Document Type : Review Article

Authors

1 Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran & Department of Nutrition, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran

2 2. Student Research Committee, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran & Department of Nutrition, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Probiotics were first proposed by Metchnikoff as contributing factors to health. These living microorganisms, which mainly belong to the microflora bacteria of the gastrointestinal tract, can have beneficial effects on human health if consumed in moderation. The most studied probiotics are lactic acid bacteria, which include Lactobacillus and Bifidobacteria. The present study is an overview of some studies conducted on the effects of using probiotics and their possible patterns in the prevention or reduction of certain human diseases and disorders. The available data suggest that probiotics can play a role in improving constipation and liver enzymes level and functions, and have significant effects on rooting and improving the symptoms of Helicobacter pylori. It was concluded that probiotics have positive effects in metabolic syndrome treatment, preventing gestational diabetes, and improving oral health. Since many probiotics are microorganisms familiar to the gastrointestinal tract, if consumed in moderation, there are no side effects for the host. Using them as complementary therapies for some diseases related to the gastrointestinal tract microflora bacteria can be an effective and low-cost approach to alleviating the annoying symptoms of such diseases.

Keywords

  1. Nariman M. Probiotics, a new generation of living drugs. Research in Medicine. 2008; 32(3):169-74.
  2. Bonyadi F, Tukmechi A, Mohebalian H. An overview of probiotics and their role in cancer management. J Mazandaran Univ Med Sci. 2014; 24 (112):128-40. [In Persian].
  3. Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: A systematic review. Gut. 2010; 59(3):325-32. doi: 10.1136/gut.2008.167270.
  4. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: Probiotics for functional constipation. World J Gastroenterol. 2010; 16(1):69-75. doi: 10.3748/wjg.v16.i1.69.
  5. Didari T, Solki S, Mozaffari S, Nikfar S, Abdollahi M. A systematic review of the safety of probiotics. Expert Opin Drug Saf. 2014; 13(2):227-39. doi: 10.1517/14740338.2014.872627.
  6. American Gastroenterological Association, Bharucha AE, Dorn SD, Lembo A, Pressman A. American Gastroenterological Association medical position statement on constipation. Gastroenterology. 2013; 144(1):211-7. doi: 10.1053/j.gastro.2012.10.029.
  7. Chatoor D, Emmnauel A. Constipation and evacuation disorders. Best Pract Res Clin Gastroenterol. 2009; 23(4):517-30. doi: 10.1016/j.bpg.2009.05.001.
  8. Tack J, Müller-Lissner S, Stanghellini V, Boeckxstaens G, Kamm MA, Simren M, et al. Diagnosis and treatment of chronic constipation-a European perspective. Neurogastroenterol Motil. 2011; 23(8):697-710. doi: 10.1111/j.1365-2982.2011.01709.x.
  9. Eoff JC. Optimal treatment of chronic constipation in managed care: Review and roundtable discussion. J Manag Care Pharm. 2008; 14(9):1-15. doi: 10.18553/jmcp.2008.14.S8-A.1.
  10. Jahangiri S, Tadayonfar Mar, Rahmani A, Rakhshani Mh. The effect of probiotics on constipation stroke patients admitted To ICU. Journal of Sabzevar University of Medical Sciences. 2016; 23(5):776-81. [In Persian]. doi: 10.21859/sums-2305776.
  11. van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: A systematic review. Am J Gastroenterol. 2006; 101(10):2401-9. doi: 10.1111/j.1572-0241.2006.00771.x.
  12. American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care. 2011; 34(1):11-61. doi: 10.2337/dc11-S011.
  13. Abediny M, Ataiee P, Afkhamzadeh A, Seifmanesh M, Sedaghat B. The effect of probiotics on the treatment of functional constipation in children of 4-12 years of age. Journal of Isfahan Medical School. 2016; 33(368):2448-54. [In Persian].
  14. Turan I, Dedeli O, Bor S, İlter T. Effects of a kefir supplement on symptoms, colonic transit, and bowel satisfaction score in patients with chronic constipation: A pilot study. Turk J Gastroenterol. 2014; 25(6):650-6. doi: 10.5152/tjg.2014.6990.
