Role of Probiotics in Health and Disease – A Review
Abstract
Human intestinal microbiota has undergone a lot of research in recent years and we are beginning to expand our knowledge of the role of bacteria, fungi, viruses and helminths in our gut in health and disease.
Our gut contains myriad of over hundreds of millions of microbes that influence our body physiology, nutrition, metabolism, and immunity. A change in the type of these microbes has been shown to be associated with gastrointestinal diseases such as inflammatory bowel disease and systemic diseases like metabolic syndrome and cancer.
In this article, an attempt has been made to review some significant recent studies that have looked into the complex types of intestinal microbes and how they interact with the human body. This paper also serves to explain what probiotics are, and how they function as a separate “organ” within our body. It includes their method of action, the latest evidence - based research on their use in health and disease and some common sources of probiotic bacteria.
Keywords:
Gastrointestinal microbiome, Gut health, Probiotics, Evidence based medicine on probiotics
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References
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Barichella, M., Pacchetti, C., Bolliri, C., Cassani, E., Iorio, L., & Pusani, C. et al.. (2016). SUN-P199: Double-Blind, Placebo-Controlled Trial of a Fermented Milk Containing Multiple Probiotic Strains and Prebiotic Fiber for Constipation Associated with Parkinson's Disease. Clinical Nutrition, 35, pp. S118. doi: 10.1016/s0261-5614(16)30542-8
Besselink, M., van Santvoort, H., Buskens, E., Boermeester, M., van Goor, H., & Timmerman, H. et al.. (2008). Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. The Lancet, 371(9613), pp.651-659. doi: 10.1016/s0140-6736(08)60207-x.
Binns, N. (2013). Probiotics, prebiotics and the gut microbiota. [online] Ilsi.org. Available at: http://ilsi.org/europe/wp-content/uploads/sites/3/2016/05/ Prebiotics-Probiotics.pdf [Accessed 27 Apr. 2019].
Carlson, A., Xia, K., Azcarate-Peril, M., Goldman, B., Ahn, M., & Styner, M. et al.. (2018). Infant Gut Microbiome Associated With Cognitive Development. Biological Psychiatry, 83(2), pp. 148-159. doi: 10.1016/j.biopsych.2017.06.021
Ciorba, M., Riehl, T., Rao, M., Moon, C., Ee, X., & Nava, G. et al.. (2011). Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut, 61(6), pp.829-838. doi: 10.1136/gutjnl-2011-300367
Claesson, M., Jeffery, I., Conde, S., Power, S., O’Connor, E., & Cusack, S. et al.. (2012). Gut microbiota composition correlates with diet and health in the elderly. Nature, 488(7410), pp.178-184. doi: 10.1038/nature11319
Coviello C, C., Corsini I, I., Arena, F., Antonelli, A., Rossolini, G., & Dani, C. (2015). Lactobacillus Sepsis and Probiotic Therapy in Newborns: Two New Cases and Literature Review. American Journal of Perinatology Reports, 06(01), pp.e25-e29. doi: 10.1055/s-0035-1566312
Dinan, T., Stanton, C., & Cryan, J. (2013). Psychobiotics: A Novel Class of Psychotropic. Biological Psychiatry, 74(10), pp.720-726. doi: 10.1016/j.biopsych.2013.05.001
Doron, S., & Snydman, D. (2015). Risk and Safety of Probiotics. Clinical Infectious Diseases, 60(suppl_2), S129-S134. doi: 10.1093/cid/civ085
Dosage - Probiotic Advisor. (2019). Retrieved from https://www.probioticadvisor.com/probiotic-essentials-2/dosage/
Ejtahed, H., Mohtadi-Nia, J., Homayouni-Rad, A., Niafar, M., Asghari-Jafarabadi, M., Mofid, V., & Akbarian-Moghari, A. (2011). Effect of probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis on lipid profile in individuals with type 2 diabetes mellitus. Journal of Dairy Science, 94(7), pp. 3288-3294. doi: 10.3168/jds.2010-4128
