Probiotics

of
Raghuwanshi et al., J Prob Health 2018, 6:1

&
Journal

Health
DOI: 10.4172/2329-8901.1000194

ISSN: 2329-8901
Journal of Probiotics & Health
Review Article Open Access

Probiotics: Nutritional Therapeutic Tool

Shailendra Raghuwanshi1*, Swati Misra2, Rohit Sharma1 and Bisen PS1,3
1Department of Biotechnology, Tropilite Food Pvt. Ltd., Davar Campus, Tansen Road Industrial Estate, Gwalior, India
2Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology, Delhi, India
3School of Studies in Biotechnology, Jiwaji University, Gwalior, India
*Corresponding author: Shailendra Raghuwanshi, Department of Biotechnology, Tropilite Food Pvt. Ltd., Tansen Road Industrial Estate, Gwalior 474002, India, Tel:
+91-751-4056381; E-mail: [email protected]
Received date: March 12, 2018; Accepted date: April 06, 2018; Published date: April 12, 2018
Copyright: © 2018 Raghuwanshi S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The advent of various health care policies and digital revolution has fuelled interest in the direction of food
supplements, and as preventive or curative drug containing live non-pathogenic bacteria, probiotics. The widespread
usage of probiotics by consumers and in clinical practice has emphatically made to understand the benefits
associated with these products. The probiotic products are now being marketed worldwide by several multinational
companies. Present review attempts to overview the health benefits of probiotics in impeding various lifestyle or
metabolic associated disorders, clinical significance, their efficacy and influence on immune system.

Keywords: Probiotics; Gastrointestine; Lactic Acid Bacteria; Health In the past, there has been an increased interest in probiotic
care; Food supplements research and in understanding their concepts. Genomic,
transcriptomic and proteomic studies unfolded the genes and proteins
Introduction responsible in probiotic adaptation in host while exerting favourable
effects. The on-going clinical research in the field of probiotics and
The term probiotics refers to viable, non-pathogenic changes in consumer behaviour due to increased health awareness has
microorganisms (bacteria or yests) that, when, ingested, are able to paved the path for the innovation in probiotics product development.
reach the intestine in sufficient numbers to confer health benefits to Besides this, the advancement of healthcare polices and digital
the host http://probioticindia.com/2011-11-12-13-28-20/probioics- revolution continues to sustain the development of the specific new
products. Probiotics are naturally occurring microorganisms of probiotic organisms. These live non-pathogenic bacteria, probiotics
ecosystem in different parts of the human body such as oral cavity, were identified characterized in lines of food supplements and
skin, vaginal cavity and gastrointestinal tract [1] and have been proved attempts were made in order to verify their health claims being used as
to be safe essentially needed for performing some of our body’s vital preventive or curative drugs.
functions [2,3]. The probiotics play a vital role in keeping the gut
healthy. The recommended dose of probiotics is 108-1011 CFU per Health Claims for Probiotics
serving with one to several servings per day. Probiotics have been
defined by the Food and Agriculture Organization (FAO)/World The probiotics improve the intestinal microbial balance through
Health Organization (WHO) as “live microorganisms which when lowering of pH to provide a hostile environment for pathogens. Yeasts
administered in adequate amount (generally numbering one billion) as probiotic improve nutrient absorption/assimilation from food and
confer a benefit to host health”. They should be resistant to gastric acid, digestion. LAB used as probiotic stimulates and balances the immune
bile and pancreatic juices and reach the target site (small intestine/ system [2], prevents vaginal and urinary tract infections [10,11],
large intestine) in numbers sufficient enough to elicit the beneficial prevents and treats side effects of antibiotic therapy [12], aids in
effect [4]. It should be scientifically validated through well controlled digestion of lactose and dairy products by reducing lactose intolerance
clinical trials (FAO/WHO Expert Consultation Report). The use of [13,14] helps in the regulation of bowel movements [15], reduces the
probiotics in animal feed is well controlled and is regulated by toxic load of liver [16,17] inhibits the growth of bacteria which
regulation (EC) no. 183/2003. produces nitrates in bowel as production of nitrates could in certain
cases cause cancer [2], prevents excessive growth of pathogenic
In general, probiotic bacteria are categorized amongst the most
microbes such as candida, E. coli, Helicobacter pylori and Salmonella
friendly bacteria belonging to the class of lactic acid bacteria (LAB)
[18-22] reduces the incidence of yeast infections [11], virginities and
[5]. The most prominent members from this category are Lactobacilli
candidacies [23], calms down the colon irritation following surgery,
(cures diarrhea and lactose intolerance in patients) and Bifidobacteria
supports healthy skin in youth, and is the primary bacteria in infants,
(ease the symptoms of irritable bowel syndrome (IBS) [6]. Certain
which helps them to grow and develop their immune system [24,25],
yeasts are also included in this group; Saccharomyces boulardii is the
therapeutic for upper respiratory complaints [26], act as remedy for
common yeast aiding in improving the digestion [7,8]. Probiotic
bad breath (halitosis) [27], increase ability to synthesize vitamin B,
products such as dahi, yogurt or dietary supplements are part of the
manufactures vitamin B complex [28], increase the ability to absorb
fermented foods having active live cultures [9].
calcium [29,30] reduce the occurrence of bladder cancer [31], prevent
and manage atopic dermatitis (eczema) in children [32]. Evidences

