Vitetta Luis, Coulson Samantha, Thomsen Michael, Nguyen Tony, Hall Sean
a Sydney Medical School , The University of Sydney , Sydney , New South Wales , Australia.
b Medlab Clinical Ltd , Sydney , New South Wales , Australia.
Gut Microbes. 2017 Jul 4;8(4):311-322. doi: 10.1080/19490976.2017.1279379. Epub 2017 Jan 12.
The existence of an implicit living microscopic world, composed primarily of bacteria, has been known for centuries. The exact mechanisms that govern the contribution of bacteria to human health and disease have only recently become the subject of intense research efforts. Within this very evident shift in paradigms, the rational design of probiotic formulations has led to the creation of an industry that seeks to progress the engineering of probiotic bacteria that produce metabolites that may enhance human host health and prevent disease. The promotion of probiotics is often made in the absence of quality scientific and clinically plausible data. The latest incursions into the probiotic market of claims have posited the amelioration of oxidative stress via potent antioxidant attributes or limiting the administration of probiotics to those species that do not produce D-Lactic acid (i.e., claims that D-Lactic acid acidosis is linked to chronic health conditions) or are strain-specific (shaping an industry point of difference) for appraising a therapeutic effect. Evidence-based research should guide clinical practice, as there is no place in science and medicine that supports unsubstantiated claims. Extravagant industry based notions continue to fuel the imprimatur of distrust and skepticism that is leveled by scientists and clinicians at an industry that is already rife with scientific and medical distrust and questionable views on probiotics. Ignoring scientifically discordant data, when sorting through research innovations and false leads relevant to the actions of probiotics, drives researcher discomfit and keeps the bar low, impeding the progress of knowledge. Biologically plausible posits are obligatory in any research effort; companies formulating probiotics often exhibit a lack of analytical understanding that then fuels questionable investigations failing to build on research capacity.
一个主要由细菌组成的隐性微观生命世界的存在已为人所知达数百年之久。然而,细菌对人类健康与疾病影响的确切机制直到最近才成为深入研究的课题。在这一明显的范式转变中,益生菌制剂的合理设计催生了一个产业,该产业致力于推进益生菌工程,使其产生可能增进人类宿主健康并预防疾病的代谢产物。益生菌的推广往往缺乏高质量的科学及临床可信数据。最近涌入益生菌市场的宣称包括通过强大的抗氧化特性改善氧化应激,或者将益生菌的使用局限于不产生D - 乳酸的菌株(即宣称D - 乳酸酸中毒与慢性健康状况有关),或者强调菌株特异性(塑造行业差异化卖点)以评估治疗效果。循证研究应指导临床实践,因为在科学和医学领域没有任何依据支持未经证实的宣称。基于行业的夸张观念持续助长了科学家和临床医生对该行业的不信任与怀疑,而这个行业本身就充斥着对益生菌的科学和医学不信任以及可疑观点。在筛选与益生菌作用相关的研究创新和错误线索时忽略科学上不一致的数据,会导致研究人员感到不安,并使标准降低,阻碍知识的进步。在任何研究工作中,生物学上合理的假设都是必不可少的;生产益生菌制剂的公司往往缺乏分析理解,这进而助长了有问题的研究,无法基于研究能力取得进展。