**5.3 Application of probiotics in clinical use**

As described earlier, probiotics prevent or mitigate various diseases and severe symptoms by various mechanisms, but it is advisable to take care when used in immune-compromised patients. Encouraging evidences are emerging for probiotics' efficiency in the management of pouchitis and pediatric atopic diseases. Probiotics are also helpful in preventing postoperative infections [89]. There is strong evidence that some bacterial strains are efficient in enhancing immune function. Probiotics are also beneficial in mental disorders and reduce carcinogenic activity, cholesterol level, and blood pressure [35]. The significance of probiotics in preventing traveler's diarrhea, sepsis-associated with severe pancreatitis, ulcerative colitis, and reduction of hyper cholesterol is unproven [89, 90]. The chemotherapeutic drugs such as L-asparaginase with fewer side effects from probiotic bacteria are still being explored. A study reported the use of kimchi to treat cancer [21]. Furthermore, the development of alternative antibiotics such as lantibiotics, antimicrobial peptides (AMPs) from probiotic bacteria are being explored to reduce side effects caused by traditional drug therapies and as a next-generation drug system against resistant pathogens. LAB bacteriocin- Nisin is commercially used

as a food preservative [35]. It also has biomedical applications as it exhibits antimicrobial activity against resistant pathogens and anti-biofilm properties to use in combination with therapeutic drugs [91]. Although probiotics have shown encouraging evidence of efficacy in various diseases, there is much exploration needed for standard clinical practice in humans.