J Prob Health, an open access journal Volume 6 • Issue 1 • 1000194

ISSN: 2329-8901
Citation: Raghuwanshi S, Misra S, Sharma R, Bisen PS (2018) Probiotics: Nutritional Therapeutic Tool. J Prob Health 6: 194. doi:
10.4172/2329-8901.1000194

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revealed that all the health claims linked to probiotics are mainly strain promises to be an alternative to milk [13] having high level of the
specific and the health claim raised by one strain could not be assumed enzyme, lactase (β-galactosidase) [39]. Lactase is produced from
for another strain, even though both comes under the same species bacteria when lysed through bile secretions and is made available to
[33]. Health benefits associated with probiotics are shown in Figure 1. intestinal lumen. The reduced intestinal transit time of yogurt is the
alternate reason for the reduction of lactose intolerance thereby
allowing slow lactose assimilation. The lactase producing bacteria
present in yogurt is Lactobacillus acidophilus, which aids in the
digestion and lactose absorption [26,40]. Other lactase producing
bacteria preventing lactose intolerance are Lactobacillus bulgaricus
and Streptococcus thermophiles [41]. The response of the
consumption of fermented milk having Bifidobacterium longum was
reported to significantly reduce hydrogen production as well as
flatulence compared to pasteurized milk [42,43].

Intestinal Disorders
The imbalance in microbial population in gastrointestine leads to
disturbance in host microbe interaction in the digestive tract
(gastrointestine) due to the harsh conditions and negative environment
associated with low stomach pH, bile salts, and digestive enzymes [44].
The consumption of probiotic bacteria in large number ensuring to
reach the site of action in the lower GI in adequate number could
Figure 1: Beneficial role of probiotics.
significantly improves the health of gastrointestine and the benefits are
dose dependent [45]. The appropriate number of probiotic bacteria has
been set as 107 bifidobacteria/g or mL as per the probiotic products
Lactose Intolerance such as fermented milk and other lactic acid bacteria containing
beverages. It is reported that the gastric inflammation is reduced
The lactose-intolerant, lactase deficiency or hypolactasia individuals through administration of probiotics viz. L. casei, L. reuteri, L.
could even tolerate lactose to larger extent through the ingestion of acidophilus, L. plantarum, B. infantis, B. animalis and S. boulardii
certain active strains [34]. About two-third of the world’s adult [46,47]. Diarrhea is reported to be the major cause of deaths in
population, mainly in Africa and Asia, suffers from lactose intolerance children and adults in third world countries. Table 1 shows the
due to the absence of an enzyme lactase [35,36]. Lactose-intolerant effective probiotic strains normally employed against gastrointestinal
individuals are not able to digest lactose, the sole sugar mainly present abnormalities.
in dairy products [37,38]. Yogurt and probiotic lactic acid bacteria

S.No. Disease Effective probiotic strains

Diarrhea
Antibiotic-associated diarrhea
1 L. rehamnosus GG (LGG), S. boulardii
Traveller’s diarrhea
Rotavirus diarrhea

VSL#3 (B. longum, B. infantis, B. breve, L. acidophilus, L. casei, L. delbrueckii ssp.

