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Review
. 2011 Jan;140(1):8-14.
doi: 10.1053/j.gastro.2010.11.010. Epub 2010 Nov 12.

Probiotics, enteric and diarrheal diseases, and global health

Geoffrey A Preidis  1 , Colin Hill, Richard L Guerrant, B S Ramakrishna, Gerald W Tannock, James Versalovic
Affiliations
Review

Probiotics, enteric and diarrheal diseases, and global health

Geoffrey A Preidis et al. Gastroenterology. 2011 Jan.
No abstract available

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Figures

Figure 1
Figure 1. The vicious cycle of diarrhea and undernutrition in susceptible children
(A) The devastating synergy between enteric infections and undernutrition is influenced by the environment, the human genome, host nutrition, and the human microbiome. Various interventions (red boxes) may inhibit progression to the next step in the cycle, minimizing both acute and chronic morbidities. (B) Employing a spectrum of disease outcome measures would lend greater insight into the pathology underlying enteric and diarrheal diseases, while providing a more complete understanding of interventions targeting basic steps of enteric and diarrheal disease pathogenesis. Adapted with permission from Wiley: Nutrition Reviews,4 copyright 2008. http://www.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1753-4887.
Figure 2
Figure 2. Three general mechanisms of probiosis for enteric infections
In direct antagonism, probiotics kill or inhibit the pathogen to limit infection, or they down-regulate the expression of virulence factors, such as adhesins or toxins, required for pathogenesis. Probiotics can also interact with the immune system (immunomodulation) to enhance the functionality of innate and/or adaptive immunity, or to limit the ability of the pathogen to initiate or facilitate an immune response. Through “exclusion,” probiotics can alter the microenvironment to prevent pathogens from gaining access to appropriate receptors, to limit pathogen attachment, entry, or translocation, or to improve barrier function. A beneficial microbe may use a combination of these mechanisms, and may employ different mechanisms against different pathogens. B, B cell; DC, dendritic cell; IEC, intestinal epithelial cell; M, M cell; MAC, macrophage; T, T cell; TJ, tight junction.
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