Probiotics: Potential Benefits and Safety in Hematological Malignancies
Probiotics in Hematologic Cancers
DOI:
https://doi.org/10.31661/gmj.v13i.3149Keywords:
Probiotics; Hematologic Malignancy; Chemotherapy; Radiation Therapy; Hematopoietic Stem Cell Transplantation; HSCT; GVHDAbstract
Cancer remains one of the most significant global health challenges, with increasing incidence and mortality rates and a substantial socioeconomic burden. Traditional cancer treatments such as chemotherapeutic drugs and radiation therapies, while effective, have significant adverse effects on the body, prompting the search for less invasive treatment options. In recent years, probiotics have emerged as a promising alternative in the prevention and treatment of cancer and its associated complications, especially in gastrointestinal malignancies. Probiotics have been found to have several beneficial effects on the body, including the ability to mitigate the gastrointestinal side effects of cancer treatments by restoring gut microbiota balance and improving intestinal barrier function. By reducing inflammation and enhancing the immune response, probiotics can also help alleviate other cancer-related symptoms and improve the overall well-being of cancer patients. Despite their potential benefits, the efficacy and safety of probiotics in immunocompromised patients remain uncertain, and caution must be exercised during their administration. Further research is needed to determine the optimal clinical use, safety, and efficacy of probiotics in cancer treatment.
References
Mattiuzzi C, Lippi G. Current cancer epidemiology. J Epidemiol Glob Health. 2019;9(4):217-22.
https://doi.org/10.2991/jegh.k.191008.001
PMid:31854162 PMCid:PMC7310786
Chen L, Zheng Y, Yu K, Chen S, Wang W, Gale RP, et al. Changing causes of death in persons with haematological cancers 1975-2016. Leukemia. 2022;36(7):1850-60.
https://doi.org/10.1038/s41375-022-01596-z
PMid:35577905 PMCid:PMC9252904
Roman E, Smith A, Appleton S, Crouch S, Kelly R, Kinsey S, et al. Myeloid malignancies in the real-world: Occurrence, progression and survival in the UK's population-based Haematological Malignancy Research Network 2004-15. Cancer Epidemiol. 2016;42:186-98.
https://doi.org/10.1016/j.canep.2016.03.011
PMid:27090942 PMCid:PMC4911595
Pearce A, Haas M, Viney R, Pearson S-A, Haywood P, Brown C, et al. Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study. PLoS One. 2017;12(10):e0184360.
https://doi.org/10.1371/journal.pone.0184360
PMid:29016607 PMCid:PMC5634543
Schirrmacher V. From chemotherapy to biological therapy: A review of novel concepts to reduce the side effects of systemic cancer treatment (Review). Int J Oncol. 2019;54(2):407-19.
https://doi.org/10.3892/ijo.2018.4661
PMid:30570109 PMCid:PMC6317661
Baudino TA. Targeted cancer therapy: the next generation of cancer treatment. Curr Drug Discov Technol. 2015;12(1):3-20.
https://doi.org/10.2174/1570163812666150602144310
PMid:26033233
Reis Ferreira M, Andreyev HJN, Mohammed K, Truelove L, Gowan SM, Li J, et al. Microbiota- and Radiotherapy-Induced Gastrointestinal Side-Effects (MARS) Study: A Large Pilot Study of the Microbiome in Acute and Late-Radiation Enteropathy. Clin Cancer Res. 2019;25(21):6487-500.
https://doi.org/10.1158/1078-0432.CCR-19-0960
PMid:31345839
Elliott SP, Malaeb BS. Long-term urinary adverse effects of pelvic radiotherapy. World J Urol. 2011;29(1):35-41.
https://doi.org/10.1007/s00345-010-0603-x
PMid:20959990 PMCid:PMC3075494
Fattizzo B, Cavallaro F, Folino F, Barcellini W. Recent insights into the role of the microbiome in malignant and benign hematologic diseases. Crit Rev Oncol Hematol. 2021;160:103289.
https://doi.org/10.1016/j.critrevonc.2021.103289
PMid:33667659
Hong B-Y, Sobue T, Choquette L, Dupuy AK, Thompson A, Burleson JA, et al. Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis. Microbiome. 2019;7(1):66.
https://doi.org/10.1186/s40168-019-0679-5
PMid:31018870 PMCid:PMC6482518
Rashidi A, Kaiser T, Graiziger C, Holtan SG, Rehman TU, Weisdorf DJ, et al. Gut dysbiosis during antileukemia chemotherapy versus allogeneic hematopoietic cell transplantation. Cancer. 2020;126(7):1434-47.
