Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis
Purpose Probiotics have been reported to be beneficial for inflammatory bowel disease (IBD), but the types, number of strains, dosage, and intervention time of probiotics used remain controversial. Furthermore, the changes of gut microbiota in IBD’s patients are also intriguing. Thus, this meta-anal...
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| Veröffentlicht in: | European journal of nutrition 2021-08, Vol.60 (5), p.2855-2875 |
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| creator | Zhang, Xiao-Feng Guan, Xiao-Xian Tang, Yu-Jun Sun, Jin-Feng Wang, Xiao-Kai Wang, Wei-Dong Fan, Jian-Ming |
| description | Purpose
Probiotics have been reported to be beneficial for inflammatory bowel disease (IBD), but the types, number of strains, dosage, and intervention time of probiotics used remain controversial. Furthermore, the changes of gut microbiota in IBD’s patients are also intriguing. Thus, this meta-analysis was to explore the clinical effects and gut microbiota changes of using probiotics, prebiotics and synbiotics in IBD.
Methods
The search was performed in PubMed, Web of Science and the Cochrane library from inception to April 2020. Qualified randomized controlled trials were included. IBD’s remission rate, disease activity index and recurrence rate were extracted and analyzed. Changes in the gut microbiota of patients with IBD are comprehensively described.
Results
Thirty-eight articles were included. Probiotics, prebiotics and synbiotics can induce/maintain IBD’s remission and reduce ulcerative colitis (UC) disease activity index (RR = 1.13, 95% CI 1.02, 1.26,
P
|
| doi_str_mv | 10.1007/s00394-021-02503-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_proquest_journals_2550483369</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2550483369</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-eeee6f45142c709a3678fe3f1a3612c9ba993e616a39a62d60a6add6cac8a58f3</originalsourceid><addsrcrecordid>eNqNkd-K1TAQxoso7rr6Al5IwBtBq0nTpK13UvwHC97odZmmk2OWNlk77R7Oy_isjtuzR_BCDAn5Qn4zmcmXZU-VfK2krN6QlLopc1koXkbq3NzLzlWpbW4LZe6ftKzOskdEV1LKQlv1MDvT2hijK3Oe_WzHEIODUaD36BYSEAexWxcxBTenPqQFhPsOcYckkhcrhbgT19tNcPSKNR61SLOgQ7w7hcjTjzBNsKT5IPq0x1EMgRAI3wpglhbky-DEjDcB97dvT7hADhHGAwV6nD3wMBI-Oe4X2bcP77-2n_LLLx8_t-8uc1eWasmRh_WlUWXhKtmAtlXtUXvFShWu6aFpNFplQTdgi8FKsDAM1oGrwdReX2Qvtrzc2Y8VaemmQA7HESKmlbqirKtSS9tIRp__hV6ldeZ6mTJGlrXWtmGq2Cj-RKIZfXc9hwnmQ6dk99u9bnOvY_e6W_c6w0HPjqnXfsLhFHJnFwMvN2CPffLkAkaHJ4z95RalLWpWUjNd_z_dhoWdSLFNa1w4VG-hxDh7P_9p8h_1_wJvxMj_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2550483369</pqid></control><display><type>article</type><title>Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis</title><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>SpringerNature Journals</source><creator>Zhang, Xiao-Feng ; Guan, Xiao-Xian ; Tang, Yu-Jun ; Sun, Jin-Feng ; Wang, Xiao-Kai ; Wang, Wei-Dong ; Fan, Jian-Ming</creator><creatorcontrib>Zhang, Xiao-Feng ; Guan, Xiao-Xian ; Tang, Yu-Jun ; Sun, Jin-Feng ; Wang, Xiao-Kai ; Wang, Wei-Dong ; Fan, Jian-Ming</creatorcontrib><description>Purpose
Probiotics have been reported to be beneficial for inflammatory bowel disease (IBD), but the types, number of strains, dosage, and intervention time of probiotics used remain controversial. Furthermore, the changes of gut microbiota in IBD’s patients are also intriguing. Thus, this meta-analysis was to explore the clinical effects and gut microbiota changes of using probiotics, prebiotics and synbiotics in IBD.
Methods
The search was performed in PubMed, Web of Science and the Cochrane library from inception to April 2020. Qualified randomized controlled trials were included. IBD’s remission rate, disease activity index and recurrence rate were extracted and analyzed. Changes in the gut microbiota of patients with IBD are comprehensively described.
