A Gastroenterologist's Guide to Probiotics

Matthew a. Ciorba, MD


Clin Gastroenterol Hepatol. 2012;10(9):960-968. 

In This Article

What Lies Ahead for Probiotics in Digestive Diseases

Inspired investigators and technical advances in genomics are facilitating in-depth scientific investigation of the human microbiome and the functional capacities of probiotics. These advances are sure to bring paradigmatic changes to our fundamental understanding of how microbiota influence health and how they can be manipulated to combat disease and improve quality of life. Future indications and therapeutic directions for probiotics may include conditions as diverse as mood disorders, obesity, autism, and diabetes. Recent clinical trials and translational studies suggest that lactobacillus probiotics may offer epithelial cytoprotection to limit symptoms of radiation enteritis, a dose-limiting side effect for patients receiving abdominal radiation therapy for malignancy.[8,81,82] Promise is held for confirmative testing of helminth-based therapy and "turbo-probiotics" designed to secrete human cytokines. Gene-based bacterial profiling studies from disease affected humans have identified what may be novel "probiotics" such as Faecalibacterium prausnitizii and Clostridium species IV and XIVa. Finally, the identification, purification, and repackaging of probiotic-derived soluble factors possessing proven capacity to modify biological function may allow us to harness the power of probiotics while averting the potential risks associated with live bacteria. As these advances progress to the clinic, the term pharmabiotic has been proposed by some investigators in an effort to encompass both beneficial microbes and their products.[83]