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How do probiotics and prebiotics work?

We invite you to read our series of articles on the microbiota and prebiotics (Part 2)

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How do probiotics and prebiotics work?
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How do probiotics and prebiotics work? post image

We invite you to read our series of articles on the microbiota and prebiotics (Part 2)

How do probiotics work?

Probiotics perform many functions simultaneously – some of these are felt by the patient almost immediately (e.g. relief from diarrhoea), whilst others work more subtly, regulating the immune system and metabolism. Recent research shows that probiotics:

  • affect the composition of the microbiota,
  • communicate with immune cells and the intestinal epithelium,
  • modulate the inflammatory response and the intestinal barrier.

The main mechanisms of action of probiotics:

  • Competition with pathogens
    • occupy sites of adhesion on the intestinal epithelium,
    • use up the available nutrients,
    • produce substances with antibacterial properties.
    • increased mucus production,
    • effect on tight junction proteins (claudins, occludin),
    • a reduction in the permeability of the intestinal barrier.
    : Strengthening the intestinal barrier
    • activation and regulation of dendritic cells,
    • effect on the Th1/Th2/Treg balance,
    • reduction of chronic inflammation.
    : Modulation of the immune system

Examples of probiotic microorganism strains used industrially with proven efficacy in clinical trials (source: Kordowska-Wiater, Małgorzata. “Probiotics – functional and technological aspects.” Advances in Microbiology 52, no. 2 (2013): 161–170.)

Species / StrainClinical application / proven efficacy
Lactobacillus acidophilusUlcerative colitis; treatment of bowel motility disorders.
L. acidophilus + L. bulgaricusReducing the risk of post-antibiotic diarrhoea.
L. acidophilus + B. longumReducing the risk of post-antibiotic diarrhoea.
L. acidophilus + B. bifidum + L. bulgaricus + S. thermophilusReducing the risk of traveller’s diarrhoea (preliminary results).
L. casei rhamnosus Lcr35Treatment of functional constipation.
L. casei DN-114 001To increase the eradication rate of H. pylori and reduce treatment-related side effects.
L. casei DN-114 001 + S. thermophilus + L. bulgaricusPrevention of post-antibiotic diarrhoea and C. difficile infections (in people aged over 50).
L. rhamnosus GGUlcerative colitis; reduction in atopic dermatitis symptoms; prevention of post-antibiotic diarrhoea; competition with pathogens; increased mucin secretion; moderate efficacy in community-acquired and hospital-acquired diarrhoea in children; reduction in C. difficile recurrences; fewer adverse effects in the treatment of H. pylori.
L. rhamnosus Pen + L. rhamnosus E/N + L. rhamnosus OxyPrevention of post-antibiotic diarrhoea.
L. rhamnosus 19070-2 + L. reuteri DSM 12246Treatment of acute infectious diarrhoea.
L. reuteriRotavirus diarrhoea; reducing the duration of diarrhoea in children.
L. bulgaricusThe production of bacteriocins; the breakdown of lactose in yoghurt – a benefit for those with lactose intolerance.
L. plantarum 299vAdhesion to the epithelium, increased mucin secretion; reduced recurrence of C. difficile.
L. plantarum DSM 9843Treatment of bowel motility disorders.
L. lactis DN-173 010Treatment of functional constipation.
Bifidobacterium animalisShortening of the intestinal tract (in older people).
B. lactis Bb-12 (+ Streptococcus thermophilus)Relief of atopic dermatitis symptoms; prevention of post-antibiotic and rotavirus diarrhoea in children.
Escherichia coli Nissle 1917Ulcerative colitis; remission of Crohn’s disease; treatment of defecation disorders.
Saccharomyces boulardiiAcute and post-antibiotic diarrhoea; neutralisation of C. difficile toxins; remission of Crohn’s disease; reduction of side effects associated with H. pylori treatment; traveller’s diarrhoea.

How do prebiotics work?

To understand how prebiotics work, we need to view the gut as a living ecosystem. For bacteria to grow, they need the right nutrients. Prebiotics act as a targeted fertiliser – they support only the strains we want to cultivate and help them multiply rapidly.

Unlike probiotics, which we add like building blocks, prebiotics strengthen the foundations of the entire microbial ecosystem.

The main effects of prebiotics:

  • selective stimulation of ‘good’ bacteria (e.g. Bifidobacterium, Lactobacillus),
  • increased production of SCFAs (including butyrate),
  • strengthening the intestinal barrier (tighter connections between cells),
  • regulation of bowel motility (including relief from constipation),
  • modulation of the immune system (reduced susceptibility to chronic inflammation),
  • metabolic effects (blood glucose levels, lipid profile, insulin resistance).

What the research shows:

  • FOS, GOS and inulin increase the abundance of Bifidobacterium and Lactobacillus (Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995 Jun;125(6):1401-12. doi: 10.1093/jn/125.6.1401. PMID: 7782892, Markowiak P, Śliżewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients. 15 September 2017;9(9):1021. doi: 10.3390/nu9091021. PMID: 28914794; PMCID: PMC5622781.).
  • In Crohn’s disease and other IBDs, certain prebiotics reduce inflammation and improve gut comfort (Lindsay JO, Whelan K, Stagg AJ, Gobin P, Al-Hassi HO, Rayment N, Kamm MA, Knight SC, Forbes A. Clinical, microbiological, and immunological effects of fructo-oligosaccharide in patients with Crohn’s disease. Gut. 2006 Mar;55(3):348-55. doi: 10.1136/gut.2005.074971. Epub 2005 Sep 14. PMID: 16162680; PMCID: PMC1856087.),
  • Inulin helps to increase calcium absorption (Bovee-Oudenhoven IM, Termont DS, Heidt PJ, Van der Meer R. Increasing the intestinal resistance of rats to the invasive pathogen Salmonella enteritidis: additive effects of dietary lactulose and calcium. Gut. 1997 Apr;40(4):497-504. doi: 10.1136/gut.40.4.497. PMID: 9176078; PMCID: PMC1027125.),
  • Prebiotic polysaccharides (e.g. arabinoxylans) improve glycaemic control in people with type 2 diabetes (Lu ZX, Walker KZ, Muir JG, O'Dea K. Arabinoxylan fibre improves metabolic control in people with Type II diabetes. Eur J Clin Nutr. 2004 Apr;58(4):621-8. doi: 10.1038/sj.ejcn.1601857. PMID: 15042130.).

Read now or save for later:

Part 1: Why is the gut microbiota so important?: https://novolabs.pl/artykul/dlaczego-mikrobiota-jelitowa-ma-takie-znaczenie/

Part 2: How probiotics and prebiotics work: https://novolabs.pl/artykul/jak-dzialaja-probiotyki-i-prebiotyki/

Part 3: Why does combining a prebiotic and a probiotic (a synbiotic) produce the best results?: https://novolabs.pl/artykul/dlaczego-synbiotyk-dziala-najskuteczniej-i-dla-kogo/

Part 4: Frequently asked questions about prebiotics and probiotics: https://novolabs.pl/artykul/najczesciej-zadawane-pytania-o-prebiotyki-i-probiotyki/

Part 5: MegaPre™: a precisely targeted prebiotic https://novolabs.pl/artykul/megapre-precyzyjnie-ukierunkowany-prebiotyk/

Part 6: For experts: MegaPre™ in clinical practice https://novolabs.pl/artykul/dla-ekspertow-megapre-w-praktyce-klinicznej/