https://doi.org/10.1002/cncr.32641
PMid:31873965
Montassier E, Gastinne T, Vangay P, Al-Ghalith GA, Bruley des Varannes S, Massart S, et al. Chemotherapy-driven dysbiosis in the intestinal microbiome. Aliment Pharmacol Ther. 2015;42(5):515-28.
https://doi.org/10.1111/apt.13302
PMid:26147207
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34.
https://doi.org/10.3322/caac.21551
PMid:30620402
Górska A, Przystupski D, Niemczura MJ, Kulbacka J. Probiotic bacteria: A promising tool in cancer prevention and therapy. Curr Microbiol. 2019;76(8):939-49.
https://doi.org/10.1007/s00284-019-01679-8
PMid:30949803 PMCid:PMC6586914
Sharifi M, Moridnia A, Mortazavi D, Salehi M, Bagheri M, Sheikhi A. Kefir: a powerful probiotics with anticancer properties. Med Oncol. 2017;34(11):183.
https://doi.org/10.1007/s12032-017-1044-9
PMid:28956261
Pop OL, Suharoschi R, Gabbianelli R. Biodetoxification and Protective Properties of Probiotics. Microorganisms. 2022;10(7):1278.
https://doi.org/10.3390/microorganisms10071278
PMid:35888997 PMCid:PMC9319832
Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic. Nat Rev Gastroenterol Hepatol. 2019;16(10):605-16.
https://doi.org/10.1038/s41575-019-0173-3
PMid:31296969
Hrdý J, Alard J, Couturier-Maillard A, Boulard O, Boutillier D, Delacre M, et al. Lactobacillus reuteri 5454 and Bifidobacterium animalis ssp lactis 5764 improve colitis while differentially impacting dendritic cells maturation and antimicrobial responses. Sci Rep. 2020;10(1):5345.
https://doi.org/10.1038/s41598-020-62161-1
PMid:32210304 PMCid:PMC7093418
Kim SK, Guevarra RB, Kim YT, Kwon J, Kim H, Cho JH, et al. Role of probiotics in human gut microbiome-associated diseases. J Microbiol Biotechnol. 2019;29(9):1335-40.
https://doi.org/10.4014/jmb.1906.06064
PMid:31434172
Sotoudegan F, Daniali M, Hassani S, Nikfar S, Abdollahi M. Reappraisal of probiotics' safety in human. Food Chem Toxicol. 2019;129:22-9.
https://doi.org/10.1016/j.fct.2019.04.032
PMid:31009735
Sender R, Fuchs S, Milo R. Are we really vastly outnumbered Revisiting the ratio of bacterial to host cells in humans. Cell. 2016;164(3):337-40.
https://doi.org/10.1016/j.cell.2016.01.013
PMid:26824647
Tierney BT, Yang Z, Luber JM, Beaudin M, Wibowo MC, Baek C, et al. The Landscape of Genetic Content in the Gut and Oral Human Microbiome. Cell Host Microbe. 2019;26(2):283-95 e8.
https://doi.org/10.1016/j.chom.2019.07.008
PMid:31415755 PMCid:PMC6716383
Zou S, Fang L, Lee M-H. Dysbiosis of gut microbiota in promoting the development of colorectal cancer. Gastroenterology Report. 2017;6(1):1-12.
https://doi.org/10.1093/gastro/gox031
PMid:29479437 PMCid:PMC5806407
Slizewska K, Markowiak-Kopec P, Slizewska W. The role of probiotics in cancer prevention. Cancers (Basel). 2020;13(1):20.
https://doi.org/10.3390/cancers13010020
PMid:33374549 PMCid:PMC7793079
Sanchez B, Delgado S, Blanco-Miguez A, Lourenco A, Gueimonde M, Margolles A. Probiotics, gut microbiota, and their influence on host health and disease. Mol Nutr Food Res. 2017;61(1):1600240.
https://doi.org/10.1002/mnfr.201600240
PMid:27500859
Hamasalim HJ. Synbiotic as feed additives relating to animal health and performance. Adv Microbiol. 2016;6(4):288-302.
https://doi.org/10.4236/aim.2016.64028
Smith PM, Howitt MR, Panikov N, Michaud M, Gallini CA, Bohlooly YM, et al. The microbial metabolites, short-chain fatty acids, regulate colonic Treg cell homeostasis. Science. 2013;341(6145):569-73.
