This review summarizes health benefits of a combination of a four-strain probiotic consisting of L. paracasei Lpc-37, B. lactis Bl-04, L. acidophilus La-14, and L. plantarum Lp-115.The safety of the individual strains for absence of transferable antibiotic resistance and adverse events in human intervention studies has been documented. The strains have been shown, both in vitro and in human studies, to survive gastro-intestinal transit and transiently colonize the intestine in a dose-dependent manner. In digestive health, the strains have shown to modulate the intestinal microbiota and reduce risk for both diarrhea and constipation. In vitro, animal and human studies have shown these strains to positively modulate many immune markers, in particular anti-inflammatory markers. These modifications also suggest a reduced risk for respiratory tract infections and seasonal respiratory allergies. The strains contributed positively to weight management in humans and reduced markers of metabolic syndrome in animal models. Finally, one of the strains (L. acidophilus La-14) was shown to colonize the vagina and contribute to reduced risk for recurrent bacterial vaginosis, vulvovaginal candidiasis and urinary tract infection. The combination of these four strains can therefore be expected to provide a broad spectrum of health benefits. Keywords: Bifidobacterium, Lactobacillus, Multi-strain, Probiotic Abbreviations Used: Antibiotic associated diarrhea, AAD; Atopic dermatitis, AD; American Type Culture Collection, ATCC; Break point, BP; Bacterial vaginosis, BV; Calcium oxalate, CaOx; Colony forming units, CFU; Colorectal cancer, CRC; Deutsche Sammlung von Microorganismen (German collection of microorganisms and cell cultures), DSM; European Food Safety Agency, EFSA; Fructo-oligosaccharides, FOS; Generally regarded as safe, GRAS; GRAS notification, GRN; Gastrointestinal, GI; Interleukin, IL; Lipopolysaccharide, LPS; Metabolic syndrome, MetS; Not tested, NT; Oxalate, Ox; Oxalyl-coenzyme A decarboxylase, OXC; Peripheral blood mononucleocytes, PBMCs; Vulvovaginal candidiasis, VVC Corresponding Author: A.C Ouwehand, Global Health & Nutrition Sciences, DuPont Nutrition and Biosciences, 02460 Kantvik, Finland; E-mail: firstname.lastname@example.org
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