2 Irritable bowel syndrome
bulgaricus, L. plantarum and S. thermophilus)

3 Inflammatory bowel disease Saccharomyces boulardii

4 Pouchitis VSL#3

5 Helicobacter pylori infection L. johnsonii La1, Saccharomyces boulardii

Table 1: The effective probiotic strains against gastrointestinal abnormalities.

Inflammatory Bowel Diseases (IBD) inflammatory response or through the modulation of the composition
of gut microbiota. VSL#3 is a probiotic formulation composed of four
The intestinal disorders such as ulcerative colitis and Crohn's lactobacilli (L. acidophilus, L. casei, L. plantarum, L. bulgaricus), three
disease could finally lead to the surgical removal of colon. The reason bifidobacteria (B. breve, B. longum, B. infantis) and S. thermophilus.
for IBD is still unknown but it is believed that both genetic as well as The mixture has proven to be quite effective in reducing the recurrence
environmental factors contribute to certain extent [48]. The most of chronic relapsing pouchitis [48,49]. A probiotic formulation SCM-
important factor in the development and recurrence of IBD is believed III developed with a combination of three different strains
to be the intestinal flora but the exact mechanism has not yet been (Lactobacillus helveticus, L. acidophilus, and Bifidobacterium sp.) was
explained. The symptoms of IBD could be relieved when probiotic is
administered. The mechanism of regulation is either through

J Prob Health, an open access journal Volume 6 • Issue 1 • 1000194

ISSN: 2329-8901
Citation: Raghuwanshi S, Misra S, Sharma R, Bisen PS (2018) Probiotics: Nutritional Therapeutic Tool. J Prob Health 6: 194. doi:
10.4172/2329-8901.1000194