https://doi.org/10.1126/science.1241165
PMid:23828891 PMCid:PMC3807819
Chen J, Vitetta L. Inflammation-modulating effect of butyrate in the prevention of colon cancer by dietary fiber. Clin Colorectal Cancer. 2018;17(3):e541-e4.
https://doi.org/10.1016/j.clcc.2018.05.001
PMid:29866614
Ding S, Yan W, Ma Y, Fang J. The impact of probiotics on gut health via alternation of immune status of monogastric animals. Animal Nutrition. 2021;7(1):24-30.
https://doi.org/10.1016/j.aninu.2020.11.004
PMid:33997328 PMCid:PMC8110871
Evrard B, Coudeyras S, Dosgilbert A, Charbonnel N, Alame J, Tridon A, et al. Dose-dependent immunomodulation of human dendritic cells by the probiotic Lactobacillus rhamnosus Lcr35. PLoS One. 2011;6(4):e18735.
https://doi.org/10.1371/journal.pone.0018735
PMid:21533162 PMCid:PMC3078917
Mohammed AT, Khattab M, Ahmed AM, Turk T, Sakr N, A MK, et al. The therapeutic effect of probiotics on rheumatoid arthritis: a systematic review and meta-analysis of randomized control trials. Clin Rheumatol. 2017;36(12):2697-707.
https://doi.org/10.1007/s10067-017-3814-3
PMid:28914373
Plaza-Díaz J, Ruiz-Ojeda FJ, Vilchez-Padial LM, Gil A. Evidence of the Anti-Inflammatory Effects of Probiotics and Synbiotics in Intestinal Chronic Diseases. Nutrients. 2017;9(6):555.
https://doi.org/10.3390/nu9060555
PMid:28555037 PMCid:PMC5490534
Yousefi B, Eslami M, Ghasemian A, Kokhaei P, Salek Farrokhi A, Darabi N. Probiotics importance and their immunomodulatory properties. J Cell Physiol. 2019;234(6):8008-18.
https://doi.org/10.1002/jcp.27559
PMid:30317594
Zhou A, Yuan Y, Yang M, Huang Y, Li X, Li S, et al. Crosstalk between the gut microbiota and epithelial cells under physiological and infectious conditions. Front Cell Infect Microbiol. 2022;12:832672.
https://doi.org/10.3389/fcimb.2022.832672
PMid:35155283 PMCid:PMC8829037
Wang C, Li Q, Ren J. Microbiota-Immune Interaction in the Pathogenesis of Gut-Derived Infection. Front Immunol. 2019;10:1873.
https://doi.org/10.3389/fimmu.2019.01873
PMid:31456801 PMCid:PMC6698791
Lemme-Dumit JM, Polti MA, Perdigon G, Galdeano CM. Probiotic bacteria cell walls stimulate the activity of the intestinal epithelial cells and macrophage functionality. Benef Microbes. 2018;9(1):153-64.
https://doi.org/10.3920/BM2016.0220
PMid:29124968
Maldonado Galdeano C, Cazorla SI, Lemme Dumit JM, Vélez E, Perdigón G. Beneficial Effects of Probiotic Consumption on the Immune System. Annals of nutrition & metabolism. 2019;74(2):115-24.
https://doi.org/10.1159/000496426
PMid:30673668
Rizzello V, Bonaccorsi I, Dongarra ML, Fink LN, Ferlazzo G. Role of natural killer and dendritic cell crosstalk in immunomodulation by commensal bacteria probiotics. J Biomed Biotechnol. 2011;2011:473097.
https://doi.org/10.1155/2011/473097
PMid:21660136 PMCid:PMC3110311
Lin W-Y, Kuo Y-W, Chen C-W, Huang Y-F, Hsu C-H, Lin J-H, et al. Viable and Heat-Killed Probiotic Strains Improve Oral Immunity by Elevating the IgA Concentration in the Oral Mucosa. Curr Microbiol. 2021;78(9):3541-9.
https://doi.org/10.1007/s00284-021-02569-8
PMid:34345965 PMCid:PMC8363536
DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current understanding of dysbiosis in disease in human and animal models. Inflamm Bowel Dis. 2016;22(5):1137-50.
https://doi.org/10.1097/MIB.0000000000000750
PMid:27070911 PMCid:PMC4838534
Goodman B, Gardner H. The microbiome and cancer. J Pathol. 2018;244(5):667-76.
