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Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit on the
host. Recent research has suggested that probiotics exert a wide range of effects through different mechanisms and sites of
action, dependent on the host. Although the European Food Safety Agency has evaluated current probiotic strains insufficient
characterized and clinical research ample for health claim approval, consumers (e.g., in the US) are interested in potential
therapeutic and preventive health benefits. The Food and Agriculture Organization of the United Nations and the World Health
Organization provide guidelines for probiotics: Proper identification to the level of strain of all probiotics in the product, with
deposit of all strains in an international culture collection; Characterization of each strain for traits important to its safety and
function; Validation of health benefits in human studies, including identification of the quantity of the microorganism required
to provide the benefit and; Truthful and not misleading labeling of efficacy claims and content through the end of shelf life.
Over the last years we have seen examples of genetically modified strains with adapted physiological properties compared to the
parenteral strain and these provide a start for prosperous future developments. The genetic modifications can impact improved
survival/retention in the gastrointestinal tract, cell cycle, cell wall, antibiotic resistance and biochemical/metabolic properties
of the strains. The current guidelines that any strain of microorganism that would be assigned to a group would be freed from
the need for further safety assessment is insufficient to guarantee any health impact in short and long term. It is therefore
crucial that improved guidelines allow flexible developments to secure quality and safety, specifically when it concerns infants
and premature infants or metabolically compromised individuals and when it concerns the possible long-term effects.