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found to be significantly effective against 68 patients of IBD tested individuals [64]. The diabetic mice fed with probiotic containing
[50]. Bifidobacterium have significant positive effect in terms of glucose
tolerance and low grade inflammation [65]. A probiotic pill having
Allergies genetically engineered live bacterial strains of normal inhabitants of
intestine when administered in mice model, the GLP-1 hormone
Probiotics found in yogurt are reported to be effective to treat triggers the release of insulin and blocks the release of glucagon from
seasonal pollen allergies [51] by altering the bacterial balance in the gut pancreatic α-cells thereby helping in the reduction of blood glucose
by influencing T-cells [52], or a special type of white blood cell which level [66,67]. This product is now commercially available for
is involved in our immune response (www.naturalnews.com). nutritional therapy of Type-2 diabetes treatment.
Probiotics are also known to induce cytokines or produce secretory
IgA for direct modulation of the immune system [53]. The use of
Cardiovascular Diseases
probiotics in children suffering from atopic dermatitis resulted in an
increased level of IFN-production simultaneously with the decrease Cardiovascular diseases fall under the category of metabolic
level of IgE, antigen-induced TNF-α, IL-5, and IL-10 secretion [53]. It syndrome involving heart or blood vessels. It is mainly attributed to
is further reported that stress is a vital component which induces mast palmitic acid a high-fat diet. The response to heart disease is triggered
cells to release histamine and thereby worsens allergic symptoms [54]. in obese individuals by action on adipocytes and macrophages of
Different probiotic LAB bacteria viz. L. casei, L. paracasei, L. adipose tissue via TLR-4, a LPS receptor. The increased level of adipose
acidophilus, L. reuteri, B. infantis and B. animalis showed variable TNF-α and IL-6 concentration results to metabolic endotoxaemia
effects in clinical trials [55]. The probiotic culture of Lactobacillus having resistance towards insulin and stimulates vascular
rhamnosus has been shown to down-regulate the production of IgE inflammation thereby leading to hypertension and CVD [68].
and histamine 4 receptor at the same time up-regulate the anti-
Probiotics play a vital role in preventing cardiovascular diseases.
inflammatory agents like (IL)-8 (http://thelowhistaminechef.com/).
Lactobacillus reuteri 30242 is reported to lower down the LDL
cholesterol level in two distinct ways (a) remove excessive cholesterol
Metabolic Syndrome from body and/or (b) increase the cholesterol metabolism [66,67]. The
Metabolic syndrome (MetS) is a medical problem caused by a group bile acids produced from cholesterol in liver is broken down when
of potential factors that accelerates the risk for cardiovascular diseases probiotics are administered; the cholesterol level is depleted, thereby
(heart disease) and type 2 diabetes. The potential risk factors are reducing the risk of cardiovascular diseases [69].
overweight/obesity, hypertension and disturbances of lipid and
carbohydrate metabolism [47,56]. There is an urgent need to prevent Respiratory Infections
these risk factors by integrating the changes in the diet plan through
Probiotic bacterial strains are also reported to prevent viral
blending the food products with probiotics in order to employ a
respiratory tract infections [70-72]. However, the effectiveness of
practical approach to deal with metabolic syndrome without any side
probiotics is strain and dose dependent with variable results under
effects [57]. The aforesaid syndrome is determined by genetic, lifestyle
different clinical studies. Probiotic therapy is based on the mechanism
and environmental factors (gut microbiota). The gastrointestinal tract
of competition for the adhesion ability to bind the same site of a
(GI) in human contains mixed culture (approx. 1× 1013 to 1 × 1014)
common receptor by probiotics and pathogenic bacteria. The
having collective genome encoding genes which exceeds human
probiotics are able to displace the pathogen during competition.
genome by a magnitude of 150 [58]. The advancement in
Probiotics have the potential for epithelial cell surface or mucus
metagenomics has paved the path to understand and decipher the
adherence through the formation of a protective layer between
diversity of microorganisms in human’s gastrointestine tract. Majority
pathogen and host cells [73]. Strains of Lactobacillus such as L.
of the known bacterial phylotypes (about 90%) belong to the members
rhamnosus, L. casei, L. gasseri, and Bifidobacterium B. longum , B.
of Bacteroidetes and Firmicutes followed by Actinobacteria and
bifidum (verum) have been used to treat respiratory tract infections
Proteobacteria [59,60].
(otitis media, sinusitis, bronchitis and pneumonia) in children and
elderly subjects [74,75]. There is a considerable reduction in nasal
Obesity colonization with pathogens in healthy adults after administering
Studies have shown that VSL#3, probiotic strain formulation, having Lactobacillus rhamnosus GG [70]. Lactobacillus acidophilus NCFM
combination of eight different strains of bacteria, is able to treat obesity reduces fever, rhinorrhoea and cough incidence in healthy children
and type 2 diabetes [48,49]. There are several other reports also [71], Lactobacillus delbrueckii subsp. bulgaricus OLL 1073R-1 reduces
available to prove the potential of probiotics products (containing live risk of catching cold or influenza virus in healthy adults and in elderly
microorganisms) against obesity [61]. The individuals suffering from group [76], Bifidobacterium animalis sub sp. lactis Bi-07 and L.
obesity has an altered ratio of Bacteroidetes, Firmicutes and Archea acidophilus NCFM has the ability to reduce the incidence of fever,
[62]. Yogurt is reported to aid in reducing fat absorption in small cough and sneezing [72].
intestine with a significant weight loss and an increased level of lipid in
faeces in mice [63]. Urogenital Infections
Lactobacillus rhamnosus, Lactobacillus acidophilus, L. gasseri, L.
Type 2 Diabetes reuteri, L. jhonsenii and L. crispatus have been used to cure bacterial
The type 2 diabetic patients are reported to have reduced proportion vaginosis [77]. The cure for urogenital tract infection, bacterial
of Firmicutes and Clostridia with an increase proportion of vaginosis and vulvuvaginal candidasis is interlinked to H2O2 and acid
Bacteriodetes and Proteobacteria compared to non-diabetic production with probiotic concentration used. The vaginal microflora
could be modified through the daily intake of L. fermentum and L.