https://doi.org/10.1002/path.5047
PMid:29377130
Noroozi E, Tebianian M, Taghizadeh M, Dadar M, Mojgani N. Anticarcinogenic potential of probiotic, postbiotic metabolites and paraprobiotics on human cancer cells. In: Mojgani N, Dadar M, editors. Probiotic Bacteria and Postbiotic Metabolites: Role in Animal and Human Health. Microorganisms for Sustainability. Singapore: Springer Singapore; 2021. p. 153-77.
https://doi.org/10.1007/978-981-16-0223-8_6
Weill FS, Cela EM, Paz ML, Ferrari A, Leoni J, Maglio DHG. Lipoteichoic acid from Lactobacillus rhamnosus GG as an oral photoprotective agent against UV-induced carcinogenesis. Br J Nutr. 2013;109(3):457-66.
https://doi.org/10.1017/S0007114512001225
PMid:22874095
Maalouf K, Baydoun E, Rizk S. Kefir induces cell-cycle arrest and apoptosis in HTLV-1-negative malignant T-lymphocytes. Cancer Manag Res. 2011;3:39-47.
https://doi.org/10.2147/CMR.S15109
PMid:21448298 PMCid:PMC3064404
Jalali F, Sharifi M, Salehi R. Kefir induces apoptosis and inhibits cell proliferation in human acute erythroleukemia. Med Oncol. 2016;33(1):7.
https://doi.org/10.1007/s12032-015-0722-8
PMid:26708130
Chiu YH, Hsieh YJ, Liao KW, Peng KC. Preferential promotion of apoptosis of monocytes by Lactobacillus casei rhamnosus soluble factors. Clin Nutr. 2010;29(1):131-40.
https://doi.org/10.1016/j.clnu.2009.07.004
PMid:19665262
Calcinotto A, Brevi A, Chesi M, Ferrarese R, Garcia Perez L, Grioni M, et al. Microbiota-driven interleukin-17-producing cells and eosinophils synergize to accelerate multiple myeloma progression. Nat Commun. 2018;9(1):4832.
https://doi.org/10.1038/s41467-018-07305-8
PMid:30510245 PMCid:PMC6277390
Pianko MJ, Golob JL. Host-microbe interactions and outcomes in multiple myeloma and hematopoietic stem cell transplantation. Cancer Metastasis Rev. 2022;41(2):367-82.
https://doi.org/10.1007/s10555-022-10033-7
PMid:35488106 PMCid:PMC9378527
Salas C, Niembro A, Lozano V, Gallardo E, Molina B, Sanchez S, et al. Persistent genomic instability in peripheral blood lymphocytes from Hodgkin lymphoma survivors. Environ Mol Mutagen. 2012;53(4):271-80.
https://doi.org/10.1002/em.21691
PMid:22434555
Cozen W, Yu G, Gail MH, Ridaura VK, Nathwani BN, Hwang AE, et al. Fecal microbiota diversity in survivors of adolescent/young adult Hodgkin lymphoma: a study of twins. Br J Cancer. 2013;108(5):1163-7.
https://doi.org/10.1038/bjc.2013.60
PMid:23443674 PMCid:PMC3619077
Greaves P, Clear A, Owen A, Iqbal S, Lee A, Matthews J, et al. Defining characteristics of classical Hodgkin lymphoma microenvironment T-helper cells. Blood. 2013;122(16):2856-63.
https://doi.org/10.1182/blood-2013-06-508044
PMid:24004665 PMCid:PMC5291299
Ghoneum M, Gimzewski J. Apoptotic effect of a novel kefir product, PFT, on multidrug-resistant myeloid leukemia cells via a hole-piercing mechanism. Int J Oncol. 2014;44(3):830-7.
https://doi.org/10.3892/ijo.2014.2258
PMid:24430613 PMCid:PMC3928472
Pflug N, Kluth S, Vehreschild JJ, Bahlo J, Tacke D, Biehl L, et al. Efficacy of antineoplastic treatment is associated with the use of antibiotics that modulate intestinal microbiota. Oncoimmunology. 2016;5(6):e1150399.
https://doi.org/10.1080/2162402X.2016.1150399
PMid:27471619 PMCid:PMC4938364
Rafei H, Jenq RR. Microbiome-intestine cross talk during acute graft-versus-host disease. Blood. 2020;136(4):401-9.