Results
Thirty-eight articles were included. Probiotics, prebiotics and synbiotics can induce/maintain IBD’s remission and reduce ulcerative colitis (UC) disease activity index (RR = 1.13, 95% CI 1.02, 1.26,
P
< 0.05; SMD = 1.00, 95% CI 0.27, 1.73,
P
< 0.05). In subgroup analyses of IBD remission rate and UC disease activity index, we obtained some statistically significant results in some subgroup (
P
< 0.05). To some extent, probiotic supplements can increase the number of beneficial bacteria (especially
Bifidobacteria
) in the intestinal tract of patients with IBD.
Conclusions
Our results support the treatment of IBD (especially UC) with pro/pre/synbiotics, and synbiotics are more effective. Probiotic supplements that are based on
Lactobacillus
and
Bifidobacterium
or more than one strain are more likely to be beneficial for IBD remission. The dose of 10
10
–10
12
CFU/day may be a reference range for using probiotics to relieve IBD.</description><identifier>ISSN: 1436-6207</identifier><identifier>EISSN: 1436-6215</identifier><identifier>DOI: 10.1007/s00394-021-02503-5</identifier><identifier>PMID: 33555375</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Chemistry ; Chemistry and Materials Science ; Clinical trials ; Digestive system ; Dosage ; Gastrointestinal tract ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Intestinal microflora ; Intestine ; Life Sciences & Biomedicine ; Meta-analysis ; Microbiota ; Nutrition ; Nutrition & Dietetics ; Original Contribution ; Patients ; Prebiotics ; Probiotics ; Remission ; Remission (Medicine) ; Science & Technology ; Statistical analysis ; Systematic review ; Ulcerative colitis</subject><ispartof>European journal of nutrition, 2021-08, Vol.60 (5), p.2855-2875</ispartof><rights>Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>99</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000616062800003</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c441t-eeee6f45142c709a3678fe3f1a3612c9ba993e616a39a62d60a6add6cac8a58f3</citedby><cites>FETCH-LOGICAL-c441t-eeee6f45142c709a3678fe3f1a3612c9ba993e616a39a62d60a6add6cac8a58f3</cites><orcidid>0000-0001-8053-611X ; 0000-0002-7571-6981 ; 0000-0002-5577-7891 ; 0000-0001-6217-1874 ; 0000-0003-4907-9226 ; 0000-0002-9118-1411 ; 0000-0002-4961-3399</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00394-021-02503-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00394-021-02503-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27933,27934,39267,41497,42566,51328</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33555375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Xiao-Feng</creatorcontrib><creatorcontrib>Guan, Xiao-Xian</creatorcontrib><creatorcontrib>Tang, Yu-Jun</creatorcontrib><creatorcontrib>Sun, Jin-Feng</creatorcontrib><creatorcontrib>Wang, Xiao-Kai</creatorcontrib><creatorcontrib>Wang, Wei-Dong</creatorcontrib><creatorcontrib>Fan, Jian-Ming</creatorcontrib><title>Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis</title><title>European journal of nutrition</title><addtitle>Eur J Nutr</addtitle><addtitle>EUR J NUTR</addtitle><addtitle>Eur J Nutr</addtitle><description>Purpose
Probiotics have been reported to be beneficial for inflammatory bowel disease (IBD), but the types, number of strains, dosage, and intervention time of probiotics used remain controversial. Furthermore, the changes of gut microbiota in IBD’s patients are also intriguing. Thus, this meta-analysis was to explore the clinical effects and gut microbiota changes of using probiotics, prebiotics and synbiotics in IBD.
Methods
The search was performed in PubMed, Web of Science and the Cochrane library from inception to April 2020. Qualified randomized controlled trials were included. IBD’s remission rate, disease activity index and recurrence rate were extracted and analyzed. Changes in the gut microbiota of patients with IBD are comprehensively described.
Results
Thirty-eight articles were included. Probiotics, prebiotics and synbiotics can induce/maintain IBD’s remission and reduce ulcerative colitis (UC) disease activity index (RR = 1.13, 95% CI 1.02, 1.26,
P
< 0.05; SMD = 1.00, 95% CI 0.27, 1.73,
P
< 0.05). In subgroup analyses of IBD remission rate and UC disease activity index, we obtained some statistically significant results in some subgroup (
P
< 0.05). To some extent, probiotic supplements can increase the number of beneficial bacteria (especially
Bifidobacteria
) in the intestinal tract of patients with IBD.