J Prob Health, an open access journal Volume 6 • Issue 1 • 1000194

ISSN: 2329-8901
Citation: Raghuwanshi S, Misra S, Sharma R, Bisen PS (2018) Probiotics: Nutritional Therapeutic Tool. J Prob Health 6: 194. doi:
10.4172/2329-8901.1000194

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rhamnosus in combination through oral route [78]. Probiotics reduced Competitive exclusion by competition for binding sites or
the occurrence of both yeast and bacterial pathogens in vagina [78]. stimulation of epithelial barrier function
Probiotic administration could normalize the flora and opens up the
avenues for possible long term therapy especially for pregnant women The microbial population in the intestinal tract resides as a prior
and for UTI susceptible individuals [79]. established complex natural resource and is able to maintain
themselves in the environment. These colonized organisms prevent
other organism to establish and to reduce the impact of pathogenic
Cancer bacteria [47]. The beneficial organism shares same receptor sites with
Clinical studies, on animal models asnd in in vitro system have pathogens whereby the probiotics exclude pathogens from the host
clearly demonstrated that both prebiotics and synbiotics exert anti intestine, urogenital tract and other host sites. The mechanism
neoplastic effect [80]. It was reported in a study that the polysaccharide described for pathogen exclusion from intestine through probiotics is
fraction of Bifidobacterium bifidum BGN4 inhibits the growth of in the following manner [89] (i) steric hindrance and competitive
HCT-116 and HT-29 cells but could not inhibit the growth of Caco-2 depletion of essential nutrients (ii) competitive exclusion by adhered
cells [81]. The probiotic strains, Lactobacillus reuteri ATCC 6475, L. probiotics, through competition for receptor sites and by displacement
rhamnoses and Bifidobacterium lactis have been found to be able to of adhered pathogens (iii) non-competitive exclusion through
activate caspase proteins amongst the cancerous cell line [82]. The induction of secretion of antimicrobial components from host cell and
probiotic consumption is useful in preventing the onset of cancer and by regulation of epithelial barrier function.
also for therapy [2,3].
Stimulation of immune responses via increases of sIgA and
Immune System anti-inflammatory cytokines and regulation of pro-
inflammatory cytokines
Several investigations have indicated that each individual may have
a unique metagenomic genotype. The gut microbiota is characterised The intestine microflora exerts both harmful and beneficial effects
not just at the level of species or phyla but also at the strain level. on human health [90]. The interaction between probiotic with
Probiotics have a great economic value and it has been accepted that epithelial cells and dendritic cells (DC) is believed to be the initiating
they contribute significantly in improving human health by step in immunomodulation. The effect of probiotic is strain specific,
maintaining the health of gastrointestinal tract and also aids in the and for each strain the profile of cytokines secreted by lymphocytes,
treatment and/or prevention of specific intestinal infections. The enterocytes or dendritic cells has to be established when it comes in
probiotic strains with predictable and measurable beneficial effect contact. Certain intracellular signalling pathways are activated on
require strict attention to strain selection. The mechanism involved interaction of probiotics with the cell surface receptors and induce
behind is still not very clear [2,3,83]. The proposed mechanisms immune system.
involved are: (a) direct antimicrobial activity through production of
The major encounters with antigens occur at mucosal surface
bacteriocins or inhibitors of virulence gene expression; (b) competitive
through mucosal immune system, including the surface lining of
exclusion by competition for binding sites or stimulation of epithelial
gastrointestinal, respiratory and genitourinary tracts [91]. The
barrier function; (c) stimulation of immune responses via increases of
intestinal microbiota influences the mucosal immune system to
sIgA and anti-inflammatory cytokines and regulation of
respond as tolerance or defence. Probiotics are absorbed orally and
proinflammatory cytokines; and (d) inhibition of virulence gene or
influence the immune response at the mucosal frontier of
protein expression in gastrointestinal pathogens [84]. Each of these
gastrointestinal tract [92]. The intestine is protected from pathogens
mechanisms is classified further on the basis of functions involved. The
due to mucous membrane covering epithelial layer. The intestinal
prominent among them are epithelial barrier function [85].
immune system recognizes the pathogen as a whole by the intestinal
epithelial layer or the substances known as antigens released by the
Direct antimicrobial activity through production of pathogen and responds appropriately. The cytokine profile plays an
bacteriocins or inhibitors of virulence gene expression important role in the maintenance of intestinal immune homeostasis
The probiotics are antimicrobial in nature. It could produce certain that favours tolerance and IgA production. The equilibrium between
active metabolites which are capable of inhibiting or killing potential Th1 and Th2 cytokine production deciphers the direction and outcome
pathogens. These active metabolites are (i) organic acids such as acetic of an immune response. It is associated with chronic inflammatory
acid and lactic acid as end products of sugar fermentation. These end diseases if the deviation is towards Th1. While, on the other hand, an
products at low pH range possess robust antimicrobial activity [86]. (ii) abnormal response of Th2 type have allergic reactions. A slight
Acetaldehyde, ethanol, acetoin, reuterin, carbon dioxide, reutericyclin deviation towards Th2 response over Th1 response was observed in
and other germicidal compounds. These are low molecular weight case of chronic inflammatory bowel diseases such as ulcerative colitis.
components which are able to inhibit microbial growth or disrupt A predominant Th1-mediated cytokine profile was noted in Crohn’s
membrane of the pathogens [86]. (iii) proteinaceous antibiotic like disease [93]. The imbalance between Th1 (IL-2, IFNγ, TNF α) and Th2
substances designated as bacteriocins which are mainly ribosomally responses (IL-4, IL-5, IL-10) led to a chronic inflammatory
coded short peptides and exert antimicrobial action by interfering with characterized by the production of pro-inflammatory cytokines (IL-1,
cell wall synthesis and causing pore formation in cell wall of the target IL-6, TNFα) from dendritic cells (DC), but regulates the degree of
organisms [87] (iv) hydrogen peroxide by the action of flavoprotein- innate immune activation and prevents excessive inflammation.
containing oxidases, NADH oxidases and superoxide dismutase. Microbe-associated molecular patterns (MAMPs) from probiotics
Presence of H2O2 in lower concentration aids in oxidizing the expressed by major histocompatibility complex molecule (MHC) of
sulphydryl group of surface proteins and enzymes of target organisms DC, interact with T cell receptor (TCR) of T cells and shapes the
[88]. adaptive immunity of host. The consumption of probiotics led to
immunomodulatory effect by interfering with helper cell