https://doi.org/10.1182/blood.2019000950
PMid:32526029 PMCid:PMC7378453
Le Bastard Q, Chevallier P, Montassier E. Gut microbiome in allogeneic hematopoietic stem cell transplantation and specific changes associated with acute graft vs host disease. World J Gastroenterol. 2021;27(45):7792-800.
https://doi.org/10.3748/wjg.v27.i45.7792
PMid:34963742 PMCid:PMC8661383
Li J, Zhang X, Chen Y, Zheng Q, Zhao M, Jiang H. A promising insight: the potential influence and therapeutic value of the gut microbiota in GI GVHD. Oxid Med Cell Longev. 2022;2022:2124627.
https://doi.org/10.1155/2022/2124627
PMid:35571252 PMCid:PMC9098338
Pirozzolo I, Li Z, Sepulveda M, Alegre ML. Influence of the microbiome on solid organ transplant survival. J Heart Lung Transplant. 2021;40(8):745-53.
https://doi.org/10.1016/j.healun.2021.04.004
PMid:34030971 PMCid:PMC8319047
Gałązka P, Styczyński J, Czyżewski K, Salamonowicz-Bodzioch M, Frączkiewicz J, Zając-Spychała O, et al. Impact of decontamination therapy on gastrointestinal acute graft-versus-host disease after allogeneic hematopoietic cell transplantation in children: Decontamination therapy in allo-HCT. Curr Res Transl Med. 2021;69(3):103298.
https://doi.org/10.1016/j.retram.2021.103298
PMid:34144374
Biagi E, Zama D, Nastasi C, Consolandi C, Fiori J, Rampelli S, et al. Gut microbiota trajectory in pediatric patients undergoing hematopoietic SCT. Bone Marrow Transplant. 2015;50(7):992-8.
https://doi.org/10.1038/bmt.2015.16
PMid:25893458
Simms-Waldrip TR, Sunkersett G, Coughlin LA, Savani MR, Arana C, Kim J, et al. Antibiotic-induced depletion of anti-inflammatory clostridia is associated with the development of graft-versus-host disease in pediatric stem cell transplantation patients. Biol Blood Marrow Transplant. 2017;23(5):820-9.
https://doi.org/10.1016/j.bbmt.2017.02.004
PMid:28192251
Iravani-Saadi M, Karimi MH, Yaghobi R, Geramizadeh B, Ramzi M, Niknam A, et al. Polymorphism of costimulatory molecules (CTLA4, ICOS, PD.1 and CD28) and allogeneic hematopoietic stem cell transplantation in Iranian patients. Immunol Invest. 2014;43(4):391-404.
https://doi.org/10.3109/08820139.2013.879594
PMid:24564845
Biagi E, Zama D, Rampelli S, Turroni S, Brigidi P, Consolandi C, et al. Early gut microbiota signature of aGvHD in children given allogeneic hematopoietic cell transplantation for hematological disorders. BMC Med Genomics. 2019;12(1):49.
https://doi.org/10.1186/s12920-019-0494-7
PMid:30845942 PMCid:PMC6404274
Khuat LT, Dave M, Murphy WJ. The emerging roles of the gut microbiome in allogeneic hematopoietic stem cell transplantation. Gut Microbes. 2021;13(1):1966262.
https://doi.org/10.1080/19490976.2021.1966262
PMid:34455917 PMCid:PMC8436969
Rodriguez-Arrastia M, Martinez-Ortigosa A, Rueda-Ruzafa L, Folch Ayora A, Ropero-Padilla C. Probiotic supplements on oncology patients' treatment-related side effects: a systematic review of randomized controlled trials. Int J Environ Res Public Health. 2021;18(8):4265.
https://doi.org/10.3390/ijerph18084265
PMid:33920572 PMCid:PMC8074215
Fernandes A, Oliveira A, Soares R, Barata P. The effects of ionizing radiation on gut microbiota, a systematic review. Nutrients. 2021;13(9):3025.
https://doi.org/10.3390/nu13093025
PMid:34578902 PMCid:PMC8465723
Ali H, Khurana S, Ma W, Peng Y, Jiang ZD, DuPont H, et al. Safety and efficacy of fecal microbiota transplantation to treat and prevent recurrent Clostridioides difficile in cancer patients. J Cancer. 2021;12(21):6498-506.
https://doi.org/10.7150/jca.59251
PMid:34659541 PMCid:PMC8489149
Koyama S, Fujita H, Shimosato T, Kamijo A, Ishiyama Y, Yamamoto E, et al. Septicemia from Lactobacillus rhamnosus GG, from a probiotic enriched yogurt, in a patient with autologous stem cell transplantation. Probiotics Antimicrob Proteins. 2019;11(1):295-8.
