Unlocking the probiotic potential of breast milk-derived lactobacillus against urinary tract infections: mechanisms, therapeutic prospects, and future directions.

Urinary tract infections (UTIs) are the most common bacterial infection worldwide, disproportionately affecting women and increasingly complicated by the rising prevalence of antimicrobial resistance (AMR). The investigation of several approaches to treat UTIs has brought attention to the potential therapeutic benefits of probiotics, especially Lactobacillus species. Human breast milk, a unique reservoir of commensal and beneficial microbes, harbours diverse Lactobacillus strains with demonstrated antimicrobial, immunomodulatory, and anti-adhesive properties. The probiotic potential of Lactobacillus strains isolated from human breast milk in the treatment and prevention of UTIs is critically examined. An overview of the clinical burden and epidemiology of UTIs, focusing on the issues related to antibiotic resistance, were discussed. Investigation of how Lactobacillus strains isolated from breast milk provides protection by the generation of antimicrobial metabolites, competition for adhesion sites, host immune response regulation, and uropathogen biofilm disintegration. The most recent data from animal models, in vitro research, and early clinical trials emphasize the potential of treatments such as vaginal formulations, oral supplements, and targeted distribution via nano-encapsulation. Significant information gaps, technological advancements, and future research initiatives were identified to convert these findings into therapies that can be used in future clinical settings. This review highlights breast milk-derived Lactobacillus as a unique and durable probiotic therapy against UTIs in the age of antibiotic resistance by combining microbiological, immunological, and translational aspects.