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      Probiotics, prebiotics, and postbiotics in health and disease

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          Abstract

          The gut microbiota and its homeostasis play a crucial role in human health. However, for some diseases related to the gut microbiota, current traditional medicines can only relieve symptoms, and it is difficult to solve the root causes or even cause side effects like disturbances in the gut microbiota. Increasing clinical studies and evidences have demonstrated that probiotics, prebiotics, and postbiotics can prevent and treat various diseases, but currently they can only be used as dietary supplements rather than medicines, which restricts the application of probiotics in the field of medicine. Here, this review analyzes the importance of gut microbiota in human health and the current problems of traditional medicines, and systematically summarizes the effectiveness and mechanisms of probiotics, prebiotics, and postbiotics in maintaining health and treating diseases based on animal models and clinical trials. And based on current research outcomes and development trends in this field, the challenges and prospects of their clinical application in maintaining health, alleviating and treating diseases are analyzed. It is hoped to promote the application of probiotics, prebiotics, and postbiotics in disease treatment and open up new frontiers in probiotic research.

          Abstract

          Extensive research and clinical evidence have demonstrated the mechanisms and effectiveness of probiotics, prebiotics, and postbiotics in restoring gut microbiota homeostasis and treating a variety of diseases. Prebiotics can promote the growth of beneficial intestinal bacteria, while probiotics produce postbiotics through “addition” to regulate the gut microbiota, and “subtraction” to remove harmful metabolites and exogenous substances to reduce their impact on the body, thereby alleviating or treating diseases. Probiotics, prebiotics, and postbiotics may represent the next generation of medicines, with the potential to revolutionize the way we treat and manage disease.

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          Most cited references211

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          Diet rapidly and reproducibly alters the human gut microbiome

          Long-term diet influences the structure and activity of the trillions of microorganisms residing in the human gut 1–5 , but it remains unclear how rapidly and reproducibly the human gut microbiome responds to short-term macronutrient change. Here, we show that the short-term consumption of diets composed entirely of animal or plant products alters microbial community structure and overwhelms inter-individual differences in microbial gene expression. The animal-based diet increased the abundance of bile-tolerant microorganisms (Alistipes, Bilophila, and Bacteroides) and decreased the levels of Firmicutes that metabolize dietary plant polysaccharides (Roseburia, Eubacterium rectale, and Ruminococcus bromii). Microbial activity mirrored differences between herbivorous and carnivorous mammals 2 , reflecting trade-offs between carbohydrate and protein fermentation. Foodborne microbes from both diets transiently colonized the gut, including bacteria, fungi, and even viruses. Finally, increases in the abundance and activity of Bilophila wadsworthia on the animal-based diet support a link between dietary fat, bile acids, and the outgrowth of microorganisms capable of triggering inflammatory bowel disease 6 . In concert, these results demonstrate that the gut microbiome can rapidly respond to altered diet, potentially facilitating the diversity of human dietary lifestyles.
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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.

            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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              A human gut microbial gene catalogue established by metagenomic sequencing.

              To understand the impact of gut microbes on human health and well-being it is crucial to assess their genetic potential. Here we describe the Illumina-based metagenomic sequencing, assembly and characterization of 3.3 million non-redundant microbial genes, derived from 576.7 gigabases of sequence, from faecal samples of 124 European individuals. The gene set, approximately 150 times larger than the human gene complement, contains an overwhelming majority of the prevalent (more frequent) microbial genes of the cohort and probably includes a large proportion of the prevalent human intestinal microbial genes. The genes are largely shared among individuals of the cohort. Over 99% of the genes are bacterial, indicating that the entire cohort harbours between 1,000 and 1,150 prevalent bacterial species and each individual at least 160 such species, which are also largely shared. We define and describe the minimal gut metagenome and the minimal gut bacterial genome in terms of functions present in all individuals and most bacteria, respectively.
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                Author and article information

                Contributors
                liusj@im.ac.cn
                jiaozy@lzu.edu.cn
                xkli@lzu.edu.cn
                Journal
                MedComm (2020)
                MedComm (2020)
                10.1002/(ISSN)2688-2663
                MCO2
                MedComm
                John Wiley and Sons Inc. (Hoboken )
                2688-2663
                04 November 2023
                December 2023
                : 4
                : 6 ( doiID: 10.1002/mco2.v4.6 )
                : e420
                Affiliations
                [ 1 ] MOE Key Laboratory of Cell Activities and Stress Adaptations School of Life Sciences Lanzhou University Lanzhou Gansu China
                [ 2 ] Institute of Cancer Neuroscience Medical Frontier Innovation Research Center The First Hospital of Lanzhou University The First Clinical Medical College of Lanzhou University Lanzhou Gansu China
                [ 3 ] State Key Laboratory of Microbial Resources Institute of Microbiology Chinese Academy of Sciences Beijing China
                [ 4 ] Cuiying Biomedical Research Center The Second Hospital of Lanzhou University Lanzhou Gansu China
                Author notes
                [*] [* ] Correspondence

                Xiangkai Li, MOE Key Laboratory of Cell Activities and Stress Adaptations, School of Life Sciences, Lanzhou University, Lanzhou, Gansu, China.

                Email: xkli@ 123456lzu.edu.cn

                Zuoyi Jiao, Cuiying Biomedical Research Center, The Second Hospital of Lanzhou University, Lanzhou, Gansu, China.

                Email: jiaozy@ 123456lzu.edu.cn

                Shuang‐Jiang Liu, State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.

                Email: liusj@ 123456im.ac.cn

                [#]

                Jing Ji and Weilin Jin contributed equally to this work.

                Author information
                https://orcid.org/0000-0003-2931-7565
                Article
                MCO2420
                10.1002/mco2.420
                10625129
                37929014
                cdc84998-6d9d-4d63-bce5-eed8c145e8a2
                © 2023 The Authors. MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 September 2023
                : 25 July 2023
                : 13 October 2023
                Page count
                Figures: 6, Tables: 3, Pages: 23, Words: 15264
                Funding
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 32370110
                Award ID: 32300049
                Funded by: Gansu Youth Science and Technology Fund
                Award ID: 22JR5RA529
                Categories
                Review
                Reviews
                Custom metadata
                2.0
                December 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.4 mode:remove_FC converted:04.11.2023

                clinical trials,gut microbiota,postbiotics,prebiotics,probiotics

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