Search Results (55)

Ulcerative colitis (UC) is a chronic disease marked by mucosal inflammation of the colon, and its prevalence has progressively increased worldwide. Gut dysbiosis is recognized as a key contributor to its pathogenesis. Although conventional treatments are effective in managing symptoms, they often fail to address the underlying gut microbial imbalance, prompting growing interest in microbiota-based therapies. Probiotic supplementation has demonstrated potential to modulate the disease. However, its clinical application is limited by variability in formulations and strain composition. Debate persists regarding the relative benefits of single-strain probiotics (SSPs), which depend on strain specificity, versus multi-strain probiotics (MSPs), which may provide synergistic effects. The literature remains inconclusive, with some studies indicating that MSPs outperform SSPs, while others emphasize the importance of strain specificity. This review describes the mechanistic basis of both approaches and descriptively synthesizes their clinical efficacy in UC management based on the clinical studies published between 2018 and 2025. Several studies report that both SSPs and MSPs are associated with clinical improvements, including reduced disease activity, symptom alleviation, and enhanced endoscopic outcomes. Given the methodological heterogeneity across included studies, comparative findings should be interpreted with appropriate caution. A direct head-to-head trial could provide a better understanding to determine the optimal approach. Advancing toward personalized probiotic therapy may further enhance the clinical application of probiotics for disease management. Full article

Obesity and type 2 diabetes mellitus (T2DM) represent intertwined global epidemics driven by gut dysbiosis, chronic inflammation, and impaired SCFA production, identifying the microbiome as a therapeutic target. This review synthesizes mechanistic insights and clinical evidence on the role of probiotics as microbiome modulators in the management of metabolic disease. A comprehensive literature search across PubMed, Scopus, Web of Science, and Google Scholar up to May 2026 identified ~230 records using keywords such as probiotics, SCFAs, obesity, and T2DM; a narrative synthesis integrated preclinical, RCT, and meta-analytic data without formal pooling due to heterogeneity. Probiotics restore eubiosis via strain-specific mechanisms, Lacticaseibacillus rhamnosus GG enhances tight junctions (ZO-1), Bifidobacterium breve BBr60 boosts butyrate cross-feeding, and pasteurized Akkermansia muciniphila remodels bile acids (FXR/FGF19), activating G-Protein Coupled Receptor 41 (GPR41)/43-GLP-1 signaling, Treg expansion, and NF-κB suppression. Beyond immunometabolic effects, probiotics mitigate obesity- and T2DM-related oxidative stress by upregulating endogenous antioxidant enzymes (e.g., SOD, catalase, GPx), modulating Nrf2/Keap1 signaling, and reducing lipid peroxidation and other oxidative stress markers in experimental and clinical settings. Meta-analyses of RCTs reveal modest benefits: BMI reductions (~0.3 kg m⁻²), waist circumference (WC) reductions (1–2 cm), HbA1c reductions (0.3–0.4%), and improvements in homeostatic model assessment of insulin resistance (HOMA-IR), especially with multi-strain (>10⁹ CFU day⁻¹, ≥12 weeks) synbiotics. Innovative strategies—synbiotics, postbiotics, AI-tailored consortia, and fermented dairy—address engraftment and response variability. Current guidelines recommend 10⁹–10¹¹ CFU day⁻¹ using multi-strain formulations for 12–24 weeks alongside lifestyle measures, with regimen selection tailored to the dysbiosis phenotype (e.g., NAFLD). Future longitudinal RCTs integrating multi-omics endpoints with AI-driven strain selection should refine—and ultimately individualize—precision probiotic strategies for metabolic therapy. Full article

Maintenance of gut homeostasis is critical for overall health, as the gut microbiota plays a central role in regulating host metabolism, immune responses, and intestinal barrier integrity. Dysbiosis is closely associated with gastrointestinal disorders and inflammatory diseases, yet the ability of probiotics to preserve microbial resilience under inflammatory stress remains incompletely understood. In this study, we evaluated the protective effects of a multi-strain probiotic formulation, Neuralli^TM-CORE (CORE), using a dextran sulfate sodium (DSS)-induced colitis mouse model. Mice were pre-supplemented with CORE for two weeks prior to DSS exposure. CORE supplementation significantly reduced disease activity index, increased body weight, and partially recovered the colonic histopathological damage in DSS-treated mice. Cytokine profiling showed that CORE reduced circulating PTX2, CHI3L1, CXCL13, and MMP-2 levels, suggesting attenuation of inflammation and tissue remodeling. Microbiota analysis revealed that CORE did not fully prevent DSS-induced dysbiosis but attenuated the early decline in α-diversity and promoted re-emergence of specific microbial taxa, including Duncaniella and Muribaculum, members of the Muribaculaceae family, which are inversely associated with inflammation. Correlation analysis further linked these taxa to reduced colitis severity. Collectively, CORE attenuates DSS-induced colitis by improving inflammatory resolution, supporting mucosal recovery, and enhancing microbiota resilience. Full article

