Probiotics are live microorganisms that are intended to have health benefits when consumed or applied to the body. They can be found in yogurt and other fermented foods, dietary supplements and beauty products. Traditional probiotics have been isolated from many sources as intestinal and traditional fermented foods. The United States Food and Drug Administration (FDA) has classified them as Generally Regarded as Safe (GRAS) at the strain level or as Qualified Presumption of Safety (QPS) at the species level by the European Food Safety Authority (EFSA).
They mostly belong to a limited list of genera, basically Lactobacillus spp. Although there are also some members of Bacillus and Escherichia coli for bacteria and Saccharomyces yeast among others. All of them have a long history of use and their proven safety is therefore allowed to be used as food or food supplements from the regulatory point of view. On the contrary, NPGs have recently been isolated thanks to powerful new tools to isolate, identify and even modify these commensal bacteria.
They have been identified mainly on the basis of comparative analysis of microbiota compositions between healthy and unhealthy individuals and belong to various genera. They do not have a long history of safe use and therefore their safety is not considered proven. Both traditional and NGP fit the classic definition of probiotics and could be administered daily to induce beneficial effects. Recently, the FDA has introduced the term live biotherapeutic product (LBP) which is “a biological product that contains living organisms; it is applicable to the prevention, treatment or cure of a disease or condition of humans; and it is not a vaccine.
This term, sometimes proposed as a substitute for NGP, includes the living biotherapeutic microorganism and the other ingredients that make up final low back pain. This is why we strongly believe that the term LBP should not be used systematically to replace the NGP. From our point of view, the concept of NGP is broader, since it includes the microorganisms that will make up the LBP, but also those that are being analyzed and that do not yet correspond to a defined potential product, including genetically modified bacteria and potentially beneficial commensal bacteria. From a translational point of view, the jungle of terms that we have exposed in this opinion piece is in itself an impediment to the transfer of scientific knowledge.
The best way to combat problems related to lack of information is to disseminate as much rigorous scientific information as possible. As researchers, one of our missions is to disseminate our research in a clear and indisputable way. To do this, we need to avoid the use of unnecessary new terms and jargon and better define the key messages to communicate. We believe that it is not necessary to create a new word for each advance.
For example, the word phagebiotics has been proposed to name bacteriophages used as pharmaceuticals. When the general public is just beginning to understand well-established basic terms, such as probiotics, this strategy only creates difficulties in the correct exchange and does not provide advantages, so, in our opinion, it should be avoided. Another problem is that outreach activities are often not well recognized by the scientific community in terms of professional appreciation. In a world as competitive as the scientific one, this can be an obstacle.
We strongly believe that new research strategies at all levels should include a comprehensive dissemination plan as a mandatory part of research project proposals and adequately assess the outreach activities carried out earlier. In this perspective paper, our goal was to discuss all the emerging terms introduced due to the explosion of knowledge in the area of probiotics, mainly during the last few years. Our goal is to shed light on the differences between all definitions to allow clear and direct communication between all stakeholders. These authors acknowledge that this independent review was commissioned and funded by the International Probiotics Association.
They warmly thank their colleagues Francisco Guarner and Bruno Pot for their careful reading of their manuscript and their suggestions. With probiotics, for most conditions, there are few or no comparative studies, dosing studies or duration trials. Importantly, all stakeholders must work together in the performance of their respective roles in order for society to benefit from scientific advances in the field of probiotic research. The concept of traditional probiotics was initially based on the observations of Elie Metchnikoff in 1907.Lack of meaningful FDA oversight of efficacy claims makes it difficult for consumers to distinguish probiotic products that are correctly formulated and labeled from those that are not.
Sanders served as founding president of the International Scientific Association for Probiotics and Prebiotics and is currently the executive scientific director of the organization. MS consults with companies that manufacture probiotics or products containing probiotics and serves as executive scientific director of ISAPP. However, numerous examples of administration of probiotics that go beyond food applications appear in these documents. While the most common microorganisms used as probiotics come from the genera Lactobacillus and Bifidobacterium, other bacterial genera are used, including Enterococcus, Streptococcus and Escherichia.
For the daily use of probiotics by the healthy population in general, potential safety concerns arising from the administration of live microorganisms should be addressed. The term “probiotic” should be used only for products that meet the scientific criteria for this term, i.e. products containing an adequate dose of live microbes that have been documented in target-host studies conferring a health benefit. As mentioned above, the definition of probiotics has evolved since its inception and has been carefully analyzed by several experts.
ISAPP is an international non-profit collaboration of scientists dedicated to promoting scientific excellence in probiotics and prebiotics. Interest in probiotics is at an all-time high in the United States, driven in part by new products that are emerging on the market, by US researchers eager to rigorously evaluate claims of efficacy, and by consumers interested in potential therapeutic and preventive benefits for health. However, it would be prudent to exercise caution in routine home administration of probiotics for those at increased risk of translocation-related problems (e.g. central venous catheters, artificial heart valves), those at high risk of developing sepsis (e.g.
low white blood cell count), very young babies or those with intestinal immotility problems (for example, the use of probiotics producing D-lactic acid). . .