J Prob Health, an open access journal Volume 6 • Issue 1 • 1000194

ISSN: 2329-8901
Citation: Raghuwanshi S, Misra S, Sharma R, Bisen PS (2018) Probiotics: Nutritional Therapeutic Tool. J Prob Health 6: 194. doi:
10.4172/2329-8901.1000194

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differentiation and upsetting the equilibrium between the ratios of the probiotic therapy has proven to be useful. The specific strains of
Th1/Th2. The pro inflammatory effect or anti-inflammatory action is healthy micro flora are used in this therapy “Nutritional therapy”.
stimulated by different probiotic strains through alteration of Th1/Th2 Probiotics act as both preventive and curative agent in this therapy. The
ratio toward Th1 or towards Th2 respectively [92]. global probiotic demand was $27.9 billion in 2011 and is expected to
reach $44.9 billion in 2018 as per CAGR of 6.8% [2,97]. The worldwide
Inhibition of virulence gene or protein expression in demand for probiotics is majorly covered by Asia-Pacific and
gastrointestinal pathogens European region, with Asia-pacific being prominent player with an
expected CAGR of 7% from 2013 to 2018. The market revenue for
Lactobacilli and Bifidobacteria play a vital role in maintaining the probiotics is mainly dominated by the Asia-pacific region, and the
optimal balance amongst the micro flora present in the healthy gut major revenue is generated from China and Japan. India has made a
[94]. Any sort of alteration in the equilibrium of the microbial remarkable growth in terms of market revenue in Asia. On the other
community may cause change in immune and inflammatory response hand, U.K and Germany amongst the European countries are the most
along with the change in the metabolism of the epithelial cells [95]. The profitable market with an expected CAGR of 6% from 2013 to 2018. It
probiotics have the potential to regulate intestinal homeostasis by (a) is estimated that amongst the probiotics, the most influential segments
reducing the adherence and pathogen invasion as it shares different are foods and beverages which is expected to be of $37.9 billion by
adhesion sites on epithelium with pathogens and/or (b) activating 2018. The aforesaid segments are followed by dietary supplements and
various intracellular signalling pathways by reinforcing tight junctions animal feed which too witnesses the remarkable growth. The dairy
and intestinal barrier function [84]. The activated proteins produced products are the largest application market for probiotics and are
induce mucin expression, antimicrobial peptides (defensins, estimated to reach US$ 32.2 billion in 2018. While, under the new
cathelicidins) leading to the rearrangement of tight junction proteins emerging segment amongst probiotics is animal feed, which is
[96]. estimated to cross US$ 3 billion by 2018. The major hurdle in terms of
Probiotics modulates the metabolism of short chain fatty acids market growth is high price, cultivation of culture and lack of product
production (e.g. acetate and butyrate). These SCFAs modulate the gene standardization [2]. The market for probiotics, in India, in terms of
expression of epithelial cells by influencing epigenetic modulations. food applications is larger compared to that for probiotics sold in the
These changes stimulate epithelial proliferation and barrier function. form of probiotics sachets, capsules and in other pharmaceutical
preparations. Many spurious and ineffective probiotic products with
false claims are entering the market due to absence of any regulatory
Probiotic Market Segment standards which brings the consumers in dilemma about the
The immense importance and progressive interest on these magic acceptability of probiotics products in many Asia-pacific countries
bugs, probiotic products are able to establish itself amongst the masses including India. The probiotic drugs hold a promising market and have
in a short span of time for alternative and “natural” means to promote been realized by the number of indigenous pharmaceutical companies.
intestinal health. Probiotics serve as bio therapeutics in restoration of Many food companies have taken step forward to extend their existing
inflammatory metabolic disorders including cardiovascular diseases market profile and to enter into the upcoming probiotic market
such as hypertension, atherosclerosis, and stroke etc. In order to [80,98]. Some of the probiotic products available in the global market
combat the imbalance of indigenous micro flora in the intestinal tract, are displayed in Table 2.