  15. Ou Y, Chen S, Ren F, Zhang M, Ge S, Guo H, Zhang H, Zhao L. Lactobacillus casei strain shirota alleviates constipation in adults by increasing the pipecolinic acid level in the Gut. Front Microbiol. 2019; 10:324. doi: 10.3389/fmicb.2019.00324.
  16. Indrio F, Di Mauro A, Riezzo G. Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation--reply. JAMA Pediatr. 2014; 168(8):778. doi: 10.1001/jamapediatrics.2014.368.
  17. Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: A systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014; 100(4):1075-84. doi: 10.3945/ajcn.114.089151.
  18. Bekkali NLH, Bongers ME, Van den Berg MM, Liem O, Benninga MA. The role of a probiotics mixture in the treatment of childhood constipation: A pilot study. Nutr J. 2007; 6:17. doi: 10.1186/1475-2891-6-17
  19. Favretto DC, Pontin B, Moreira TR. Effect of the consumption of a cheese enriched with probiotic organisms (Bifidobacterium lactis bi-07) in improving symptoms of constipation. Arq Gastroenterol. 2013; 50(3):196-201. doi: 10.1590/S0004-28032013000200035.
  20. Jayasimhan S, Yap NY, Roest Y, Rajandram R, Chin KF. Efficacy of microbial cell preparation in improving chronic constipation: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2013; 32(6):928-34. doi: 10.1016/j.clnu.2013.03.004.
  21. Zhang C, Jiang J, Tian F, Zhao J, Zhang H, Zhai Q, et al. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr. 2020; 39(10):2960-9. doi: 10.1016/j.clnu.2020.01.005.
  22. Gold BD, Colletti RB, Abbott M, Czinn SJ, Elitsur Y, Hassall E, et al. Helicobacter pylori infection in children: Recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr. 2000; 31(5):490-7. doi: 10.1097/00005176-200011000-00007.
  23. Bourke B, Ceponis P, Chiba N, Czinn S, Ferraro R, Fischbach L, et al. Canadian helicobacter study group. canadian helicobacter study group consensus conference: Update on the approach to helicobacter pylori infection in children and adolescents--an evidence-based evaluation. Can J Gastroenterol. 2005; 19(7):399-408.
  24. Bhatia SJ, Kochar N, Abraham P, Nair NG, Mehta AP. Lactobacillus acidophilus inhibits growth of Campylobacter pylori in vitro. J Clin Microbiol. 1989; 27(10):2328-30. doi: 10.1128/jcm.27.10.2328-2330.1989.
  25. Bernet MF, Brassart D, Neeser JR, Servin A. Lactobacillus acidophilus LA 1 binds to cultured human intestinal cell lines and inhibits cell attachment and cell invasion by enterovirulent bacteria. Gut. 1994; 35(4):483-9. doi: 10.1136/gut.35.4.483.
  26. Saneeyan H, Layegh S, Rahimi H. Effectiveness of probiotic on treatment of Helicobacter pylori infection in children. Journal of Isfahan Medical School. 2011; 29(146):882-9.
  27. Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: Antibiotics or probiotics. Appl Microbiol Biotechnol. 2018; 102(1):1-7. doi: 10.1007/s00253-017-8535-7.
  28. Zhang J, Ma S, Wu S, Guo C, Long S, Tan H. Effects of probiotic supplement in pregnant women with gestational diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. J Diabetes Res. 2019; 2019:5364730. doi: 10.1155/2019/5364730.
  29. Boltin D. Probiotics in Helicobacter pylori-induced peptic ulcer disease. Best Pract Res Clin Gastroenterol. 2016; 30(1):99-109. doi: 10.1016/j.bpg.2015.12.003.
  30. Feng JR, Wang F, Qiu X, McFarland LV, Chen PF, Zhou R, et al. Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis. Eur J Clin Pharmacol. 2017; 73(10):1199-208. doi: 10.1007/s00228-017-2291-6.
  31. Fang HR, Zhang GQ, Cheng JY, Li ZY. Efficacy of Lactobacillus-supplemented triple therapy for Helicobacter pylori infection in children: A meta-analysis of randomized controlled trials. Eur J Pediatr. 2019; 178(1):7-16. doi: 10.1007/s00431-018-3282-z.
