{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:13:32Z","timestamp":1788783212203,"version":"build-2803163510"},"reference-count":78,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T00:00:00Z","timestamp":1745020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>COVID-19 presents a wide range of symptoms, including gastrointestinal manifestations such as diarrhea, nausea, and abdominal pain. Lactobacillus acidophilus has been proposed as a potential adjunct therapy to alleviate these symptoms due to its probiotic properties, which help restore gut microbiota balance and modulate immune responses. This review systematically analyzed studies assessing the effects of L. acidophilus in COVID-19 patients with gastrointestinal symptoms. The literature search was conducted through PubMed and the WHO COVID-19 database using keywords such as \u201cLactobacillus acidophilus\u201d, \u201cCOVID-19\u201d, \u201cgastrointestinal symptoms\u201d, and \u201cinflammation markers\u201d. The search covered studies published until February 2025. Inclusion criteria: observational and clinical trials with L. acidophilus for symptom relief. Exclusion: animal studies and non-ethical approvals. The findings suggest that L. acidophilus supplementation may contribute to faster resolution of diarrhea, improved gut microbiota balance, and reduced inflammatory markers. However, some studies have found no significant impact on hospitalization rates or disease progression. The probiotic\u2019s mechanisms of action appear to involve microbiota modulation, intestinal barrier reinforcement, and anti-inflammatory effects rather than direct viral inhibition in COVID-19 after progression. Some L. acidophilus strains show promise, and clinical validation should follow careful preclinical studies (in vitro, cell lines, and animal models), especially in vulnerable populations such as immunocompromised individuals. Understanding the gut\u2013lung axis and its role in immune response regulation, together with the need for a thorough characterization of the specific strains, including biochemical, genomic, and functional properties, before testing in humans, may provide deeper insights into the therapeutic potential of probiotics in viral infections.<\/jats:p>","DOI":"10.3390\/microorganisms13040944","type":"journal-article","created":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T21:58:46Z","timestamp":1745186326000},"page":"944","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Mystery of Certain Lactobacillus acidophilus Strains in the Treatment of Gastrointestinal Symptoms of COVID-19: A Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Bel\u00e9n","family":"Bertola","sequence":"first","affiliation":[{"name":"Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Cotol\u00ed-Crespo","sequence":"additional","affiliation":[{"name":"Faculty of Psychology and Speech Therapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"San Onofre","sequence":"additional","affiliation":[{"name":"NUTRALiSS Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou 156, 08018 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2846-1311","authenticated-orcid":false,"given":"Jose M.","family":"Soriano","sequence":"additional","affiliation":[{"name":"Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain"},{"name":"Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-de-las-Pe\u00f1as, C., Raveendran, A.V., Giordano, R., and Arendt-Nielsen, L. (2023). Long COVID or Post-COVID-19 Condition: Past, present and future research directions. Microorganisms, 11.","DOI":"10.3390\/microorganisms11122959"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.7861\/clinmedicine.4-2-152","article-title":"Severe acute respiratory syndrome (SARS): A review","volume":"4","author":"Vijayanand","year":"2004","journal-title":"Clin. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Mostafa, A., Kandeil, A., Shehata, M., El Shesheny, R., Samy, A.M., Kayali, G., and Ali, M.A. (2020). Middle East Respiratory Syndrome Coronavirus (MERS-CoV): State of the science. Microorganisms, 8.","DOI":"10.3390\/microorganisms8070991"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Coronaviridae Study Group of the International Committee on Taxonomy of Viruses (2020). The species Severe acute respiratory syndrome-related coronavirus: Classification of 2019-nCoV and designation SARS-CoV-2. Nat. Microbiol., 5, 536\u2013544.","DOI":"10.1038\/s41564-020-0695-z"},{"key":"ref_5","unstructured":"World Health Organization (2025, March 12). WHO Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19\u201311 March 2020. Available online: https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"577","DOI":"10.7326\/M20-0504","article-title":"The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application","volume":"172","author":"Lauer","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Boselli, P.M., and Soriano, J.M. (2023). COVID-19 in Italy: Is the mortality analysis a way to estimate how the epidemic lasts?. Biology, 12.","DOI":"10.3390\/biology12040584"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"102433","DOI":"10.1016\/j.jaut.2020.102433","article-title":"Epidemiology and pathogenesis of coronavirus disease (COVID-19)","volume":"109","author":"Rothan","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"431","DOI":"10.3390\/gastroent14040032","article-title":"SARS-CoV-2 Variant-Specific Gastrointestinal Symptoms of COVID-19: 2023 Update","volume":"14","author":"Slabakova","year":"2023","journal-title":"Gastroenterol. Insights"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vernia, F., Ashktorab, H., Cesaro, N., Monaco, S., Faenza, S., Sgamma, E., Viscido, A., and Latella, G. (2023). COVID-19 and Gastrointestinal Tract: From Pathophysiology to Clinical Manifestations. Medicina, 59.","DOI":"10.3390\/medicina59101709"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Rodrigues, R., and Costa de Oliveira, S. (2021). The Impact of Angiotensin-Converting Enzyme 2 (ACE2) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review. Microorganisms, 9.","DOI":"10.3390\/microorganisms9081692"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.tips.2004.04.001","article-title":"ACE2: From vasopeptidase to SARS virus receptor","volume":"25","author":"Turner","year":"2004","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ijid.2020.03.017","article-title":"Prevalence of comorbidities in Wuhan novel coronavirus (COVID-19) infection: A systematic review and meta-analysis","volume":"94","author":"Yang","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Infusino, F., Marazzato, M., Mancone, M., Fedele, F., Mastroianni, C.M., Severino, P., Ceccarelli, G., Santinelli, L., Cavarretta, E., and Marullo, A.G.M. (2020). Diet Supplementation, Probiotics, and Nutraceuticals in SARS-CoV-2 Infection: A Scoping Review. Nutrients, 12.","DOI":"10.3390\/nu12061718"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Serek, P., and Oleksy-Wawrzyniak, M. (2021). The Effect of Bacterial Infections, Probiotics and Zonulin on Intestinal Barrier Integrity. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222111359"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Jabczyk, M., Nowak, J., Hudzik, B., and Zubelewicz-Szkodzi\u0144ska, B. (2021). Diet, Probiotics and Their Impact on the Gut Microbiota during the COVID-19 Pandemic. Nutrients, 13.","DOI":"10.3390\/nu13093172"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"m1182","DOI":"10.1136\/bmj.m1182","article-title":"COVID-19: A remote assessment in primary care","volume":"368","author":"Greenhalgh","year":"2020","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"m606","DOI":"10.1136\/bmj.m606","article-title":"Clinical findings in patients infected with SARS-CoV-2 outside Wuhan, China: Retrospective case series","volume":"368","author":"Xu","year":"2020","journal-title":"BMJ"},{"key":"ref_20","first-page":"147","article-title":"Managing Coronavirus Disease 2019 (COVID-19): The Experience of Zhejiang","volume":"49","author":"Xu","year":"2020","journal-title":"J. Zhejiang Univ. (Med. Sci.)"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Wei, X.S., Wang, X., Niu, Y.R., Ye, L.L., Peng, W.B., Wang, Z.H., and Wang, X.R. (2025, March 12). Clinical Features of SARS-CoV-2 Infected Pneumonia with Diarrhea. SSRN 2020. Available online: https:\/\/ssrn.com\/abstract=3546120.","DOI":"10.2139\/ssrn.3546120"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1093\/cid\/ciaa478","article-title":"Guidelines from the Infectious Diseases Society of America on the Treatment and Management of Patients with COVID-19","volume":"78","author":"Bhimraj","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s12519-020-00356-2","article-title":"Clinical Features of Pediatric Patients with COVID-19: A Report of Two Family Cluster Cases","volume":"16","author":"Ji","year":"2020","journal-title":"World J. Pediatr."