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Microbes & Immunity Probiotics from ancient wisdom to modern days

support in the literature, given that introducing intervention led to a significant improvement
a live culture to enter the bloodstream may have in cardiac function. The authors concluded:
73
unpredictable consequences. “Our results suggest the cell-derived, genetically
• An example is found in a case report of a 25-year- engineered EVs may be used therapeutically
old who was accidentally injected intravenously for the delivery of miRNAs for the rescue of
with 2 billion spores of Bacillus clausii. It took myocardial infarction and may benefit patients in
5 months of various antibiotic treatments before the future.”
blood tests finally confirmed clearance of the
infection 69 8.5. Other delivery methods
• A study showed that extracellular vesicles (EVs) • Nasal sprays: Probiotics are being explored for
secreted by B. longum and L. plantarum could their potential to improve sinus health and prevent
be used for intravenous and subcutaneous respiratory infections. In a pioneering effort, one
administration in mice, with the subcutaneous study developed a probiotic nasal spray that showed
pathway showing particular promise 70 success in treating upper respiratory issues. 74
• Mechanism: EVs offer a promising avenue for • Inhalable probiotics: Research into the use of inhaled
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circumventing the risks associated with the direct probiotics delivered for lung health is ongoing,
administration of live probiotics. though it remains in the early stages. Nonetheless,
• EVs are nanosized particles released by cells, the development of a dry powder inhaler formulation
composed of a cellular membrane and associated offers a promising avenue for targeting the lower
proteins, enclosing an aqueous core containing respiratory tract. 75
soluble molecules, such as proteins and nucleic
acids. Figure 6 is an artist’s impression of EVs 9. Challenges and considerations
being transferred from a donor cell to a recipient Despite their potential benefits, the use of probiotics also
cell. presents some challenges:
• EVs play a crucial role in various physiological • Strain specificity: The effects of probiotics are highly
and pathological processes by facilitating the strain-specific. Not all probiotic strains are equally
transfer of biological molecules between cells. 72 effective or safe for all individuals. McFarland et al.
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• In the study conducted using a pre-clinical concluded from their work: “Strong evidence was
myocardial infarction animal model, intravenous found supporting the hypothesis that the efficacy of
probiotics is both strain-specific and disease-specific.”
This further supports the need to account for both the
particular strain of probiotics and the target disease.
• Variability in clinical outcomes: The results of
clinical trials with probiotics have been inconsistent,
highlighting the need for further research to identify
the most effective strains and dosages for specific
conditions. Achieving reliable, credible, and
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repeatable results remains a significant challenge in
the field.
• Safety concerns: While generally considered
safe, some probiotic strains may pose risks for
immunocompromised individuals, such as those with
acquired immunodeficiency syndrome or undergoing
chemotherapy. 77
• Regulatory issues: The regulatory landscape for
probiotics varies across different countries, which can
create challenges for the development and marketing
of new probiotic products. For example, the European
Food Safety Authority takes a stringent approach to
regulating the probiotic landscape as “must do good”
Figure 6. Schematic illustration of extracellular vesicles being transferred
from a donor cell to a recipient cell. Image created by the author using rather than “does no harm.” This becomes particularly
Gemini artificial intelligence (CorelDraw Graphics Suite 2017). challenging as many diseases have long incubation

Volume 2 Issue 3 (2025) 40 doi: 10.36922/mi.6424