Conclusions
Our results support the treatment of IBD (especially UC) with pro/pre/synbiotics, and synbiotics are more effective. Probiotic supplements that are based on
Lactobacillus
and
Bifidobacterium
or more than one strain are more likely to be beneficial for IBD remission. The dose of 10
10
–10
12
CFU/day may be a reference range for using probiotics to relieve IBD.</description><subject>Chemistry</subject><subject>Chemistry and Materials Science</subject><subject>Clinical trials</subject><subject>Digestive system</subject><subject>Dosage</subject><subject>Gastrointestinal tract</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Intestinal microflora</subject><subject>Intestine</subject><subject>Life Sciences & Biomedicine</subject><subject>Meta-analysis</subject><subject>Microbiota</subject><subject>Nutrition</subject><subject>Nutrition & Dietetics</subject><subject>Original Contribution</subject><subject>Patients</subject><subject>Prebiotics</subject><subject>Probiotics</subject><subject>Remission</subject><subject>Remission (Medicine)</subject><subject>Science & Technology</subject><subject>Statistical analysis</subject><subject>Systematic review</subject><subject>Ulcerative colitis</subject><issn>1436-6207</issn><issn>1436-6215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNkd-K1TAQxoso7rr6Al5IwBtBq0nTpK13UvwHC97odZmmk2OWNlk77R7Oy_isjtuzR_BCDAn5Qn4zmcmXZU-VfK2krN6QlLopc1koXkbq3NzLzlWpbW4LZe6ftKzOskdEV1LKQlv1MDvT2hijK3Oe_WzHEIODUaD36BYSEAexWxcxBTenPqQFhPsOcYckkhcrhbgT19tNcPSKNR61SLOgQ7w7hcjTjzBNsKT5IPq0x1EMgRAI3wpglhbky-DEjDcB97dvT7hADhHGAwV6nD3wMBI-Oe4X2bcP77-2n_LLLx8_t-8uc1eWasmRh_WlUWXhKtmAtlXtUXvFShWu6aFpNFplQTdgi8FKsDAM1oGrwdReX2Qvtrzc2Y8VaemmQA7HESKmlbqirKtSS9tIRp__hV6ldeZ6mTJGlrXWtmGq2Cj-RKIZfXc9hwnmQ6dk99u9bnOvY_e6W_c6w0HPjqnXfsLhFHJnFwMvN2CPffLkAkaHJ4z95RalLWpWUjNd_z_dhoWdSLFNa1w4VG-hxDh7P_9p8h_1_wJvxMj_</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Zhang, Xiao-Feng</creator><creator>Guan, Xiao-Xian</creator><creator>Tang, Yu-Jun</creator><creator>Sun, Jin-Feng</creator><creator>Wang, Xiao-Kai</creator><creator>Wang, Wei-Dong</creator><creator>Fan, Jian-Ming</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8053-611X</orcidid><orcidid>https://orcid.org/0000-0002-7571-6981</orcidid><orcidid>https://orcid.org/0000-0002-5577-7891</orcidid><orcidid>https://orcid.org/0000-0001-6217-1874</orcidid><orcidid>https://orcid.org/0000-0003-4907-9226</orcidid><orcidid>https://orcid.org/0000-0002-9118-1411</orcidid><orcidid>https://orcid.org/0000-0002-4961-3399</orcidid></search><sort><creationdate>20210801</creationdate><title>Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis</title><author>Zhang, Xiao-Feng ; Guan, Xiao-Xian ; Tang, Yu-Jun ; Sun, Jin-Feng ; Wang, Xiao-Kai ; Wang, Wei-Dong ; Fan, Jian-Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-eeee6f45142c709a3678fe3f1a3612c9ba993e616a39a62d60a6add6cac8a58f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Chemistry</topic><topic>Chemistry and Materials Science</topic><topic>Clinical trials</topic><topic>Digestive system</topic><topic>Dosage</topic><topic>Gastrointestinal tract</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Intestinal microflora</topic><topic>Intestine</topic><topic>Life Sciences & Biomedicine</topic><topic>Meta-analysis</topic><topic>Microbiota</topic><topic>Nutrition</topic><topic>Nutrition & Dietetics</topic><topic>Original Contribution</topic><topic>Patients</topic><topic>Prebiotics</topic><topic>Probiotics</topic><topic>Remission</topic><topic>Remission (Medicine)</topic><topic>Science & Technology</topic><topic>Statistical analysis</topic><topic>Systematic review</topic><topic>Ulcerative colitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Xiao-Feng</creatorcontrib><creatorcontrib>Guan, Xiao-Xian</creatorcontrib><creatorcontrib>Tang, Yu-Jun</creatorcontrib><creatorcontrib>Sun, Jin-Feng</creatorcontrib><creatorcontrib>Wang, Xiao-Kai</creatorcontrib><creatorcontrib>Wang, Wei-Dong</creatorcontrib><creatorcontrib>Fan, Jian-Ming</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Career & Technical Education Database</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Xiao-Feng</au><au>Guan, Xiao-Xian</au><au>Tang, Yu-Jun</au><au>Sun, Jin-Feng</au><au>Wang, Xiao-Kai</au><au>Wang, Wei-Dong</au><au>Fan, Jian-Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis</atitle><jtitle>European journal of nutrition</jtitle><stitle>Eur J Nutr</stitle><stitle>EUR J NUTR</stitle><addtitle>Eur J Nutr</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>60</volume><issue>5</issue><spage>2855</spage><epage>2875</epage><pages>2855-2875</pages><issn>1436-6207</issn><eissn>1436-6215</eissn><abstract>Purpose
Probiotics have been reported to be beneficial for inflammatory bowel disease (IBD), but the types, number of strains, dosage, and intervention time of probiotics used remain controversial. Furthermore, the changes of gut microbiota in IBD’s patients are also intriguing. Thus, this meta-analysis was to explore the clinical effects and gut microbiota changes of using probiotics, prebiotics and synbiotics in IBD.
Methods
The search was performed in PubMed, Web of Science and the Cochrane library from inception to April 2020. Qualified randomized controlled trials were included. IBD’s remission rate, disease activity index and recurrence rate were extracted and analyzed. Changes in the gut microbiota of patients with IBD are comprehensively described.
Results
Thirty-eight articles were included. Probiotics, prebiotics and synbiotics can induce/maintain IBD’s remission and reduce ulcerative colitis (UC) disease activity index (RR = 1.13, 95% CI 1.02, 1.26,
P
< 0.05; SMD = 1.00, 95% CI 0.27, 1.73,
P
< 0.05). In subgroup analyses of IBD remission rate and UC disease activity index, we obtained some statistically significant results in some subgroup (
P
< 0.05). To some extent, probiotic supplements can increase the number of beneficial bacteria (especially
Bifidobacteria
) in the intestinal tract of patients with IBD.
Conclusions
Our results support the treatment of IBD (especially UC) with pro/pre/synbiotics, and synbiotics are more effective. Probiotic supplements that are based on
Lactobacillus
and
Bifidobacterium
or more than one strain are more likely to be beneficial for IBD remission. The dose of 10
10
–10
12
CFU/day may be a reference range for using probiotics to relieve IBD.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33555375</pmid><doi>10.1007/s00394-021-02503-5</doi><tpages>21</tpages><orcidid>https://orcid.org/0000-0001-8053-611X</orcidid><orcidid>https://orcid.org/0000-0002-7571-6981</orcidid><orcidid>https://orcid.org/0000-0002-5577-7891</orcidid><orcidid>https://orcid.org/0000-0001-6217-1874</orcidid><orcidid>https://orcid.org/0000-0003-4907-9226</orcidid><orcidid>https://orcid.org/0000-0002-9118-1411</orcidid><orcidid>https://orcid.org/0000-0002-4961-3399</orcidid></addata></record> |
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| ispartof | European journal of nutrition, 2021-08, Vol.60 (5), p.2855-2875 |
| issn | 1436-6207 1436-6215 |
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| source | Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; SpringerNature Journals |
| subjects | Chemistry Chemistry and Materials Science Clinical trials Digestive system Dosage Gastrointestinal tract Inflammatory bowel disease Inflammatory bowel diseases Intestinal microflora Intestine Life Sciences & Biomedicine Meta-analysis Microbiota Nutrition Nutrition & Dietetics Original Contribution Patients Prebiotics Probiotics Remission Remission (Medicine) Science & Technology Statistical analysis Systematic review Ulcerative colitis |
| title | Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis |
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