Not quite a cure yet: unlocking the unfulfilled promise of live biotherapeutics for disease treatment
Bibliographic record
Abstract
Few live microbial therapeutics have demonstrated conclusive or reproducible clinical efficacy. Cochrane meta-analyses of probiotic interventions across multiple clinical trials, analyzed using a rank-biserial correlation test, revealed that intestinal inflammation is negatively correlated with clinical responsiveness. This is exemplified by Escherichia coli Nissle 1917, which shows efficacy in maintaining remission comparable to frontline therapies, yet fails to demonstrate clear benefit in the treatment of active ulcerative colitis, an inflammatory bowel disease defined by chronic intestinal inflammation. Beyond inflammation as a key barrier to efficacy, inadequate shelf life and delivery strategies further compromise microbial viability and functional persistence in the gastrointestinal tract. Here, we highlight both the challenges and emerging opportunities in the field of live microbial therapeutics, emphasizing the urgent need to integrate scientific, clinical, and industrial efforts to achieve durable and clinically meaningful outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.004 |
| Scholarly communication | 0.005 | 0.007 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.007 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".