An expert panel was convened in October 2013 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) to discuss the field of probiotics. It is now 13 years since the definition of probiotics and 12 years after guidelines were published for regulators, scientists and industry by the Food and Agriculture Organization of the United Nations and the WHO (FAO/WHO). The FAO/WHO definition of a probiotic--"live microorganisms which when administered in adequate amounts confer a health benefit on the host"--was reinforced as relevant and sufficiently accommodating for current and anticipated applications. However, inconsistencies between the FAO/WHO Expert Consultation Report and the FAO/WHO Guidelines were clarified to take into account advances in science and applications. A more precise use of the term 'probiotic' will be useful to guide clinicians and consumers in differentiating the diverse products on the market. This document represents the conclusions of the ISAPP consensus meeting on the appropriate use and scope of the term probiotic.

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Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)71142-9.pdf

Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders.

http://envismadrasuniv.org/Physiology/pdf/Gut%20flora%20in%20health%20and%20disease.pdf

Gut flora in health and disease

Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma

Gut microbiota is an assortment of microorganisms inhabiting the length and width of the mammalian gastrointestinal tract. The composition of this microbial community is host specific, evolving throughout an individual's lifetime and susceptible to both exogenous and endogenous modifications. Recent renewed interest in the structure and function of this "organ" has illuminated its central position in health and disease. The microbiota is intimately involved in numerous aspects of normal host physiology, from nutritional status to behavior and stress response. Additionally, they can be a central or a contributing cause of many diseases, affecting both near and far organ systems. The overall balance in the composition of the gut microbial community, as well as the presence or absence of key species capable of effecting specific responses, is important in ensuring homeostasis or lack thereof at the intestinal mucosa and beyond. The mechanisms through which microbiota exerts its beneficial or detrimental influences remain largely undefined, but include elaboration of signaling molecules and recognition of bacterial epitopes by both intestinal epithelial and mucosal immune cells. The advances in modeling and analysis of gut microbiota will further our knowledge of their role in health and disease, allowing customization of existing and future therapeutic and prophylactic modalities.

Gut Microbiota in Health and Disease

Probiotics: effects on immunity

Demonstration of safety of probiotics — a review

Probiotics have been defined in several ways, depending on our understanding of the mechanisms of action of their effects on health and well-being of humans. The term probiotic was coined by Lilly and Stillwell [1] to describe substances produced by one microorganism, that stimulate the growth of another, thus meaning the opposite of antibiotics. Parker [2] subsequently defined probiotics as organisms and substances that contribute to intestinal balance. This definition, however, did not exclude antibiotics. At present, the most commonly used definition is that of Fuller [3] : Probiotics are live microbial feed supplements which beneficially affect the host animal by improving its intestinal microbial balance . Recently a European expert group widened the definition to include mechanisms other than just microflora mediated ones. The definition was as follows: Probiotics are live microbial food ingredients that have a beneficial effect on human health [4,5] . To include the current application and scientific data on proven effects of probiotics we propose the following definition: Probiotics are microbial cell preparations or components of microbial cells that have a beneficial effect on the health and well-being of the host . This definition implies that probiotics do not necessarily need to be viable. Non-viable forms of probiotics have also been shown to have health effects [6] . The definition does not restrict the use of probiotics in foods; several other applications have been reported to have beneficial health effects. Not only whole microbial cells, but also parts of cells have been observed to improve host health. Metabolites are, however, not included in the current definition. Thus, it excludes antibiotics. The proposed definition is based on the mechanisms of action, selection criteria, viability and non-viability, and scientifically documented health effects that will be discussed.

Probiotics: how should they be defined?

Recent advances in probiotic research have finally confirmed the health benefits of some probiotic bacterial strains. In addition to their application to dairy products, probiotic bacteria are now being applied to new food products including fermented cereals, infant formulae and therapeutic foods. It is very important to be able to enhance the stability of probiotic bacteria both in old and new applications in order to expand their new uses and also to guarantee minimum effective doses for particular products.

The coming of age of probiotics

A newly isolated strain of a species ofLactobacillus of human origin, designated GG (Lactobacillus GG), has been studied to determine its ability to survive in the human gastrointestinal tract. When fed to 76 volunteers as a frozen concentrate or as a fermented preparation in milk or whey,Lactobacillus GG was recovered in the feces of all subjects receiving the fermented milk or whey and in 86% receiving the frozen concentrate when a single fecal specimen was cultured. The organism was also present in the feces of subjects concurrently receiving ampicillin. After terminating feeding of the organism,Lactobacillus GG persisted in the feces of 87% of volunteers four days later and in 33% of subjects seven days later.Lactobacillus GG lowered fecal bacterial β-glucuronidase activity by approximately 80% in volunteers given the organism for four weeks. These studies demonstrate thatLactobacillus GG can survive and temporarily colonize the human gastrointestinal tract and can affect the metabolic activity of the resident microflora.

Seppo Salminen

Papers

Probiotics: effects on immunity

Demonstration of safety of probiotics — a review

Probiotics: how should they be defined?

The coming of age of probiotics

Survival of Lactobacillus species (strain GG) in human gastrointestinal tract.