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

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Abbreviations

SMD:

Standardized mean difference

T2DM:

Type 2 diabetes mellitus

MtS:

Metabolic syndrome

CVD:

Cardiovascular disease

NAFLD:

Non-alcoholic fatty liver disease

SCFAs:

Short-chain fatty acids

IBD:

Inflammatory bowel disease

IBS:

Irritable bowel syndrome

CRP:

C-reactive protein

TNF-a:

Tumor necrosis factor-a

SD:

Standard deviation

SE:

Standard error

MD:

Mean difference

RCT:

Randomized clinical trial

GALT:

Gut-associated lymphoid tissue

IL:

Interleukin

IL-1B:

Interleukin 1 beta

IFN-g:

Interferon-gama

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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.

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Correspondence to Bagher Larijani or Ahmad Esmaillzadeh.

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Milajerdi, A., Mousavi, S.M., Sadeghi, A. et al. The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials. Eur J Nutr 59, 633–649 (2020). https://doi.org/10.1007/s00394-019-01931-8

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Keywords

  • Diet
  • Probiotic
  • Inflammation
  • Cytokine
  • Meta-analysis