Chapter 29 : The Road Ahead: a Look at the Future

Abstract:

Probiotics may be useful as part of a multipronged strategy to confront malnutrition in the developing world and may be combined with prebiotics, micronutrients, and other foods in global health programs. Future descriptions of probiotics are likely to describe entirely novel classes of microbes as fundamental discoveries are made in the international microbiome project. Beneficial effects of probiotics include the provision of key nutrients for the intestinal mucosa, regulation of cell proliferation and differentiation, and immunomodulation. While probiotics have been studied for the prevention of infections and the suppression of inflammation, new applications and refinements of existing strategies will be based on the science of systems biology. Next-generation probiotics may be selected or engineered to contain such bioconversion features as part of solutions in preventative medicine and therapeutics. Exciting new developments in the understanding of probiotics and the regulation of mucosal immunity are pointing to new directions with respect to selection and engineering of beneficial microbes. Probiotics may also suppress immunity in disorders of chronic inflammation, and such effects may reflect the activation of different immune signaling pathways requiring different types of probiotics for disease amelioration. Advances in comparative and functional genomics are creating new opportunities for rational engineering of different probiotic species. A more detailed understanding is emerging regarding the respective roles of different indigenous and symbiotic microbes in the gastrointestinal tract. Comparative genomics of symbiotic bacterial species has highlighted molecular evolution and its role in niche and habitat adaptation of Bacteroidetes in the distal human intestine.