Potential effects of probiotics on atherosclerosis

Gerrit A. Stuivenberg , Annabel Poon , Jeremy P. Burton , J. David Spence

Microbiome Research Reports ›› 2024, Vol. 4 ›› Issue (1) : 11

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Microbiome Research Reports ›› 2024, Vol. 4 ›› Issue (1) :11 DOI: 10.20517/mrr.2024.22
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Potential effects of probiotics on atherosclerosis

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Abstract

The rising global incidence of atherosclerosis highlights the inadequacies in our understanding of the pathophysiology and treatment of the disease. Increasing evidence outlines the importance of the intestinal microbiome in atherosclerosis, wherein gut-derived uremic toxins (GDUTs) may be of concern. Plasma levels of the GDUTs trimethylamine n-oxide (TMAO), p-cresyl sulfate, and indoxyl sulfate are associated with accelerated renal function decline and increased cardiovascular risk. Thus, reducing the amount of GDUTs in circulation is expected to benefit patients with atherosclerosis. Because some beneficial bacteria can clear GDUTs in vitro and in vivo, orally administered probiotics targeting the intestinal tract represent a promising way to bring about these changes. Atherosclerosis such, this perspective reviews the potential use of probiotics to treat atherosclerosis, particularly in patients with non-traditional risk factors and/or impaired renal function.

Keywords

Probiotics / atherosclerosis / uremic toxins / gut microbiota

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Gerrit A. Stuivenberg, Annabel Poon, Jeremy P. Burton, J. David Spence. Potential effects of probiotics on atherosclerosis. Microbiome Research Reports, 2024, 4(1): 11 DOI:10.20517/mrr.2024.22

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References

[1]

Bogiatzi C,Allen-Vercoe E.Metabolic products of the intestinal microbiome and extremes of atherosclerosis.Atherosclerosis2018;273:91-7

[2]

Spence JD,DiCicco M,Galil R.Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy.Stroke2002;33:2916-22

[3]

Jie Z,Zhong SL.The gut microbiome in atherosclerotic cardiovascular disease.Nat Commun2017;8:845 PMCID:PMC5635030

[4]

Trøseid M,Hov JR.Microbiota-dependent metabolite trimethylamine-N-oxide is associated with disease severity and survival of patients with chronic heart failure.J Intern Med2015;277:717-26

[5]

Bartolomaeus H,Yakoub M.Short-chain fatty acid propionate protects from hypertensive cardiovascular damage.Circulation2019;139:1407-21 PMCID:PMC6416008

[6]

Mitra S,Alhede M.In silico analyses of metagenomes from human atherosclerotic plaque samples.Microbiome2015;3:38 PMCID:PMC4559171

[7]

Korpela K,Vepsäläinen O.Probiotic supplementation restores normal microbiota composition and function in antibiotic-treated and in caesarean-born infants.Microbiome2018;6:182 PMCID:PMC6192119

[8]

Hemarajata P.Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation.Therap Adv Gastroenterol2013;6:39-51 PMCID:PMC3539293

[9]

Nguyen TTU,Kim W.Effects of probiotics, prebiotics, and synbiotics on uremic toxins, inflammation, and oxidative stress in hemodialysis patients: a systematic review and meta-analysis of randomized controlled trials.J Clin Med2021;10:4456 PMCID:PMC8509328

[10]

Stuivenberg GA,Akouris PP,Reid G.Probiotic bifidobacteria mitigate the deleterious effects of para-cresol in a drosophila melanogaster toxicity model.mSphere2022;7:e0044622 PMCID:PMC9769938

[11]

Din AU,Zhu Y,Gregersen H.Amelioration of TMAO through probiotics and its potential role in atherosclerosis.Appl Microbiol Biotechnol2019;103:9217-28

[12]

Spence JD.Resistant atherosclerosis: the need for monitoring of plaque burden.Stroke2017;48:1624-9

[13]

Baber U,Sartori S.Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults: the BioImage study.J Am Coll Cardiol2015;65:1065-74

[14]

Wang Z,Bennett BJ.Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.Nature2011;472:57-63 PMCID:PMC3086762

[15]

