Emerging issues in probiotic safety: 2023 perspectives
Daniel Merenstein,
Bruno Pot,
Gregory Leyer,
Arthur C. Ouwehand,
Geoffrey A. Preidis,
Christopher A. Elkins,
Colin Hill,
Zachery T. Lewis,
Andi L. Shane,
Niv Zmora,
Mariya I. Petrova,
Maria Carmen Collado,
Lorenzo Morelli,
Gina A. Montoya,
Hania Szajewska,
Daniel J. Tancredi,
Mary Ellen Sanders
Affiliations
Daniel Merenstein
Department of Family Medicine, Georgetown University Medical Center, Washington, DC USA
Bruno Pot
Yakult Europe BV, Almere, Netherlands
Gregory Leyer
Scientific Affairs, Chr. Hansen, Milwaukee, WI, USA
Arthur C. Ouwehand
Global Health & Nutrition Sciences, International Flavors & Fragrances, Kantvik, Finland
Geoffrey A. Preidis
Division of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Christopher A. Elkins
Clinical and Environmental Microbiology Branch, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
Colin Hill
APC Microbiome Ireland, University College Cork, Cork, Ireland
Zachery T. Lewis
Synbiotic Health Inc, Lincoln, NE, USA
Andi L. Shane
Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Emory Children’s Center, Atlanta, Georgia
Niv Zmora
Scientific consultant, Elinav Lab, Immunology Department, Weizmann Institute of Science, Department of Gastroenterology and Liver Diseases, Tel Aviv, Israel
Mariya I. Petrova
Winclove Probiotics B.V., Amsterdam, The Netherlands
Maria Carmen Collado
Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Valencia, Spain
Lorenzo Morelli
Department of Food Science and Technology, Università Cattolica del Sacro Cuore, Piacenza, Italy
Gina A. Montoya
Department of Chemical Risk Assessment, Nestlé S.A., Lausanne, Switzerland
Hania Szajewska
Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
Daniel J. Tancredi
Department of Pediatrics, UC Davis School of Medicine, Sacramento, CA, USA
Mary Ellen Sanders
International Scientific Association for Probiotics and Prebiotics, Centennial, CO, USA
ABSTRACTProbiotics are used for both generally healthy consumers and in clinical settings. However, theoretical and proven adverse events from probiotic consumption exist. New probiotic strains and products, as well as expanding use of probiotics into vulnerable populations, warrants concise, and actionable recommendations on how to work toward their safe and effective use. The International Scientific Association for Probiotics and Prebiotics convened a meeting to discuss and produce evidence-based recommendations on potential acute and long-term risks, risks to vulnerable populations, the importance for probiotic product quality to match the needs of vulnerable populations, and the need for adverse event reporting related to probiotic use. The importance of whole genome sequencing, which enables determination of virulence, toxin, and antibiotic resistance genes, as well as clear assignment of species and strain identity, is emphasized. We present recommendations to guide the scientific and medical community on judging probiotic safety.
