The article "Probiotics and Prebiotics in Intestinal Health and Disease: From Biology to the Clinic" by Sanders et al. (2019) provides a comprehensive review of the current understanding and clinical applications of probiotics and prebiotics. Probiotics and prebiotics are microbial management tools aimed at improving host health, particularly in the gastrointestinal tract. The authors discuss the rapid accumulation of research on the gut microbiome and the increasing interest in probiotics and prebiotics as means to modulate the gut microbiota. Key points include: - **Probiotics**: Strains of *Lactobacillus*, *Bifidobacterium*, and *Saccharomyces* have a long history of safe and effective use. New strains like *Roseburia*, *Akkermansia*, *Propionibacterium*, and *Faecalibacterium* show promise. - **Prebiotics**: Glucans and fructans are well-proven, with other substances like oligomers of mannose, glucose, xylose, pectin, starches, human milk, and polyphenols showing potential. - **Mechanisms of Action**: Probiotics can modulate immune functions, produce organic acids, interact with gut microbiota, improve barrier function, and manufacture small molecules with local and non-local effects. Prebiotics can defend against pathogens, modulate the immune system, increase mineral absorption, improve bowel function, and have metabolic effects. - **Clinical Applications**: Probiotics and prebiotics have shown benefits in various conditions such as necrotizing enterocolitis, antibiotic-associated diarrhea, H. pylori infection, and irritable bowel syndrome. Prebiotics are particularly effective in infant formulae and functional foods. - **Future Directions**: The field is poised for conceptual advances, with a focus on expanding target microbes beyond traditional probiotics and improving precision in microbial composition measurements. More well-designed randomized controlled trials are needed to robustly prove the clinical benefits of gut microbiome alterations. The authors emphasize the importance of rigorous research and the need for responsible scientists to consider the totality of available information when drawing conclusions about the effectiveness of probiotics and prebiotics. They also highlight the potential of these interventions to improve human health and reduce disease risk, especially in developing countries where access to these interventions is limited.The article "Probiotics and Prebiotics in Intestinal Health and Disease: From Biology to the Clinic" by Sanders et al. (2019) provides a comprehensive review of the current understanding and clinical applications of probiotics and prebiotics. Probiotics and prebiotics are microbial management tools aimed at improving host health, particularly in the gastrointestinal tract. The authors discuss the rapid accumulation of research on the gut microbiome and the increasing interest in probiotics and prebiotics as means to modulate the gut microbiota. Key points include: - **Probiotics**: Strains of *Lactobacillus*, *Bifidobacterium*, and *Saccharomyces* have a long history of safe and effective use. New strains like *Roseburia*, *Akkermansia*, *Propionibacterium*, and *Faecalibacterium* show promise. - **Prebiotics**: Glucans and fructans are well-proven, with other substances like oligomers of mannose, glucose, xylose, pectin, starches, human milk, and polyphenols showing potential. - **Mechanisms of Action**: Probiotics can modulate immune functions, produce organic acids, interact with gut microbiota, improve barrier function, and manufacture small molecules with local and non-local effects. Prebiotics can defend against pathogens, modulate the immune system, increase mineral absorption, improve bowel function, and have metabolic effects. - **Clinical Applications**: Probiotics and prebiotics have shown benefits in various conditions such as necrotizing enterocolitis, antibiotic-associated diarrhea, H. pylori infection, and irritable bowel syndrome. Prebiotics are particularly effective in infant formulae and functional foods. - **Future Directions**: The field is poised for conceptual advances, with a focus on expanding target microbes beyond traditional probiotics and improving precision in microbial composition measurements. More well-designed randomized controlled trials are needed to robustly prove the clinical benefits of gut microbiome alterations. The authors emphasize the importance of rigorous research and the need for responsible scientists to consider the totality of available information when drawing conclusions about the effectiveness of probiotics and prebiotics. They also highlight the potential of these interventions to improve human health and reduce disease risk, especially in developing countries where access to these interventions is limited.