Harnessing Probiotics to Combat Candidiasis: Mechanisms, Evidence, and Future Directions

Area of Science:

• Microbiology
• Immunology
• Pharmacology

Background:

• Candida species are opportunistic human pathogens causing candidiasis, particularly in vulnerable populations.
• Disruption of host-microbe homeostasis facilitates Candida's transition from commensal to pathogen.
• Candida's adherence, biofilm formation, and invasion capabilities contribute to its pathogenicity.

Purpose of the Study:

• To review the antifungal activity of common probiotic genera against Candida.
• To explore the mechanisms of action employed by probiotics against Candida infections.
• To assess the evidence supporting probiotic efficacy in managing candidiasis.

Main Methods:

• Systematic review of studies and clinical trials on probiotic antifungal activity.
• Analysis of research methodologies to evaluate evidence robustness.
• Examination of probiotic genera including Lactobacillus, Bacillus, Bifidobacterium, and Saccharomyces.

Main Results:

• Selected probiotic strains and formulations significantly decrease Candida colonization.
• Probiotics reduce the prevalence of candidiasis symptoms across various body sites.
• Anti-Candida effects and clinical improvements are observed, though outcomes vary by strain and target site.

Conclusions:

• Probiotics exhibit prominent anti-Candida effects through mechanisms like competitive exclusion and metabolite secretion.
• Specific probiotic species and their secreted substances can promote clinical improvements in candidiasis.
• Future research should explore prebiotics, postbiotics, and synbiotics to enhance probiotic efficacy.