Evaluation of health and nutritional properties of powder milk and live lactic acid bacteria. (2001). Retrieved from https://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf
Fijan, S. (2014). Microorganisms with Claimed Probiotic Properties: An Overview of Recent Literature. International Journal of Environmental Research and Public Health, 11(5), pp. 4745-4767. doi: 10.3390/ijerph110504745
Franceschi, C. (2008). Inflammaging as a Major Characteristic of Old People: Can It Be Prevented or Cured? Nutrition Reviews, 65, pp.S173-S176. doi: 10.1111/j.1753-4887.2007.tb00358.x
Guinane, C., & Cotter, P. (2013). Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. Therapeutic Advances In Gastroenterology, 6(4), pp.295-308. doi: 10.1177/1756283x13482996
Hao, Q., Lu, Z., Dong, B., Huang, C., & Wu, T. (1996). Cochrane Database of Systematic Reviews: Probiotics for preventing acute upper respiratory tract infections. CD006895.Pub2. doi: 10.1002/14651858
Hu, G., Chen, G., Xu, H., Ge, R., & Lin, J. (2010). Activation of the AMP activated protein kinase by short-chain fatty acids is the main mechanism underlying the beneficial effect of a high fiber diet on the metabolic syndrome. Medical Hypotheses, 74(1), 123-126. doi:10.1016/j.mehy.2009.07.022
Kau, A., Ahern, P., Griffin, N., Goodman, A., & Gordon, J. (2011). Human nutrition, the gut microbiome and the immune system. Nature, 474(7351), pp.327-336. doi: 10.1038/nature10213
Kelishadi, R., Farajian, S., & Mirlohi, M. (2013). Probiotics as a Novel Treatment for Non-Alcoholic Fatty Liver Disease; A Systematic Review on the Current Evidences. Hepatitis Monthly, 13(4). doi:10.5812/hepatmon.7233
Kelly, C., Zheng, L., Campbell, E., Saeedi, B., Scholz, C., & Bayless, A. et al.. (2015). Crosstalk between Microbiota-Derived Short-Chain Fatty Acids and Intestinal Epithelial HIF Augments Tissue Barrier Function. Cell Host & Microbe, 17(5), pp. 662-671. doi: 10.1016/j.chom.2015.03.005
Ley, R., Peterson, D., & Gordon, J. (2006). Ecological and Evolutionary Forces Shaping Microbial Diversity in the Human Intestine. Cell, 124(4), pp. 837-848. doi: 10.1016/j.cell.2006.02.017
Liu, S. (2016). The Development of Our Organ of Other Kinds—The Gut Microbiota. Frontiers In Microbiology, 7. doi: 10.3389/fmicb.2016.02107
Manzanares, W., Lemieux, M., Langlois, P., & Wischmeyer, P. (2016). Probiotic and synbiotic therapy in critical illness: a systematic review and meta-analysis. Critical Care, 20(1), pp.262. doi: 10.1186/s13054-016-1434-y
Melissa Conrad Stoppler, M. (2017). Digestive Health: 10 Probiotic Foods That Help Digestion. Retrieved from https://www.onhealth.com/content/1/probiotic_foods
O'Hara, A., & Shanahan, F. (2006). The gut flora as a forgotten organ. EMBO Reports, 7(7), pp. 688-693. doi: 10.1038/sj.embor.7400731
Ooi, L., & Liong, M. (2010). Cholesterol-Lowering Effects of Probiotics and Prebiotics: A Review of in Vivo and in Vitro Findings. International Journal of Molecular Sciences, 11(6), pp. 2499-2522. doi: 10.3390/ijms11062499
Parvaneh, K., Jamaluddin, R., Karimi, G., & Erfani, R. (2014). Effect of Probiotics Supplementation on Bone Mineral Content and Bone Mass Density. The Scientific World Journal, pp. 1-6. doi: 10.1155/2014/595962
Patterson, E., Ryan, P., Cryan, J., Dinan, T., Ross, R., Fitzgerald, G., & Stanton, C. (2016). Gut microbiota, obesity and diabetes. Postgraduate Medical Journal, 92(1087), pp.286-300. doi: 10.1136/postgradmedj-2015-133285
Prantera, C., Scribano, M., Falasco, G., Andreoli, A., & Luzi, C. (2002). Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease: a randomised controlled trial with Lactobacillus GG. Gut, 51(3), pp. 405-409. doi: 10.1136/gut.51.3.405
