The past 15 years has witnessed a remarkable surge of interest in the human microbiome, now reflected by the annual publication of circa 3000 scientific articles. The reasons are clear: the microbiota population, established at birth and ‘part of us’ for the remainder of our lives, connects with profoundly effects many parts of our physiology, including the immune, neuroendocrine, and metabolic systems. The implications of this are similarly clear: perturbations in the microbiome will undoubtedly effect the nature and outcome of this communication, potentially in an adverse way.
Probiotics can be considered as simple proxies for the vastly complex microbiome, and both scientific and commercial interest in their capabilities has similarly soared over the past 15 years.
Probiotics can potentially work by a) preventing an adverse microbiome alteration, b) correcting one which has already occurred, and c) ‘improve’ the physiological cross-talk homeostasis.
But how effective are they?
In this lecture, the evidence for the benefits of probiotic intervention on modifying both physiologies and pathologies will be comprehensively and objectively reviewed. The current limitations of probiotics as well as the exciting future prospects for next generation ‘biotherapeutic products’ including FMT will also be explored, along with the increasingly challenging navigation through the regulatory frameworks and commercial plethora of available probiotic solutions.