Targeting diseases with genetically engineered Lactococcus lactis and its course towards medical translation

The use of the lactic acid bacterium Lactococcus lactis, primarily used in food fermentations, as therapeutic agent is no longer speculative but an imminent reality. After the successful completion of Phase I and II clinical trials in humans for the treatment of inflammatory bowel disease, an ongoing clinical trial to alleviate oral mucositis as well as the development of a pneumococcal and a flu vaccine using genetically modified L. lactis, many exciting possibilities exist to develop novel therapeutic and prophylactic biopharmaceuticals to alleviate a wide range of diseases. Here, we discuss existing characteristics of the systems currently employed and the nature of the immune responses evoked. We also discuss the criteria that are fundamental to making the systems feasible and efficient which should ultimately translate into human therapies. Finally, we examine the prospects for L. lactis to become a commercially viable therapeutic agent.