Ramanan, D., Bowcutt, R., Lee, S., Tang, M., Kurtz, Z., & Ding, Y. et al.. (2016). Helminth infection promotes colonization resistance via type 2 immunity. Science, 352(6285), pp. 608-612. doi: 10.1126/science.aaf3229
Saab, S., Suraweera, D., Au, J., Saab, E., Alper, T., & Tong, M. (2015). Probiotics are helpful in hepatic encephalopathy: a meta-analysis of randomized trials. Liver International, 36(7), pp. 986-993. doi: 10.1111/liv.13005
Sanders, M., Merenstein, D., Merrifield, C., & Hutkins, R. (2018). Probiotics for human use. Nutrition Bulletin, 43(3), pp. 212-225. doi: 10.1111/nbu.12334
Scarpellini, E., Ianiro, G., Attili, F., Bassanelli, C., De Santis, A., & Gasbarrini, A. (2015). The human gut microbiota and virome: Potential therapeutic implications. Digestive and Liver Disease, 47(12), pp. 1007-1012. doi: 10.1016/j.dld.2015.07.008
Scholz-Ahrens, K., Ade, P., Marten, B., Weber, P., Timm, W., & Aςil, Y. et al.. (2007). Prebiotics, Probiotics, and Synbiotics Affect Mineral Absorption, Bone Mineral Content, and Bone Structure. The Journal of Nutrition, 137(3), pp. 838S-846S. doi: 10.1093/jn/137.3.838s
Shan, L., Hou, P., Wang, Z., Liu, F., Chen, N., & Shu, L. et al.. (2013). Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections. Beneficial Microbes, 4(4), pp. 329-334. doi: 10.3920/bm2013.0008
Smith, T., Watt, H., Gunn, L., Car, J., & Boyle, R. (2016). Recommending Oral Probiotics to Reduce Winter Antibiotic Prescriptions in People With Asthma: A Pragmatic Randomized Controlled Trial. The Annals of Family Medicine, 14(5), pp.422-430. doi: 10.1370/afm.1970
Song, H., Kim, J., Jung, S., Kim, S., Park, H., & Jeong, Y. et al.. (2010). Effect of Probiotic Lactobacillus (Lacidofil® Cap) for the Prevention of Antibiotic-associated Diarrhea: A Prospective, Randomized, Double-blind, Multicenter Study. Journal of Korean Medical Science, 25(12), pp.1784. doi: 10.3346/jkms.2010.25.12.1784
Summers, R. (2005). Trichuris suis therapy in Crohn's disease. Gut, 54(1), pp. 87-90. doi: 10.1136/gut.2004.041749
The History Of Probiotics » The Candida Diet. Retrieved from https://www.thecandidadiet.com/the-history-of-probiotics/
Vaghef-Mehrabany, E., Alipour, B., Homayouni-Rad, A., Sharif, S., Asghari-Jafarabadi, M., & Zavvari, S. (2014). Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition, 30(4), 430-435. doi: 10.1016/j.nut.2013.09.007
Vieira, A., Teixeira, M., & Martins, F. (2013). The Role of Probiotics and Prebiotics in Inducing Gut Immunity. Frontiers In Immunology, 4. doi: 10.3389/fimmu.2013.00445
Wallace, C., & Milev, R. (2017). The effects of probiotics on depressive symptoms in humans: a systematic review. Annals of General Psychiatry, 16(1). doi: 10.1186/s12991-017-0138-2
Weston, S. (2005). Effects of probiotics on atopic dermatitis: a randomised controlled trial. Archives of Disease in Childhood, 90(9), pp. 892-897. doi: 10.1136/adc.2004.060673
Wilkins, T., & Sequoia, J. (2017). Probiotics for Gastrointestinal Conditions: A Summary of the Evidence. American Family Physician, 96(3), pp. 170-178.
Xu, J., & Gordon, J. (2003). Honor thy symbionts. Proceedings of the National Academy of Sciences, 100(18), 10452-10459. doi: 10.1073/pnas.1734063100
Yeo, S., & Liong, M. (2010). Angiotensin I-converting enzyme inhibitory activity and bioconversion of isoflavones by probiotics in soymilk supplemented with prebiotics. International Journal of Food Sciences and Nutrition, 61(2), pp. 161-181. doi: 10.3109/09637480903348122
Yu, A., & Li, L. (2016). The Potential Role of Probiotics in Cancer Prevention and Treatment. Nutrition and Cancer, 68(4), pp. 535-544.