This study evaluated the effects of dietary host-derived Bacillus strains combined with fructo-oligosaccharide (FOS) on growth performance, basal physiological status, intestinal morphology, and thermal stress responses in juvenile olive flounder (Paralichthys olivaceus). A total of 486 fish with an initial body weight of 7.26 ± 0.04 g were randomly distributed into 27 tanks and fed nine experimental diets for nine weeks. The diets consisted of a basal control, an FOS-only diet, three single-strain synbiotic diets containing FOS and one host-derived Bacillus strain (B. sonorensis, B. subtilis, or B. velezensis), and four multi-strain synbiotic diets containing FOS and combinations of two or three strains. Probiotics were included at 1 × 10⁷ CFU g⁻¹ diet, and FOS was supplemented at 5 g kg⁻¹ diet. After the feeding trial, no significant dietary effects were observed on growth performance, somatic indices, whole-body proximate composition, plasma biochemical parameters, antioxidant enzyme activities, immune-related indicators, stress-related biomarkers, or intestinal morphology. Fish were subsequently subjected to lethal and acute high-temperature challenges to evaluate thermal stress tolerance and associated physiological responses. In the lethal temperature challenge, fish fed the multi-strain diets FOS + B. sonorensis + B. velezensis and FOS + B. sonorensis + B. subtilis + B. velezensis showed numerically higher survival than the other groups; however, these differences were not statistically significant. Following acute heat exposure, dietary treatments did not significantly affect plasma metabolites, and most heat-shock- and energy-metabolism-related genes were not differentially expressed among treatments. Hepatic AMPKβ expression showed a significant dietary treatment effect, with higher expression in the BCF and ACF groups than in the ABF group. Overall, host-derived synbiotic supplementation did not significantly enhance growth performance or basal physiological responses under the present experimental conditions. However, some multi-strain combinations showed a non-significant tendency toward higher survival under lethal thermal stress. Further studies incorporating gut microbiome profiling, metabolomic analysis, and alternative dietary conditions are required to clarify whether host-derived Bacillus–FOS synbiotic formulations can influence thermal stress resilience in olive flounder. Full article

The quality and flavor of probiotic fermented milk are highly dependent on the strain composition of the starter culture and their metabolic interactions. Although constructing a multi-strain system is an effective strategy for enhancing product quality, traditional formulation methods rely heavily on empirical approaches and lack mechanistic guidance. Herein, this study utilized genome-scale metabolic models (GEMs) to rationally design a multi-strain co-fermentation system. The results demonstrated that the GEM-predicted optimal system, comprising Lacticaseibacillus paracasei subsp. paracasei 63 (L. paracasei subsp. paracasei 63) and Lactococcus cremoris 290 (Lc. cremoris 290), significantly reduced the curd time by approximately 44.0% and 71.0% compared to the L. paracasei subsp. paracasei 63 and Lc. cremoris 290 monocultures, respectively. Furthermore, the co-fermented milk exhibited a 4.3-fold increase in apparent viscosity relative to the 290 single-strain group and achieved a significantly higher diacetyl concentration (1.98 ± 0.09 mg/L), representing a 2.8-fold enhancement. Volatile flavor profiling and untargeted metabolomics provided suggestive evidence supporting the GEM-predicted cross-feeding mechanisms, particularly within the arginine and pyruvate metabolic pathways. This study offers a solid theoretical foundation and practical guidance for the rational design of synthetic microbial communities to develop high-quality fermented dairy products with optimized flavor and functional properties. Full article

Necrotizing enterocolitis (NEC) and sepsis/late-onset sepsis (LOS) are significant contributors to preterm infant morbidity and mortality, with prematurity and low birth weight representing major risk factors for these interconnected conditions. Although the pathogenesis of NEC and LOS is not fully understood, there is a clear association with an immature intestinal mucosal barrier, which may enable bacterial invasion and translocation, resulting in an inflammatory cascade. Increasing recognition of the gut microbiome as a marker for health and disease has driven interest in probiotics, particularly Bifidobacterium spp. and Lactobacillus spp., as potential adjunctive agents for the prevention and management of NEC and LOS in preterm infants, which is the area of focus of this review. The focus of this paper was to analyze clinical studies using different probiotic strains, and compare single-strain versus multi-strain probiotic formulations. Several studies support that probiotic supplementation in preterm infants has the potential to decrease NEC incidence and, to a lesser extent, sepsis/LOS. Nonetheless, inconsistent results due to strain differences and clinical heterogeneity limit the widespread adoption of this mode of therapy, as do safety concerns in this vulnerable population. Further high-quality standardized studies are necessary to establish consistent guidelines for probiotic use in preterm infants. Full article