  32. Lionetti E, Miniello VL, Castellaneta SP, Magistá AM, de Canio A, Maurogiovanni G, et al. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children: A randomized placebo controlled trial. Aliment Pharmacol Ther. 2006; 24(10):1461-8. doi: 10.1111/j.1365-2036.2006.03145.x.
  33. Song H, Zhou L, Liu D, Ge L, Li Y. Probiotic effect on Helicobacter pylori attachment and inhibition of inflammation in human gastric epithelial cells. Exp Ther Med. 2019; 18(3):1551-62. doi: 10.3892/etm.2019.7742.
  34. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine, 19/E (Vol. 1 & Vol. 2). New York: McGraw Hill Professional; 2015.
  35. Talley N. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, and noncardiac chest pain. In: Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.
  36. Pourfarzi F, Enteshari Mogaddam A, Yazdanbod A, Tazakkori Z, Farzaneh E, Mirzarahimi M. The effect of probiotic yogurt on controlling the symptoms of irritable bowel syndrome . J Ardabil Univ Med Sci. 2011; 11(1):24-32. [In Persian].
  37. Francavilla R, Piccolo M, Francavilla A, Polimeno L, Semeraro F, Cristofori F, et al. Clinical and microbiological effect of a multispecies probiotic supplementation in celiac patients with persistent ibs-type symptoms: A randomized, double-blind, placebo-controlled, multicenter trial. J Clin Gastroenterol. 2019; 53(3):117-25. doi: 10.1097/MCG.0000000000001023.
  38. Camilleri M. Probiotics and irritable bowel syndrome: Rationale, putative mechanisms, and evidence of clinical efficacy. J Clin Gastroenterol. 2006; 40(3):264-9. doi: 10.1097/00004836-200603000-00020.
  39. Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015; 21(10):3072-84. doi: 10.3748/wjg.v21.i10.3072.
  40. Nikfar S, Rahimi R, Rahimi F, Derakhshani S, Abdollahi M. Efficacy of probiotics in irritable bowel syndrome: A meta-analysis of randomized, controlled trials. Dis Colon Rectum. 2008; 51(12):1775-80. doi: 10.1007/s10350-008-9335-z.
  41. Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: Definitions and controversies. BMC Med. 2011; 9:48. doi: 10.1186/1741-7015-9-48.
  42. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. International diabetes federation task force on epidemiology and prevention; hational heart, lung, and blood institute; american heart association; world heart federation; international atherosclerosis society; international association for the study of obesity. harmonizing the metabolic syndrome: A joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; american heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation. 2009; 120(16):1640-5. doi: 10.1161/CIRCULATIONAHA.109.192644.
  43. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002; 288(21):2709-16. doi: 10.1001/jama.288.21.2709.
  44. Vaghef Mehrabani E, Vaghef Mehrabani L, Norouzi S, Ziyadi S, Homayouni Rad A. The effect of probiotics on prevention and treatment of metabolic syndrome-associated disorders. J Arak Uni Med Sci. 2015; 18(9):74-84. [In Persian].
  45. Talaei B, Bahreini S. The effects of cinnamon on diabetes mellitus: A narrative review. IEJM. 2019; 8(1):37-46.
  46. Rezazadeh L, Gargari BP, Jafarabadi MA, Alipour B. Effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome. Nutrition. 2019; 62:162-8. doi: 10.1016/j.nut.2018.12.011.
  47. Bernini LJ, Simao ANC, Alfieri DF, Lozovoy MAB, Mari NL, de Souza CHB, et al. Beneficial effects of Bifidobacterium lactis on lipid profile and cytokines in patients with metabolic syndrome: A randomized trial. Effects of probiotics on metabolic syndrome. Nutrition. 2016;32(6):716-9. doi: 10.1016/j.nut.2015.11.001.
  48. Sáez-Lara MJ, Robles-Sanchez C, Ruiz-Ojeda FJ, Plaza-Diaz J, Gil A. Effects of probiotics and synbiotics on obesity, insulin resistance syndrome, type 2 diabetes and non-alcoholic fatty liver disease: A review of human clinical trials. Int J Mol Sci. 2016; 17(6):928. doi: 10.3390/ijms17060928.