Aceti, A., Gori, D., Barone, G., Callegari, M., Di Mauro, A., & Fantini, M. et al.. (2015). Probiotics for prevention of necrotizing enterocolitis in preterm infants: systematic review and meta-analysis. Italian Journal of Pediatrics, 41(1). doi: 10.1186/s13052-015-0199-2
Barichella, M., Pacchetti, C., Bolliri, C., Cassani, E., Iorio, L., & Pusani, C. et al.. (2016). SUN-P199: Double-Blind, Placebo-Controlled Trial of a Fermented Milk Containing Multiple Probiotic Strains and Prebiotic Fiber for Constipation Associated with Parkinson's Disease. Clinical Nutrition, 35, pp. S118. doi: 10.1016/s0261-5614(16)30542-8
Besselink, M., van Santvoort, H., Buskens, E., Boermeester, M., van Goor, H., & Timmerman, H. et al.. (2008). Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. The Lancet, 371(9613), pp.651-659. doi: 10.1016/s0140-6736(08)60207-x.
Binns, N. (2013). Probiotics, prebiotics and the gut microbiota. [online] Ilsi.org. Available at: http://ilsi.org/europe/wp-content/uploads/sites/3/2016/05/ Prebiotics-Probiotics.pdf [Accessed 27 Apr. 2019].
Carlson, A., Xia, K., Azcarate-Peril, M., Goldman, B., Ahn, M., & Styner, M. et al.. (2018). Infant Gut Microbiome Associated With Cognitive Development. Biological Psychiatry, 83(2), pp. 148-159. doi: 10.1016/j.biopsych.2017.06.021
Ciorba, M., Riehl, T., Rao, M., Moon, C., Ee, X., & Nava, G. et al.. (2011). Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut, 61(6), pp.829-838. doi: 10.1136/gutjnl-2011-300367
Claesson, M., Jeffery, I., Conde, S., Power, S., O’Connor, E., & Cusack, S. et al.. (2012). Gut microbiota composition correlates with diet and health in the elderly. Nature, 488(7410), pp.178-184. doi: 10.1038/nature11319
Coviello C, C., Corsini I, I., Arena, F., Antonelli, A., Rossolini, G., & Dani, C. (2015). Lactobacillus Sepsis and Probiotic Therapy in Newborns: Two New Cases and Literature Review. American Journal of Perinatology Reports, 06(01), pp.e25-e29. doi: 10.1055/s-0035-1566312
Dinan, T., Stanton, C., & Cryan, J. (2013). Psychobiotics: A Novel Class of Psychotropic. Biological Psychiatry, 74(10), pp.720-726. doi: 10.1016/j.biopsych.2013.05.001
Doron, S., & Snydman, D. (2015). Risk and Safety of Probiotics. Clinical Infectious Diseases, 60(suppl_2), S129-S134. doi: 10.1093/cid/civ085
Dosage - Probiotic Advisor. (2019). Retrieved from https://www.probioticadvisor.com/probiotic-essentials-2/dosage/
Ejtahed, H., Mohtadi-Nia, J., Homayouni-Rad, A., Niafar, M., Asghari-Jafarabadi, M., Mofid, V., & Akbarian-Moghari, A. (2011). Effect of probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis on lipid profile in individuals with type 2 diabetes mellitus. Journal of Dairy Science, 94(7), pp. 3288-3294. doi: 10.3168/jds.2010-4128
Evaluation of health and nutritional properties of powder milk and live lactic acid bacteria. (2001). Retrieved from https://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf
Fijan, S. (2014). Microorganisms with Claimed Probiotic Properties: An Overview of Recent Literature. International Journal of Environmental Research and Public Health, 11(5), pp. 4745-4767. doi: 10.3390/ijerph110504745
Franceschi, C. (2008). Inflammaging as a Major Characteristic of Old People: Can It Be Prevented or Cured? Nutrition Reviews, 65, pp.S173-S176. doi: 10.1111/j.1753-4887.2007.tb00358.x
Guinane, C., & Cotter, P. (2013). Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. Therapeutic Advances In Gastroenterology, 6(4), pp.295-308. doi: 10.1177/1756283x13482996
