficiency. Am J Clin Nutr. 2001; 73: 421S–429S. [DOI] [PubMed] [Google Scholar]
  • 33. Dunn SR, Simenhoff ML, Ahmed KE, et al. Effect of oral administration of freeze‐dried Lactobacillus aci‐dophilus on small bowel bacterial overgrowth in patients with end stage kidney disease: reducing uremic toxins and improving nutrition. Int Dairy J. 1998; 8: 545–553. [Google Scholar]
  • 34. Reid G. Probiotics for urogenital health. Nutr Clin Care. 2002; 5: 3–8. [DOI] [PubMed] [Google Scholar]
  • 35. Yeung PSM, Sanders ME, Kitts CL, Cano R, Tong PS. Species‐specific identification of commercial probiotic strains. J Dairy Sci. 2002; 85: 1039–1051. [DOI] [PubMed] [Google Scholar]
  • 36. Sanders ME, Morelli L, Bush S. “Lactobacillus sporogenes” is not a Lactobacillus probiotic. ASM News. 2001; 67: 385–386. [Google Scholar]
  • 37. Franz CMAP, Muscholl‐Silberhorn AB, Yousif FMK, Vancanneyt M, Swings J, Holzapfel WH. Incidence and virulence factors and antibiotic resistance among enterococci isolated from food. Appl Environ Microbiol. 2001; 67: 4385–4389. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38. Franz CMAP, Holzapfel WH, Stiles ME. Enterococci at the crossroads of food safety Int J Food Microbiol. 1999; 47: 1–24. [DOI] [PubMed] [Google Scholar]
  • 39. http://63.75.126.224/google/fda_search.pl?client=fdagov&site=fdagov&restrict=&searchselector=08.
  • 40. http://www.actimel.com.
  • 41. http://www.culturelle.com.
  • 42. FAO/WHO. Guidelines for the evaluation of probiotics in food. Report of a Joint FAO/WHO Working Group. 2002. Available at: ftp://ftp.fao.org/es/esn/food/wgreport2.pdf.
  • 43. Gasser F. Safely of lactic acid bacteria and their occurrence in human clinical infections. Bull Inst Pasteur. 1994; 92: 45–67. [Google Scholar]
  • 44. Aguirre M, Collins MD. Lactic acid bacteria and human clinical infection. J Appl Bacteriol. 1993; 75: 95–107. [DOI] [PubMed] [Google Scholar]
  • 45. Saxelin M, Chuang MH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland, 1989–1992. Clin Infect Dis. 1996; 22: 564–566. [DOI] [PubMed] [Google Scholar]
  • 46. Day AS, Abbott GD. D‐lactic acidosis in short bowel syndrome. N Z Med J. 1999; 112: 277–278. [PubMed] [Google Scholar]
  • 47. Rautio M, Jousimies‐Somer H, Kauma H, et al. Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis. 1999; 28: 1159–1160. [DOI] [PubMed] [Google Scholar]
  • 48. Mackay AD, Taylor MB, Kibbler CC, Hamilton‐Miller JMT. Lactobacillus endocarditis caused by a probiotic organism. Clin Microbiol Infect. 1999; 5: 290–292. [DOI] [PubMed] [Google Scholar]
  • 49. Hennequin C, Kauffmann‐Lacroix C, Jobert A, et al. Possible role of catheters in Saccharomyces bou‐lardii fungemia. Eur J Clin Microbiol Infect Dis. 2000; 19: 16–20. [DOI] [PubMed] [Google Scholar]
  • 50. Spinosa MR, Wallet F, Courcol RJ, Oggioni MR. The trouble in tracing opportunistic pathogens: cholangitis due to Bacillus in a French hospital caused by a strain related to an Italian probiotic Microbiol EcoI Health Dis. 2000; 12: 99–101. [Google Scholar]
  • 51. Oggioni MR, Pozzi G, Balensin PE, Galieni P, Big‐azzi C. Recurrent septicemia in an immunocompro‐mised patient due to probiotic strains of Bacillus subtilis. J Clin Microbiol. 1998; 36: 325–326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 52. Richard V, Auwera P, Snoeck R, Daneau D, Meunier F. Nosocomial bacteremia caused by Bacillus species. Eur J Clin Microbiol Infect Dis. 1988; 7: 783–785. [DOI] [PubMed] [Google Scholar]
  • 53. Patton AW, Morono R, Paton JC. A new biological agent for treatment of shiga toxigenic Escherichia coli infections and dysentery in humans. Nat Med. 2000; 6: 265–270. [DOI] [PubMed] [Google Scholar]
  • 54. Enouf V, Langella P, Commissaire J, et al. Bovine rotavirus nonstructural protein 4 produced by Lactococcus lactis is antigenic and immunogenic. Appl Environ Microbiol. 2001; 67: 1423–1428. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 55. Pouwels PH, Leer RJ, Boersma WJ. The potential of Lactobacillus as a carrier for oral immunization: development and preliminary characterization of vector systems for targeted delivery of antigens. J Bio-technol. 1996; 44: 183–192. [DOI] [PubMed] [Google Scholar]
  • 56. Langella P, Le Loir Y. Heterologous protein secretion in Lactococcus lactis: a novel antigen delivery system. Braz J Med Biol Res. 1999; 32: 191–198. [DOI] [PubMed] [Google Scholar]
  • 57. Steidler L, Hans W, Schotte L, et al. Treatment of muring colitis by Lactococcus lactis secreting inter‐leukin‐10. Science. 2000; 289: 1352–1355. [DOI] [PubMed] [Google Scholar]
  • 58. Kitts CL. Terminal restriction fragment patterns: a tool for comparing microbial communities and assessing community dynamics. Curr Issues Intest Microbiol. 2001; 2: 17–25. [PubMed] [Google Scholar]

Articles from Nutrition Reviews are provided here courtesy of Wiley

RESOURCES