Chemotherapy- and/or radiotherapy-induced oral mucositis (CRIOM) is a common complication in patients with head and neck cancer, driven largely by excessive proinflammatory cytokine signalling and treatment-associated bacterial dysbiosis. This narrative review synthesizes current mechanistic evidence and summarizes emerging therapeutic strategies targeting these pathways. Research indicates that elevated levels of IL-1β, IL-6, TNF, iNOS, and nitric oxide amplify tissue injury and ulceration, while disruption of oral and gut microbial communities, characterized by loss of beneficial commensals and enrichment of pathogenic taxa, further exacerbates mucosal inflammation. Anti-inflammatory agents, including pentoxifylline, atorvastatin, trans-caryophyllene, azilsartan, recombinant human IL-11, and low-level laser therapy have been shown in preclinical models to reduce cytokine levels and promote mucosal healing. Similarly, microbiome-targeted approaches, such as oral microbiota transplantation and multi-strain probiotic formulations, have demonstrated potential in restoring microbial balance and attenuating CRIOM severity, with current evidence including both preclinical and clinical studies. Overall, current findings highlight cytokine toxicity and dysbiosis as synergistic drivers of CRIOM and support anti-inflammatory and microbiome-modulating strategies as promising adjunctive approaches; however, further well-designed clinical studies are required to validate their efficacy and guide clinical translation. Full article

Probiotics are widely used to support host health by modulating microbial communities and immune–metabolic homeostasis. Such interventions may be particularly relevant in long COVID syndrome, a condition characterized by persistent symptoms, low-grade inflammation, and microbiota alterations following SARS-CoV-2 infection. This study investigated the effects of a multi-strain probiotic on gut microbiota composition and predicted functional potential and biochemical parameters in individuals with long COVID and convalescent participants. Healthy individuals were included as reference controls. In an interventional study, 34 participants received a 12-week probiotic formulation containing Saccharomyces boulardii, Lacticaseibacillus rhamnosus GG, and two Lactiplantibacillus plantarum strains, while 40 served as non-supplemented controls. Fecal microbiota, assessed using 16S rRNA sequencing, and biochemical markers were measured at baseline and post-intervention. Probiotic supplementation induced selective compositional changes without significantly altering overall microbial diversity. Effects were more pronounced in long COVID participants and included enrichment of bacteria associated with metabolic and immune regulation, including Adlercreutzia, Coprococcus, and Eubacterium. Functional prediction analysis identified a probiotic-responsive signature in long-COVID-affected individuals, characterized by enrichment of pathways related to energy metabolism and redox balance. These microbial changes were accompanied by a consistent trend toward reduced inflammatory and hepatic markers. Overall, probiotic intervention demonstrated microbiota-status-dependent potential in long COVID recovery. Full article

The decline of honey bee health has intensified interest in microbiome-based strategies to support colony resilience and reduce reliance on chemical interventions. In this study, we performed an in vitro probiotic screening of five lactic acid bacteria (LAB) strains of honey bee origin and two multi-strain consortia for prospective application in apiculture. Two formulations were evaluated: LAB Mix 1 (Apilactobacillus kunkeei and Lactobacillus apis) and LAB Mix 2 (Lactiplantibacillus plantarum, Fructobacillus fructosus, and A. kunkeei). Functional and safety-related traits were investigated, including auto-aggregation, cell-surface hydrophobicity, inter-strain compatibility, organic acid production, oxidative detoxification capacity, antibiotic susceptibility, haemolytic activity, and growth dynamics in sugar-based feeding syrups. All strains exhibited time-dependent increases in aggregation and hydrophobicity, with A. kunkeei and F. fructosus showing particularly strong surface-associated properties. No mutual antagonism or haemolytic activity was observed. Organic acid profiling revealed strain-specific metabolic signatures, with high lactic and citric acid production by L. plantarum and LAB consortia. Several strains displayed peroxidase activity, suggesting a role in oxidative stress mitigation. Growth assays demonstrated that high sugar concentrations severely limited bacterial growth, whereas moderate dilution significantly improved growth. Under osmotic stress conditions, mixed cultures generally achieved higher optical density values than individual strains. Collectively, these findings support bee-associated LAB and multi-strain formulations as promising candidates for further probiotic development. Full article

