The role of probiotics and postbiotics in modulating the gut microbiome-immune system axis in the pediatric age

Minerva Pediatr (Torino). 2021 Apr;73(2):115-127. doi: 10.23736/S2724-5276.21.06188-0.


The complex microbial community of the gut microbiome plays a fundamental role in driving development and function of the human immune system. This phenomenon is named the gut microbiome-immune system axis. When operating optimally, this axis influences both innate and adaptive immunity, which orchestrates the maintenance of crucial elements of host-microorganisms symbiosis, in a dialogue that modulates responses in the most beneficial way. Growing evidence reveals some environmental factors which can positively and negatively modulate the gut microbiome-immune system axis with consequences on the body health status. Several conditions which increasingly affect the pediatric age, such as allergies, autoimmune and inflammatory disorders, arise from a failure of the gut microbiome-immune system axis. Prenatal or postnatal modulation of this axis through some interventional strategies (including diet, probiotics and postbiotics), may lead to a positive gene-environment interaction with improvement of immune-modulatory effects and final positive effect on human health. In particular probiotics and postbiotics exerting pleiotropic regulatory actions on the gut-microbiome-immune system axis provide an innovative preventive and therapeutic strategy for many pediatric conditions.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity / physiology
  • Child, Preschool
  • Dysbiosis / immunology
  • Gastrointestinal Microbiome / physiology*
  • Gene-Environment Interaction
  • Humans
  • Immune System / physiology*
  • Immunity, Innate / physiology
  • Infant
  • Infant, Newborn
  • Prebiotics*
  • Probiotics / pharmacology*


  • Prebiotics