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Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus are lactic acid bacteria traditionally used as starter cultures for yogurt production. As a probiotic combination, they exhibit a proto-cooperative relationship where metabolic exchanges, such as nitrogen, purine, and iron metabolism, enhance their growth and functional properties. Therapeutically, this combination has been investigated as an adjunct to triple therapy for Helicobacter pylori eradication, where it helps improve eradication rates and reduce antibiotic-associated side effects. It also demonstrates protective effects on the intestinal barrier by ameliorating dysfunction caused by inflammatory cytokines and suppressing the internalization of nanoplastics in intestinal epithelial cells.
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