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In addition, they were also able to show that the rapid relief of abdominal pain may be explained by altered pain perception in the brain of CD patients owing to the inhibition of TNF-α [78]

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It is not yet well-understood how these bacteria can exert these benefits, but documented mechanisms of action include antimicrobial activity against major gastrointestinal 171 and urogenital pathogens 172 , barrier-promoting effects at the gut epithelium 173 and other mucosa 174 , immunomodulatory effects by stimulating host antimicrobial compounds such as α- defensins 175 and modulating the secretion of cytokines such as IL-10, IL-6, IL-1b, IL-2, TNF-α, and impacting different cell types such as intestinal epithelial cells, dendritic cells, macrophages and regulatory T cells 176,177,178