Koeth RA,Levison BS.Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis.Nat Med2013;19:576-85 PMCID:PMC3650111

[16]

Zhen J,He M.The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases.Front Endocrinol2023;14:1085041 PMCID:PMC9941174

[17]

Tang WH,Levison BS.Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk.N Engl J Med2013;368:1575-84 PMCID:PMC3701945

[18]

Zhu W,Org E.Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk.Cell2016;165:111-24 PMCID:PMC4862743

[19]

Tang WHW,Kennedy DJ.Gut microbiota-dependent trimethylamine N-oxide (TMAO) pathway contributes to both development of renal insufficiency and mortality risk in chronic kidney disease.Circ Res2015;116:448-55 PMCID:PMC4312512

[20]

Pignanelli M,Gloor G.Moderate renal impairment and toxic metabolites produced by the intestinal microbiome: dietary implications.J Ren Nutr2019;29:55-64

[21]

Olechnowicz-Tietz S,Paradowska A,Rysz J.The risk of atherosclerosis in patients with chronic kidney disease.Int Urol Nephrol2013;45:1605-12 PMCID:PMC3844144

[22]

Wang Z,Levison BS.Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women.Eur Heart J2019;40:583-94 PMCID:PMC6374688

[23]

Pathak P,Brown AL.Small molecule inhibition of gut microbial choline trimethylamine lyase activity alters host cholesterol and bile acid metabolism.Am J Physiol Heart Circ Physiol2020;318:H1474-86 PMCID:PMC7311702

[24]

Liu H,Hu X.Alterations in the gut microbiome and metabolism with coronary artery disease severity.Microbiome2019;7:68 PMCID:PMC6486680

[25]

Verhaar BJH,Nieuwdorp M.Gut microbiota in hypertension and atherosclerosis: a review.Nutrients2020;12:2982 PMCID:PMC7601560

[26]

Shen X,Sun Z.Gut microbiota and atherosclerosis-focusing on the plaque stability.Front Cardiovasc Med2021;8:668532 PMCID:PMC8368126

[27]

Plaza-Diaz J,Gil-Campos M.Mechanisms of action of probiotics.Adv Nutr2019;10:S49-66 PMCID:PMC6363529

[28]

Melamed ML,Shafi T.Retained organic solutes, patient characteristics and all-cause and cardiovascular mortality in hemodialysis: results from the retained organic solutes and clinical outcomes (ROSCO) investigators.BMC Nephrol2013;14:134 PMCID:PMC3698023

[29]

Cantero MA,Fernandes R.Trimethylamine N-oxide reduction is related to probiotic strain specificity: a systematic review.Nutr Res2022;104:29-35

[30]

Tang J,Tang L.Enterobacter aerogenes ZDY01 inhibits choline-induced atherosclerosis through CDCA-FXR-FGF15 axis.Food Funct2021;12:9932-46

[31]

Gryp T,Vaneechoutte M.p-Cresyl sulfate.Toxins2017;9:52 PMCID:PMC5331431

[32]

Kwiatkowska I,Mysliwiec M.Oxidative storm induced by tryptophan metabolites: missing link between atherosclerosis and chronic kidney disease.Oxid Med Cell Longev2020;2020:6656033 PMCID:PMC7787774

[33]

Ramezani A,Meijers B,Vanholder R.Role of the gut microbiome in uremia: a potential therapeutic target.Am J Kidney Dis2016;67:483-98 PMCID:PMC5408507

[34]

Meijers BK,Bammens B.p-Cresol and cardiovascular risk in mild-to-moderate kidney disease.Clin J Am Soc Nephrol2010;5:1182-9 PMCID:PMC2893077

[35]

Nakano T,Chen M.Uremic toxin indoxyl sulfate promotes proinflammatory macrophage activation via the interplay of OATP2B1 and Dll4-notch signaling.Circulation2019;139:78-96 PMCID:PMC6311723

[36]

Opdebeeck B,Azmi A.Indoxyl sulfate and p-cresyl sulfate promote vascular calcification and associate with glucose intolerance.J Am Soc Nephrol2019;30:751-66 PMCID:PMC6493976

[37]

