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Important gaps persist, including limited long-term safety data in vulnerable populations, incomplete monitoring of antimicrobial resistance transfer, and scarce head-to-head comparisons between strains or formulations, which hinder the development of clear, strain-specific clinical guidelines ( This review aims to (i) summarize current evidence on probiotic mechanisms and health benefits, (ii) critically evaluate therapeutic applications and associated risks, and (iii) highlight novel directions such as NGPs, engineered strains, and microbiome-targeted interventions