Published online Aug 15, 2015. doi: 10.4291/wjgp.v6.i3.73
Peer-review started: March 12, 2015
First decision: April 13, 2015
Revised: April 23, 2015
Accepted: July 11, 2015
Article in press: July 14, 2015
Published online: August 15, 2015
Given the increasing commercial and clinical relevance of probiotics, improving their stress tolerance profile and ability to overcome the physiochemical defences of the host is an important biological goal. Herein, I review the current state of the art in the design of engineered probiotic cultures, with a specific focus on their utility as therapeutics for the developing world; from the treatment of chronic and acute enteric infections, and their associated diarrhoeal complexes, to targeting HIV and application as novel mucosal vaccine delivery vehicles.
Core tip: Genetically engineered probiotic bacteria, with improved in vivo stress survival and persistence, have the potential to enhance, and in some instances replace, conventional prophylactic and therapeutic measures. This is particularly relevant in the developing world, where chronic and acute infections, and their associated sequelae impose a significant clinical and economic burden.