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Jarocki, P., Komo\u0144-Janczara, E., Glibowska, A., Dworniczak, M., Pytka, M., Korzeniowska-Kowal, A., Wzorek, A., and Kordowska-Wiater, M. (2020). Molecular Pathways for Specific Identification of the Lactobacillus Casei Group at the Species, Subspecies, and Strain Levels. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21082694"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"63","DOI":"10.15446\/rev.colomb.biote.v21n2.81576","article-title":"Review of Lactobacillus in the Food Industry and Their Culture Media","volume":"21","author":"Serna","year":"2019","journal-title":"Rev. Colomb. Biotecnol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Thorakkattu, P., Khanashyam, A.C., Shah, K., Babu, K.S., Mundanat, A.S., Deliephan, A., Deokar, G.S., Santivarangkna, C., and Nirmal, N.P. (2022). Postbiotics: Current Trends in Food and Pharmaceutical Industry. Foods, 11.","DOI":"10.3390\/foods11193094"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Raman, J., Kim, J.-S., Choi, K.R., Eun, H., Yang, D., Ko, Y.-J., and Kim, S.-J. (2022). Application of Lactic Acid Bacteria (LAB) in Sustainable Agriculture: Advantages and Limitations. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23147784"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Huang, R., Wu, F., Zhou, Q., Wei, W., Yue, J., Xiao, B., and Luo, Z. (2022). Lactobacillus and Intestinal Diseases: Mechanisms of Action and Clinical Applications. Microbiol. Res., 260.","DOI":"10.1016\/j.micres.2022.127019"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and PRISMA Group (2009). Preferred Reporting Elements for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.2427\/5768"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"65","DOI":"10.7326\/0003-4819-151-4-200908180-00136","article-title":"The PRISMA Statement for the Reporting of Systematic Reviews and Meta-Analyses of Studies Evaluating Health Care Interventions: Explanation and Elaboration","volume":"151","author":"Liberati","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_31","unstructured":"National Heart, Lung and Blood Institute (2025, March 12). Quality Assessment Tool for Case Series Studies, Available online: https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools."},{"key":"ref_32","unstructured":"ClinicalTrials.gov (2025, March 16). Monitoring the Efficacy of a Probiotic Dietary Supplement SmartProbio C in Patients with Severe COVID-19 Infection, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05474144."},{"key":"ref_33","unstructured":"ClinicalTrials.gov (2025, March 16). Synbiotic Therapy of Gastrointestinal Symptoms During COVID-19 Infection, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04420676."},{"key":"ref_34","first-page":"101063","article-title":"Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases","volume":"30","author":"Horowitz","year":"2020","journal-title":"Respir. Med. Case Rep."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Feng, Z., Wang, Y., and Qi, W. (2020). The small intestine, an underestimated site of SARS-CoV-2 infection: From Red Queen effect to probiotics. Preprints.","DOI":"10.20944\/preprints202003.0161.v1"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Saviano, A., Potenza, A., Siciliano, V., Petruzziello, C., Tarli, C., Migneco, A., Nasella, F., Franceschi, F., and Ojetti, V. (2022). COVID-19 Pneumonia and Gut Inflammation: The Role of a Mix of Three Probiotic Strains in Reducing Inflammatory Markers and Need for Oxygen Support. J. Clin. Med., 11.","DOI":"10.3390\/jcm11133758"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2018899","DOI":"10.1080\/19490976.2021.2018899","article-title":"Probiotic improves symptomatic and viral clearance in COVID-19 outpatients: A randomized, quadruple-blinded, placebo-controlled trial","volume":"14","author":"Abreu","year":"2022","journal-title":"Gut