Probiotics in human infections.

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Abstract
At the beginning of the last century, the Russian immunologist Elie Metchnikoff argued that life-long intake of yoghurt containing lactic acid-producing microorganisms could explain the differences in length of life between ethnic groups. The idea was that the bacteria in the fermented products competed with microorganisms that are injurious to health.1 Today it is known that the normal human microflora is important as a barrier against colonization by exogenous pathogenic microorganisms and potentially pathogenic bacteria already present in small numbers in the microflora.2 The normal microflora influence several biochemical, physiological and immunological features of the host, particularly the gastrointestinal flora, which consists of the most dense and diverse collection of bacteria.3 Disturbances in the normal microflora can be caused by several things, one being the administration of antimicrobial agents.4 Probiotic microorganisms are thought to counteract disturbances and thereby reduce the risk of colonization by pathogenic bacteria.5 Studies on strains of microorganisms used in probiotic dietary supplements have demonstrated that several strains produce antimicrobial substances such as organic acids, bacteriocins and peptides. In vitro and animal studies have further shown inhibitory effects of probiotic bacteria to be mediated by their interference with the adhesion of gastrointestinal pathogens or with toxins produced by the pathogenic microorganisms. Adjuvant-like effects on intestinal and systemic immunity have also been demonstrated for some strains.6 However, it is important to remember that even closely related strains have heterogeneous qualities.

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