Samira Ranjbar,1 Afsoon Asadollahi,2 Fatemeh Ghanimati,3 Farzaneh Rafie Sedaghat,4 Hossein Samadi Kafil51Student Research Committee, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 2Department of Maxillofacial Medicine, Faculty of Dentistry, Urmia University of Medical Sciences, Urmia, Iran; 3Research Center for Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran; 4Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 5Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IranCorrespondence: Afsoon Asadollahi; Hossein Samadi Kafil, Email afsoon.asadollahi@gmail.com; Kafilhs@tbzmed.ac.irAbstract: Postbiotics—non-viable microbial components or metabolites derived from probiotics—have emerged as promising modulators of the gut microbiota (GM), offering probiotic-like health benefits without the risks associated with live microorganisms. The GM is a crucial determinant of human health, and its disturbance (known as dysbiosis) is closely linked to conditions such as inflammatory bowel disease (IBD), colorectal cancer (CRC), sepsis, and metabolic syndromes. This review uniquely synthesizes mechanistic insights with therapeutic perspectives and summarizes current knowledge of the therapeutic potential of postbiotics to restore microbial balance and maintain intestinal homeostasis. Bioactive postbiotic molecules, including short-chain fatty acids (SCFAs), bacteriocins, exopolysaccharides, antimicrobial peptides, and vitamins, play key roles in inhibiting pathogens, enhancing beneficial bacterial populations, modulating immune responses, and strengthening epithelial barriers, and could also serve as an alternative to antibiotics. Postbiotics demonstrated therapeutic potential across multiple diseases, including IBD, CRC, metabolic syndrome, sepsis, and antibiotic-resistant infections, primarily through modulation of the GM, enhancement of intestinal barrier integrity, and regulation of immune responses. SCFAs, such as butyrate, reduce inflammation in ulcerative colitis; propionate induces apoptosis in gastric cancer cells. Most of the data in this area are preclinical, and further studies are needed. Evidence from preclinical and mechanistic studies suggests that postbiotics may represent a safe, effective alternative or adjunct to probiotics and antibiotics in managing GM-associated disorders.Keywords: probiotics, postbiotics, metabolites, SCFA, immunomodulation, gut microbiota
Ara KirakosyanPure Green Pharmaceuticals Inc., West Bloomfield, MI, USACorrespondence: Ara Kirakosyan, Email akirakosyan@pgpharma.co
Sayed Mortaza FayezDepartment of Nutrition, Medicine School, Kabul University of Medical Sciences Ali Ibn Sina, Kabul, AfghanistanCorrespondence: Sayed Mortaza Fayez, Email sayedmortazafayez455@gmail.comAfghanistan’s maternal nutrition crisis epitomizes the intersection of conflict, systemic collapse, and entrenched gender inequality within the global hunger emergency. Nearly one‑third of Afghan women of reproductive age are underweight, while 45% of pregnant women suffer from anemia, driving one of the world’s highest child stunting rates at 41%. These stark figures reveal overlapping macronutrient and micronutrient deficiencies, compounded by food contamination, poor supplement quality, and restrictive socio‑cultural norms. The December 2022 ban on female NGO workers dismantled the primary channel of care delivery in a gender-segregated society; moreover, wider restrictions on women’s participation in civic space, education, and public life have further exacerbated humanitarian vulnerability and limited access to care. These interconnected rights restrictions underscore how systemic gender inequality intensifies humanitarian need. The human cost is measured in elevated maternal mortality, impaired child development, and communities locked in cycles of poverty and poor health. Evidence‑based interventions such as community‑based malnutrition management and fortified food distribution remain effective but are paralyzed by political and operational barriers. Afghanistan’s case highlights urgent lessons for global strategy: gender equality as foundational, systems strengthening as essential, food safety and quality as non-negotiable, and local data as critical for adaptation. Ultimately, maternal nutrition security in Afghanistan is both a humanitarian imperative and a critical measure of international resolve to confront structural barriers and uphold human rights in ending hunger.Keywords:Afghanistan, maternal nutrition, food insecurity, hunger crisis, maternal health
Background: Vitamin D is essential for skeletal health and has been increasingly recognized for potential extra-skeletal benefits. Despite this, vitamin D deficiency remains prevalent, with corrective efforts focused on skeletal outcomes, whereas extra-skeletal benefits remain controversial due to conflicting evidence between small-scale studies and randomized control trials (RCTs). Furthermore, region-specific challenges are a barrier to first-line corrective strategies. Aim: This is the first Saudi-specific Delphi consensus, aiming to address skeletal and extra-skeletal outcomes, drive actionable corrective strategies, and encourage large-scale research in the Kingdom of Saudi Arabia (KSA). Methods: Eleven multidisciplinary key opinion leaders from KSA participated in a modified Delphi process involving a premeeting survey, two in-person meetings, and three iterative survey rounds. Consensus, predefined as >= 75% agreement consistent with established Delphi thresholds, was achieved across all 38 statements, covering the landscape of vitamin D deficiency, strategies for correction, maintenance, monitoring, and safety considerations. Results: Key consensus-based recommendations included: (i) vitamin D deficiency contributes to disease development, while correction could help improve outcomes; (ii) oral supplementation is the primary corrective strategy in the Saudi context; (iii) screening should be limited to patients in whom deficiency impacts disease or treatment, with empiric supplementation preferred otherwise; (iv) dosing regimens of 50,000 IU weekly for deficient or empirically treated patients and 1,000-2,000 IU daily or 50,000 IU monthly for sufficient patients and the general population; (v) conditions associated with reduced response to standard dosing are eligible for higher dose; (vi) indefinite maintenance with monitoring every 3-6 months for screened patients; (vii) expert-informed target serum 25-hydroxyvitamin D (25(OH)D) concentrations of >= 30 ng/mt for the general population, >= 50-<60 ng/mt for the elderly, and >= 70 ng/mt for patients with comorbidities. The recommendations for broad empiric supplementation, indefinite maintenance, and the >= 70 ng/mt target diverge from current international guidance and rest on expert consensus and limited evidence; they require prospective regional validation and should be applied with appropriate caution and safety monitoring. Conclusion: This framework provides the first Saudi-specific, Delphi-based recommendations for managing vitamin D deficiency, both skeletal and extra-skeletal and context for future research efforts.
