Probiotics Application in the Treatment of Autoimmune Diseases and Enhancement of Efficacy Through Genetic Engineering

The development of multidrug resistance in most pathogenic microorganisms and the rapidly increasing prevalence of non-communicable diseases are becoming major health concerns worldwide. Among non-communicable diseases, autoimmune diseases are caused mainly by imbalances in the gut microbiota (dysbiosis). Gut microbiota colonization and immune system establishment started in the early years of life. A defect in the gut microbiota predominantly affects the proper functioning of immune cells. Hence, restoring gut dysbiosis has received considerable attention for the last few decades as a potential therapeutic option. In this regard, probiotics have been the focus of research during recent decades because of their safe history of use along with fermented foods and beverages. Currently, advanced research is being conducted on the use of probiotics as immunomodulatory mediators and for the amelioration of gut dysbiosis as therapeutic adjuncts in the treatment of autoimmune diseases. In addition, probiotics are genetically engineered to enhance treatment efficacy and to develop live biotherapeutics (LBP). In this review, research articles summarizing findings in autoimmune disease treatment via probiotic strains, emphasizing type 1 diabetes, rheumatoid arthritis, Graves' disease, systemic lupus erythematosus and inflammatory bowel disease in both clinical trials and animal models, were reviewed. Finally, promising results of genetic engineering of probiotics for use as biosensors, delivery of therapeutic proteins, and diagnosis of infections were reported.