Probiotics and its Predominant Role in COVID-19

 What are Probiotics and it's Predominant Role in COVID-19

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1.     Meaning of Probiotics

Probiotic bacteria have become increasingly popular during the last two decades as a result of the continuously expanding scientific evidence pointing to their beneficial effects on human health. As a result they have been applied as various products with the food industry having been very active in studying and promoting them.

Within this market the probiotics have been incorporated in various products, mainly fermented dairy foods. In light of this ongoing trend and despite the strong scientific evidence associating these microorganisms to various health benefits, further research is needed in order to establish them and evaluate their safety as well as their nutritional aspects.

2.     Importance of Probiotics w.r.t COVID-19

The typical clinical symptoms of SARS-CoV-2 infection include dry cough (67%), fever (88%), fatigue (38%), myalgia (14.9%), and dyspnea (18.7%). Other symptoms include headache, sore throat, rhinorrhea, and gastrointestinal symptoms. Pneumonia appears to be the most common and severe manifestation of the infection. Currently, there is no vaccine or specific drug for COVID-19.  In addition to the SARS-CoV2, avian influenza, ebola, dengue, and Zika viral infections remain poorly controlled around the world.

The live microbes, which possess health benefits on the host when administered in appropriately adequate amount, are referred to as probiotics and it includes a number of genera of bacteria and yeasts. Probiotics include Lactobacillus, Bifidobacterium, Leuconostoc, Pediococcus, and Enterococcus.  Probiotics play a role in balancing the host defensive immune response, thereby stimulating mucosal barrier function and modulating the immune system. 

3.     Probiotic as Immune Enhancers

Probiotics exert several health beneficial effects to the host by several potential systems through the local immunity (by keeping up gut wellbeing and gut wall integrity) and systemic immunity (by enhancing specific and non-specific immune system). The application of probiotics is efficient and competent for several ailments, including viral infections.

Source: Appl Microbiol Biotechno

The mechanism involved upon host infected by COVID-19. Pro inflammatory cytokines and interferons are released, and viral cellular translation is suppressed to induce viral clearance as a part of the host immune response and an antiviral state in adjacent epithelial cells. Viral clearance occurs in lung and gut epithelium depending on the immune status of the host. However, probiotic consumption improves.

4.     Gut Microbiota

The microbial communities (bacteria, fungi, archaea, viruses, and protozoa) in the human Gastrointestinal tract, lungs, skin, and mouth exist in a commensal relationship with host cells, thereby playing a major role in human health. The commensal bacteria that are present in the GI tract are equivalent to the number of human cells. This colonization starts shortly after birth and their profiles and numbers stabilize by the age of 1 year with more than 1000 bacterial species.

The GI microbiota has the ability to interact with human cells, including specific immune cells. These interactions produce different health benefits in the host including regulating GI motility activating and destroying toxins.  Probiotics are also usually recommended for patients who have recently used antibiotics for treating any disease. Other causes of dysbiosis in the human GI tract include exposure to toxins, stress, disease, insufficient diet, and age.

5.     Lung Microbiota and Respiratory Infection

As compared with the lower gastrointestinal part, the lungs contain about 10 to 100 bacteria per 1000 human cells that is relatively less bacterial biomass. Probiotics mainly colonize in the gut, but it has a fundamental impact on the systemic immune responses. It can also colonize and exert the immune responses at distant mucosal sites, including the lung.

6.     Gut-lung axis and COVID-19

The gastrointestinal tract and lung are among the body compartments that host microbiota  however, the lung has a small number of microbiota when compared to that of the gut. In addition to the most frequently described respiratory symptoms such as fever, cough and severe respiratory syndrome caused by COVID-19 infection, it has also been reported that patients exhibited GI symptoms including diarrhea, vomiting, nausea, loss of appetite, GI bleeding, and abdominal pain.

Prebiotics may also have an excellent potential effect against COVID-19 by enhancing probiotics growth and survivability. Furthermore, prebiotics could have a direct effect on GI symptoms caused by COVID-19 via blocking the ACE enzymes.