  49. Stadlbauer V, Leber B, Lemesch S, Trajanoski S, Bashir M, Horvath A, et al,. Lactobacillus casei shirota supplementation does not restore gut microbiota composition and gut barrier in metabolic syndrome: A randomized pilot study. PLoS One. 2015; 10(10):0141399. doi: 10.1371/journal.pone.0141399.
  50. Leber B, Tripolt NJ, Blattl D, Eder M, Wascher TC, Pieber TR, et al. The influence of probiotic supplementation on gut permeability in patients with metabolic syndrome: An open label, randomized pilot study. Eur J Clin Nutr. 2012; 66(10):1110-5. doi: 10.1038/ejcn.2012.103.
  51. Barreto FM, Colado Simão AN, Morimoto HK, Batisti Lozovoy MA, Dichi I, Helena da Silva Miglioranza L. Beneficial effects of Lactobacillus plantarum on glycemia and homocysteine levels in postmenopausal women with metabolic syndrome. Nutrition. 2014; 30(7-8):939-42. doi: 10.1016/j.nut.2013.12.004.
  52. He M, Shi B. Gut microbiota as a potential target of metabolic syndrome: The role of probiotics and prebiotics. Cell Biosci. 2017; 7:54. doi: 10.1186/s13578-017-0183-1.
  53. Mahan LK, Escott-Stump S. Krause's food & nutrition therapy. 12th Edition. Saunders Elsevier, St. Louis; 2008.
  54. Koren O, Goodrich JK, Cullender TC, Spor A, Laitinen K, Bäckhed HK,et al. Host remodeling of the gut microbiome and metabolic changes during pregnancy. Cell. 2012; 150(3):470-80. doi: 10.1016/j.cell.2012.07.008.
  55. Yadav H, Jain S, Sinha PR. Oral administration of dahi containing probiotic Lactobacillus acidophilus and Lactobacillus casei delayed the progression of streptozotocin-induced diabetes in rats. J Dairy Res. 2008; 75(2):189-95. doi: 10.1017/S0022029908003129.
  56. Zhang J, Ma S, Wu S, Guo C, Long S, Tan H. Effects of probiotic supplement in pregnant women with gestational diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. J Diabetes Res. 2019; 2019:5364730. doi: 10.1155/2019/5364730.
  57. Kijmanawat A, Panburana P, Reutrakul S, Tangshewinsirikul C. Effects of probiotic supplements on insulin resistance in gestational diabetes mellitus: A double-blind randomized controlled trial. J Diabetes Investig. 2019; 10(1):163-70. doi: 10.1111/jdi.12863.
  58. Taylor BL, Woodfall GE, Sheedy KE, O'Riley ML, Rainbow KA, Bramwell EL, et al. Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2017; 9(5):461. doi: 10.3390/nu9050461.
  59. Pan J, Pan Q, Chen Y, Zhang H, Zheng X. Efficacy of probiotic supplement for gestational diabetes mellitus: A systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2019; 32(2):317-23. doi: 10.1080/14767058.2017.1376318.
  60. Hajifaraji M, Dolatkhah N. Probiotics and metabolic outcomes of gestational diabetes: A review article. J Mazandaran Univ Med Sci. 2018; 28(162):155-74.
  61. Jameshorani M, Rafiee E, Kamali K. Treatment effects of probiotic in non alcoholic fatty liver disease. J Adv Med Biomed Res. 2017; 25(109):23-35. [In Persian].
  62. Nabavi S, Rafraf M, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi M. Effects of probiotic yogurt consumption on metabolic factors in individuals with nonalcoholic fatty liver disease. J Dairy Sci. 2014; 97(12):7386-93. doi: 10.3168/jds.2014-8500.
  63. Aller R, De Luis DA, Izaola O, Conde R, Gonzalez Sagrado M, Primo D, et al. Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: A double blind randomized clinical trial. Eur Rev Med Pharmacol Sci. 2011; 15(9):1090-5. PMID: 22013734.
  64. Xue L, He J, Gao N, Lu X, Li M, Wu X, et al. Probiotics may delay the progression of nonalcoholic fatty liver disease by restoring the gut microbiota structure and improving intestinal endotoxemia. Sci Rep. 2017; 7:45176. doi: 10.1038/srep45176.
