Loveren H. Probiotics: immunomodulation and evaluation of safety and efficacy. Nutr Rev

Abstract

The intake of probiotics has been associated with beneficial effects on the immune system, such as im-proved disease resistance and diminished risk of al-lergies. This review gives an overview of the immu-nomodulatory effects of probiotics investigated with in vitro assays, experimental animal models, and clinical trials, and explores possible mechanisms underlying the immunomodulatory effects. Immunomodulation, however, is not always beneficial and might induce detrimental effects; therefore, a scheme is proposed for benefit-risk assessment of immunomodulation by probiotics. Within this scheme, expert judgment based on data derived from a panel of in vitro assays, animal models, and clinical trials should lead to conclusions on efficacy and safety aspects of probiotics