Dobre M,Hostetter TH.Searching for uremic toxins.Clin J Am Soc Nephrol2013;8:322-7 PMCID:PMC3562857

[38]

Cosola C,di Bari I.An innovative synbiotic formulation decreases free serum indoxyl sulfate, small intestine permeability and ameliorates gastrointestinal symptoms in a randomized pilot trial in stage IIIb-IV CKD patients.Toxins2021;13:334 PMCID:PMC8147955

[39]

Guida B,Trio R.Effect of short-term synbiotic treatment on plasma p-cresol levels in patients with chronic renal failure: a randomized clinical trial.Nutr Metab Cardiovasc Dis2014;24:1043-9

[40]

Rossi M,Morrison M.Synbiotics easing renal failure by improving gut microbiology (SYNERGY): a randomized trial.Clin J Am Soc Nephrol2016;11:223-31 PMCID:PMC4741035

[41]

Natarajan R,Vyas U.Randomized controlled trial of strain-specific probiotic formulation (Renadyl) in dialysis patients.Biomed Res Int2014;2014:568571 PMCID:PMC4132402

[42]

de Faria Barros A,Nakao LS.Effects of probiotic supplementation on inflammatory biomarkers and uremic toxins in non-dialysis chronic kidney patients: a double-blind, randomized, placebo-controlled trial.J Funct Foods2018;46:378-83

[43]

Pavan M.Influence of prebiotic and probiotic supplementation on the progression of chronic kidney disease.Minerva Urol Nefrol2016;68:222-6

[44]

De Mauri A,Bagnati M.Probiotics-supplemented low-protein diet for microbiota modulation in patients with advanced chronic kidney disease (ProLowCKD): results from a placebo-controlled randomized trial.Nutrients2022;14:1637 PMCID:PMC9025298

[45]

Poesen R,de Loor H.The influence of prebiotic arabinoxylan oligosaccharides on microbiota derived uremic retention solutes in patients with chronic kidney disease: a randomized controlled trial.PLoS One2016;11:e0153893 PMCID:PMC4839737

[46]

Ranganathan N,Ranganathan P.Probiotic amelioration of azotemia in 5/6th nephrectomized Sprague-Dawley rats.ScientificWorldJournal2005;5:652-60 PMCID:PMC5936581

[47]

Nakabayashi I,Kawakami K.Effects of synbiotic treatment on serum level of p-cresol in haemodialysis patients: a preliminary study.Nephrol Dial Transplant2011;26:1094-8

[48]

Takayama F,Niwa T.Bifidobacterium in gastro-resistant seamless capsule reduces serum levels of indoxyl sulfate in patients on hemodialysis.Am J Kidney Dis2003;41:S142-5

[49]

Andrade-Oliveira V,Correa-Costa M.Gut bacteria products prevent AKI induced by ischemia-reperfusion.J Am Soc Nephrol2015;26:1877-88 PMCID:PMC4520159

[50]

Taki K,Niwa T.Beneficial effects of Bifidobacteria in a gastroresistant seamless capsule on hyperhomocysteinemia in hemodialysis patients.J Ren Nutr2005;15:77-80

[51]

Ando Y,Tanba K.[Effect of oral intake of an enteric capsule preparation containing Bifidobacterium longum on the progression of chronic renal failure].Nihon Jinzo Gakkai Shi2003;45:759-64

[52]

Iwashita Y,Yashiro M.Dietary changes involving Bifidobacterium longum and other nutrients delays chronic kidney disease progression.Am J Nephrol2018;47:325-32

[53]

Stuivenberg GA,Akouris PP.Supplementing yogurt with probiotic Bifidobacteria to counter chronic kidney disease.Fermentation2023;9:391

[54]

Yamaguchi J,Inagi R.Effect of AST-120 in chronic kidney disease treatment: still a controversy?.Nephron2017;135:201-6

[55]

Schulman G,Niwa T.AST-120 for the management of progression of chronic kidney disease.Int J Nephrol Renovasc Dis2014;7:49-56 PMCID:PMC3912158

[56]

Noda H,Irie F,Ohtaka E.Gender difference of association between LDL cholesterol concentrations and mortality from coronary heart disease amongst Japanese: the Ibaraki Prefectural Health Study.J Intern Med2010;267:576-87

[57]

Imamura T,Arima H.LDL cholesterol and the development of stroke subtypes and coronary heart disease in a general Japanese population: the Hisayama study.Stroke2009;40:382-8

[58]

Tanabe N, Iso H, Okada K, et al; Japan Arteriosclerosis Longitudinal Study Group. Serum total and non-high-density lipoprotein cholesterol and the risk prediction of cardiovascular events - the JALS-ECC -. Circ J 2010;74:1346-56.

