Probiotics in type 1 diabetes: immunomodulatory mechanisms and the unresolved question of clinical efficacy
- 1Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University
- 2Department of Oncology, Provincial Hospital Affiliated to Shandong First Medical University
Abstract
Type 1 Diabetes (T1D) is a common autoimmune disease worldwide, which is associated with imbalanced gut microbiota. Intestinal dysbiosis plays a key role in the pathogenesis of T1D, and it may affect immune tolerance and autoimmune responses of pancreatic islet β-cells. As a potential immunomodulator, probiotics can help restore this balance, regulate immune responses, and reduce the risk of T1D. Although probiotics offer a logical immunomodulatory strategy to restore microbial and immune homeostasis, the translational gap between robust preclinical mechanisms and inconsistent clinical outcomes remains poorly defined. This review summarizes the mechanisms of action and clinical research progress of probiotics in the immunotherapy of T1D. Firstly, it elaborates on the key pathways through which probiotics regulate the gut-immune-pancreas axis. Subsequently, it conducts a comparative analysis of important clinical trials on probiotic therapy for T1D in recent years, comparing the differences in efficacy of different intervention timings, different bacterial strains, etc., in the prevention and adjuvant treatment of T1D, and explores their relationships with patients’ age, disease duration, and genetic background. Meanwhile, it points out the limitations of current research, so as to provide important references for future studies. Furthermore, this review looks forward to the future directions of probiotics in the field of T1D immunotherapy, including innovative approaches such as engineered bacteria transformation, targeted delivery, and personalized microbiota intervention. Finally, it evaluates the safety of probiotics in the treatment of T1D, aiming to explore an individualized probiotic therapy method and lay a more reliable foundation for subsequent clinical translation.
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BibTeX
@article{chen2026probiotics,
title = {{Probiotics in type 1 diabetes: immunomodulatory mechanisms and the unresolved question of clinical efficacy}},
author = {Simiao Chen and Lu Wang and Shuotong Zhang and Jun Zhang and Xin Yan and Zhongming Wu},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1931902},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1931902/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Probiotics in type 1 diabetes: immunomodulatory mechanisms and the unresolved question of clinical efficacy
AU - Simiao Chen
AU - Lu Wang
AU - Shuotong Zhang
AU - Jun Zhang
AU - Xin Yan
AU - Zhongming Wu
PY - 2026
DA - 2026/10/07
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1931902
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1931902/full
AB - Type 1 Diabetes (T1D) is a common autoimmune disease worldwide, which is associated with imbalanced gut microbiota. Intestinal dysbiosis plays a key role in the pathogenesis of T1D, and it may affect immune tolerance and autoimmune responses of pancreatic islet β-cells. As a potential immunomodulator, probiotics can help restore this balance, regulate immune responses, and reduce the risk of T1D. Although probiotics offer a logical immunomodulatory strategy to restore microbial and immune homeostasis, the translational gap between robust preclinical mechanisms and inconsistent clinical outcomes remains poorly defined. This review summarizes the mechanisms of action and clinical research progress of probiotics in the immunotherapy of T1D. Firstly, it elaborates on the key pathways through which probiotics regulate the gut-immune-pancreas axis. Subsequently, it conducts a comparative analysis of important clinical trials on probiotic therapy for T1D in recent years, comparing the differences in efficacy of different intervention timings, different bacterial strains, etc., in the prevention and adjuvant treatment of T1D, and explores their relationships with patients’ age, disease duration, and genetic background. Meanwhile, it points out the limitations of current research, so as to provide important references for future studies. Furthermore, this review looks forward to the future directions of probiotics in the field of T1D immunotherapy, including innovative approaches such as engineered bacteria transformation, targeted delivery, and personalized microbiota intervention. Finally, it evaluates the safety of probiotics in the treatment of T1D, aiming to explore an individualized probiotic therapy method and lay a more reliable foundation for subsequent clinical translation.
SN - 1664-3224
ER -