Selected Topics in Probiotics and Prebiotics:

On August 29–31, 2004, 84 academic and industry scientists from 16 countries gathered in Copper Mountain, Colorado USA to discuss certain issues at the forefront of the science of probiotics and prebiotics. The format for this invitation only meeting included six featured lectures: engineering human vaginal lactobacilli to express HIVinhibitory molecules (Peter Lee, Stanford University), programming the gut for health (Thaddeus Stappenbeck, Washington University School of Medicine), immune modulation by intestinal helminthes (Joel Weinstock, University of Iowa Hospitals and Clinics), hygiene as a cause of autoimmune disorders (G. A. Rook, University College London), prebiotics and bone health (Connie Weaver, Purdue University) and prebiotics and colorectal cancer risk (Ian Rowland, Northern Ireland Centre for Food and Health). In addition, all participants were included in one of eight discussion groups on the topics of engineered probiotics, host-commensal bacteria communication, ‘omics’ technologies, hygiene and immune regulation, biomarkers for healthy people, prebiotic and probiotic applications to companion animals, development of a probiotic dossier, and physiological relevance of prebiotic activity. Brief conclusions from these discussion groups are summarized in this paper. Introduction The International Scientific Association for Probiotics and Prebiotics (www.isapp.net) was founded in 2001 as an international non-profit collaboration of scientists dedicated to advancing the science of probiotics and prebiotics. Its mission is to engender and disseminate information on high quality, multidisciplinary, scientific investigation in the fields of probiotics and prebiotics, and to advance the development of scientifically substantiated, healthpromoting probiotic and prebiotic products worldwide. Convening meetings with targeted discussion topics and key specialists in the field have led to progress toward these goals. Numerous reviews on the topics of probiotic and prebiotic functionality have been advanced during recent years (Isolauri et al., 2004; Marteau et al., 2004). The focus of this report will be conclusions from the eight specific topic areas addressed by the discussion groups (Table 1) at the meeting. This report presents current thinking for eight areas of research in the field as addressed by selected discussion groups at the 2004 meeting. Biomarkers for healthy people Certain safe and effective probiotics and prebiotics appear to be used by, and apparently beneficial to, individuals who are healthy as well as those who have an illness. The concept of using probiotics and prebiotics to maintain or enhance health is of interest to many people. However, documenting such an effect, especially when dealing with healthy subjects, is a scientific challenge. What is health? According to the WHO “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1946). From a practical perspective, it is likely that health as so defined is not usually achieved in real life. It would be hard to find individuals with complete wellbeing considering that many individuals who generally considered themselves healthy might often have minor ailments and many individuals without identified illness/ disease will consider themselves not healthy. Rather than being able to compartmentalize people into one of two groups, healthy or not healthy, more descriptive is a depiction of health as a continuum (Fig. 1). A more practical (less restrictive) definition for health might be a state with no recognizable disease (normal functions), no symptoms that require treatment (according to welldefined guidelines), and no nutritional deficiencies. In this case, there might be a window of opportunity for the use of probiotics and prebiotics for healthy people. Selected Topics in Probiotics and Prebiotics: Meeting Report for the 2004 International Scientific Association for Probiotics and Prebiotics