[59]

Sugiyama D, Okamura T, Watanabe M, et al; NIPPON DATA 80/90 Research Group. Risk of hypercholesterolemia for cardiovascular disease and the population attributable fraction in a 24-year Japanese cohort study. J Atheroscler Thromb 2015;22:95-107.

[60]

Russo MW,Gu J.Spectrum of statin hepatotoxicity: experience of the drug-induced liver injury network.Hepatology2014;60:679-86 PMCID:PMC4110177

[61]

Libby P.The forgotten majority: unfinished business in cardiovascular risk reduction.J Am Coll Cardiol2005;46:1225-8

[62]

Parker BA,Grimaldi AS.Effect of statins on skeletal muscle function.Circulation2013;127:96-103 PMCID:PMC4450764

[63]

Michael DR,Moss JWE.The anti-cholesterolaemic effect of a consortium of probiotics: an acute study in C57BL/6J mice.Sci Rep2017;7:2883 PMCID:PMC5460276

[64]

Ivey KL,Kerr DA,Stojceski B.The effect of yoghurt and its probiotics on blood pressure and serum lipid profile; a randomised controlled trial.Nutr Metab Cardiovasc Dis2015;25:46-51

[65]

Yang M,Zong X.Preventive effect and molecular mechanism of Lactobacillus rhamnosus JL1 on food-borne obesity in mice.Nutrients2021;13:3989 PMCID:PMC8621931

[66]

Huang Y,Quan G,Yang L.Lactobacillus acidophilus ATCC 4356 prevents atherosclerosis via inhibition of intestinal cholesterol absorption in apolipoprotein E-knockout mice.Appl Environ Microbiol2014;80:7496-504 PMCID:PMC4249224

[67]

O'Morain VL,Williams JO.The Lab4P consortium of probiotics attenuates atherosclerosis in LDL receptor deficient mice fed a high fat diet and causes plaque stabilization by inhibiting inflammation and several pro-atherogenic processes.Mol Nutr Food Res2021;65:e2100214 PMCID:PMC9373067

[68]

Sun Y,Jiang Y.Aerobic exercise inhibits inflammatory response in atherosclerosis via Sestrin1 protein.Exp Gerontol2021;155:111581

[69]

Kwaifa IK,Yong YK.Endothelial dysfunction in obesity-induced inflammation: molecular mechanisms and clinical implications.Biomolecules2020;10:291 PMCID:PMC7072669

[70]

Ridker PM, Devalaraja M, Baeres FMM, et al; RESCUE Investigators. IL-6 inhibition with ziltivekimab in patients at high atherosclerotic risk (RESCUE): a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet 2021;397:2060-9.

[71]

Bhasin S, Gill TM, Reuben DB, et al; STRIDE Trial Investigators. A randomized trial of a multifactorial strategy to prevent serious fall injuries. N Engl J Med 2020;383:129-40. PMCID:PMC7421468

[72]

Fatkhullina AR,Koltsova EK.The role of cytokines in the development of atherosclerosis.Biochemistry2016;81:1358-70 PMCID:PMC5471837

[73]

Han SK.Lactobacillus mucosae and Bifidobacterium longum synergistically alleviate immobilization stress-induced anxiety/depression in mice by suppressing gut dysbiosis.J Microbiol Biotechnol2019;29:1369-74

[74]

Primec M,Di Gioia D.Clinical intervention using Bifidobacterium strains in celiac disease children reveals novel microbial modulators of TNF-α and short-chain fatty acids.Clin Nutr2019;38:1373-81

[75]

