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World J Gastroenterol. Mar 14, 2013; 19(10): 1527-1540
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1527
Actual concept of "probiotics": Is it more functional to science or business?
Michele Caselli, Francesca Cassol, Girolamo Calò, John Holton, Giovanni Zuliani, Antonio Gasbarrini
Michele Caselli, School of Gastroenterology, University of Ferrara, I-44121 Ferrara, Italy
Francesca Cassol, Department of Gastroenterology, S Anna Hospital, I-44121 Ferrara, Italy
Girolamo Calò, Department of Experimental and Clinical Medicine, Section of Pharmacology, University of Ferrara, I-44121 Ferrara, Italy
John Holton, Department of Health and Social Science, University of Middlesex, London, NW4 4BT, United Kingdom
Giovanni Zuliani, Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatrics, University of Ferrara, I-44121 Ferrara, Italy
Antonio Gasbarrini, Division of Internal Medicine and Gastroenterology, Catholic University of Rome, I-00168 Rome, Italy
Author contributions: Caselli M and Cassol F conceived the study and drafted the article; Holton J revised the article and revised the microbiological aspects; Calò G contributed to acquisition and analysis of data; Zuliani G and Gasbarrini A revised the article and critically revised the clinical aspects.
Correspondence to: Francesca Cassol, MD, Department of Gastroenterology, S Anna Hospital, 44121 Ferrara, Italy.
Telephone: +39-348-4121382  Fax: +39-532-762096
Received: November 10, 2012
Revised: December 18, 2012
Accepted: January 11, 2013
Published online: March 14, 2013

It is our contention that the concept of a probiotic as a living bacterium providing unspecified health benefits is inhibiting the development and establishment of an evidence base for the growing field of pharmacobiotics. We believe this is due in part to the current regulatory framework, lack of a clear definition of a probiotic, the ease with which currently defined probiotics can be positioned in the market place, and the enormous profits earned for minimum investment in research. To avoid this, we believe the following two actions are mandatory: international guidelines by a forum of stakeholders made available to scientists and clinicians, patient organizations, and governments; public research funds made available to the scientific community for performing independent rigorous studies both at the preclinical and clinical levels.

Keywords: Probiotics, Market, Regulations, Guidelines, Metanalysis