Immunosuppression and probiotics: are they effective and safe?

Area of Science:

• Immunology
• Microbiology
• Gastroenterology

Background:

• Immunosuppressed patients are at increased risk of infections.
• Probiotics are live microorganisms intended to confer a health benefit.

Purpose of the Study:

• To review the indications, efficacy, and safety of probiotics in immunosuppressed patient populations.
• To identify patient groups where probiotic use is supported by evidence.

Main Methods:

• This is an opinion statement based on a review of available evidence.
• The review focused on studies examining probiotic interventions in various immunosuppressed conditions.

Main Results:

• Strongest evidence supports probiotics for infection prophylaxis in liver transplant recipients and patients with liver cirrhosis.
• Efficacy is unproven and safety is a concern in other organ transplantations and bone marrow transplant patients.
• Data on efficacy are inconclusive and safety is a concern in critically ill patients; however, probiotics appear safe in HIV patients and post-major surgery patients.

Conclusions:

• Probiotic use in immunosuppressed patients requires careful consideration of the specific clinical context.
• Further research is needed to establish efficacy and safety in certain patient groups, particularly solid organ and bone marrow transplant recipients.