Rodríguez-Nogales A,Garrido-Mesa J.Differential intestinal anti-inflammatory effects of Lactobacillus fermentum and Lactobacillus salivarius in DSS mouse colitis: impact on microRNAs expression and microbiota composition.Mol Nutr Food Res2017;61:1700144

[76]

Wang Q,Wang J,Qi R.Lactobacillus plantarum 299v changes miRNA expression in the intestines of piglets and leads to downregulation of LITAF by regulating ssc-miR-450a.Probiotics Antimicro2021;13:1093-105

[77]

Rudzki L,Pawlak D.Probiotic Lactobacillus Plantarum 299v decreases kynurenine concentration and improves cognitive functions in patients with major depression: a double-blind, randomized, placebo controlled study.Psychoneuroendocrinology2019;100:213-22

[78]

Aker S,Reis P.Influence of interleukin-6 G-174C gene polymorphism on coronary artery disease, cardiovascular complications and mortality in dialysis patients.Nephrol Dial Transplant2009;24:2847-51

[79]

Han W,Zhang H.The association between sortilin and inflammation in patients with coronary heart disease.J Inflamm Res2020;13:71-9 PMCID:PMC7020934

[80]

Zaharuddin L,Muhammad Nawawi KN.A randomized double-blind placebo-controlled trial of probiotics in post-surgical colorectal cancer.BMC Gastroenterol2019;19:131 PMCID:PMC6657028

[81]

Pepys MB.C-reactive protein: a critical update.J Clin Invest2003;111:1805-12 PMCID:PMC161431

[82]

Peña E,Arderiu G,Badimon L.mCRP triggers angiogenesis by inducing F3 transcription and TF signalling in microvascular endothelial cells.Thromb Haemost2017;117:357-70

[83]

Li Y,Cheng G.Hs-CRP and all-cause, cardiovascular, and cancer mortality risk: a meta-analysis.Atherosclerosis2017;259:75-82

[84]

Akkasheh G,Tajabadi-Ebrahimi M.Clinical and metabolic response to probiotic administration in patients with major depressive disorder: a randomized, double-blind, placebo-controlled trial.Nutrition2016;32:315-20

[85]

Ostadmohammadi V,Bahmani F.Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome.J Ovarian Res2019;12:5 PMCID:PMC6340184

[86]

Moss JWE,Ramji DP.Nutraceuticals as therapeutic agents for atherosclerosis.Biochim Biophys Acta Mol Basis Dis2018;1864:1562-72 PMCID:PMC5906642

[87]

Ooi BK,Goh BH.The role of natural products in targeting cardiovascular diseases via Nrf2 pathway: novel molecular mechanisms and therapeutic approaches.Front Pharmacol2018;9:1308 PMCID:PMC6249275

[88]

Rezazadeh L,Jafarabadi MA.Effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome.Nutrition2019;62:162-8

[89]

Malik M,Tyagi S.Lactobacillus plantarum 299v supplementation improves vascular endothelial function and reduces inflammatory biomarkers in men with stable coronary artery disease.Circ Res2018;123:1091-102 PMCID:PMC6205737

[90]

Aboulgheit A,Zhang Z.Lactobacillus plantarum probiotic induces Nrf2-mediated antioxidant signaling and eNOS expression resulting in improvement of myocardial diastolic function.Am J Physiol Heart Circ Physiol2021;321:H839-49 PMCID:PMC8616611

[91]

Bian W,Yang Z.Downregulation of LncRNA NORAD promotes Ox-LDL-induced vascular endothelial cell injury and atherosclerosis.Aging2020;12:6385-400 PMCID:PMC7185106

[92]

Zhang N,Wu B.Deacetylation-dependent regulation of PARP1 by SIRT2 dictates ubiquitination of PARP1 in oxidative stress-induced vascular injury.Redox Biol2021;47:102141 PMCID:PMC8461381

[93]

Yan G,Feng C.Blue light emitting diodes irradiation causes cell death in colorectal cancer by inducing ROS production and DNA damage.Int J Biochem Cell Biol2018;103:81-8

[94]

Friques AG,Kalil IC.Chronic administration of the probiotic kefir improves the endothelial function in spontaneously hypertensive rats.J Transl Med2015;13:390 PMCID:PMC4696190