Country Probiotic products

Japan Yakult Meiji bulgaria yogurt and drink Morinaga bifidus yogurt Calpis ameal s120, aprobiotic yogurt drink

Culturelle probiotic
Europe Lifeway kefir France, bravo friscus Yoplait yogurt Danone activia Actimel yogurt drink
infant formula

Blue bunny-sedona yoghurt ice cream, choclate sweet

USA Activia creamy yoghurt Danone gyoplus Yoyation pierre’s probiotic ice cream
scoops-frozen yoghurt

Yeo valley bioliye yoghurt yeo valley natural fat free

UK Vita-yo creamy probiotic yoghurt Unilever’s flora pro activ cholesterol
yoghurt

Finland Valio gefilus® and valio kidius gefilus® and evolus® milk drink and yoghurt (lgg) Yosa yoghurt oat product Bioferme, valio villis

Biobest plant sterols probiotic Kraft liveactive cheddar cheese and chocolate Olympic natural no fat probiotic
Canada Liberte yoghurt
yoghurt raspberry bars yogurt

Spain Kaiku vita, a functional dairy drink from valio Bio herbal bifidus active green tea yogurt dannone

F and n’s alive Wallaby organic Bio-life probiotic Vaalia probiotic Ombar probiotic
Australia Yo-plus digestive yogurt
fruitchunk youhurt yogurt yogurt yogurt chocolate

Brazil Chamyto probiotic drink nestle Actimel l casei defensis Danito l. Casei danone Sofyl yakult

Czech Republic Olma revital active yogurt and drink yogurt

Sweden Proviva yogurt Yogenfruz frozen yoghurt Biogaia products Liveactive probiotic products

J Prob Health, an open access journal Volume 6 • Issue 1 • 1000194

ISSN: 2329-8901
Citation: Raghuwanshi S, Misra S, Sharma R, Bisen PS (2018) Probiotics: Nutritional Therapeutic Tool. J Prob Health 6: 194. doi:
10.4172/2329-8901.1000194

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Germany Probiotic vitality yogurt Soyogurt

Denmark Klover drinkable yoghurt Danimal lactobacillus gg Probio arla cultura

France B.aktiy lgg dukat yoghurt and drinks

Ganedenbc30® probiotic low Probiotic dairy drinks latteria sociale

Italy Danacol fermented dairy beverage Yolive frozen yoghurt
fat yogurt merano

New Zealand Biofarm acidophilus yoghurt

Tropilite foods pvt. Ltd. Bioflex probiotic

Amul probiotic dahi (prolife),
India Mother dairy b-activ probiotic dahi/lassi/curd & nutrifit culture (Animal/ Human) Bioflex starter
frozen yoghurt (flaavyo)
culture (Dahi/ Yoghurt)

Table 2: List of probiotic products available worldwide.

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