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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 - defensins 175 and modulating the secretion of cytokines such as IL-10, IL-6, IL-1b, IL-2, TNF-, and impacting different cell types such as intestinal epithelial cells, dendritic cells, macrophages and regulatory T cells 176,177,178