[95]

Lee JY.Probiotics alleviate oxidative stress in H2O2-exposed hepatocytes and t-BHP-induced C57BL/6 mice.Microorganisms2022;10:234 PMCID:PMC8877580

[96]

Herrington W,Sherliker P,Lewington S.Epidemiology of atherosclerosis and the potential to reduce the global burden of atherothrombotic disease.Circ Res2016;118:535-46

[97]

Bao MH,Zhou QL.Effects of miR-590 on oxLDL-induced endothelial cell apoptosis: roles of p53 and NF-κB.Mol Med Rep2016;13:867-73

[98]

Liu J,Pei W.Lipidomics reveals the dysregulated ceramide metabolism in oxidized low-density lipoprotein-induced macrophage-derived foam cell.Biomed Chromatogr2022;36:e5297

[99]

Lew LC,Jaafar MH.Lactobacilli modulated AMPK activity and prevented telomere shortening in ageing rats.Benef Microbes2019;10:883-92

[100]

Ge Q,Liu R.Antioxidant activity of Lactobacillus plantarum NJAU-01 in an animal model of aging.BMC Microbiol2021;21:182 PMCID:PMC8207596

[101]

Meephat S,Potue P,Pakdeechote P.Diosmetin ameliorates vascular dysfunction and remodeling by modulation of Nrf2/HO-1 and p-JNK/p-NF-κB expression in hypertensive rats.Antioxidants2021;10:1487 PMCID:PMC8469706

[102]

Lv D,Yan J,Luo S.Protective effect of sirtuin 3 on CLP-induced endothelial dysfunction of early sepsis by inhibiting NF-κB and NLRP3 signaling pathways.Inflammation2021;44:1782-92

[103]

Gresele P,Guglielmini G.Nitric oxide-enhancing or -releasing agents as antithrombotic drugs.Biochem Pharmacol2019;166:300-12

[104]

Toral M,Jiménez R.The probiotic Lactobacillus coryniformis CECT5711 reduces the vascular pro-oxidant and pro-inflammatory status in obese mice.Clin Sci2014;127:33-45

[105]

Cizkova D,Maloveska M,Kmet V.Cell-free Lactobacillus casei 21L10 modulates nitric oxide release and cell proliferation/cell death in lipopolysaccharide-challenged HT-29 cells.Inflammation2021;44:2419-28

[106]

Förstermann U,Pollock JS.Nitric oxide synthase isozymes. Characterization, purification, molecular cloning, and functions.Hypertension1994;23:1121-31

[107]

Toral M,Rodríguez-Nogales A.Lactobacillus fermentum improves tacrolimus-induced hypertension by restoring vascular redox state and improving eNOS coupling.Mol Nutr Food Res2018;62:e1800033

[108]

Szulińska M,Skrypnik K.Multispecies probiotic supplementation favorably affects vascular function and reduces arterial stiffness in obese postmenopausal women-A 12-week placebo-controlled and randomized clinical study.Nutrients2018;10:1672 PMCID:PMC6265939

[109]

Tripolt NJ,Blattl D.Short communication: effect of supplementation with Lactobacillus casei Shirota on insulin sensitivity, β-cell function, and markers of endothelial function and inflammation in subjects with metabolic syndrome--a pilot study.J Dairy Sci2013;96:89-95

[110]

Reid G,Köhler GA.Selecting, testing and understanding probiotic microorganisms.FEMS Immunol Med Microbiol2006;46:149-57

[111]

Stuivenberg G,Akouris P.In vitro assessment of histamine and lactate production by a multi-strain synbiotic.J Food Sci Technol2022;59:3419-27 PMCID:PMC9304488

[112]

Lahtinen SJ,Margolles A,Gueimonde M.Safety assessment of probiotics. In: Charalampopoulos D, Rastall RA, editors. Prebiotics and probiotics science and technology. New York: Springer; 2009. pp. 1193-235.

[113]

Sanders ME,Haller D.Safety assessment of probiotics for human use.Gut Microbes2010;1:164-85 PMCID:PMC3023597

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