Background/Objectives: Clostridioides difficile infection (CDI) is a major healthcare-associated infection associated with profound antibiotic-induced gut microbiome disruption that frequently persists after clinical resolution. This pilot study aimed to characterize early post-infectious gut microbiome recovery following an inaugural CDI episode and to descriptively assess microbiome remodeling during adjunctive multi-strain probiotic supplementation. Methods: Adult patients with mild-to-moderate CDI were prospectively enrolled after completing standard antimicrobial therapy and received a 30-day course of a high-potency, 10-strain probiotic formulation. Stool samples were collected before and after supplementation and analyzed using 16S rRNA gene sequencing with microbiome-inferred functional profiling, alongside targeted screening for enteric protozoa and yeasts. Results: Five patients completed paired analyses. At baseline, all patients exhibited severe dysbiosis characterized by markedly reduced microbial diversity, depletion of Actinobacteria and short-chain fatty acid-producing taxa, expansion of Proteobacteria, and unfavorable inferred metabolic signatures. After supplementation, four of five patients were observed to exhibit increased microbial diversity and partial improvement in global dysbiosis indices. Microbiome recovery was heterogeneous and non-linear, involving variable reductions in Proteobacteria, recovery of Actinobacteria, or both, with incomplete normalization of taxonomic balances and inferred functions. Enterotype shifts were observed in three patients, consistent with ecological reorganization rather than full restoration. Baseline protozoal colonization resolved in affected patients, while fungal dynamics showed clearance or species-level replacement. No early CDI recurrences were observed during follow-up. Conclusions: Interpretation is limited by the single-arm design without a control group, which precludes distinguishing supplementation-associated changes from natural post-antibiotic recovery. Even so, our findings highlight the complexity and inter-individual variability of early post-CDI microbiome recovery and support further investigation of integrative microbiome profiling to describe post-infectious dysbiosis dynamics. Full article

Evidence suggests that gut dysbiosis may contribute to acute myocardial infarction (AMI) and its complications, including reduced physical performance and muscle weakness. We hypothesized that probiotic supplementation could improve muscle strength during post-AMI recovery. In a randomized, controlled, triple-blind clinical trial, adults and older adults undergoing myocardial revascularization received either a multistrain probiotic formulation (Lacticaseibacillus paracasei, Lacticaseibacillus rhamnosus, Lacticaseibacillus acidophilus, and Bifidobacterium lactis) or placebo for 90 days. The primary outcome was handgrip strength (HGS). Forty-five participants completed the study. No significant between-group differences were observed in the main analysis. However, in an exploratory subgroup of men aged 50 years and older with low baseline HGS (n = 30), probiotic supplementation led to a greater improvement in non-dominant HGS after 90 days compared with placebo (mean difference: +4.6 kg/f; p = 0.04). A baseline-adjusted ANCOVA confirmed a significant baseline-by-treatment interaction for the non-dominant hand (β = +0.33; 95% CI: +0.02 to +0.62; p = 0.038), indicating greater improvements among participants with lower initial strength. Although the primary analysis yielded null results, these exploratory findings indicate a potential benefit of probiotic supplementation in a clinically vulnerable subgroup of revascularized men with low baseline strength. Larger and prospectively powered trials are warranted to confirm these observations. Trial registration: RBR-6ztyb7. Full article

Probiotics, whether consisting of a single strain or multiple strains, are attracting growing interest in the management of type 2 diabetes mellitus (T2DM). However, their efficacy remains a matter of controversy and requires careful consideration. Accordingly, this meta-analysis aimed to compare the efficacy of single-strain to that of multi-strain probiotics supplementation on glycated haemoglobin (HbA1c) and fasting blood glucose (FBG) levels in adults with T2DM. Nineteen articles published between 2017 and 2024 obtained from 4 databases (Cochrane, Web of Science, Scopus, and PubMed) were included. These interventions, conducted in a total of 1159 participants, lasted from 6 to 24 weeks and were based on clearly identified probiotic formulations, with assessments of HbA1c and FBG. The results showed that, overall, probiotic supplementation had no significant effect on HbA1c (−0.24%; 95% CI [−0.76; 0.27]; p = 0.36), although a trend towards reduction was observed for single-strain formulations (−0.57%; p = 0.05). Regarding FBG, only the multi-strain group showed a significant reduction (−0.76; 95% CI [−1.18; −0.34]; p < 0.001), while the effect of the single-strain formulation was not significant. The comparison between the two formulations (Wald test) showed that there was no significant difference (p ≤ 0.05). However, high heterogeneity (I² > 75%) and variable strains/doses limit confidence in these findings. Full article

