Review supports benefits of probiotics for patients with multiple sclerosis

The findings found supplementation with Lactobacillus casei, L. acidophilus, L. reuteni, Bifidobacterium bifidumand Thermophilic streptococcus Stimulated the production of anti-inflammatory agents and / or inhibited the production of pro-inflammatory markers.

Commenting on the analysis of 152 articles found, the research team calls on doctors and dietitians to consider probiotic supplements to manage the health problems that characterize MS.

“Evidence supports probiotic supplementation in patients with relapsing-remitting multiple sclerosis (RRMS) for disease disability, depression, and general health” they add.

“Patients with RRMS also have an increased risk of a more progressive form. Probiotics can keep RRMS from getting worse.

Literature search

The team began a literature search in English using PubMed, Scopus, Web of Science and the Central Cochrane Library until January 2021.

Study selection criteria included all clinical trials with a parallel or crossover design and at least two arms that investigated the effects of probiotic supplementation on disease progression (EDSS), depression (BDI-Ⅱ) and general health (GHQ).

Studies that also included anthropometric measures such as body weight and BMI for more than two weeks with simultaneous control groups in the MS-only population were also considered.

The studies selected were randomized open-label trials (single, double or triple blind). There were no inclusion criteria for studies reviewed systematically.

The study criteria included profiles of subjects, with males and females between 18 and 60 years old and a duration of MS between 2 and 20 years.

From the studies included in the review, the team at the Iranian University of Medical Sciences in Isfahan found a significant reduction in the Extended Scale of Disability Status (EDSS), a measure of quantification of disability in multiple sclerosis, seen in patients who received supplementation.

In a pooled analysis of studies with 173 participants, the use of probiotics appeared to positively influence how respondents responded to the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI-II).

BDI-II is one of the most common methods used to measure depression; the highest overall score indicates the most severe depressive symptoms. All trials included in the review reported significant effects of probiotics on reducing overall BDI-II score in participants with RRMS.

“Based on our knowledge, this is the first meta-analysis examining the effects of probiotic supplementation on anthropometric measures in MS.the team highlights.

“A recent study reanalyzed three published trials (sample size, 173; intervention, 86; control, 87) and observed a significant reduction in EDSS, BDI-II and GHQ in patients with MS. Our results were somewhat similar to those of the previously mentioned study.

Gut-CNS axis

While the exact mechanism of the pathogenesis of MS is not yet clear; the role of the intestinal microbiota has been reinforced since the discovery of the “intestine-CNS axis” concept.

The existence of the axis has been supported by the results of fecal transplantation or probiotic supplementation that seek to rebalance the diversity of the microbiome and facilitate the treatment of MS.

Trials on this link are few in number, those that exist have a relatively short duration.

Recently a meta-analysison the efficacy of probiotics in MS reported significant beneficial effects of probiotic supplementation on EDSS, BDI-II and GHQ.

Source: International Journal of Clinical Practice

Posted online:

“Effect of probiotic supplementation on disease progression, depression, general health, and anthropometric measures in patients with relapsing-remitting multiple sclerosis: a systematic review and meta-analysis of clinical trials.” “

Authors: Shahrzad Mirashrafi et al.

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