Chapter 31 - Probiotics: current regulatory aspects of probiotics for use in different disease conditions

Abstract

This chapter provides an overview of the definitions of probiotics, prebiotics, and synbiotics as noted by the International Scientific Association for Probiotics and Prebiotics and the interpretation of live biotherapeutic agents, psychobiotics, immunobiotics as well as postbiotics, parabiotics, and pharmabiotics with regard to health and regulations. The most common regulation bodies that mention probiotics are also outlined. Reviews and meta-analyses of clinical studies on the efficacy of probiotics and the supporting regulations on the use of probiotics for the most common gastrointestinal diseases, including acute gastroenteritis, inflammatory bowel diseases, irritable bowel syndrome, antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea, and Helicobacter pylori infections, were assessed. The efficacy of strain-specific probiotics for allergies, anxiety, depression and other mood disorders, wound healing and wound infections, and common acute infections were also assessed and, where applicable, regulations were mentioned. These studies also show that the efficacy of probiotics is strain specific and that clinical studies clearly show the diverse health effects of probiotics; however, several studies do not succeed in proving statistically significant benefits. Therefore more well-designed, multicenter, randomized, double-blind placebo-controlled clinical studies with clearly defined probiotics strains are warranted to scientifically prove the knowledge of these important beneficial microbes for selected clinical outcomes.