Probiotics and microbiome-based therapeutics are increasingly used to prevent antibiotic-associated diarrhea (AAD) and support gut microbiota health across children, adults, and elderly populations. Evidence synthesized in this narrative review from randomized controlled trials and meta-analyses (>20,000 participants) suggests that early probiotic administration, particularly Lactobacillus rhamnosus GG, Bifidobacterium species, multistrain formulations, and Saccharomyces boulardii, is associated with a 30–40% relative reduction in AAD incidence across heterogeneous studies, with absolute risk reductions of approximately 5–12% depending on baseline risk, strain, dose, and timing. Probiotics are generally well tolerated, with mild gastrointestinal adverse effects reported in 3–5% of users and rare serious events mainly in immunocompromised individuals. However, heterogeneity in formulations, populations, and limited long-term real-world data underscores the need for further pharmacoepidemiological studies, microbiome surveillance, and evaluation of antimicrobial resistance implications. Full article

Background/Objectives: Gut dysbiosis in Chronic Fatigue Syndrome (CFS) drives low-grade inflammation and shifts tryptophan metabolism toward neurotoxic pathways. The causal link between bacterial translocation, kynurenine pathway dysregulation, and symptom severity remains under-defined. We evaluated the impact of a high-concentration multi-strain probiotic on the “gut-kynurenine axis” and clinical status in CFS patients with co-morbid IBS-U and confirmed dysbiosis. Methods: Forty female patients with confirmed dysbiosis (GA-map™ Dysbiosis Index > 2) received the CDS22 formula (450 billion CFU/day) for 12 weeks. We compared urinary tryptophan metabolite profiles (LC-MS/MS), gut dysbiosis markers (3-indoxyl sulfate), and fatigue severity (FSS) against 40 age-matched healthy controls. Results: Baseline analysis revealed profound metabolic perturbations: elevated bacterial proteolytic markers (3-IS), substrate depletion (low tryptophan), and a neurotoxic signature (high quinolinic acid [QA], low kynurenic acid [KYNA]). Following the intervention, fatigue scores declined by 40.3%, with 97.5% of patients reaching the remission threshold (FSS < 36). Biochemically, 3-IS levels decreased to the range observed in healthy controls and attenuated xanthurenic acid levels. Although absolute QA concentrations remained elevated compared to controls, the neuroprotective KYNA/QA ratio increased significantly (+45%). Increased systemic tryptophan availability correlated directly with clinical symptom reduction (Spearman’s rho = −0.36, p = 0.024). Conclusions: The CDS22 formulation was associated with a restoration of intestinal eubiosis and functional tryptophan partitioning. Clinical remission coincides with a metabolic shift favoring neuroprotection (increased KYNA/QA ratio), validating the gut–kynurenine axis as a modifiable therapeutic target. Peripheral metabolic improvement relative to the healthy baseline appeared sufficient for symptom relief in this specific phenotype, despite incomplete clearance of neurotoxic metabolites. Full article

Atopic dermatitis (AD) is a chronic inflammatory skin disease in which barrier impairment, immune dysregulation, and gut–skin dysbiosis intersect, prompting growing interest in probiotics as microbiota-modulating adjuncts. We conducted a narrative review of peer-reviewed articles indexed in PubMed, Scopus, and Google Scholar, restricted to publications from 1 January 2018 to 31 October 2025 (searches last run in December 2025). Eligible evidence included randomized controlled trials (RCTs), observational studies, and mechanistic or conceptual reviews addressing microbiome alterations and microbiota-modulating interventions in AD. Most pediatric RCTs using multistrain, Lactobacillus-dominant formulations (often combined with Bifidobacterium) reported modest improvements in AD severity and pruritus and in selected barrier- and inflammation-related biomarkers. However, direct cutaneous microbiome “restoration” outcomes were reported in a minority of studies, and most clinical evidence relies on clinical endpoints and gut–skin axis plausibility rather than longitudinal skin microbiome readouts. Single-strain regimens showed inconsistent effects, and evidence in adolescents and adults remained heterogeneous. Mechanistically, probiotics may enhance short-chain fatty acid (SCFA) signaling, dampen toll-like receptor 2/4 (TLR2/4)-nuclear factor kappa B (NF-κB) activation, and promote interleukin-10 (IL-10)- and transforming growth factor-β (TGF-β)-driven tolerance. Probiotics are a biologically plausible adjunct targeting the gut–skin axis in AD and are generally well tolerated; however, heterogeneity across trials, limited follow-up, inconsistent adverse-event reporting, and scarce skin microbiome endpoints preclude firm clinical recommendations. Full article