SARS-CoV-2 is a newly emerging virus that currently lacks curative treatments and vaccines. To date, no study has reported the use of prebiotics and probiotics to treat or prevent COVID-19, but the use of probiotics in the clinical treatment or prevention of COVID-19 could be a suitable strategy. So far, several registered trials that aim to investigate the efficiency of probiotics in treating COVID-19 patients are ongoing. 

7.     Future Augurs Well for Probiotics

With a growing bank of scientific research behind it, the probiotics category is understandably booming. According to recent figures, the market is expected to reach $7.1 billion by 2026, at a CAGR of 7.8%.

The global probiotics market size was estimated at USD 48.38 billion in 2018 and is anticipated to expand at a CAGR of 6.9% during the forecast period. It is driven by the growing consumer inclination towards preventive healthcare in conjunction with the development of efficient probiotic strains.

8.     Reason for growth in Probiotics due to COVID

Probiotics are the potential candidates which need to be tested more often in moderate and severe cases of COVID-19 due to several beneficial effects, including easy availability, easy to administer, safety, and cost effectiveness.

Probiotics – targeting the pathophysiological processes in the context of COVID-19 infections, are one of the strategies that exert beneficial effects by manipulation of the gut microbiota, activation of mucosal immunity, and modulation of the innate and adaptive immune response.

9.     Antiviral effects of Probiotics

Probiotics may act as antiviral agents by interfering with the entry of the virus into host cells and/or inhibiting viral replication. This may lead to a reduction in the spread of SARS-CoV-2 in the respiratory tract and gut. In addition, with the restoration of the gut and respiratory microbial harmony, immune function, and gut-lung axis, the course of COVID-19 may be altered.

Most of the probiotic strains are generally safe even in the vulnerable patient groups and in-hospital care settings, including neonates, children, and adults. Many probiotic strains have indicated even beneficial effects in these settings.

10.     Replacement of pharmaceutical agents provides a major opportunity for probiotics

The increasing demand for probiotics has shown that customers are preferring products with proven benefits. The increased evidence of health benefits associated with probiotics for health restoration has increased the customer expectations related to probiotics for health curing functions. This inclination toward a safe, natural, and cost-effective substitute for drugs has led the application of probiotics as pharmaceutical agents.

Beneficial effects of probiotics as pharmaceutical agents seem to be strain-and dose-dependent. Clinical trials have displayed that probiotics may cure certain disorders or diseases in humans, especially those related to the gastrointestinal tract.

11.     Health Benefits Associated with Probiotics Fortified Food is A Major Driver for The Market

Health awareness among consumers is on the rise and most consumers are constantly in search of healthy food products for consumption. Probiotics have proven strong benefits related to health, more specifically to the human digestive system. 

Probiotics are found in supplement form or as components of foods & beverages. Their integration with inexpensive health foods, such as yogurt, fruit juices, and cultured dairy drinks has contributed to a significant market size.

The most commonly used bacteria include Bifidobacteria and Lactobacilli, which are found in various dairy products, including yogurt. In the dairy category, yogurt is the most popular option for consumption of probiotics.

12.     High R&D costs for developing new probiotic strains is a major restraint for the probiotics market

Probiotics applications are linked with health benefits, which make it challenging for manufacturers to get an adequate return on investments on high initial investments. Research is needed to determine the accurate mechanisms of action of probiotics against coronaviruses including SARS-CoV-2 in healthy or infected animal models. These studies may lead to a better understanding of the bacterial dynamics in the GI tract.

Animal or human studies could be used to assess the direct effects of intranasal probiotics through targeting pathogens in the lungs and indirect effect occurring through the modulation of immune activity. These studies may be helpful for treating viral infections such as COVID-19.

13.     Probiotics Market Segment

14.     Top Impacting Factors for Growth in Probiotics

1)     Growing Health Concerns due to Novel Coronavirus

2)     Rising Consumption of functional food

3)     High awareness among consumers after Covid-19

4)     Stringent Government Regulations

5)     Increasing R&D Cost

Sources:

sfamjournals.onlinelibrary

Sundararaman 2020 Article - Appl Microbiol Biotechno

Grandview Research

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Twitter Handle: @shuchi_nahar