Hao, Q., Lu, Z., Dong, B., Huang, C., & Wu, T. (1996). Cochrane Database of Systematic Reviews: Probiotics for preventing acute upper respiratory tract infections. CD006895.Pub2. doi: 10.1002/14651858
Hu, G., Chen, G., Xu, H., Ge, R., & Lin, J. (2010). Activation of the AMP activated protein kinase by short-chain fatty acids is the main mechanism underlying the beneficial effect of a high fiber diet on the metabolic syndrome. Medical Hypotheses, 74(1), 123-126. doi:10.1016/j.mehy.2009.07.022
Kau, A., Ahern, P., Griffin, N., Goodman, A., & Gordon, J. (2011). Human nutrition, the gut microbiome and the immune system. Nature, 474(7351), pp.327-336. doi: 10.1038/nature10213
Kelishadi, R., Farajian, S., & Mirlohi, M. (2013). Probiotics as a Novel Treatment for Non-Alcoholic Fatty Liver Disease; A Systematic Review on the Current Evidences. Hepatitis Monthly, 13(4). doi:10.5812/hepatmon.7233
Kelly, C., Zheng, L., Campbell, E., Saeedi, B., Scholz, C., & Bayless, A. et al.. (2015). Crosstalk between Microbiota-Derived Short-Chain Fatty Acids and Intestinal Epithelial HIF Augments Tissue Barrier Function. Cell Host & Microbe, 17(5), pp. 662-671. doi: 10.1016/j.chom.2015.03.005
Ley, R., Peterson, D., & Gordon, J. (2006). Ecological and Evolutionary Forces Shaping Microbial Diversity in the Human Intestine. Cell, 124(4), pp. 837-848. doi: 10.1016/j.cell.2006.02.017
Liu, S. (2016). The Development of Our Organ of Other Kinds—The Gut Microbiota. Frontiers In Microbiology, 7. doi: 10.3389/fmicb.2016.02107
Manzanares, W., Lemieux, M., Langlois, P., & Wischmeyer, P. (2016). Probiotic and synbiotic therapy in critical illness: a systematic review and meta-analysis. Critical Care, 20(1), pp.262. doi: 10.1186/s13054-016-1434-y
Melissa Conrad Stoppler, M. (2017). Digestive Health: 10 Probiotic Foods That Help Digestion. Retrieved from https://www.onhealth.com/content/1/probiotic_foods
O'Hara, A., & Shanahan, F. (2006). The gut flora as a forgotten organ. EMBO Reports, 7(7), pp. 688-693. doi: 10.1038/sj.embor.7400731
Ooi, L., & Liong, M. (2010). Cholesterol-Lowering Effects of Probiotics and Prebiotics: A Review of in Vivo and in Vitro Findings. International Journal of Molecular Sciences, 11(6), pp. 2499-2522. doi: 10.3390/ijms11062499
Parvaneh, K., Jamaluddin, R., Karimi, G., & Erfani, R. (2014). Effect of Probiotics Supplementation on Bone Mineral Content and Bone Mass Density. The Scientific World Journal, pp. 1-6. doi: 10.1155/2014/595962
Patterson, E., Ryan, P., Cryan, J., Dinan, T., Ross, R., Fitzgerald, G., & Stanton, C. (2016). Gut microbiota, obesity and diabetes. Postgraduate Medical Journal, 92(1087), pp.286-300. doi: 10.1136/postgradmedj-2015-133285
Prantera, C., Scribano, M., Falasco, G., Andreoli, A., & Luzi, C. (2002). Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease: a randomised controlled trial with Lactobacillus GG. Gut, 51(3), pp. 405-409. doi: 10.1136/gut.51.3.405
Ramanan, D., Bowcutt, R., Lee, S., Tang, M., Kurtz, Z., & Ding, Y. et al.. (2016). Helminth infection promotes colonization resistance via type 2 immunity. Science, 352(6285), pp. 608-612. doi: 10.1126/science.aaf3229
Saab, S., Suraweera, D., Au, J., Saab, E., Alper, T., & Tong, M. (2015). Probiotics are helpful in hepatic encephalopathy: a meta-analysis of randomized trials. Liver International, 36(7), pp. 986-993. doi: 10.1111/liv.13005