  65. Ma YY, Li L, Yu CH, Shen Z, Chen LH, Li YM. Effects of probiotics on nonalcoholic fatty liver disease: A meta-analysis. World J Gastroenterol. 2013;19(40):6911-8.doi: 10.3748/wjg.v19.i40.6911.
  66. Davari M, Hashemi R, Mirmiran P, Hedayati M, Sahranavard S, Bahreini S, et al. Effects of cinnamon supplementation on expression of systemic inflammation factors, NF-kB and Sirtuin-1 (SIRT1) in type 2 diabetes: A randomized, double blind, and controlled clinical trial. Nutr J. 2020; 19(1):1. doi: 10.1186/s12937-019-0518-3.
  67. Ipar N, Aydogdu SD, Yildirim GK, Inal M, Gies I, Vandenplas Y, Dinleyici EC. Effects of synbiotic on anthropometry, lipid profile and oxidative stress in obese children. Benef Microbes. 2015; 6(6):775-82. doi: 10.3920/BM2015.0011.
  68. Rajkumar H, Mahmood N, Kumar M, Varikuti SR, Challa HR, Myakala SP. Effect of probiotic (VSL#3) and omega-3 on lipid profile, insulin sensitivity, inflammatory markers, and gut colonization in overweight adults: A randomized, controlled trial. Mediators Inflamm. 2014; 2014:348959. doi: 10.1155/2014/348959.
  69. Li Z, Yang S, Lin H, Huang J, Watkins PA, Moser AB, et al. Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology. 2003; 37(2):343-50. doi: 10.1053/jhep.2003.50048.
  70. Famouri F, Shariat Z, Hashemipour M, Keikha M, Kelishadi R. Effects of probiotics on nonalcoholic fatty liver disease in obese children and adolescents. J Pediatr Gastroenterol Nutr. 2017; 64(3):413-7. doi: 10.1097/MPG.0000000000001422.
  71. Gao X, Zhu Y, Wen Y, Liu G, Wan C. Efficacy of probiotics in non-alcoholic fatty liver disease in adult and children: A meta-analysis of randomized controlled trials. Hepatol Res. 2016; 46(12):1226-33. doi: 10.1111/hepr.12671.
  72. Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954; 14(5):421-35. PMID: 13214956.
  73. Rafeey M, Mostafa Gharehbaghi M, Shoaran M, Gholshaian F. Survey in efficacy of probiotics in infantile colic. Research in Medicine. 2016; 40(3):135-42.
  74. Chau K, Lau E, Greenberg S, Jacobson S, Yazdani-Brojeni P, Verma N, et al. Probiotics for infantile colic: A randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938. J Pediatr. 2015; 166(1):74-8. doi: 10.1016/j.jpeds.2014.09.020.
  75. Kianifar H, Ahanchian H, Grover Z, Jafari S, Noorbakhsh Z, Khakshour A, et al. Synbiotic in the management of infantile colic: A randomised controlled trial. J Paediatr Child Health. 2014; 50(10):801-5. doi: 10.1111/jpc.12640.
  76. Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long-term consumption of infant formulas containing live probiotic bacteria: Tolerance and safety. Am J Clin Nutr. 2004; 79(2):261-7. doi: 10.1093/ajcn/79.2.261.
  77. Schreck Bird A, Gregory PJ, Jalloh MA, Risoldi Cochrane Z, Hein DJ. Probiotics for the treatment of infantile colic: A systematic review. J Pharm Pract. 2017; 30(3):366-74. doi: 10.1177/0897190016634516.
  78. Sung V. Probiotic interventions in infantile colic. Curr Opin Clin Nutr Metab Care. 2015; 18(3):307-11. doi: 10.1097/MCO.0000000000000157.
  79. Anabrees J, Indrio F, Paes B, AlFaleh K. Probiotics for infantile colic: A systematic review. BMC Pediatr. 2013; 13:186. doi: 10.1186/1471-2431-13-186.
  80. Meurman JH, Stamatova I. Probiotics: contributions to oral health. Oral Dis. 2007; 13(5):443-51. doi: 10.1111/j.1601-0825.2007.01386.x.
