{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:35:17Z","timestamp":1790883317984,"version":"4.1.0"},"reference-count":63,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University\u2013Industry Cooperation Fund, National Taiwan Sport University","award":["1121062"],"award-info":[{"award-number":["1121062"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: As individuals age, there is a gradual loss of muscle mass and strength, which not only impairs physical functionality but also heightens the risk of falls and diminishes independence among older adults. Probiotics have emerged as a focus of recent research due to their potential role in enhancing muscle health via the gut\u2013muscle axis. This study evaluates the effects of live and heat-treated Lacticaseibacillus paracasei PS23 (PS23) supplementation on muscle strength and mass in the elderly. Methods: This study recruited 119 participants, aged 65\u201385 years, and randomly assigned them to receive a placebo (0 \u00d7 1010 CFU\/day), L-PS23 (live PS23, 2 \u00d7 1010 CFU\/day), or HT-PS23 (heat-treated PS23, 2 \u00d7 1010 cells\/day) for a duration of 12 weeks. Assessments of blood pressure, body composition, muscle strength, functional physical fitness, and biochemical parameters were conducted at baseline, 6 weeks, and 12 weeks. Results: Among the 100 subjects who completed the trial, supplementation with both L-PS23 and HT-PS23 significantly enhanced lower limb muscle strength and endurance compared to the placebo (p &lt; 0.05), although no significant differences were observed in muscle mass or upper limb muscle strength across the groups. Additionally, while most muscle anabolism-related markers showed no significant changes, both supplements effectively decreased inflammatory markers related to aging\u2014C-reactive protein (CRP: L-PS23, p = 0.016; HT-PS23, p = 0.013) and interleukin-6 (IL-6: L-PS23, p = 0.003; HT-PS23, p &lt; 0.001)\u2014and increased interleukin-10 levels (L-PS23, p = 0.014; HT-PS23, p = 0.005). Notably, only the HT-PS23 group demonstrated a significant increase in testosterone levels (p = 0.029). Conclusions: 12 weeks of supplementation with L-PS23 and HT-PS23 improved lower limb muscle strength and endurance but did not significantly enhance muscle mass in older adults. Both supplements also proved effective in reducing inflammatory markers and elevating testosterone levels. HT-PS23, administered as a heat-treated probiotic, provided more pronounced benefits to the elderly compared with its probiotic counterpart, L-PS23.<\/jats:p>","DOI":"10.3390\/nu17030463","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:38:49Z","timestamp":1737977929000},"page":"463","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Enhancement of Lower Limb Muscle Strength and Reduction of Inflammation in the Elderly: A Randomized, Double-Blind Clinical Trial Comparing Lacticaseibacillus paracasei PS23 Probiotic with Heat-Treated Supplementation"],"prefix":"10.3390","volume":"17","author":[{"given":"Mon-Chien","family":"Lee","sequence":"first","affiliation":[{"name":"Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan"},{"name":"Center for General Education, Taipei Medical University, Taipei 110301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ju","family":"Hsu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Jen","family":"Yang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan"},{"name":"Department of General Medicine, Min-Sheng General Hospital, Taoyuan City 330, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1446-6787","authenticated-orcid":false,"given":"Chi-Chang","family":"Huang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11005\/jbm.2024.31.1.1","article-title":"Sarcopenia as the Mobility Phenotype of Aging: Clinical Implications","volume":"31","author":"Ji","year":"2024","journal-title":"J. Bone Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.1532-5415.2000.tb04719.x","article-title":"Epidemiology of sarcopenia","volume":"48","author":"Melton","year":"2000","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S2213-8587(14)70034-8","article-title":"Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases","volume":"2","author":"Kalyani","year":"2014","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e16323","DOI":"10.1016\/j.heliyon.2023.e16323","article-title":"Can artificial intelligence simplify the screening of muscle mass loss?","volume":"9","author":"Buccheri","year":"2023","journal-title":"Heliyon"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1007\/s00421-003-0991-3","article-title":"Muscle strength, power and adaptations to resistance training in older people","volume":"91","author":"Macaluso","year":"2004","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Prokopidis, K., Chambers, E., Lochlainn, M.N., and Witard, O.C. (2021). Mechanisms Linking the Gut-Muscle Axis With Muscle Protein Metabolism and Anabolic Resistance: Implications for Older Adults at Risk of Sarcopenia. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.770455"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.exger.2016.01.008","article-title":"Muscle function and fat content in relation to sarcopenia, obesity and frailty of old age\u2014An overview","volume":"76","author":"Buch","year":"2016","journal-title":"Exp. Gerontol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1163.e1","DOI":"10.1016\/j.jamda.2016.09.010","article-title":"Frailty and prediction of negative health outcomes: A meta-analysis","volume":"17","author":"Vermeiren","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2912539","DOI":"10.1155\/2018\/2912539","article-title":"The Microbiota and Immune System Crosstalk in Health and Disease","volume":"2018","author":"Cianci","year":"2018","journal-title":"Mediat. Inflamm."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Weyh, C., Kr\u00fcger, K., and Strasser, B. (2020). Physical Activity and Diet Shape the Immune System during Aging. Nutrients, 12.","DOI":"10.3390\/nu12030622"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.18632\/aging.101262","article-title":"Aging and sarcopenia associate with specific interactions between gut microbes, serum biomarkers and host physiology in rats","volume":"9","author":"Siddharth","year":"2017","journal-title":"Aging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1080\/10408398.2016.1211086","article-title":"Diet, the intestinal microbiota, and immune health in aging","volume":"58","author":"Clements","year":"2018","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e13105","DOI":"10.1111\/acel.13105","article-title":"Physical fitness in community-dwelling older adults is linked to dietary intake, gut microbiota, and metabolomic signatures","volume":"19","author":"Khakimov","year":"2020","journal-title":"Aging Cell"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"105063","DOI":"10.1016\/j.archger.2023.105063","article-title":"Relationships between sarcopenia, nutrient intake, and gut microbiota in Chinese community-dwelling older women","volume":"113","author":"Yan","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"7026198","DOI":"10.1155\/2018\/7026198","article-title":"Gut Dysbiosis and Muscle Aging: Searching for Novel Targets against Sarcopenia","volume":"2018","author":"Picca","year":"2018","journal-title":"Mediat. Inflamm."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Liao, X., Wu, M., Hao, Y., and Deng, H. (2020). Exploring the Preventive Effect and Mechanism of Senile Sarcopenia Based on \u201cGut-Muscle Axis\u201d. Front. Bioeng. Biotechnol., 8.","DOI":"10.3389\/fbioe.2020.590869"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.tifs.2023.06.013","article-title":"Targeting gut microbiota and metabolism as the major probiotic mechanism-An evidence-based review","volume":"138","author":"Ma","year":"2023","journal-title":"Trends Food Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Sugimura, Y., Kanda, A., Sawada, K., Wai, K.M., Tanabu, A., Ozato, N., Midorikawa, T., Hisada, T., Nakaji, S., and Ihara, K. (2022). Association between Gut Microbiota and Body Composition in Japanese General Population: A Focus on Gut Microbiota and Skeletal Muscle. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19127464"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4975","DOI":"10.1002\/fsn3.3515","article-title":"A meta-analysis of the effect of probiotic administration on age-related sarcopenia","volume":"11","author":"Navab","year":"2023","journal-title":"Food Sci. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E7554","DOI":"10.1073\/pnas.1607235113","article-title":"Gut microbiota induce IGF-1 and promote bone formation and growth","volume":"113","author":"Yan","year":"2016","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Zhang, L., Zhang, R., and Li, L. (2023). Effects of Probiotic Supplementation on Exercise and the Underlying Mechanisms. Foods, 12.","DOI":"10.3390\/foods12091787"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4161\/gmic.23283","article-title":"New insights into probiotic mechanisms: A harvest from functional and metagenomic studies","volume":"4","author":"Bienenstock","year":"2013","journal-title":"Gut Microbes"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1038\/s41575-021-00440-6","article-title":"The International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of postbiotics","volume":"18","author":"Salminen","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Teame, T., Wang, A., Xie, M., Zhang, Z., Yang, Y., Ding, Q., Gao, C., Olsen, R.E., Ran, C., and Zhou, Z. (2020). Paraprobiotics and Postbiotics of Probiotic Lactobacilli, Their Positive Effects on the Host and Action Mechanisms: A Review. Front. Nutr., 7.","DOI":"10.3389\/fnut.2020.570344"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"756","DOI":"10.18632\/aging.101782","article-title":"Lactobacillus paracasei PS23 decelerated age-related muscle loss by ensuring mitochondrial function in SAMP8 mice","volume":"11","author":"Chen","year":"2019","journal-title":"Aging"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"104651","DOI":"10.1016\/j.jff.2021.104651","article-title":"Lactobacillus paracasei PS23 dietary supplementation alleviates muscle aging via ghrelin stimulation in d-galactose-induced aging