https://doi.org/10.1007/s12602-018-9399-6
PMid:29455334
Avcin SL, Pokorn M, Kitanovski L, Premru MM, Jazbec J. Bifidobacterium breve Sepsis in Child with High-Risk Acute Lymphoblastic Leukemia. Emerg Infect Dis. 2015;21(9):1674-5.
https://doi.org/10.3201/eid2109.150097
PMid:26291071 PMCid:PMC4550169
Gilliam CH, Brazelton de Cardenas J, Carias D, Maron Alfaro G, Hayden RT, Hakim H. Lactobacillus bloodstream infections genetically related to probiotic use in pediatric hematopoietic cell transplant patients. Infect Control Hosp Epidemiol. 2023;44(3):484-7.
https://doi.org/10.1017/ice.2021.515
PMid:35225182
Kullar R, Goldstein EJC, Johnson S, McFarland LV. Lactobacillus Bacteremia and Probiotics: A Review. Microorganisms. 2023;11(4):896.
https://doi.org/10.3390/microorganisms11040896
PMid:37110319 PMCid:PMC10145752
Ambesh P, Stroud S, Franzova E, Gotesman J, Sharma K, Wolf L, et al. Recurrent Lactobacillus Bacteremia in a Patient With Leukemia. Journal of Investigative Medicine High Impact Case Reports. 2017;5(4):2324709617744233.
https://doi.org/10.1177/2324709617744233
PMid:29204452 PMCid:PMC5703097
Costa RL, Moreira J, Lorenzo A, Lamas CC. Infectious complications following probiotic ingestion: a potentially underestimated problem A systematic review of reports and case series. BMC Complement Altern Med. 2018;18(1):329.
https://doi.org/10.1186/s12906-018-2394-3
PMid:30541524 PMCid:PMC6292120
Lo C-H, Wu D-C, Jao S-W, Wu C-C, Lin C-Y, Chuang C-H, et al. Enrichment of Prevotella intermedia in human colorectal cancer and its additive effects with Fusobacterium nucleatum on the malignant transformation of colorectal adenomas. J Biomed Sci. 2022;29(1):88.
https://doi.org/10.1186/s12929-022-00869-0
PMid:36303164 PMCid:PMC9615364
Torp AM, Bahl MI, Boisen A, Licht TR. Optimizing oral delivery of next generation probiotics. Trends in Food Science & Technology. 2022;119:101-9.
https://doi.org/10.1016/j.tifs.2021.11.034
Roobab U, Batool Z, Manzoor MF, Shabbir MA, Khan MR, Aadil RM. Sources, formulations, advanced delivery and health benefits of probiotics. Current Opinion in Food Science. 2020;32:17-28.
https://doi.org/10.1016/j.cofs.2020.01.003
Baral KC, Bajracharya R, Lee SH, Han H-K. Advancements in the Pharmaceutical Applications of Probiotics: Dosage Forms and Formulation Technology. International Journal of Nanomedicine. 2021;16(null):7535-56.
https://doi.org/10.2147/IJN.S337427
PMid:34795482 PMCid:PMC8594788
Ouwehand A. A review of dose-responses of probiotics in human studies. Beneficial Microbes. 2017;8(2):143-51.
https://doi.org/10.3920/BM2016.0140
PMid:28008787
Shi L, Sheng J, Wang M, Luo H, Zhu J, Zhang B, et al. Combination Therapy of TGF-β Blockade and Commensal-derived Probiotics Provides Enhanced Antitumor Immune Response and Tumor Suppression. Theranostics. 2019;9(14):4115-29.
https://doi.org/10.7150/thno.35131
PMid:31281535 PMCid:PMC6592171
Palumbo VD, Romeo M, Marino Gammazza A, Carini F, Damiani P, Damiano G, et al. The long-term effects of probiotics in the therapy of ulcerative colitis: A clinical study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016;160(3):372-7.
https://doi.org/10.5507/bp.2016.044
PMid:27623957
Kong X-J, Liu J, Liu K, Koh M, Sherman H, Liu S, et al. Probiotic and oxytocin combination therapy in patients with autism spectrum disorder: a randomized, double-blinded, placebo-controlled pilot trial. Nutrients. 2021;13(5):1552.
https://doi.org/10.3390/nu13051552
PMid:34062986 PMCid:PMC8147925
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