  81. Busscher HJ, Mulder AF, van der Mei HC. In vitro adhesion to enamel and in vivo colonization of tooth surfaces by Lactobacilli from a bio-yoghurt. Caries Res. 1999; 33(5):403-4. doi: 10.1159/000016541.
  82. Haukioja A, Yli-Knuuttila H, Loimaranta V, Kari K, Ouwehand AC, Meurman JH, et al. Oral adhesion and survival of probiotic and other lactobacilli and bifidobacteria in vitro. Oral Microbiol Immunol. 2006; 21(5):326-32. doi: 10.1111/j.1399-302X.2006.00299.x.
  83. Hatakka K, Ahola AJ, Yli-Knuuttila H, Richardson M, Poussa T, Meurman JH, et al. Probiotics reduce the prevalence of oral candida in the elderly--a randomized controlled trial. J Dent Res. 2007; 86(2):125-30. doi: 10.1177/154405910708600204.
  84. Tsubura S, Mizunuma H, Ishikawa S, Oyake I, Okabayashi M, Katoh K, et al. The effect of Bacillus subtilis mouth rinsing in patients with periodontitis. Eur J Clin Microbiol Infect Dis. 2009; 28(11):1353-6. doi: 10.1007/s10096-009-0790-9.
  85. Matsubara VH, Bandara HM, Ishikawa KH, Mayer MP, Samaranayake LP. The role of probiotic bacteria in managing periodontal disease: A systematic review. Expert Rev Anti Infect Ther. 2016; 14(7):643-55. doi: 10.1080/14787210.2016.1194198.
  86. Stamatova I, Meurman JH. Probiotics: health benefits in the mouth. Am J Dent. 2009; 22(6):329-38. PMID: 20178208.
  87. Saxelin M, Tynkkynen S, Mattila-Sandholm T, de Vos WM. Probiotic and other functional microbes: from markets to mechanisms. Curr Opin Biotechnol. 2005; 16(2):204-11. doi: 10.1016/j.copbio.2005.02.003.
  88. Kunz AN, Noel JM, Fairchok MP. Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr. 2004; 38(4):457-8. doi: 10.1097/00005176-200404000-00017.
  89. De Groote MA, Frank DN, Dowell E, Glode MP, Pace NR. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J. 2005; 24(3):278-80. doi: 10.1097/01.inf.0000154588.79356.e6.
  90. Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK. Lactobacillus sepsis associated with probiotic therapy. Pediatrics. 2005; 115(1):178-81. doi: 10.1542/peds.2004-2137.
  91. Pletincx M, Legein J, Vandenplas Y. Fungemia with Saccharomyces boulardii in a 1-year-old girl with protracted diarrhea. J Pediatr Gastroenterol Nutr. 1995; 21(1):113-5. doi: 10.1097/00005176-199507000-00022.
  92. Burkhardt O, Köhnlein T, Pletz M, Welte T. Saccharomyces boulardii induced sepsis: successful therapy with voriconazole after treatment failure with fluconazole. Scand J Infect Dis. 2005; 37(1):69-72. doi: 10.1080/00365540510026454.
  93. Rijnders BJ, Van Wijngaerden E, Verwaest C, Peetermans WE. Saccharomyces fungemia complicating Saccharomyces boulardii treatment in a non-immunocompromised host. Intensive Care Med. 2000; 26(6):825. doi: 10.1007/s001340051261.
  94. Prasanna PHP, Grandison AS, Charalampopoulos Bifidobacteria in milk products: An overview of physiological and biochemical properties, exopolysaccharide production, selection criteria of milk products and health benefits. Food Research International. 2014; 55:247-62. doi: 10.1016/j.foodres.2013.11.013.
  95. Nami Y, Haghshenas B, Vaseghi Bakhshayesh R, Mohammadzadeh Jalaly H, Lotfi H, Eslami S, et al. Novel autochthonous lactobacilli with probiotic aptitudes as a main starter culture for probiotic fermented milk. LWT. 2018; 98: 85-93. doi: 10.1016/J.LWT.2018.08.035.
  96. Jeon HL, Yang S-J, Son SH, Kim WS, Lee NK, Paik H-D. Evaluation of probiotic Bacillus subtilis P229 isolated from cheonggukjang and its application in soybean fermentation. LWT. 2018; 97:94-9. doi: 10.1016/j.lwt.2018.06.054.