The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials

  • Alireza Milajerdi
  • Seyyed Mohammad Mousavi
  • Alireza Sadeghi
  • Asma Salari-Moghaddam
  • Mohammad Parohan
  • Bagher LarijaniEmail author
  • Ahmad EsmaillzadehEmail author
Original Contribution



No study has summarized earlier findings on the effect of probiotic supplementation on inflammatory biomarkers. This systematic review and meta-analysis was conducted to systematically review the available placebo-controlled clinical trials about the effect of probiotic supplementation on several inflammatory biomarkers in adults.


Relevant papers published up to March 2018 were searched up through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using following suitable keywords. Clinical trials that examined the effect of probiotic supplementation on inflammation in adults were included.


Overall, 42 randomized clinical trials (1138 participants in intervention and 1120 participants in control groups) were included. Combining findings from included studies, we found a significant reduction in serum hs-CRP [standardized mean difference (SMD) − 0.46; 95% CI − 0.73, − 0.19], TNF-a (− 0.21; − 0.34, − 0.08), IL-6 (− 0.37; − 0.51, − 0.24), IL-12 (− 0.47; − 0.67, − 0.27), and IL-4 concentrations (− 0.48; − 0.76, − 0.20) after probiotic supplementation. Pooling effect sizes from 11 studies with 12 effect sizes, a significant increase in IL-10 concentrations was seen (0.21; 0.04, 0.38). We failed to find a significant effect of probiotic supplementation on serum IL-1B (− 0.17; − 0.37, 0.02), IL-8 (− 0.01; − 0.30, 0.28), and IFN-g (− 0.08; − 0.31, 0.15) and IL-17 concentrations (0.06; − 0.34, 0.46).


Probiotic supplementation significantly reduced serum concentrations of pro-inflammatory cytokines including, hs-CRP, TNF-a, IL-6, IL-12, and IL-4, but it did not influence IL-1B, IL-8, IFN-g, and IL-17 concentrations. A significant increase in serum concentrations of IL-10, as a anti-inflammatory cytokine was also documented after probiotic supplementation.


Diet Probiotic Inflammation Cytokine Meta-analysis 



Standardized mean difference


Type 2 diabetes mellitus


Metabolic syndrome


Cardiovascular disease


Non-alcoholic fatty liver disease


Short-chain fatty acids


Inflammatory bowel disease


Irritable bowel syndrome


C-reactive protein


Tumor necrosis factor-a


Standard deviation


Standard error


Mean difference


Randomized clinical trial


Gut-associated lymphoid tissue




Interleukin 1 beta




Author contributions

AM, BL, and AE designed research; AM, SMM, AS, ASM, and MP conducted research; AM analyzed data; AM and AE wrote the paper; and AE had primary responsibility for final content. All authors read and approved the final manuscript.



Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

394_2019_1931_MOESM1_ESM.doc (241 kb)
Supplementary material 1 (DOC 241 KB)


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
  2. 2.Students’ Scientific Research Center (SSRC)Tehran University of Medical Sciences (TUMS)TehranIran
  3. 3.Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
  4. 4.Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
  5. 5.Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences InstituteTehran University of Medical SciencesTehranIran
  6. 6.Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesEsfahānIran

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