Sanders, M., Merenstein, D., Merrifield, C., & Hutkins, R. (2018). Probiotics for human use. Nutrition Bulletin, 43(3), pp. 212-225. doi: 10.1111/nbu.12334
Scarpellini, E., Ianiro, G., Attili, F., Bassanelli, C., De Santis, A., & Gasbarrini, A. (2015). The human gut microbiota and virome: Potential therapeutic implications. Digestive and Liver Disease, 47(12), pp. 1007-1012. doi: 10.1016/j.dld.2015.07.008
Scholz-Ahrens, K., Ade, P., Marten, B., Weber, P., Timm, W., & Aςil, Y. et al.. (2007). Prebiotics, Probiotics, and Synbiotics Affect Mineral Absorption, Bone Mineral Content, and Bone Structure. The Journal of Nutrition, 137(3), pp. 838S-846S. doi: 10.1093/jn/137.3.838s
Shan, L., Hou, P., Wang, Z., Liu, F., Chen, N., & Shu, L. et al.. (2013). Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections. Beneficial Microbes, 4(4), pp. 329-334. doi: 10.3920/bm2013.0008
Smith, T., Watt, H., Gunn, L., Car, J., & Boyle, R. (2016). Recommending Oral Probiotics to Reduce Winter Antibiotic Prescriptions in People With Asthma: A Pragmatic Randomized Controlled Trial. The Annals of Family Medicine, 14(5), pp.422-430. doi: 10.1370/afm.1970
Song, H., Kim, J., Jung, S., Kim, S., Park, H., & Jeong, Y. et al.. (2010). Effect of Probiotic Lactobacillus (Lacidofil® Cap) for the Prevention of Antibiotic-associated Diarrhea: A Prospective, Randomized, Double-blind, Multicenter Study. Journal of Korean Medical Science, 25(12), pp.1784. doi: 10.3346/jkms.2010.25.12.1784
Summers, R. (2005). Trichuris suis therapy in Crohn's disease. Gut, 54(1), pp. 87-90. doi: 10.1136/gut.2004.041749
The History Of Probiotics » The Candida Diet. Retrieved from https://www.thecandidadiet.com/the-history-of-probiotics/
Vaghef-Mehrabany, E., Alipour, B., Homayouni-Rad, A., Sharif, S., Asghari-Jafarabadi, M., & Zavvari, S. (2014). Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition, 30(4), 430-435. doi: 10.1016/j.nut.2013.09.007
Vieira, A., Teixeira, M., & Martins, F. (2013). The Role of Probiotics and Prebiotics in Inducing Gut Immunity. Frontiers In Immunology, 4. doi: 10.3389/fimmu.2013.00445
Wallace, C., & Milev, R. (2017). The effects of probiotics on depressive symptoms in humans: a systematic review. Annals of General Psychiatry, 16(1). doi: 10.1186/s12991-017-0138-2
Weston, S. (2005). Effects of probiotics on atopic dermatitis: a randomised controlled trial. Archives of Disease in Childhood, 90(9), pp. 892-897. doi: 10.1136/adc.2004.060673
Wilkins, T., & Sequoia, J. (2017). Probiotics for Gastrointestinal Conditions: A Summary of the Evidence. American Family Physician, 96(3), pp. 170-178.
Xu, J., & Gordon, J. (2003). Honor thy symbionts. Proceedings of the National Academy of Sciences, 100(18), 10452-10459. doi: 10.1073/pnas.1734063100
Yeo, S., & Liong, M. (2010). Angiotensin I-converting enzyme inhibitory activity and bioconversion of isoflavones by probiotics in soymilk supplemented with prebiotics. International Journal of Food Sciences and Nutrition, 61(2), pp. 161-181. doi: 10.3109/09637480903348122
Yu, A., & Li, L. (2016). The Potential Role of Probiotics in Cancer Prevention and Treatment. Nutrition and Cancer, 68(4), pp. 535-544.
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Sen, M. (2019). Role of Probiotics in Health and Disease – A Review. International Journal of Advancement in Life Sciences Research, 2(2), 1-11. Retrieved from http://ijalsr.org/index.php/journal/article/view/52
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