mice","volume":"85","author":"Cheng","year":"2021","journal-title":"J. Funct. Foods"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Rondanelli, M., Gasparri, C., Barrile, G.C., Battaglia, S., Cavioni, A., Giusti, R., Mansueto, F., Moroni, A., Nannipieri, F., and Patelli, Z. (2022). Effectiveness of a Novel Food Composed of Leucine, Omega-3 Fatty Acids and Probiotic Lactobacillus paracasei PS23 for the Treatment of Sarcopenia in Elderly Subjects: A 2-Month Randomized Double-Blind Placebo-Controlled Trial. Nutrients, 14.","DOI":"10.3390\/nu14214566"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lee, M.C., Ho, C.S., Hsu, Y.J., and Huang, C.C. (2022). Live and Heat-Killed Probiotic Lactobacillus paracasei PS23 Accelerated the Improvement and Recovery of Strength and Damage Biomarkers after Exercise-Induced Muscle Damage. Nutrients, 14.","DOI":"10.3390\/nu14214563"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lee, M.C., Hsu, Y.J., Ho, C.S., Tsai, Y.S., Chen, C.C., and Huang, C.C. (2024). Supplementation with Lactiplantibacillus brevis GKEX Combined with Resistance Exercise Training Improves Muscle Mass, Strength Performance, and Body Fat Condition in Healthy Humans. Foods, 13.","DOI":"10.3390\/foods13071030"},{"key":"ref_32","unstructured":"Sports Administration (2020, May 23). Fitness Guide 2020. Available online: https:\/\/www.fitness.org.tw\/direct01.php."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Lee, M.C., Tu, Y.T., Lee, C.C., Tsai, S.C., Hsu, H.Y., Tsai, T.Y., Liu, T.H., Young, S.L., Lin, J.S., and Huang, C.C. (2021). Lactobacillus plantarum TWK10 Improves Muscle Mass and Functional Performance in Frail Older Adults: A Randomized, Double-Blind Clinical Trial. Microorganisms, 9.","DOI":"10.3390\/microorganisms9071466"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Li, F., Chang, C.H., Ho, C.A., Wu, C.Y., Yeh, H.C., Chan, Y.S., Cheng, J.Y., ChangChien, W.S., and Ho, C.S. (2022). The Determination of Step Frequency in 3-min Incremental Step-in-Place Tests for Predicting Maximal Oxygen Uptake from Heart Rate Response in Taiwanese Adults. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010563"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"161","DOI":"10.33594\/000000628","article-title":"Role of Nutritional Supplements on Gut-Muscle Axis Across Age: A Mini-Review","volume":"57","author":"Nucci","year":"2023","journal-title":"Cell Physiol. Biochem."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1002\/jcsm.13132","article-title":"Impact of probiotics on muscle mass, muscle strength and lean mass: A systematic review and meta-analysis of randomized controlled trials","volume":"14","author":"Prokopidis","year":"2023","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Handajani, Y.S., Turana, Y., Hengky, A., Hamid, G., Schroeder-Butterfill, E., and Kristian, K. (2024). Probiotics supplementation or probiotic-fortified products on sarcopenic indices in older adults: Systematic review and meta-analysis from recent randomized controlled trials. Front. Aging, 5.","DOI":"10.3389\/fragi.2024.1307762"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e012951","DOI":"10.1136\/bmjopen-2016-012951","article-title":"Physical activity as intervention for age-related loss of muscle mass and function: Protocol for a randomised controlled trial (the LISA study)","volume":"6","author":"Eriksen","year":"2016","journal-title":"BMJ Open"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Sorkin, B.C., Murch, S.J., Weaver, C.M., and Jafari, M. (2022). Editorial: Plant Foods and Dietary Supplements: Building Solid Foundations for Clinical Trials. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.881688"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bullo, V., Roma, E., Gobbo, S., Duregon, F., Bergamo, M., Bianchini, G., Doria, E., Cugusi, L., Blasio, A.D., and Bocalini, D.S. (2020). Lower Limb Strength Profile in Elderly with Different Pathologies: Comparisons with Healthy Subjects. Geriatrics, 5.","DOI":"10.3390\/geriatrics5040083"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1007\/s11357-023-00750-4","article-title":"Sex differences in skeletal muscle-aging trajectory: Same processes, but with a different ranking","volume":"45","author":"Attema","year":"2023","journal-title":"Geroscience"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1093\/gerona\/glq012","article-title":"Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults","volume":"65","author":"Clark","year":"2010","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/gerona\/60.2.148","article-title":"Differences in size, strength, and power of upper and lower body muscle groups in young and older men","volume":"60","author":"Candow","year":"2005","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Zhang, L., Quan, M., and Cao, Z.B. (2019). Effect of vitamin D supplementation on upper and lower limb muscle strength and muscle power in athletes: A meta-analysis. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0215826"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.archger.2008.12.002","article-title":"An explanatory mechanism for the different decline in limb strength in older women","volume":"49","author":"Ferrreira","year":"2009","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/jcp.10227","article-title":"Role of insulin-like growth factor binding protein-3 (IGFBP-3) in the differentiation of primary human adult skeletal myoblasts","volume":"195","author":"Foulstone","year":"2003","journal-title":"J. Cell Physiol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ahmad, S.S., Ahmad, K., Lee, E.J., Lee, Y.H., and Choi, I. (2020). Implications of Insulin-Like Growth Factor-1 in Skeletal Muscle and Various Diseases. Cells, 9.","DOI":"10.3390\/cells9081773"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1210\/er.2001-0033","article-title":"Cellular actions of the insulin-like growth factor binding proteins","volume":"23","author":"Firth","year":"2002","journal-title":"Endocr. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"101245","DOI":"10.1016\/j.molmet.2021.101245","article-title":"Insulin-like growth factors: Ligands, binding proteins, and receptors","volume":"52","author":"LeRoith","year":"2021","journal-title":"Mol. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Valadez-Bustos, N., Escamilla-Silva, E.M., Garc\u00eda-V\u00e1zquez, F.J., Gallegos-Corona, M.A., Amaya-Llano, S.L., and Ramos-G\u00f3mez, M. (2019). Oral Administration of Microencapsulated B. Longum BAA-999 and Lycopene Modulates IGF-1\/IGF-1R\/IGFBP3 Protein Expressions in a Colorectal Murine Model. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20174275"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/j.1469-7793.2000.t01-1-00203.x","article-title":"Oxidative capacity and ageing in human muscle","volume":"526","author":"Conley","year":"2000","journal-title":"J. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Antu\u00f1a, E., Cach\u00e1n-Vega, C., Bermejo-Millo, J.C., Potes, Y., Caballero, B., Vega-Naredo, I., Coto-Montes, A., and Garcia-Gonzalez, C. (2022). Inflammaging: Implications in Sarcopenia. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232315039"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1146\/annurev.immunol.19.1.683","article-title":"Interleukin-10 and the interleukin-10 receptor","volume":"19","author":"Moore","year":"2001","journal-title":"Annu. Rev. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1017\/S0007114509993801","article-title":"The effects of probiotic and conventional yoghurt on lipid profile in women","volume":"103","author":"Elmadfa","year":"2010","journal-title":"Br. J. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000349922","article-title":"Effect of multispecies probiotic supplements on metabolic profiles, hs-CRP, and oxidative stress in patients with type 2 diabetes","volume":"63","author":"Asemi","year":"2013","journal-title":"Ann. Nutr. Metab."},{"key":"ref_56","first-page":"1","article-title":"Effects of Probiotic Supplementation on Hormonal Profiles, Biomarkers of Inflammation and Oxidative Stress in Women With Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"21","author":"Karamali","year":"2018","journal-title":"Arch. Iran. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.yhbeh.2011.09.010","article-title":"Testosterone and sport: Current perspectives","volume":"61","author":"Wood","year":"2012","journal-title":"Horm. Behav."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.4049\/jimmunol.167.4.2060","article-title":"Testosterone acts directly on CD4+ T lymphocytes to increase IL-10 production","volume":"167","author":"Liva","year":"2001","journal-title":"J. Immunol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Poutahidis, T., Springer, A., Levkovich, T., Qi, P., Varian, B.J., Lakritz, J.R., Ibrahim, Y.M., Chatzigiagkos, A., Alm, E.J., and Erdman, S.E. (2014). Probiotic microbes sustain youthful serum testosterone levels and testicular size in aging mice. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0084877"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"638","DOI":"10.4014\/jmb.2201.01015","article-title":"Immunostimulatory Effect of Heat-Killed Probiotics on RAW264.7 Macrophages","volume":"32","author":"Noh","year":"2022","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Fiore, W., Arioli, S., and Guglielmetti, S. (2020). The Neglected Microbial Components of Commercial Probiotic Formulations. Microorganisms, 8.","DOI":"10.3390\/microorganisms8081177"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12938\/bmfh.2020-026","article-title":"Gerobiotics: Probiotics targeting fundamental aging processes","volume":"40","author":"Tsai","year":"2021","journal-title":"Biosci. Microbiota Food Health"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Piqu\u00e9, N., Berlanga, M., and Mi\u00f1ana-Galbis, D. (2019). Health Benefits of Heat-Killed (Tyndallized) Probiotics: An Overview. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20102534"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/463\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:37:25Z","timestamp":1759919845000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":63,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["nu17030463"],"URL":"https:\/\/doi.org\/10.3390\/nu17030463","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]}}}