Microbes"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Horvath, A., Haller, R., Feldbacher, N., Habisch, H., \u017dukauskait\u0117, K., Madl, T., and Stadlbauer, V. (2024). Probiotic Therapy of Gastrointestinal Symptoms During COVID-19 Infection: A Randomized, Double-Blind, Placebo-Controlled, Remote Study. Nutrients, 16.","DOI":"10.3390\/nu16223970"},{"key":"ref_39","first-page":"901","article-title":"The effects of probiotic Lactobacillus acidophilus and colchicine on the control of symptoms, duration, and disease progression of mild and moderate cases of COVID-19: Randomized controlled clinical trial","volume":"5","author":"Hassan","year":"2024","journal-title":"Microbes Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.anaerobe.2013.09.011","article-title":"Antipathogenic activity of probiotics against Salmonella Typhimurium and Clostridium difficile in anaerobic batch culture systems: Is it due to synergies in probiotic mixtures or the specificity of single strains?","volume":"24","author":"Barlow","year":"2013","journal-title":"Anaerobe"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1128\/AEM.01651-08","article-title":"Effect of molecules secreted by Lactobacillus acidophilus strain La-5 on Escherichia coli O157: H7 colonization","volume":"75","author":"Griffiths","year":"2009","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s12602-018-9436-5","article-title":"Probiotics Lactobacillus acidophilus and Bacillus clausii modulate gut microbiota in Th1- and Th2-biased mice to ameliorate Salmonella typhimurium-induced diarrhea","volume":"11","author":"Pradhan","year":"2019","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Saez-Lara, M.J., Gomez-Llorente, C., Plaza-Diaz, J., and Gil, A. (2015). The role of probiotic lactic acid bacteria and Bifidobacteria in the prevention and treatment of inflammatory bowel disease and other related diseases: A systematic review of randomized human clinical trials. Biomed. Res. Int., 2015.","DOI":"10.1155\/2015\/505878"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Maftei, N.-M., Raileanu, C.R., Balta, A.A., Ambrose, L., Boev, M., Marin, D.B., and Lisa, E.L. (2024). The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties. Microorganisms, 12.","DOI":"10.3390\/microorganisms12020234"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Karimi, R., and Hosseinzadeh, D. (2024). Probiotics and Gastro-Intestinal Disorders: Augmentation, Enhancement, and Strengthening of Epithelial Lining. Probiotics, CRC Press.","DOI":"10.1201\/9781003452249-9"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"di Vito, R., Conte, C., and Traina, G. (2022). A multi-strain probiotic formulation improves intestinal barrier function by the modulation of tight and adherent junction proteins. Cells, 11.","DOI":"10.3390\/cells11162617"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1080\/10408398.2014.918533","article-title":"Adhesion of lactobacilli and their anti-infectivity potential","volume":"57","author":"Yadav","year":"2017","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Aleman, R.S., Moncada, M., and Aryana, K.J. (2023). Leaky Gut and the Ingredients That Help Treat It: A Review. Molecules, 28.","DOI":"10.3390\/molecules28020619"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Gou, H.Z., Zhang, Y.L., Ren, L.F., Li, Z.J., and Zhang, L. (2022). How do intestinal probiotics restore the intestinal barrier?. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.929346"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1039\/D1FO03360C","article-title":"Live Lactobacillus acidophilus alleviates ulcerative colitis via the SCFAs\/mitophagy\/NLRP3 inflammasome axis","volume":"13","author":"Li","year":"2022","journal-title":"Food Funct."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Gao, H., Li, X., Chen, X., Hai, D., Wei, C., Zhang, L., and Li, P. (2022). The functional roles of Lactobacillus acidophilus in different physiological and pathological processes. J. Microbiol. Biotechnol., 32.","DOI":"10.4014\/jmb.2205.05041"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Cristofori, F., Dargenio, V.N., Dargenio, C., Miniello, V.L., Barone, M., and Francavilla, R. (2021). Anti-inflammatory and immunomodulatory effects of probiotics in gut inflammation: A door to the body. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.578386"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ijfoodmicro.2006.10.007","article-title":"Immune enhancing effects of Lactobacillus acidophilus LAFTI L10 and Lactobacillus paracasei LAFTI L26 in mice","volume":"115","author":"Paturi","year":"2007","journal-title":"Int. J. Food Microbiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.biopha.2018.04.008","article-title":"IL-8 antagonist, CXCL8 (3-72) K11R\/G31P coupled with probiotic exhibit variably enhanced therapeutic potential in ameliorating ulcerative colitis","volume":"103","author":"Walana","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Kim, D.S., Park, Y., Choi, J.W., Park, S.H., Cho, M.L., and Kwok, S.K. (2021). Lactobacillus acidophilus supplementation exerts a synergistic effect on tacrolimus efficacy by modulating Th17\/Treg balance in lupus-prone mice via the SIGNR3 pathway. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.696074"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Ayesiga, I., Iqbal, S., Kyejjusa, Y., Okoboi, J., Omara, T., Adelina, T., and Kahwa, I. (2024). Key regulatory aspects of prebiotics, probiotics, and synbiotics in the management of metabolic disorders. Synbiotics in Metabolic Disorders, CRC Press.","DOI":"10.1201\/9781032702438-14"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Zhao, W., Liu, Y., Kwok, L.Y., Cai, T., and Zhang, W. (2020). The immune regulatory role of Lactobacillus acidophilus: An updated meta-analysis of randomized controlled trials. Food Biosci., 36.","DOI":"10.1016\/j.fbio.2020.100656"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Skonieczna-\u017bydecka, K., Marlicz, W., Misera, A., Koulaouzidis, A., and \u0141oniewski, I. (2018). Microbiome\u2014The Missing Link in the Gut-Brain Axis: Focus on Its Role in Gastrointestinal and Mental Health. J. Clin. Med., 7.","DOI":"10.20944\/preprints201810.0554.v1"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Montagnani, M., Bottalico, L., Potenza, M.A., Charitos, I.A., Topi, S., Colella, M., and Santacroce, L. (2023). The Crosstalk between Gut Microbiota and Nervous System: A Bidirectional Interaction between Microorganisms and Metabolome. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241210322"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Liwinski, T., Lang, U.E., Br\u00fchl, A.B., and Schneider, E. (2023). Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid in Stress and Depressive Disorders through the Gut\u2013Brain Axis. Biomedicines, 11.","DOI":"10.20944\/preprints202310.1508.v1"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1016\/j.clnu.2019.06.004","article-title":"Can psychobiotics \u201cmood\u201d ify gut? An updated systematic review of randomized controlled trials in healthy and clinical subjects, on anti-depressant effects of probiotics, prebiotics, and synbiotics","volume":"39","author":"Maleki","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"555","DOI":"10.2174\/1389201021666200107113812","article-title":"The effects of probiotics and prebiotics on mental disorders: A review on depression, anxiety, Alzheimer, and autism spectrum disorders","volume":"21","author":"Ansari","year":"2020","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Lopez-Santamarina, A., Lamas, A., del Carmen Mondrag\u00f3n, A., Cardelle-Cobas, A., Regal, P., Rodriguez-Avila, J.A., Miranda, J.M., Franco, C.M., and Cepeda, A. (2021). Probiotic Effects against Virus Infections: New Weapons for an Old War. Foods, 10.","DOI":"10.3390\/foods10010130"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Sarid, L., Zanditenas, E., Ye, J., Trebicz-Geffen, M., and Ankri, S. (2022). Insights into the mechanisms of Lactobacillus acidophilus activity against Entamoeba histolytica by using thiol redox proteomics. Antioxidants, 11.","DOI":"10.20944\/preprints202203.0201.v1"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Markowiak-Kope\u0107, P., and \u015ali\u017cewska, K. (2020). The effect of probiotics on the production of short-chain fatty acids by human intestinal microbiome. Nutrients, 12.","DOI":"10.3390\/nu12041107"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Siddiqui, A.J., Patel, M., Adnan, M., Jahan, S., Saxena, J., Alshahrani, M.M., Abdelgadir, A., Bardakci, F., Sachidanandan, M., and Badraoui, R. (2023). Bacteriocin-Nanoconjugates (Bac10307-AgNPs) Biosynthesized from Lactobacillus acidophilus-Derived Bacteriocins Exhibit Enhanced and Promising Biological Activities. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15020403"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Wei, Q., Song, L.Y., Rao, R., Yang, H.W., Wen, Y.P., Lv, L., and Wang, L. (2024). The impact of combined therapy with Lactobacillus acidophilus and montmorillonite powder on the inflammatory response in pediatric rotavirus enteritis. Int. Arch. Allergy Immunol., 1\u20137.","DOI":"10.1159\/000542593"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Steyer, A., Mi\u010deti\u0107-Turk, D., and Fijan, S. (2022). The Efficacy of Probiotics as Antiviral Agents for the Treatment of Rotavirus Gastrointestinal Infections in Children: An Updated Overview of Literature. Microorganisms, 10.","DOI":"10.3390\/microorganisms10122392"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jprot.2017.05.015","article-title":"Mucin- and carbohydrate-stimulated adhesion and subproteome changes of the probiotic bacterium Lactobacillus acidophilus NCFM","volume":"163","author":"Celebioglu","year":"2017","journal-title":"J. Proteomics"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Mei, L., Chen, Y., Wang, J., Lu, J., Zhao, J., Zhang, H., Wang, G., and Chen, W. (2022). Lactobacillus fermentum Stimulates Intestinal Secretion of Immunoglobulin A in an Individual-Specific Manner. Foods, 11.","DOI":"10.3390\/foods11091229"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"S\u0103s\u0103ran, M.O., M\u0103rginean, C.O., Adumitr\u0103chioaiei, H., and Meli\u021b, L.E. (2023). Pathogen-Specific Benefits of Probiotic and Synbiotic Use in Childhood Acute Gastroenteritis: An Updated Review of the Literature. Nutrients, 15.","DOI":"10.3390\/nu15030643"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Raheem, A., Liang, L., Zhang, G., and Cui, S. (2021). Modulatory effects of probiotics during pathogenic infections with emphasis on immune regulation. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.616713"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Mishra, V.N., Kumari, N., Pathak, A., Chaturvedi, R.K., Gupta, A.K., and Chaurasia, R.N. (2020). Possible Role for Bacteriophages in the Treatment of SARS-CoV-2 Infection. Int. J. Microbiol., 2020.","DOI":"10.1155\/2020\/8844963"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3390\/gastroent13010006","article-title":"Gastrointestinal Microbiota Dysbiosis Associated with SARS-CoV-2 Infection in Colorectal Cancer: The Implication of Probiotics","volume":"13","author":"Reddy","year":"2022","journal-title":"Gastroenterol. Insights"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"10715","DOI":"10.1007\/s11033-022-07700-x","article-title":"SARS-CoV-2 cell entry beyond the ACE2 receptor","volume":"49","author":"Alipoor","year":"2022","journal-title":"Mol. Biol. Rep."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Shahbazi, R., Yasavoli-Sharahi, H., Alsadi, N., Ismail, N., and Matar, C. (2020). Probiotics in Treatment of Viral Respiratory Infections and Neuroinflammatory Disorders. Molecules, 25.","DOI":"10.3390\/molecules25214891"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Kasti, A.N., Synodinou, K.D., Pyrousis, I.A., Nikolaki, M.D., and Triantafyllou, K.D. (2021). Probiotics Regulating Inflammation via NLRP3 Inflammasome Modulation: A Potential Therapeutic Approach for COVID-19. Microorganisms, 9.","DOI":"10.3390\/microorganisms9112376"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Synodinou, K.D., Nikolaki, M.D., Triantafyllou, K., and Kasti, A.N. (2022). Immunomodulatory Effects of Probiotics on COVID-19 Infection by Targeting the Gut\u2013Lung Axis Microbial Cross-Talk. Microorganisms, 10.","DOI":"10.3390\/microorganisms10091764"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/4\/944\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:18:05Z","timestamp":1760030285000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/4\/944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,19]]},"references-count":78,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["microorganisms13040944"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13040944","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,19]]}}}