PROBIOTIC INTERVENTIONS IN GASTROINTESTINAL PHYSIOLOGY AND PATHOPHYSIOLOGY: A SYSTEMATIC REVIEW OF MODERN THERAPEUTIC FRAMEWORKS AND FUTURE INNOVATIONS

Aleksandra Potempa; Liwia Prorok; Aleksandra Oszczypała; Michał  Petkow; Katarzyna Lipska; Monika Szyszkowska; Zuzanna Strojek; Aleksandra Ustaszewska; Zofia Parol; Mateusz Żyła

doi:10.31435/ijitss.2(50).2026.5769

Authors

Aleksandra Potempa Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0004-2698-4957
Liwia Prorok Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0008-3762-514X
Aleksandra Oszczypała Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0006-5809-3934
Michał Petkow Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0008-3398-9069
Katarzyna Lipska Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0003-5670-7726
Monika Szyszkowska Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0006-5367-0026
Zuzanna Strojek Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0005-8857-5670
Aleksandra Ustaszewska Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0001-5651-5906
Zofia Parol Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0007-0885-2637
Mateusz Żyła Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland https://orcid.org/0009-0003-9005-620X

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5769

Keywords:

Probiotics, Next-Generation Probiotics, Akkermansia muciniphila, Gastrointestinal Physiology, Inflammatory Bowel Disease, Ulcerative Colitis, Crohn's Disease, Irritable Bowel Syndrome, Antibiotic-Associated Diarrhea, Epithelial Barrier, Immunomodulation, Metabolomics, Genetically Engineered Microbes, Multi-omics

Abstract

The human gastrointestinal tract is a vast and dynamic system where interactions between host cells and microbial populations regulate the condition of systemic health. Probiotics, defined as live microorganisms that administered in sufficient amounts provide a health benefit to the host, have progressed from conventional dietary supplements to advanced biotherapeutic treatments. This systematic review presents a comprehensive analysis of the physiological and pathophysiological roles of probiotics focusing on developments between 2013 and 2026. Probiotics enhance the intestinal barrier by modulating tight junction proteins, competitively excluding enteric pathogens and orchestrating immune responses via dendritic cell and regulatory T-cell pathways. Clinical data collected from recent umbrella meta-analyses shows considerable effectiveness at reducing the risk of antibiotic-associated diarrhea, managing symptoms of irritable bowel syndrome in a strain specific manner and leading to remission in ulcerative colitis. This review addresses the increase in usage of next-generation probiotics, such as Akkermansia muciniphila, and the role of genetically engineered bacteria in the targeted delivery of anti-inflammatory agents and reactive oxygen species scavengers. Additionally, the transition toward personalized medicine is discussed through the combination of multi-omics and artificial intelligence allowing to predict probiotic responsiveness in individuals. Despite recent progress, the field faces serious challenges in terms of harmonizing regulations and standardizing safety measures in vulnerable populations. This review aims to summarize current knowledge on probiotic interventions while identifying the critical knowledge gaps that need to be addressed in order to advance the next era of precision microbiome-based therapies.

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