Background – A probiotic has been defined as a viable microbial food supplement, which beneficially influences the health of the host (1). Lactobacillus rhamnosus GG (=ATCC 53013) is one of the best-documented probiotics in the human studies and this experience forms the basis for future developments.
Objectives – We evaluated the mechanisms of probiotics and the target identification for probiotic use. Based on the assessment a rationale for probiotics and future probiotic developments has been formulated.
Design – Mechanistic and human studies on probiotics and especially on Lactobacillus GG were reviewed to identify targets for probiotic action and mechanisms of action. Based on the review and outlook for new criteria has been formulated.
Outcomes – Individual probiotics have defined strain-specific actions in the human studies and all probiotics are unique. Clinical efficacy has been demonstrated in clearly identified target aberrancies related to intestinal microbiota development. Based on meta-analyses, Lactobacillus GG and Saccharomyces boulardii and Bifidobacterium lactis a & Streptococcus thermophilus are identified as efficient in preventing antibiotic associated diarrhoea. As studies have also indicated new probiotic combinations effective for specific aberrancies such developments should be further characterized. Based on these the future selection criteria for specific probiotics and probiotic combinations can be established.
Conclusion – The available demonstrations indicate that microbiota targets should be identified for probiotic action. Genetic information on the specific strains and their action can assist in finding new probiotics and combinations for future target specific preparations with increased efficacy in the human studies.
Reference
1
Szajewska H, Ruszczynski M, Radzikowski A. Probiotics in the prevention of antibiotic-associated diarrhea in children: A meta-analysis of randomized controlled trials. J Pediatr. 2006;149:367-372.
McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006;101:812-22.